bluuebunny/crossref_metadata_2025 huggingface dataset:
Temperature dependency of the silicon heterojunction lifetime model based on the amphoteric nature of dangling bonds
Authors: Vasudevan R. , Poli I. , Deligiannis D. , Zeman M. , Smets A. H. M.
Published: November 2016

This work adapts a model to simulate the carrier injection dependent minority carrier lifetime of crystalline silicon passivated with hydrogenated amorphous silicon at elevated temperatures. Two existing models that respectively calculate the bulk lifetime and surface recombination velocity are used and the full temperature dependency of these models are explored. After a thorough description of these temperature dependencies, experimental results using this model show that the minority carrier lifetime changes upon annealing of silicon heterojunction structures are not universal. Furthermore, comparisons of the temperature dependent model to using the room temperature model at elevated temperatures is given and significant differences are observed when using temperatures above 100 °C. This shows the necessity of taking temperature effects into account during in-situ annealing experiments.
Transmission electron microscopy investigation of the LiMn2O4/NaxMnO2 interface as a model study of a Na-ion battery electrode
Authors: Kitta Mitsunori , Akita Tomoki , Kohyama Masanori
Published: November 2016

The phase transformation from spinel LiMn2O4 to layered rock-salt NaxMnO2 via Na insertion-extraction cycles is crucial for a LiMn2O4 positive electrode in a Na-ion battery. To reveal the atomic-scale mechanism of the structural conversion, we applied advanced techniques of analytical electron microscopy to a Na-containing LiMn2O4 specimen, formed by lithiation of a thin MnO wafer containing Na impurity. Scanning transmission electron microscopy (STEM)-energy dispersive X-ray spectroscopy (EDX) and electron energy loss spectroscopy (EELS) analyses revealed that Na and Li are separately distributed in the two phases of the specimen, which are layered NaxMnO2 and spinel LiMn2O4 phases confirmed by annular bright field (ABF)-STEM observation. The large difference in the ionic radii of Na and Li is considered to be the reason for the clear phase separation without atomic-scale mixture. EDX analysis showed that the layered NaxMnO2 phase with P3 structure exhibits local variations in Na composition, with the maximum value of x = 0.6. High-resolution transmission electron microscopy (HRTEM) and ABF-STEM imaging clearly showed that an epitaxial LiMn2O4/NaxMnO2 interface is formed without any lattice dislocations, however, the interface has a low inclination angle due to the lattice mismatch, and local distortions are induced in the NaxMnO2 phase. The epitaxial lattice transition suggests smooth generation of a Na-inserted phase with a layered structure in a spinel LiMn2O4 crystal, which should contribute to the superiority of the LiMn2O4 electrode in a Na-ion battery.
Preferential interactions promote blind cooperation and informed defection
Authors: Pérez-Escudero Alfonso , Friedman Jonathan , Gore Jeff
Published: November 2016

Significance

Humans often behave in seemingly irrational ways. A common instance of such perplexing behavior is that we typically care about how and why people chose their actions, rather than caring only about the actions themselves. For example, when people agree to do us a favor, we prefer them to do so directly, rather than to first gather all the relevant information. Using game theory, we show that this preference may in fact be rational: The decision-making process often reveals hidden preferences of the decision maker, which can become relevant in a future interaction. This work elucidates the conditions that make caring about motivations beneficial and makes predictions regarding the real-world situations in which it is expected to occur.
Molecular mechanisms of substrate-controlled ring dynamics and substepping in a nucleic acid-dependent hexameric motor
Authors: Thomsen Nathan D. , Lawson Michael R. , Witkowsky Lea B. , Qu Song , Berger James M.
Published: November 2016

Significance

Hexameric, ring-shaped translocases are molecular motors that convert the chemical energy of ATP hydrolysis into the physical movement of protein and nucleic acid substrates. Structural studies of several distinct hexameric translocases have provided insights into how substrates are loaded and translocated; however, the range of structural changes required for coupling ATP turnover to a full cycle of substrate loading and translocation has not been visualized for any one system. Here, we combine low- and high-resolution structural studies of the Rho transcription termination factor, defining a set of conformational transitions that accompany substrate binding and translocations by a processive hexameric helicase.
Remediation of Flow-Through Trout Raceway Effluent via Aquaponics
Authors: Buzby Karen M , West Todd P , Waterland Nicole L , Lin Lian-Shin
Published: November 2016

Production and nutrient removal were assessed for three vegetable crops (kohlrabi, lettuce, and Swiss chard) and two edible flowers (calendula and nasturtium) grown entirely on effluent from a flow-through trout raceway. Soluble nutrient concentrations in the effluent averaged 0.56 and 0.19 mg/L for total nitrogen and soluble reactive phosphate, respectively. Seeds were sown into Styrofoam trays filled with vermiculite and placed directly into the plant growing channels. Lettuce was harvested at 6, 9, and 12 weeks for a total mean harvest biomass of 4.5 kg/m2. Kohlrabi and Swiss chard were harvested at 12 weeks, with a mean harvest biomass of 15.4 and 7.5 kg/m2, respectively. Harvest biomass of kohlrabi was significantly greater than that of lettuce or Swiss chard. Nasturtium flowers were harvested at 9 and 12 weeks, while calendula did not begin to produce flowers until 12 weeks. There were no significant differences in percent removal of total ammonia nitrogen (TAN), nitrate, or phosphate at 6 weeks. However, at 9 weeks, kohlrabi, Swiss chard, and nasturtium removed significantly more TAN and nitrate than lettuce and calendula. Total ammonia nitrogen removal decreased at 12 weeks while nitrate removal increased for kohlrabi, Swiss chard, and calendula. Phosphate removal was low for all cultivars and may be the result of high phosphate concentrations in the source water. Careful crop selection will be necessary to maximize the benefits of aquaponics as crops varied in growth rates, overall nutrient removal capacity, and timing of nutrient removal.
Atg8 family LC3/GABARAP proteins are crucial for autophagosome–lysosome fusion but not autophagosome formation during PINK1/Parkin mitophagy and starvation
Authors: Nguyen Thanh Ngoc , Padman Benjamin Scott , Usher Joanne , Oorschot Viola , Ramm Georg , Lazarou Michael
Published: November 2016

