bluuebunny/crossref_metadata_2025 huggingface dataset:
Prioritization, Development, and Validation of American Association of Cardiovascular and Pulmonary Rehabilitation Performance Measures
Authors: Pack Quinn R. , Bauldoff Gerene , Lichtman Steven W. , Buckley Maria , Eichenauer Kent , Gavic Anne , Garvey Chris , King Marjorie L.
Published: June 2018

Background:

In 2014, the American Association of Cardiovascular and Pulmonary Rehabilitation Quality of Care Committee was asked to develop performance measures (PMs) to assess program quality and aid in program improvement and certification.

Methods:

A 3-step process was used to prioritize, develop, and then validate new PMs for both cardiac and pulmonary rehabilitation programs. First, we surveyed national leadership, medical directors, and program directors to identify and rank various American Association of Cardiovascular and Pulmonary Rehabilitation potential PM topics. Then, the face validity of the drafted PMs was assessed in a second national survey. Finally, we assessed the inter- and intrarater reliability and feasibility of each PM by abstracting patient charts at programs throughout the United States. At each step, modifications were made to refine and improve the measures for clarity, reliability, and consistency.

Results:

Through survey answers received from 302 people (19% response rate), we identified 5 categories for PM development: optimal blood pressure control, tobacco use cessation, and improvement in functional capacity, depression, and sensation of dyspnea. After drafting the PMs, a second survey with 82 respondents (57% response rate), found that the proposed PMs had good face validity. Finally, we found excellent inter- and intrarater reliability for the blood pressure, functional capacity, depression, and dyspnea measures (κ generally >0.80.) However, validity concerns were raised about the tobacco intervention PM as written, and it continues to undergo further refinement and testing.

Conclusions:

We developed and validated 5 new PMs for use in cardiac and pulmonary rehabilitation program quality assessment, improvement, and certification.
Effects of Preoperative Topometric Indices on Visual Gain After Intracorneal Ring Segment Implantation For Keratoconus
Authors: Utine Canan Asli , Durmaz Engin Ceren , Ayhan Ziya
Published: June 2018

Objectives:

To assess the corneal topometric parameters that can be predictive for better visual gain after intracorneal ring segment (ICRS) implantation in eyes with keratoconus.

Methods:

A total of 42 eyes of 32 patients who underwent ICRS implantation at Dokuz Eylul University, Deparment of Ophthalmology, Cornea Divison were included. Changes in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive errors, and corneal topometric indices measured using Scheimpflug topography (Pentacam, Oculus) were evaluated retrospectively.

Results:

After creation of intrastromal tunnels of 5.01±0.03 mm inner diameter, 5.71±0.03 mm outer diameter and at 384.21±34.12 μm depth, 1 or 2 ICRS of 150 to 350 µm thickness and 90 to 210° arc length were implanted. Preoperative UDVA of 0.09±0.10 and CDVA of 0.29±0.14 Snellen lines improved postoperatively to 0.42±0.26 and 0.62±0.24, respectively (P<0.001 for both). Preoperative spherical equivalent of −6.35±4.58D and refractive astigmatism of −5.89±2.40D decreased to −3.59±3.86 and −2.25±1.66D, retrospectively (P<0.001 for both). Strong negative correlations were detected between preoperative mean simulated keratometry (SimKavg)/index of surface variance (ISV) and changes in UDVA/CDVA (P<0.01, for all). Postoperative change in ISV was positively correlated with thicknesses of implanted rings. Change in topographical keratoconus classification was positively and change in index of vertical asymmetry was negatively correlated with number of implanted rings (P<0.05 for all).

Conclusions:

Preoperative ISV value seems to be beneficial in predicting visual gain after ICRS implantation, in addition to SimKavg. Future work on new nomograms for ICRS selection that include ISV, besides refractive, topographic, and cone location data, is warranted.
Long-Term Clinical Observation of Posterior Chamber Phakic Intraocular Lens Implantation in Young Population
Authors: Haiting Chen , Yu Liu , Xueyan Feng , Guangzeng Niu , Yuxiang Fan
Published: June 2018

Objectives:

To compare the clinical outcomes and vision-related quality of life after implantable collamer lens (ICL) implantation for younger patients (17 years ≤ age ≤21 years) and for older patients (age >21 years).

Methods:

Design: Retrospective observational study. This study-enrolled patients underwent ICL implantation and finished 5-year follow-up who were divided into two groups based on age. Uncorrected distance visual acuity and corrected distance visual acuity (CDVA), refractions for the evaluation of efficacy, safety, stability, and predictability, intraocular pressure, corneal endothelial cell, ICL vaults, higher-order aberration (HOA), contrast sensitivity (CS) functions, adverse events, and quality of life were evaluated on 1, 3, 7, 14 days, 1, 3, 6 months and 1, 3, 5 years after surgery.

Results:

The study enrolled 164 eyes (82 patients), 84 in younger group (17 years ≤ age ≤21 years) and 80 in older group (age >21 years). The mean postoperative log of minimal angle of resolution CDVA of younger group was better than those of older group. The mean spherical equivalent values were more myopic in younger group than older group. As for CS and HOA, the younger and older groups showed similar data. The NEI-RQL scores of dependence on correction, worry, suboptimal correction, appearance, and satisfaction of older group were higher, whereas the score of symptom and near vision was worse. Both groups showed similar results in vaults, endothelial cell density and adverse events.