Members of the Atg8 family of proteins are conjugated to autophagosomal membranes, where they have been proposed to drive autophagosome formation and selective sequestration of cargo. In mammals, the Atg8 family consists of six members divided into the LC3 and GABARAP subfamilies. To define Atg8 function, we used genome editing to generate knockouts of the LC3 and GABARAP subfamilies as well as all six Atg8 family members in HeLa cells. We show that Atg8s are dispensable for autophagosome formation and selective engulfment of mitochondria, but essential for autophagosome–lysosome fusion. We find that the GABARAP subfamily promotes PLEKHM1 recruitment and governs autophagosome–lysosome fusion, whereas the LC3 subfamily plays a less prominent role in these processes. Although neither GABARAPs nor LC3s are required for autophagosome biogenesis, loss of all Atg8s yields smaller autophagosomes and a slowed initial rate of autophagosome formation. Our results clarify the essential function of the Atg8 family and identify GABARAP subfamily members as primary contributors to PINK1/Parkin mitophagy and starvation autophagy.
Three-dimensional stochastic model of actin–myosin binding in the sarcomere lattice
Authors: Mijailovich Srboljub M. , Kayser-Herold Oliver , Stojanovic Boban , Nedic Djordje , Irving Thomas C. , Geeves Michael A.
Published: November 2016

The effect of molecule tethering in three-dimensional (3-D) space on bimolecular binding kinetics is rarely addressed and only occasionally incorporated into models of cell motility. The simplest system that can quantitatively determine this effect is the 3-D sarcomere lattice of the striated muscle, where tethered myosin in thick filaments can only bind to a relatively small number of available sites on the actin filament, positioned within a limited range of thermal movement of the myosin head. Here we implement spatially explicit actomyosin interactions into the multiscale Monte Carlo platform MUSICO, specifically defining how geometrical constraints on tethered myosins can modulate state transition rates in the actomyosin cycle. The simulations provide the distribution of myosin bound to sites on actin, ensure conservation of the number of interacting myosins and actin monomers, and most importantly, the departure in behavior of tethered myosin molecules from unconstrained myosin interactions with actin. In addition, MUSICO determines the number of cross-bridges in each actomyosin cycle state, the force and number of attached cross-bridges per myosin filament, the range of cross-bridge forces and accounts for energy consumption. At the macroscopic scale, MUSICO simulations show large differences in predicted force-velocity curves and in the response during early force recovery phase after a step change in length comparing to the two simplest mass action kinetic models. The origin of these differences is rooted in the different fluxes of myosin binding and corresponding instantaneous cross-bridge distributions and quantitatively reflects a major flaw of the mathematical description in all mass action kinetic models. Consequently, this new approach shows that accurate recapitulation of experimental data requires significantly different binding rates, number of actomyosin states, and cross-bridge elasticity than typically used in mass action kinetic models to correctly describe the biochemical reactions of tethered molecules and their interaction energetics.
Human Immunodeficiency Virus (HIV) Quality Indicators Are Similar Across HIV Care Delivery Models
Authors: Rhodes Corinne M. , Chang Yuchiao , Regan Susan , Singer Daniel E. , Triant Virginia A.
Published: November 2016

Background

There are limited data on human immunodeficiency virus (HIV) quality indicators according to model of HIV care delivery. Comparing HIV quality indicators by HIV care model could help inform best practices because patients achieving higher levels of quality indicators may have a mortality benefit.

Methods

Using the Partners HIV Cohort, we categorized 1565 patients into 3 HIV care models: infectious disease provider only (ID), generalist only (generalist), or infectious disease provider and generalist (ID plus generalist). We examined 12 HIV quality indicators used by 5 major medical and quality associations and grouped them into 4 domains: process, screening, immunization, and HIV management. We used generalized estimating equations to account for most common provider and multivariable analyses adjusted for prespecified covariates to compare composite rates of HIV quality indicator completion.

Results

We found significant differences between HIV care models, with the ID plus generalists group achieving significantly higher quality measures than the ID group in HIV management (94.4% vs 91.7%, P = .03) and higher quality measures than generalists in immunization (87.8% vs 80.6%, P = .03) in multivariable adjusted analyses. All models achieved rates that equaled or surpassed previously reported quality indicator rates. The absolute differences between groups were small and ranged from 2% to 7%.