Conclusions:

The ICL performed well for the ametropia correction of both younger and older patients throughout the 5-year period. In the younger group, the visual quality was even better, but the myopic shift was quicker.
Utilization of Facial Image Analysis Technology for Blink Detection: A Validation Study
Authors: Kitazawa Momoko , Yoshimura Michitaka , Liang Kuo-Ching , Wada Satoshi , Mimura Masaru , Tsubota Kazuo , Kishimoto Taishiro
Published: June 2018

Purpose:

The assessment of anterior eye diseases and the understanding of psychological functions of blinking can benefit greatly from a validated blinking detection technology. In this work, we proposed an algorithm based on facial recognition built on current video processing technologies to automatically filter and analyze blinking movements. We compared electrooculography (EOG), the gold standard of blinking measurement, with manual video tape recording counting (mVTRc) and our proposed automated video tape recording analysis (aVTRa) in both static and dynamic conditions to validate our aVTRa method.

Methods:

We measured blinking in both static condition, where the subject was sitting still with chin fixed on the table, and dynamic condition, where the subject's face was not fixed and natural communication was taking place between the subject and interviewer. We defined concordance of blinks between measurement methods as having less than 50 ms difference between eyes opening and closing.

Results:

The subjects consisted of seven healthy Japanese volunteers (3 male, four female) without significant eye disease with average age of 31.4±7.2. The concordance of EOG vs. aVTRa, EOG vs. mVTRc, and aVTRa vs. mVTRc (average±SD) were found to be 92.2±10.8%, 85.0±16.5%, and 99.6±1.0% in static conditions and 32.6±31.0%, 28.0±24.2%, and 98.5±2.7% in dynamic conditions, respectively.

Conclusions:

In static conditions, we have found a high blink concordance rate between the proposed aVTRa versus EOG, and confirmed the validity of aVTRa in both static and dynamic conditions.
Intrasubject Repeatability and Interdevice Agreement of Anterior Chamber Depth Measurements by Orbscan and Pentacam in Different Grades of Keratoconus
Authors: Hashemi Hassan , Asharlous Amir , Aghazadeh Amiri Mohammad , Yekta Abbasali , Ramin Shahroukh , Taheri Azadeh , Aghamirsalim Mohamadreza , Khabazkhoob Mehdi
Published: June 2018

Objectives:

To evaluate the repeatability of anterior chamber depth (ACD) measurements by Orbscan and Pentacam imaging devices in different grades of keratoconus.

Methods:

One examiner performed 3 consecutive ACD measurements with both devices on 74 eyes of 42 keratoconus patient. Repeatability was assessed using intrasession test–retest variability. Within-subject SD was determined for repeatability, and the coefficient of variation was calculated for each measurement. The intraclass correlation coefficient (ICC) was also determined to assess the variance of repeated data.

Results:

Overall, the three ACD measurements were not significantly different either with Pentacam or Orbscan. The ICC index values were greater than 90% with both devices, and it significantly reduced at higher grades of keratoconus with Pentacam. Interdevice differences were statistically significant. The interdevice agreement with ACD measurements was 0.981, and the agreement was lower at higher grades of keratoconus. The 95% limits of agreement between the 2 devices for ACD was from −0.19 to 0.04.

Conclusions:

Our results indicate acceptable repeatability for ACD measurements with both Orbscan and Pentacam in keratoconus patients. The progression of keratoconus has no significant effect on repeatability results of these devices. The good agreement between them allows their interchangeable use.
“Therapeutic Penetrating Keratoplasty: A Retrospective Review”
Authors: Roozbahani Mehdi , Hammersmith Kristin M. , Nagra Parveen K. , Ma Jenny F. , Rapuano Christopher J.
Published: June 2018

Purpose:

To report the indications, outcomes, and complications of therapeutic penetrating keratoplasty (Th PK) in patients with corneal perforation and/or nonhealing corneal ulceration.

Methods:

A retrospective review was conducted of 51 eyes of 51 patients undergoing Th PK between January 1, 2006 and April 15, 2016. Data collected included patient demographics, visual acuity (VA), size of the corneal infiltrate and epithelial defect, degree of corneal thinning/perforation, microbiological results, surgical details, and postoperative complications.

Results:

The average age at presentation was 56.0 years (range 6–92 years), and most of the patients were females (n=31, 60.8%). Th PK was performed for corneal perforation in 28 eyes (54.9% of cases), nonhealing corneal ulcer in 16 eyes (31.4% of cases), and imminent risk of corneal perforation in 7 eyes (13.7% of cases). Infection was the most common reason for performing a Th PK and was present in 92.3% (47/51) of all cases. Of the infectious cases, the most common etiologies were bacterial (44.7%, 21/47) and fungal (31.9%, 15/47). The most common identifiable risk factor for undergoing a Th PK was a history of contact lens wear, which was seen in 32.7% of patients. Initial anatomic success was achieved in all patients after performing Th PK. Most patients (33/51; 64.7%) had clear grafts at their last follow-up examination. There was an improvement in VA in 70.2% (33/47, where data were available) of the patients at the final postoperative visit compared with the preoperative visit. Average best postoperative VA (1.14±0.88 logarithm of the minimum angle of resolution [LogMAR]; 20/276) was significantly better than the presenting (1.98±0.68 LogMAR; 20/1910) and preoperative (2.18±0.55 LogMAR; 20/3,027) visual acuities (P<0.0001). The most common complication after Th PK was cataract, which was present in 81.8% (27/33) of phakic eyes in which lens status could be assessed, followed by graft failure (47.1%; 24/51), and secondary glaucoma (45.1%; 23/51). Five eyes developed infection in the therapeutic graft, four eyes had persistent corneal epithelial defect at their last follow-up visit, and two eyes underwent evisceration.