Conclusions

Our results suggest that multiple HIV care models are effective with respect to HIV quality metrics. Factors to consider when determining HIV care model include healthcare setting, feasibility, and physician and patient preference.
Cervical Length at Mid-gestation in Screening for Preterm Birth in Twin Pregnancy
Authors: Pagani G. , Stagnati V. , Fichera A. , Prefumo F.
Published: November 2016

(Abstracted from Ultrasound Obstet Gynecol 2016;48:56–60)

Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality, and the increased proportion of twin births is one factor that contributes to PTB. A short cervical length (CL) in midgestation is one among the various risk factors that is considered predictive for spontaneous PTB of less than 32 weeks in twin gestations.
Snakes and Hypertension
Authors: Miller Edward D.
Published: November 2016

Inhibition of Angiotensin Conversion in Experimental Renovascular Hypertension. By Miller ED Jr, Samuels A, Haber E, and Barger AC. Science 1972; 177:1108–9. Reprinted with permission from AAAS.

Constriction of the renal artery and controlled reduction of renal perfusion pressure is followed by a prompt increase in systemic renin activity and a concomitant rise in blood pressure in trained, unanesthetized dogs. The elevated blood pressure induced by the renal artery stenosis can be prevented by prior treatment with the nonapeptide Pyr-Trp-Pro-Arg-Pro-Gln-Ile-Pro-Pro, which blocks conversion of angiotensin I to angiotensin II. Further, the nonapeptide can restore systemic pressure to normal in the early phase of renovascular hypertension. These results offer strong evidence that the renin– angiotensin system is responsible for the initiation of hypertension in the unilaterally nephrectomized dog with renal artery constriction.
The Interobserver and Intraobserver Reliability of the Sanders Classification Versus the Risser Stage
Authors: Vira Shaleen , Husain Qasim , Jalai Cyrus , Paul Justin , Poorman Gregory W. , Poorman Caroline , Yoon Richard S. , Looze Christopher , Lonner Baron , Passias Peter G.
Published: November 2016

Background:

Estimation of skeletal maturity, classically performed using Risser sign, plays a crucial role in the treatment of AIS. Recent data, however, has shown the simplified Tanner-Whitehouse (Sanders) classification, based on an anteriorposterior (AP) hand radiographs, to correlate more closely to the rapid growth phase and thus curve progression. This study evaluated the interobserver and intraobserver reliability of the Sanders and Risser classifications among clinicians at different levels of training.

Methods:

Twenty AP scoliosis radiographs and 20 AP hand radiographs were randomized and distributed to 11 graders. The graders consisted of 3 orthopaedic residents, 3 spine fellows, 3 spine surgeons, and 1 radiologist. The graders were then asked to classify the radiographs according to the Sanders and Risser classifications. There were 3 rounds of grading, each done 3 weeks apart. The overall κ coefficient was then calculated for each system to evaluate the interobserver and intraobserver reliability.

Results:

For all graders the average κ coefficient for the interobserver and intraobserver reliability of the Sanders classification was 0.54 and 0.62, respectively, and 0.46 and 0.49 for the Risser classification. With respect to spine attendings alone, the average κ coefficient for the interobserver and intraobserver reliability of Sanders classification was 0.72 and 0.77, respectively, and 0.46 and 0.67 for the Risser classification.

Conclusions:

Our study demonstrated that the Sanders classification had moderate reliability with respect to physicians at various levels of training and had good reliability with respect to attending spine surgeons. Interestingly, the Risser staging was found to have less interobserver and intraobserver reliability overall. The Sanders classification is a reliable and reproducible system and should be in the armamentarium of surgeons who treat adolescent idiopathic scoliosis.

Level of evidence:

Level III.
Body Mass Hides the Curve: Thoracic Scoliometer Readings Vary by Body Mass Index Value
Authors: Margalit Adam , McKean Greg , Constantine Adam , Thompson Carol B. , Lee Rushyuan Jay , Sponseller Paul D.
Published: November 2016

Background:

Guidelines suggest referral for scoliosis when rib slope (scoliometer measurement, angle of trunk rotation) is ≥7 degrees. We hypothesized that overweight and obese patients would have lower scoliometer measurements compared with normal-weight and underweight patients for a given spinal curvature, causing overweight and obese patients with adolescent idiopathic scoliosis to present for treatment later and with larger curves. Our goal was to determine the association between scoliometer readings and major curve magnitudes in relation to body mass index (BMI).

Methods:

This retrospective cohort study at a tertiary referral center included 483 patients (420 girls) aged 10 to 18 years (mean age, 14±1.6 y) with thoracic adolescent idiopathic scoliosis who presented to 1 orthopaedic surgeon for initial evaluation of spinal deformity from 2010 to 2015. Records were reviewed for BMI percentile for age and sex (underweight, ≤fourth percentile; normal weight, fifth to 84th percentile; overweight, 85th to 94th percentile; obese, ≥95th percentile), patient characteristics, thoracic scoliometer measurements, and thoracic major curves.

Results:

Of the 483 patients, 23 were underweight, 372 were normal weight, 52 were overweight, and 36 were obese. Obese patients had a larger mean major curve (44 degrees) than normal-weight patients (34 degrees) (P=0.004). The odds of presenting with a major curve ≥20 degrees were 4.9 (95% confidence interval, 1.1-22; P=0.037) times higher for obese versus normal-weight patients. Receiver operating characteristic analysis of major curves (≥20 vs. <20 degrees) estimated the scoliometer values with the greatest sensitivity and specificity to be 8 degrees for underweight patients, 7 degrees for normal-weight patients, 6 degrees for overweight patients, and 5 degrees for obese patients.