Conclusions:

Therapeutic penetrating keratoplasty achieves anatomic success and it is a useful procedure for restoring a stable cornea in cases in which infection fails to heal or when the cornea perforates. Furthermore, Th PK achieves corneal clarity and improves vision in most patients.
Relationship of Water Content With Silicon and Fluorine Contents of Silicone-Hydrogel Contact Lens Materials
Authors: Dupre Terin E. , Benjamin William J.
Published: June 2018

Objectives:

The relationship between water (W) content and silicon (Si) content of silicone-hydrogel (SiHy) contact lens materials was inspected using identical methodologies, equipment, and operators for materials composing 16 types of commercially available SiHy contact lenses. Fluorine (F) content was included in the analysis for the three materials also containing a fluoropolymer. One type of lens consisted of a bulk SiHy material coated with thin layers of conventional hydrogel.

Methods:

SiHy materials were obtained in the form of 16 contact lens brands purchased on the open market in a common range of refractive powers from −3 to +6 D in single lots. All test lenses were equilibrated at room temperature in a standard saline recommended in the American National Standards Institute Z80.20-2016 and International Organization for Standardization (ISO) 18369-4:2017 standards. W content was obtained gravimetrically, in %, according to those standards for 16 lenses of each SiHy material. Si content was determined in % using inductively coupled plasma optical emission spectroscopy for four digested lenses of each material. F content was determined in % using an ion-selective electrode for four combusted lenses of each of the three fluorinated SiHy materials. W and Si contents of the bulk SiHy material of the coated lens were estimated by computational exclusion of the hydrogel layers.

Results:

The linear coefficients of determination (R2, n=16) were −0.7576 (relating mean dry Si content [n=4] to mean W content [n=16]) and −0.8819 (relating mean hydrated Si content [n=4] to mean W content [n=16]). When the 4 SiHy materials that were fluorinated or coated were excluded from the analysis, the R2 values (n=12) were −0.8869 and −0.9263, respectively. When F contents and the coating were added to the assessments, the linear coefficients of determination (R2, n=16) became −0.8948 (relating mean dry [Si+F] content to mean W content) and −0.9397 (relating mean hydrated [Si+F] content to mean W content).

Conclusions:

There is a fundamental negative linear relationship between Si and W contents for SiHy contact lens materials above 35% W content that is followed when F content and hydrogel coatings are empirically added to the analysis below 35% W content. The relationship was tightest for hydrated (Si+F) content and W content, for which the regression equation had an R2 of −0.9397: (Si+F)=−0.3073 (W)+22.148. The relationship between (Si+F) and W therefore seems to be based on composition rather than structure of available SiHy contact lens materials.
Investigation of the Effect of Orthokeratology Lenses on Quality of Life and Behaviors of Children
Authors: Zhao Feng , Zhao Guiyang , Zhao Zhihua
Published: June 2018

Purpose:

To investigate the changes in the quality of life and behaviors in children before and after wearing orthokeratology lenses and to analyze the potential impact of orthokeratology lenses on children's quality of life, behaviors, and the progression of myopia.

Methods:

A total of 100 children receiving orthokeratology lenses in the People's Hospital of Hebei Province and the Nanjing First Hospital from January 2016 to February 2017 were enrolled in this study. A questionnaire survey was conducted for the orthokeratology lenses wearers before and 3 months after wearing the orthokeratology lenses, and analysis was performed for the 69 valid questionnaires.

Results:

The scores of symptom module, entertainment module, and study and life module marked by the children differed significantly 3 months after wearing the orthokeratology lenses. Among 20 entries, the life quality scores of nine surveys before and after wearing lenses were statistically significant (P<0.05). The main reason why the children chose orthokeratology lenses was more convenience in athletic activities (43.5%). The majority of children (75.4%) were willing to accept orthokeratology lenses to correct vision and to alleviate myopia progression.

Conclusion:

Orthokeratology lenses have a good effect on children's quality of life, behaviors, and psychology. The children who wore lenses were more self-confident, more willing to try new things, and more active in participating in sports and entertainment, resulting in an increasing trend of the total time spent on outdoor activities.
Study on antilung cancer synergistic effect of Shenqi Fuzheng combined with docetaxel
Authors: Wang Cheng , Yang Bing , Wu Yali , Tan Li , Sun Zongxi , Ma Junming , Lu Yang , Du Shouying
Published: June 2018