Conclusions:

Obese patients presented with larger thoracic curves versus normal-weight patients. Differences in chest-wall thickness in patients with different BMI values may alter scoliometer measurements for a given rotational deformity. Our data suggest new referral criteria for the scoliometer test based on BMI values. Specifically, obese patients should be referred at an angle of trunk rotation of 5 degrees.

Level of Evidence:

Level II.
What’s New in the Management of Foot Deformities in Children With Cerebral Palsy
Authors: Heydemann John A. , Abousamra Oussama , Franzone Jeanne M. , Kaufman Brian E. , Sees Julieanne P.
Published: November 2016

Background:

Foot deformities have been frequently reported in cerebral palsy (CP), and numerous diagnostic modalities and treatment options have recently been developed to achieve a better level of management for children with CP.

Methods:

A thorough search of the English literature, published between January 2013 and March 2016, was performed. A summary of the new findings that had not previously described was reported. The review included recent advances regarding clinical and gait evaluation, orthotic management, botulinum toxin A treatment, and surgical correction.

Results:

The review summarized new findings reported in 46 articles and abstracts that were published between January 2013 and March 2016. Older articles were included and cited when an original description was mentioned, or when a change or development of some findings was discussed.

Conclusions:

Foot deformity forms an essential part of evaluating children with CP. Dramatic advances have been achieved in gait assessment, conservative management, and surgical correction. Promising results have been reported with the goal to reach a higher level of orthopaedic care and optimize the functional potentials for children with CP.

Level of Evidence:

Level IV—literature review.
Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals: Implementing PAD Guidelines Via the ABCDEF Bundle in 6,064 Patients*
Authors: Barnes-Daly Mary Ann , Phillips Gary , Ely E. Wesley
Published: November 2016

Objectives:

To track compliance by an interprofessional team with the Awakening and Breathing Coordination, Choice of drugs, Delirium monitoring and management, Early mobility, and Family engagement (ABCDEF) bundle in implementing the Pain, Agitation, and Delirium guidelines. The aim was to study the association between ABCDEF bundle compliance and outcomes including hospital survival and delirium-free and coma-free days in community hospitals.

Design:

A prospective cohort quality improvement initiative involving ICU patients.

Setting:

Seven community hospitals within California’s Sutter Health System.

Patients:

Ventilated and nonventilated general medical and surgical ICU patients enrolled between January 1, 2014, and December 31, 2014.

Measurements and Main Results:

Total and partial bundle compliance were measured daily. Random effects regression was used to determine the association between ABCDEF bundle compliance accounting for total compliance (all or none) or for partial compliance (“dose” or number of bundle elements used) and outcomes of hospital survival and delirium-free and coma-free days, after adjusting for age, severity of illness, and presence of mechanical ventilation. Of 6,064 patients, a total of 586 (9.7%) died before hospital discharge. For every 10% increase in total bundle compliance, patients had a 7% higher odds of hospital survival (odds ratio, 1.07; 95% CI, 1.04–1.11; p < 0.001). Likewise, for every 10% increase in partial bundle compliance, patients had a 15% higher hospital survival (odds ratio, 1.15; 95% CI, 1.09–1.22; p < 0.001). These results were even more striking (12% and 23% higher odds of survival per 10% increase in bundle compliance, respectively, p < 0.001) in a sensitivity analysis removing ICU patients identified as receiving palliative care. Patients experienced more days alive and free of delirium and coma with both total bundle compliance (incident rate ratio, 1.02; 95% CI, 1.01–1.04; p = 0.004) and partial bundle compliance (incident rate ratio, 1.15; 95% CI, 1.09–1.22; p < 0.001).

Conclusions:

The evidence-based ABCDEF bundle was successfully implemented in seven community hospital ICUs using an interprofessional team model to operationalize the Pain, Agitation, and Delirium guidelines. Higher bundle compliance was independently associated with improved survival and more days free of delirium and coma after adjusting for age, severity of illness, and presence of mechanical ventilation.
Low-Dose Medication and Long-Term Outcome in Myasthenia Gravis
Authors: Salins Salomi , Teter Barbara , Kavak Katelyn , Wolfe Gil I. , Silvestri Nicholas J.
Published: November 2016

Objectives:

Many advances have been made in the diagnosis, treatment, and management of myasthenia gravis (MG) and most patients will eventually progress to experience minimal manifestations (MM) of the disease or remission. However, there is a paucity of literature on medication dosing needed to achieve such a favorable clinical status in the long term. The objective of this article was to (1) study the course of MG and identify clinical predictors of maintenance of eventual disease remission or minimal manifestations and (2) determine if patients on low-dose medications have comparable MG Foundation of America (MGFA) scores and postintervention statuses (PIS) with those on conventional therapeutic dosing.

Methods:

This is a retrospective longitudinal chart review of 74 patients with MG. A subset of 28 of 74 patients diagnosed with MG after 2000 who were followed for at least 3 consecutive years from the year of diagnosis were also analyzed. An annual MGFA score, PIS, medication doses, and thymectomy status were obtained. Remission or MM of disease was defined as MGFA clinical classification <2 that persisted over the past 2 follow-up visits.

Results:

Thirty-four of 74 patients were on low-dose medications at last follow-up. There was no statistical difference between medication dosages and MGFA scores. In a subset of 28 patients, 23 (88.5%) with eventual disease remission or MM at last follow-up had an MGFA class <2 at their third year of diagnosis. In contrast, only 3 of 9 subjects with more symptomatic disease had similar results (P = 0.005). In terms of PIS at last follow-up, most patients were either in complete stable remission, pharmacologic remission, or MM status. Most patients (78.3%) had an MGFA class of 0 or 1 at last follow-up; 45% were on low-dose medications.

Conclusions:

Most patients with MG will realize disease stability characterized by either remission or MM status. A significant number of such patients were able to be maintained on low doses of medications to treat MG. The MGFA class at year 3 of diagnosis is a clinical predictor of long-term disease prognosis. There was no statistical difference between medication doses and MGFA scores at last follow-up.
Inclusion Body Myositis: What Most Impacts Patients' Lives
Authors: Gibson Cynthia , Johnson Nicholas E. , Eastwood Eileen , Heatwole Chad
Published: November 2016

Objective:

Inclusion body myositis (IBM) is the most common form of idiopathic inflammatory myopathy in adults older than 50 years. Few studies have focused on the functional, physical, and social limitations of this disease. This study identifies pertinent symptoms that impact the health and daily function of patients with IBM.

Methods:

We used semistructured interviews with 10 biopsy-confirmed adults with IBM to identify the psychological, physical, and functional limitations that have the greatest impact on the lives of patients with IBM.

Results:

Participants with IBM provided 644 direct quotes identifying issues that have the greatest effect on their lives. Two hundred nine individual symptoms and 17 symptomatic themes were identified by patients as having a significant impact on their lives. The symptomatic themes mentioned most frequently involved mobility and ambulation, emotional distress, and activity impairment.

Conclusions:

Identifying critical issues to patients with IBM is potentially useful for clinicians whose aim is to provide optimal care to patients with IBM.
Rapidly Resolving Weakness Related to Hypokalemia in Patients Infected With Dengue Virus
Authors: Maurya Pradeep K. , Kulshreshtha Dinkar , Singh Ajai K. , Thacker Anup K.
Published: November 2016

Objectives:

Dengue is a mosquito-borne disease caused by arbovirus and well known for its typical fever with thrombocytopenia syndrome. Acute hypokalemic quadriparesis is a rare presentation of dengue with uncertain pathogenesis. We aim to describe the clinical and biochemical characteristics of rapidly resolving weakness related to hypokalemia in patients infected with dengue virus.

Methods:

A retrospective review of the records of patients with diagnosis of dengue-associated hypokalemic weakness was performed. Demography, clinical, biochemical characteristics, and outcome of the patients were recorded during acute phase of illness.

Results:

Our study cohort comprised 12 patients and all were males from urban dwelling. The median age was 34.5 years (range, 18–50). Presentation was acute onset rapidly worsening pure motor quadriparesis preceded by short lasting febrile episode. Weakness ranged from 2/5 to 4/5 on Medical Research Council (MRC) scale with generalized hyporeflexia or areflexia. The baseline serum potassium was mean ± SD (2.7 ± 0.48 mmol/L). All patients showed elevation of liver transaminases and elevated creatine phosphokinase level. Weakness improved in 24–72 hours in all patients with correction of serum potassium.

Conclusions:

Dengue-associated acute hypokalemic paralysis is an underrecognized entity having favorable outcome. It should be suspected in patients presenting as acute pure motor quadriparesis after febrile illness in dengue endemic areas.
Dermal Titanium Dioxide Deposition Associated With Intralesional Triamcinolone Injection
Authors: Cohen Brandon E. , Bashey Sameer , Cole Christine , Abraham Jerrold L. , Ragsdale Bruce , Ngo Binh
Published: November 2016

Cutaneous discoloration secondary to dermal deposition of titanium dioxide (TiO2) particles is recognized but seldom reported in the literature. In this report, the authors describe the case of a 61-year-old gentleman, with a long history of alopecia areata, who presented with numerous, discrete dark blue macules on the scalp. Scanning electron microscopy with energy dispersive x-ray spectroscopy analysis ultimately identified the macules as deposits of TiO2. The patient had a history of intralesional triamcinolone injections for management of alopecia areata. A sample of generic 0.1% triamcinolone acetonide paste was analyzed and found to contain many TiO2 particles analogous to those seen in the patient's biopsy sample. To the authors' knowledge, this is the first reported case of TiO2 deposition in the dermis likely resulting from topical combined with intralesional triamcinolone injection.
Using Multitheory Model of Health Behavior Change to Predict Adequate Sleep Behavior
Authors: Knowlden Adam P. , Sharma Manoj , Nahar Vinayak K.
Published: November 2016

The purpose of this article was to use the multitheory model of health behavior change in predicting adequate sleep behavior in college students. A valid and reliable survey was administered in a cross-sectional design (n = 151). For initiation of adequate sleep behavior, the construct of behavioral confidence (P < .001) was found to be significant and accounted for 24.4% of the variance. For sustenance of adequate sleep behavior, changes in social environment (P < .02), emotional transformation (P < .001), and practice for change (P < .001) were significant and accounted for 34.2% of the variance.
Framed, Interactive Theory-Driven Texting
Authors: Cohen Anne , Perozich Alyssa , Rajan Radha , Persky Susan , Parisi Jeanine , Bowie Janice , Fahle Jenna , Cho Jeremy , Krishnan Aravind , Cohen Zoe , Ezike Adaora , Schulte Cara , Taylor Jarrett , Storey Douglas , Ahmed Rafay Syed , Cheskin Lawrence J.
Published: November 2016