Shenqi Fuzheng (SQFZ) is a traditional Chinese medicine injection for lung cancer that is commonly used in China. It can significantly improve the immunity of patients after chemotherapy and reduce adverse reactions of chemotherapy. In the present study, we pay attention to whether it showed a direct synergistic effect with commonly used chemotherapy drugs, and combined SQFZ with docetaxel to study the effect on cell proliferation of lung carcinoma cell lines, A549 and mouse lung cancer cell. Four-part experiments were used to study the effects of monotherapy and combined pharmacotherapy of these 2 medicines: (1) Thiazolan experiment test on the cellular toxicity effect, (2) the cellular morphology change after administration under confocal microscopy, (3) the inhibitory effect of the 2 drugs on the invasion and migration of lung cancer, and (4) the influence on apoptosis of 2 studied cell lines. The results showed that SQFZ had no cell growth inhibitory effect (Thiazolan experiment) when used alone, whereas when used in combination, it could significantly enhance the cell growth inhibitory effect of lower concentrations of docetaxel. There was obvious difference between the effects of docetaxel alone and that of combination of the 2 drugs in cell morphology from the degree of cell fragmentation, and it also showed significant synergistic effect on docetaxel (0.8–80 μg/L) on cell migration and apoptosis. These results demonstrated that applying SQFZ as an adjuvant of chemotherapeutic drugs to treat cancer has the clinical significance of reducing toxicity and increasing curative effect.
Pseudonormalization of the Typical Electrocardiography Repolarization Pattern of a Black Athlete
Authors: Dehghani Mohammadabadi Mina , Chan Winnie , Antiperovitch Pavel , Abdirahman Ifrah , Glover Benedict , Baranchuk Adrian
Published: June 2018

Cardiac repolarization of black athletes has a distinctive pattern. During an episode of pericarditis, this pattern may evolve into a “pseudonormalized” electrocardiography (ECG). On resolution of the pericardial inflammation, the ECG may return to the normal variant for a black athlete, sounding the alarms of extended disease to the myocardium. Recognizing the normal variant for a black athlete will reduce the need for unnecessary further testing or treatments. The case is discussed in detail.
Serum sodium, model for end-stage liver disease, and a recent invasive procedure are risk factors for severe acute-on-chronic liver failure and death in cirrhotic patients hospitalized with bacterial infection
Authors: Lopes-Secundo Tirzah M. , Sevá-Pereira Tiago , Correa Bárbara R. , Silva Natalie C.M. , Imbrizi Marcello R. , Cunha-Silva Marlone , Soares Elza C. , Almeida Jazon R.S.
Published: June 2018

Introduction

Bacterial infection is present in up to 30% of hospitalized cirrhotic patients. It can lead, even after its resolution, to organ dysfunction and even acute-on-chronic liver failure (ACLF). It is the precipitating factor of ACLF in one third of the cases and is the main cause of mortality in patients with liver cirrhosis.

Objectives

The aim of this study was to evaluate the prevalence and identify early risk factors for severe ACLF and death in hospitalized patients with liver cirrhosis with bacterial infection.

Patients and methods

This was a prospective observational study. Hospitalized patients with liver cirrhosis and bacterial infection were included. Clinical and laboratory data and their evolution to organ dysfunction and death were assessed. A statistical analysis were carried out to identify predictors of severe ACLF and in-hospital mortality.

Results

This study included 88 patients. ACLF was observed in 62 (70%) patients, with 48 (55%) grade 2 or higher. Of the 27 deaths (31% of all patients), 26 had severe ACLF (54% mortality) (P<0.0001). The independent risk factors for ACLF of at least 2 and death were baseline serum sodium [odds ratio (OR): 0.874; P=0.01, and OR: 0.9, P=0.04], initial MELD (OR: 1.255, P=0.0001, and OR: 1.162, P=0.005), and a recent invasive procedure (OR: 3.169, P=0.01, and OR: 6.648, P=0.003).

Conclusion

Lower serum sodium values, higher MELD scores at diagnosis of infection, and a recent history of invasive procedures were independent risk factors for severe ACLF and death in patients with cirrhosis and bacterial infection.
A Case Report of Overlapping Miller Fisher Syndrome, Guillain-Barré Syndrome, and the Bickerstaff Brainstem Encephalitis
Authors: Chae Choong Sik , Kwon Kyoung Min , Lee Jung Soo , Kim Yeo Hyung
Published: June 2018

Introduction:

Patients with overlapping Miller Fisher syndrome (MFS), Guillain-Barré syndrome (GBS), and the Bickerstaff brainstem encephalitis (BBE) have rarely been reported, and the diverse clinical features and sequelae are challenging for physicians. Through this case report, we present the clinical course, treatment, recovery, and sequelae of an overlapping MFS, GBS, and BBE syndrome and provide a review of the literature.

Case Report:

A 76-year-old woman was initially presented with diplopia, ophthalmoplegia, and ataxia, but she later developed weakness of limbs, respiratory failure, deterioration of consciousness, and cognitive impairment. After IV immunoglobulin and corticosteroid therapy, she began to recover consciousness and from the weakness from day 18. After 8 months of rehabilitative therapy, she was able to swallow food without difficulty, but she still cannot walk without assistance, showed cognitive impairment, and the tracheostomy remained in place because of persistent respiratory muscle weakness.

Conclusions:

As the clinical course of MFS-GBS-BBE overlapping syndrome is variable, involving not only the peripheral but also the central nervous system, the establishment of a comprehensive therapeutic strategy is warranted.
Inter-rater Agreement for the Diagnosis of Stroke Versus Stroke Mimic
Authors: Liberman Ava L. , Rostanski Sara K. , Ruff Ilana M. , Meyer Ashley N.D. , Maas Matthew B. , Prabhakaran Shyam
Published: June 2018

Background and Purpose:

Patients who present emergently with acute neurological signs and symptoms represent unique diagnostic challenges for clinicians. We sought to characterize the reliability of physician diagnosis in differentiating aborted or imaging-negative acute ischemic stroke from stroke mimic.