More approaches to support weight control are needed, especially among racial minorities who shoulder a disproportionate obesity burden. Using an approach influenced by regulatory fit theory, we conducted a 28-day, 4-arm experimental trial with 89 obese adults recruited from urban, predominantly African American churches to ascertain the efficacy of framed text messages to motivate behaviors conducive to weight loss. Participants were assigned to receive message framing that was matched versus mismatched to their motivational orientation. Results were mixed overall; however, matched texts elicited greater motivation to change eating and exercise behavior, suggesting promise in using motivational approaches to tailor messages.
Mapping Coaches' Views of Participation in CrossFit to the Integrated Theory of Health Behavior Change and Sense of Community
Authors: Heinrich Katie M. , Carlisle Taran , Kehler Ainslie , Cosgrove Sarah J.
Published: November 2016

Group-based training through CrossFit has recently exploded in popularity. Anecdotally, participants often make lifestyle changes and experience improved fitness. Participation factors were mapped to the Integrated Theory of Health Behavior Change and “sense of community” constructs. Key informant interviews were conducted with 6 CrossFit gym owners/coaches. Data were thematically coded with NVivo 10. Results revealed key factors that both facilitated and restricted participation in CrossFit. Findings provide implications for future theory application and highlight how to improve initiation and adherence by capitalizing on community building and taking steps to reduce intimidation and cost, facilitate realistic goals, and ensure social support.
Development and Validation of a Simultaneous Quantification Method of 14 Tyrosine Kinase Inhibitors in Human Plasma Using LC-MS/MS
Authors: Huynh Huu H. , Pressiat Claire , Sauvageon Hélène , Madelaine Isabelle , Maslanka Patricia , Lebbé Céleste , Thieblemont Catherine , Goldwirt Lauriane , Mourah Samia
Published: November 2016

Background:

A sensitive liquid chromatography coupled with tandem mass spectrometry (MS/MS) method for the analysis in a small volume of plasma of 14 tyrosine kinase inhibitors currently used (imatinib, dasatinib, ibrutinib, ponatinib, trametinib, sunitinib, cobimetinib, dabrafenib, erlotinib, lapatinib, nilotinib, bosutinib, sorafenib, and vemurafenib) has been developed and validated. This multianalyte liquid chromatography coupled with MS/MS assay is of interest for anticancer drug combination therapy.

Methods:

After a simple protein precipitation of plasma samples, the chromatographic separation was performed using an ultra performance liquid chromatography system coupled with MS/MS in a positive ionization mode. The mobile phase consisted of a gradient elution of 10 mmol/L formate ammonium buffer containing 0.1% (vol/vol) formic acid (phase A) and acetonitrile with 0.1% (vol/vol) formic acid (phase B) at a flow rate of 300 μL/min.

Results:

The analysis time was 5.0 minutes per run, and all analytes and internal standard eluted within 1.45–1.79 minutes. The calibration curves were linear over the range from 1 to 500 ng/mL for bosutinib, cobimetinib, dasatinib, ibrutinib, and trametinib, from 5 to 500 ng/mL for ponatinib and sunitinib; from 50 to 2500 ng/mL for lapatinib; from 750 to 100,000 ng/mL for vemurafenib, and from 10 to 2500 ng/mL for dabrafenib, erlotinib, imatinib, nilotinib, and sorafenib, with coefficients of correlation above 0.99 for all analytes. The intra- and interday imprecisions were below 14.36%.

Conclusions:

This method was successfully applied to therapeutic drug monitoring in clinical practice.
Prediction of an Optimal Dose of Aripiprazole in the Treatment of Schizophrenia From Plasma Concentrations of Aripiprazole Plus Its Active Metabolite Dehydroaripiprazole at Week 1
Authors: Nagai Goyo , Mihara Kazuo , Nakamura Akifumi , Nemoto Kenji , Kagawa Shoko , Suzuki Takeshi , Kondo Tsuyoshi
Published: November 2016

Background:

It has been suggested that a plasma trough concentration of aripiprazole plus its active metabolite, dehydroaripiprazole of 225 ng/mL is a threshold for a good therapeutic response in the treatment of acutely exacerbated patients with schizophrenia. The present study investigated whether or not an optimal dose of aripiprazole could be predicted from these concentrations at week 1.

Methods:

The subjects were 26 inpatients with schizophrenia, who received aripiprazole once a day for 3 weeks. The daily doses were 12 mg for the first week and 24 mg for the next 2 weeks. No other drugs except biperiden and flunitrazepam were coadministered. Blood samples were taken at weeks 1 and 3 after the treatment. Plasma concentrations of aripiprazole and dehydroaripiprazole were measured using liquid chromatography with mass-spectrometric detection.

Results:

There was a significant linear relationship between the plasma concentrations of aripiprazole plus dehydroaripiprazole at weeks 1 (x) and 3 (y) (P < 0.001). Regression equation was y = 2.580x + 34.86 (R2 = 0.698). Based on the equation, a nomogram to estimate an optimal dose of aripiprazole could be constructed.

Conclusions:

The present study suggests that an optimal dose of aripiprazole for the treatment of patients with schizophrenia can be predicted from the plasma concentrations of the sum of the 2 compounds at week 1.
Peripheral Ulcerative Keratitis Secondary to Chronic Hepatitis B Infection
Authors: Wei David W. , Pagnoux Christian , Chan Clara C.
Published: November 2016

Purpose:

To report a unique case of peripheral ulcerative keratitis secondary to hepatitis B virus (HBV)-associated cryoglobulinemia and vasculitis and its pharmacological and surgical treatment and 2-year follow-up.