Methods:

We constructed 10 case-vignettes of patients treated with thrombolysis with subsequent clinical improvement who lacked radiographic evidence of infarction. Using an online survey, we asked physicians to select a most likely final diagnosis after reading each case-vignette. Inter-rater agreement was evaluated using percent agreement and κ statistic for multiple raters with 95% confidence intervals reported.

Results:

Sixty-five physicians participated in the survey. Most participants were in practice for ≥5 years and over half were vascular neurologists. Physicians agreed on the most likely final diagnosis 71% of the time, κ of 0.21 (95% confidence interval, 0.06-0.54). Percent agreement was similar across participant practice locations, years of experience, subspecialty training, and personal experience with thrombolysis.

Conclusions:

We found modest agreement among surveyed physicians in distinguishing ischemic stroke syndromes from stroke mimics in patients without radiographic evidence of infarction and clinical improvement after thrombolysis. Methods to improve diagnostic consensus after thrombolysis are needed to assure acute ischemic stroke patients and stroke mimics are treated safely and accurately.
Prevalence and Correlates of Point-of-sex Human Immunodeficiency Virus Self-testing Among Human Immunodeficiency Virus-negative Men Who Have Sex With Men in China
Authors: Wei Chongyi , Yan Li , Lippman Sheri A. , Su Xiaoyou , Li Jianjun , Chen Liping , Raymond H. Fisher , Yan Hongjing
Published: June 2018

Background

Human immunodeficiency virus (HIV) self-testing (HIVST) provides a promising tool to screen sex partners for men who have sex with men (MSM) who engage in condomless sex and want to avoid HIV infection. Although previous studies have demonstrated HIVST acceptability and increased testing uptake, limited data exist on its use between sex partners for point-of-sex HIV testing. This study examined prevalence and correlates of point-of-sex HIVST among Chinese MSM.

Methods

A cross-sectional survey was conducted among 400 HIV-negative Chinese MSM in 2017. Participants were recruited through a multifaceted sampling approach and self-administered an electronic questionnaire. Point-of-sex HIVST was measured by asking participants if they had ever conducted HIVST with a sex partner before sex to ensure that they both knew their HIV statuses. Multivariable logistic regression was used to identify correlates of point-of-sex HIVST after controlling for age, education and sexual orientation.

Results

Overall, 19.2% (77/400) men reported point-of-sex HIVST (51.3% among self-testers). Participants who had four or more HIV self-tests before had 7.57-fold greater odds (95% confidence interval, 3.75, 15.28) of reporting point-of-sex HIVST compared to those who had fewer HIVST experiences. Point-of-sex HIVST was otherwise not associated with most other socio-demographic or behavioral practices, suggesting that it may be broadly acceptable.

Conclusions

A substantial proportion of Chinese MSM had utilized HIVST with their partners before sex, especially among those who were more experienced with HIVST. Scale up and routine implementation of HIVST programs are further warranted to facilitate point-of-sex HIV testing.
The Nature and Severity of Adverse Events in Select Outpatient Surgical Procedures in the Veterans Health Administration
Authors: Mull Hillary J. , Itani Kamal M. F. , Charns Martin P. , Pizer Steven D. , Rivard Peter E. , Hawn Mary T. , Rosen Amy K.
Published: June 2018

Background:

Research on adverse events (AEs) in outpatient surgery has been limited. As part of a Veterans Health Administration (VA) project on AE surveillance, we chart-reviewed selected outpatient surgical cases to characterize the nature and severity of AEs.

Methods:

We abstracted financial year 2012-2015 VA outpatient surgery cases selected with high (n = 1185) and low (n = 1072) likelihood of an AE based on postoperative health care utilization. The abstraction tool included established AE definitions and validated harm and severity scales.

Results:

We found AEs in 608 high-likelihood (51%) and 126 low-likelihood outpatient surgical procedures (12%). Among 1010 unique AEs, the most common were wound issues (n = 261, 26%), urinary retention (23%), and urinary tract infections (12%). While 63% of all AEs involved minimal harm, 28% required hospitalization, and 9% were severely harmful including 8 AEs requiring intervention to sustain life and 2 deaths. Overall, 102 AEs (10%) required, at minimum, a repeat surgery to treat.

Conclusions:

Among VA outpatient surgical procedures selected based on likelihood of an AE, nearly 40% of identified events carried more than minimal patient harm, undermining the claim that outpatient surgery is relatively safe. Prevalent and preventable AEs such as wound dehiscence and urinary retention may be useful targets for quality improvement.
Long-Term Results for a One-Stage Surgery Technique for Patients With Craniofacial Plexiform Neurofibroma
Authors: Chen Liangbo , Guo Chengrui , Song Xuefei , Yan Chenxi , Hu Xiaojie
Published: June 2018

Background:

Neurofibromatosis (NF) is an autosomal dominant genetic disorder, and NF type 1 (NF1) is one of the most common forms. Plexiform neurofibroma (PNF) is one of the characteristic expressions of NF1. The proper treatment for patients with craniofacial PNF is surgery. The evaluation methods for the surgical outcome of these patients are still controversial. As a consequence, a one-stage surgical technique and an appropriate evaluation method for patients with craniofacial PNF were discussed in this article.

Methods:

This research is a retrospective study. Nine patients with craniofacial PNF were included in this study. They had undergone a one-stage surgical technique of tumor debulking and nasolabial fold reconstruction. Three methods had been applied to evaluate the surgical outcome.

Results:

Significant improvement was observed in 8 patients. Eight patients were assessed by the relatively objective evaluation method. Obvious symmetry improvement was calculated using Mimics software in 7 patients.

Conclusion:

The surgical technique could achieve good surgical outcomes in both functional and cosmetic terms. Additionally, the relatively objective evaluation technique based on Mimics software could be a more convincing method for evaluating the surgical outcomes of craniofacial patients with PNF.
Fibrous Dysplasia: A Complex Maxillary Reconstruction
Authors: Mici Elidon , Belli Evaristo
Published: June 2018

Fibrous dysplasia is a benign tumor of the skeleton. Mostly 2 forms are described: a monostotic and a poliostotic form. The maxilla and the mandible are the most interested of the facial district. The authors report a patient of a huge maxillary fibrous dysplasia. A 63-year-old patient was treated for a 20-year progressive left maxillary neoformation. A total maxillectomy was performed. The defect was reconstructed with a custom-made midface implant associated with a temporal and a pericranial flap.
Auto-Fluorescence and Histopathologic Evaluation of Medication-Related Osteonecrosis of the Jaws: Perspectives for Treatment
Authors: Giovannacci Ilaria , Vescovi Paolo , Magnoni Cristina , Corradi Domenico , Corcione Luigi , Lucchina Alberta Greco , Mortellaro Carmen , Nammour Samir , Meleti Marco
Published: June 2018

Auto-fluorescence (AF) of healthy bone tissue has recently been described. Loss of AF (LAF) has, on the contrary, been reported in necrotic bone. Further, the use of LAF as a possible guidance to distinguish viable from necrotic bone during surgical treatment of osteonecrosis has been proposed. The aim of this study is to detail 8 patients of medication-related osteonecrosis of the jaws treated through an AF-guided surgical resection. The authors also provide the histopathologic description of hypo-fluorescent and hyper-fluorescent bone in each patient. After removal of necrotic bone block, Er:YAG laser was used for vaporizing further necrotic bone, up to the detection of strongly hyper-fluorescent bone. Samples of hyper-fluorescent bone were collected around areas of necrosis. Histopathologic evaluation revealed viable bone tissue in all hyper-fluorescent specimens. On the basis of these data, AF-guided surgical resection could be effective in highlighting surgical margins of necrotic bone tissue and it might have some utility in a range of applications of bone surgery.
Advanced Neuroimaging Techniques for Difficult Diagnoses: Giant Hemorrhagic Venous Infarct Or Not?
Authors: Polat Gökhan , Ogul Hayri
Published: June 2018

An 51-year-old female presented with a headache, nausea, vomiting, and weakness. The lesion resembling a hemorrhagic mass was observed in the brain tomography and magnetic resonance imaging of the patient. However, thrombosis was suspected in the cerebral venules adjacent to the lesion. Magnetic resonance spectroscopy and magnetic resonance perfusion data excluded neoplastic lesions. Thus, the patient was treated for venous infarction. Hemorrhagic venous infarcts may mimic hemorrhagic masses. For this reason, the distinction of the lesions is important for the treatment procedure. Advanced neuroimaging in lesions resembling hemorrhagic masses must be performed for accurate diagnosis.
Exposure Therapy and Simultaneous Repetitive Transcranial Magnetic Stimulation
Authors: Fryml Leah D. , Pelic Christopher G. , Acierno Ron , Tuerk Peter , Yoder Matthew , Borckardt Jeffrey J. , Juneja Natasha , Schmidt Matthew , Beaver Kathryn L. , George Mark S.
Published: June 2018

Objectives

This is a small preliminary but novel study assessing the feasibility of repetitive transcranial magnetic stimulation (rTMS) delivery to veterans with posttraumatic stress disorder (PTSD) while they simultaneously receive prolonged exposure (PE) therapy.

Methods

A prospective, randomized, double-blinded, active sham-controlled design combined weekly sessions of rTMS and standard PE at the Veterans Administration Hospital. Eight adult patients received a full course of protocol-driven PE therapy and were randomly assigned to receive either rTMS or sham rTMS. Repetitive transcranial magnetic stimulation was delivered to the right or left prefrontal cortex with a figure-eight solid core coil at 120% motor threshold, 10 Hz, 5-second train duration, and 10-second intertrain interval for 30 minutes (6000 pulses) weekly for 5 weeks (30,000 stimuli).

Results

Of the 12 veterans consented, 8 completed the study treatment protocol. The dropout rate was 34%, roughly equivalent to the pooled average dropout rates observed in traditional PE therapy with Operation Enduring Freedom/Operation Iraqi Freedom veterans with PTSD, suggesting that veterans had no difficulty tolerating the addition of rTMS to PE therapy and that this is a feasible study design for larger trials in the future. Clinician-Administered PTSD Symptom scores reflected a general nonsignificant trend toward improvement, and subjects with comorbid major depression appeared to experience significant antidepressant benefit with treatment despite the fact that the doses used in this protocol were much smaller than those used to treat patients with major depressive disorder.