Methods:

A 52-year-old woman presented with unilateral eye pain and photophobia, arthralgia, remnants of a maculopapular rash, and subsequently facial numbness several weeks later. Her best spectacle-corrected visual acuity (BSCVA) in the affected eye was 20/80. Slit-lamp examination revealed severe superior corneal thinning without infiltrate. Corneal ulceration worsened until 10% of the cornea remained. Laboratory workup was positive for rheumatoid factor and revealed significantly decreased C4 complement, and HBV serology was positive.

Results:

Clinical history, examinations, and laboratory results suggest HBV-associated cryoglobulinemia and vasculitis. Management included prednisone, cyclophosphamide, and mycophenolate mofetil for immunosuppression and tenofovir for HBV treatment. Conjunctival resection and a glue patch were used to reduce inflammation and stabilize corneal melt. BSCVA improved after treatment was initiated. Two years after initial presentation, her BSCVA is 20/30−2, significantly improved from her vision at presentation.

Conclusions:

Diagnosis of peripheral ulcerative keratitis requires thorough history and physical examinations given the numerous causes. Prompt treatment including immunosuppressive medication and, in this case, antiviral medication is crucial to preventing serious visual consequences including corneal perforation and blindness.
Long-Term Results for Entropion Repair by Tarsal Margin Rotation With Posterior Lamella Superadvancement
Authors: Russell David J. , Seiff Stuart R.
Published: November 2016

Purpose:

To report the long-term stability of tarsal margin rotation and posterior lamellar superadvancement (TMR PLS) for the repair of upper eyelid cicatricial entropion.

Methods:

A retrospective chart review was performed from January 2000 through December 2014 to identify all patients who had TMR PLS at the authors’ institution. Charts were reviewed for demographic information, recurrence of entropion or trichiasis, and surgical complications. Failure was defined as return of entropion. Patients with greater than 24 months of follow up were included.

Results:

A total of 30 TMR PLS procedures were performed during the review period. Nineteen cases from 14 patients were included in the final analysis. None of the 19 cases demonstrated recurrence of entropion over an average follow-up period of 78.3 months. Eight cases demonstrated trichiasis after TMR PLS, 5 of which required treatment.

Conclusion:

This case series suggests that TMR PLS for the treatment of upper eyelid cicatricial entropion has excellent long-term stability.
The Latino Eyelid: Anthropometric Analysis of a Spectrum of Findings
Authors: Fry Constance L. , Naugle Thomas C. , Cole Shelley A. , Gelfond Jonathan , Chittoor Geetha , Mariani Angeline F. , Goros Martin W. , Haik Barrett G. , Voruganti Venkata Saroja
Published: November 2016

Purpose:

Published anthropometric measurements of the Latino eyelid are limited. This study describes features spanning the morphologic range from non-Latino whites to East Asians in the spectrum of the Latino eyelid.

Methods:

A cross-sectional study of 68 people (32 Latinos, 18 non-Latino whites, and 18 East Asians, ages 18–39), approved by the Institutional Review Board and HIPAA-compliant, was performed. Saliva samples determined genetic components. Indirect anthropometric measurements were performed with ImageJ software. Eyelid measurements included margin reflex distance, palpebral fissure height, eyelid crease height, orbital height, horizontal fissure length, inner and outer canthal distances, medial and lateral canthal angles, and lateral canthal angle of inclination. Additionally, exophthalmometry and epicanthal folds were recorded.

Results:

Analysis of 184 markers from HumanExome Chip data revealed distinct clustering patterns. Genetically, the Asian participants were in 1 group, the whites in another group, and the Latinos spanned the spectrum between these 2 groups. In Latinos, the inner canthal distance and lateral canthal angle of inclination were similar to Asians, whereas the eyelid crease spanned the range from Asians to whites. Half of the Latinos had epicanthal folds.

Conclusions:

Latinos possess a spectrum of eyelid features spanning the morphologic characteristics from those of non-Latino whites to those of East Asians. These normative data on Latinos from Texas and Mexico aid in the diagnoses of Latino eyelid disorders and are a reference for optimizing oculofacial surgery outcomes.
Orbitocutaneous Fistula Secondary to Buried Polyethylene Mesh Implant 12 Years After Injury
Authors: Cho Won-Kyung , Ko Audrey C. , Korn Bobby S. , Kikkawa Don O.
Published: November 2016

Fabric monofilament polyethylene mesh is an implant primarily used in the repair of abdominal and chest walls. However, there have been isolated reports of using this implant in facial reconstruction. The authors describe a patient who underwent prior orbital floor fracture repair with polyethylene mesh and subsequently developed a recurrent orbital abscess 12 years later. Despite incorporation of the fabric monofilament polyethylene mesh within healed bone, an orbitocutaneous fistula developed after a secondary injury, causing hyperglobus and cicatricial lower eyelid retraction.
Localized Immunoglobulin Light Chain Amyloid of the Conjunctiva Confirmed by Mass Spectrometry Without Evidence of Systemic Disease
Authors: Hamill Eric B. , Thyparampil Preeti J. , Yen Michael T.
Published: November 2016