Conclusions

This pilot study demonstrates the safety and feasibility of rTMS delivery to PTSD patients while they simultaneously receive PE. This unique approach to the treatment of PTSD highlights the need for further studies with larger sample sizes to assess treatment outcomes.
Extensive Expansion of the Speedy gene Family in Homininae and Functional Differentiation in Humans
Authors: Wang Liang , Wang Hui , Wang Hongmei , Zhao Yuhui , Liu Xiaojun , Wong Gary , Ye Qinong , Xia Xiaoqin , Gao George F. , Gao Shan
Published: June 2018

Background

The cell cycle plays important roles in physiology and disease. The Speedy/RINGO family of atypical cyclins regulates the cell cycle. However, the origin, evolution and function of the Speedy family are not completely understood. Understanding the origins and evolution of Speedy family would shed lights on the evolution of complexity of cell cycles in eukaryotes.

Results

Here, we performed a comprehensive identification of Speedy genes in 258 eukaryotic species and found that the Speedy subfamily E was extensively expanded in Homininae, characterized by emergence of a low-Spy1-identify domain. Furthermore, the Speedy gene family show functional differentiation in humans and have a distinct expression pattern, different regulation network and co-expressed gene networks associated with cell cycle and various signaling pathways. Expression levels of the Speedy gene family are prognostic biomarkers among different cancer types.

Conclusions

Overall, we present a comprehensive view of the Speedy genes and highlight their potential function.
Expanded genetic landscape of chronic obstructive pulmonary disease reveals heterogeneous cell type and phenotype associations
Authors: Sakornsakolpat Phuwanat , Prokopenko Dmitry , Lamontagne Maxime , Reeve Nicola F. , Guyatt Anna L. , Jackson Victoria E. , Shrine Nick , Qiao Dandi , Bartz Traci M. , Kim Deog Kyeom , Lee Mi Kyeong , Latourelle Jeanne C. , Li Xingnan , Morrow Jarrett D. , Obeidat Ma’en , Wyss Annah B. , Zhou Xiaobo , Bakke Per , Barr R Graham , Beaty Terri H. , Belinsky Steven A. , Brusselle Guy G. , Crapo James D. , Jong Kim de , DeMeo Dawn L. , Fingerlin Tasha E. , Gharib Sina A. , Gulsvik Amund , Hall Ian P. , Hokanson John E. , Kim Woo Jin , Lomas David A. , London Stephanie J. , Meyers Deborah A. , O’Connor George T. , Rennard Stephen I. , Schwartz David A. , Sliwinski Pawel , Sparrow David , Strachan David P. , Tal-Singer Ruth , Tesfaigzi Yohannes , Vestbo Jørgen , Vonk Judith M. , Yim Jae-Joon , Bossé Yohan , Manichaikul Ani , Lahousse Lies , Silverman Edwin K. , Boezen H. Marike , Wain Louise V. , Tobin Martin D. , Hobbs Brian D. , Cho Michael H. ,   International COPD Genetics Consortium
Published: June 2018

Chronic obstructive pulmonary disease (COPD) is the leading cause of respiratory mortality worldwide. Genetic risk loci provide novel insights into disease pathogenesis. To broaden COPD genetic risk loci discovery and identify cell type and phenotype associations we performed a genome-wide association study in 35,735 cases and 222,076 controls from the UK Biobank and additional studies from the International COPD Genetics Consortium. We identified 82 loci with P value < 5×10−8; 47 were previously described in association with either COPD or population-based lung function. Of the remaining 35 novel loci, 13 were associated with lung function in 79,055 individuals from the SpiroMeta consortium. Using gene expression and regulation data, we identified enrichment for loci in lung tissue, smooth muscle and alveolar type II cells. We found 9 shared genomic regions between COPD and asthma and 5 between COPD and pulmonary fibrosis. COPD genetic risk loci clustered into groups of quantitative imaging features and comorbidity associations. Our analyses provide further support to the genetic susceptibility and heterogeneity of COPD.
Jinshajiangite: structure, twinning and pseudosymmetry
Authors: Jin Shiyun , Xu Huifang , Lee Seungyeol , Fu Pingqiu
Published: June 2018

The crystal structure of jinshajiangite based on a sample from its original discovery location is studied using single-crystal X-ray diffraction and transmission electron microscopy methods. Jinshajiangite is a titanium silicate mineral with an ideal chemical formula of BaNaFe4Ti2(Si2O7)2O2(OH)2F. The structure of jinshajiangite is of P\bar 1 symmetry (triclinic system), witha= 8.7331 (2) Å,b= 8.7366 (2) Å,c= 11.0404 (3) Å, α = 81.477 (1)°, β = 110.184 (1)°, γ = 104.384 (1)° andV= 764.03 (3) Å3, instead of the previously proposed C\bar 1 cell [a= 10.7059 (5) Å,b= 13.7992 (7) Å,c= 20.760 (1) Å, α = 90.008 (1)°, β = 94.972 (1)°, γ = 89.984 (1)°,V= 3055.4 (4) Å3]. The basic topology of the new structure is similar to the previously proposed C\bar 1 structure, except there is only one type of titanium silicate and intermediate cation layer in the structure (instead of two types), which are all related by the translation along thec-axis. Even though there is a significant amount of Mn in the chemical composition, no obvious ordering between Fe and Mn is observed in the structure. All the mineral species of the perraultite-type structure (jinshajiangite, perraultite, surkhobite and bobshannonite) should have the same P\bar 1 structure as jinshajiangite with ∼10 Åd001spacing, and all the previously proposed monoclinic space groups were pseudosymmetry generated by nanoscale polysynthetic twinning on the (001) composition plane. The similar phenomenon observed in bafertisite is also discussed in the paper with an alternative polytype structure model proposed.
A novel bacterial class V dye-decolourizing peroxidase from the extremophile Deinococcus radiodurans: cloning, expression optimization, purification, crystallization, initial characterization and X-ray diffraction analysis
Authors: Frade Kelly Stefany Tuna , Fernandes Andreia Cecília Pimenta , Silveira Celia Marisa , Frazão Carlos , Moe Elin
Published: June 2018