Current guidelines recommend a thorough systemic workup in patients with newly diagnosed immunoglobulin amyloid light chain (AL) amyloidosis because of a close association with an underlying plasma cell proliferative disorder. Rarely, however, AL amyloidosis may present as a localized, benign disease without systemic involvement. Few previous reports have documented localized AL amyloid of the conjunctiva, and all these used immunohistochemistry for amyloid typing, which can be inaccurate. The authors identified 2 cases of AL amyloidosis confirmed by mass spectrometry localized to the conjunctiva and without evidence of systemic disease as determined by thorough systemic workup. Despite the very sensitive diagnostic technique of mass spectrometry, AL amyloidosis of the conjunctiva may not have an association with systemic plasma cell proliferative disorder. It is important to recognize conjunctiva as a site where localized amyloidosis can occur, even with the AL subtypes, as this entity usually exhibits a benign course and may be managed conservatively.
Experimental and Clinical Evaluation of Predilution and Postdilution Continuous Venovenous Hemofiltration on Clearance Characteristics
Authors: Chihara Shinya , Masuda Yoshiki , Yamakage Michiaki
Published: November 2016

We compared the clearance characteristics of low-to-high molecular weight substances during pre-and postdilution continuous venovenous hemofiltration (CVVH) in experimental and clinical conditions. Experimental circuits for pre- and postdilution CVVH were prepared using a test solution containing creatinine (110 Da), inulin (5,000 Da), interleukin (IL)-8 (8,000 Da), IL-6 (22,000 Da), and tumor necrosis factor (TNF)-α (51,000 Da). Quantity of test solution flow and filtration flow (QF) were set to 150 ml/min and 10, 20, and 35 ml/min, respectively. Clinical CVVH settings were blood flow (QB): 150 ml/min and QF: 35 ml/min. Samples were obtained from pre- and posthemofilters, and clearance of target substances was determined during pre- and postdilution CVVH in experimental and clinical conditions. Clearance changed according to QF during both pre- and postdilution CVVH in the experiment. Clearance of creatinine, inulin (experiment only), and IL-8 during postdilution CVVH was superior to that during predilution CVVH. Few differences were seen in clearance of IL-6 and TNF-α between dilution methods in the experiment and clinical practice. Clearance of IL-8 and IL-6 decreased during postdilution CVVH over 24 hr but did not change during predilution CVVH in clinical practice. Predilution CVVH is useful for stable cytokine clearance in septic patients with acute kidney injury.
Epidemiology of hepatitis B in Portugal
Authors: Silva Mário J. , Valente João , Capela Tiago , Russo Pedro , Calinas Filipe
Published: November 2016

The epidemiology of hepatitis B in Portugal is insufficiently characterized. We aimed to review the epidemiology of hepatitis B in Portugal since 1980. A literature review was performed in MEDLINE, Scielo, Web of Science, and the Portuguese Scientific Repository for studies containing ‘Hepatitis B’ and ‘Portugal’ published from 1980 to June 2016. The initial search was complemented by abstract books from national gastroenterology and hepatology meetings and reports from the Service for Intervention on Addictive Behaviours and Dependences, the Portuguese Blood Institute, and Directorate-General of Health. Further studies were identified in references of retrieved papers and
https://www.google.pt
. Ninety references were included. Hepatitis B surface antigen (HBsAg) prevalence was up to 2% in the general population and decreased in the last decades: 1.13–2.0% in studies carried out in 1980–1989 and 0.02–1.45% in studies carried out in 1990–2014. Among pregnant women, HBsAg prevalence was 1.35% in those on primary care, but 6.2% among risk parturients. Among drug abusers, HBsAg prevalence decreased from 10–19.6% in the decades of 1980–1990 to 4.8% in 2014. Higher HBsAg prevalence rates were observed among populations of African or Asian origin. Individuals with hepatitis B were mostly men, mean age 36.9–49 years. The most frequent viral genotype was D. Genotype E is more prevalent in patient cohorts from Central-Southern Portugal (10–62%) than those from Northern Portugal (1–4.1%). The proportion of inactive carriers varied from 24.2 to 73%. The prevalence of cirrhosis varied from 5.8 to 23.7%. Portugal is a low-endemicity country for hepatitis B. Nevertheless, prevalence is high among specific subgroups that may benefit from specifically designed healthcare programs.
Introducing copayments in the emergency department would deter appropriate visits in the Netherlands
Authors: Kraaijvanger Nicole , Rijpsma Douwe , van Leeuwen Henk , Edwards Michael
Published: November 2016

Objective

To determine what the effects of introduction of copayments for self-referred emergency department (ED) visits would be in the Netherlands and at what amount patients would turn to a GP before visiting an ED.

Methods

This questionnaire study was carried out in the ED of the Rijnstate Hospital, a community teaching hospital in the Netherlands. In the Netherlands, a deductible excess system is in use and this study investigated the effects of a copayment for self-referred patients (SRPs) on top of the deductible excess. A questionnaire was developed and handed out to SRPs.

Results

A total of 433 SRPs were included; their average age was 33.1 years and 63% were male. With a copayment of €100, 47% of SRPs would choose to visit their GP instead of the ED. A further increase in the copayment amount is largely ineffective in reducing the number of self-referred ED visits. The higher the household income and education level and the more urgent the triage category, the larger the copayment patients are willing to pay. There is no significant relation between appropriateness and the amount of copayment that patients are willing to pay and we found no specific copayment level that resulted in reducing mainly inappropriate ED visits.

Conclusion

With a copayment of €100, 47% of the SRPs would choose to visit their GP instead of the ED. There was no specific copayment level that resulted in reducing mainly inappropriate ED visits.