Deinococcus radiodurans is a bacterium with extreme resistance to desiccation and radiation. The resistance mechanism is unknown, but an efficient reactive oxygen species (ROS) scavenging system and DNA-repair and DNA-protection mechanisms are believed to play important roles. Here, the cloning and small- and medium-scale expression tests of a novel dye-decolourizing peroxidase from D. radiodurans (DrDyP) using three different Escherichia coli strains and three different temperatures in order to identify the optimum conditions for the expression of recombinant DrDyP are presented. The best expression conditions were used for large-scale expression and yielded ∼10 mg recombinant DrDyP per litre of culture after purification. Initial characterization experiments demonstrated unusual features with regard to the haem spin state, which motivated the crystallization experiment. The obtained crystals were used for data collection and diffracted to 2.2 Å resolution. The crystals belonged to the trigonal space group P31 or P32, with unit-cell parameters a = b = 64.13, c = 111.32 Å, and are predicted to contain one DrDyP molecule per asymmetric unit. Structure determination by molecular replacement using previously determined structures of dye-decolourizing peroxidases with ∼30% sequence identity at ∼2 Å resolution as templates are ongoing.
Diisopropylammonium benzenesulfonate
Authors: Seye Dame , Diop Cheikh Abdoul Khadir , Diop Libasse , Geiger David K.
Published: June 2018

In the anion of the title molecular salt, C6H16N+·C6H5O3S−, the O atoms of the sulfonate group is rotationally disordered over two sets of sites in a a 0.711 (9):0.289 (9) ratio. The extended structure displays N—H...O hydrogen bonds between the cation and anion, which results in infinite chains propagating parallel to [010]. The chains are linked by weak C—H...O interactions, yielding a two-dimensional network.
Ethyl 3-methyl-1-oxo-4H-1,4-benzothiazine-2-carboxylate monohydrate
Authors: Baryala Yamna , El Bakri Youness , Anouar El Hassane , Zerzouf Abdelfettahb , Essassi El Mokhtar , Mague Joel T.
Published: June 2018

The organic molecule in the title hydrate, C12H13NO3S·H2O, is folded across the S...N vector. Chains two molecules thick extending along the a-axis direction are formed by N—H...O and O—H...O hydrogen bonds. These interactions are reinforced by C—H...S hydrogen bonds and offset π-stacking interactions between centrosymmetrically related benzene rings. The chains are associated through C—H...O hydrogen bonds.
Dicarbonyl{[(E,E)-(2,3,4,5-η)-6-methoxy-6-oxo-2,4-hexadienyl]triphenylphosphonium}(triphenylphosphane-κP)iron(1+) hexafluoridophosphate
Authors: Ma Yuzhi , Lindeman Sergey , Donaldson William A.
Published: June 2018

In the title compound, [Fe(C25H24O2P)(C18H15P)(CO)2]PF6, the Fe atom adopts a square-based pyramidal coordination geometry with the carbonyl groups and the two C=C bonds of the diene defining the basal sites and the phosphane ligand the apical position. The diene ligand has an E,E geometry, with the phosphonium fragment pointed away from the Fe atom. The crystal structure displays C—H...F and C—H...O hydrogen bonding. The PF6
− anion is rotationally disordered over four orientations.
Using design thinking to support value-based leadership for sustainable quality development
Authors: Snyder Kristen , Ingelsson Pernilla , Bäckström Ingela
Published: June 2018

Purpose

The purpose of this paper is to present findings from a study of value-based leadership in which design thinking was used as a participatory, iterative process to examine and stimulate changes in organizational culture and develop value-based leadership in Swedish manufacturing. Of particular interest to the authors was to make visible and understand the constraints in leadership that kept leaders from understanding and working with organizational culture and values.

Design/methodology/approach

A three-year multi-site case study was conducted in collaboration with three manufacturing companies in Sweden. The study design was based on a collaborative, iterative model using the Stanford Design thinking framework in which data were collected through a series of workshops using a variety of sources including: leadership survey; interviews with three general directors; focus groups with middle- and top-level managers; observations and cultural analysis, survey; storytelling and appreciative inquiry (AI); and an employee questionnaire. Respondents in the study represented leadership teams in three Swedish manufacturing companies and their employees.

Findings

In general, there is a lack of dialogue among leaders about what is leadership, what is culture and what is meant by values in the organization. As well, there is a heavy emphasis on structure and process, yet, at the same time, there lacks a clear understanding about why the structures exist and how they can be used to spawn innovation. Moreover, participating leaders in manufacturing succumb to a crisis leadership model that results from the heavy emphasis on productivity and bottom-line effectiveness. Design thinking and the methods used to develop work culture, including AI, storytelling and coaching, provided leaders with new insights into the culture within the company. Leaders were able to identify both constraints and possibilities for changing the culture from disengagement to engagement. Through the process, they also began to identify values and recognized the importance of valuing employees to affect innovation and build a culture of engagement. The authors also witnessed increased dialogue among leaders that reflected an understanding of the importance to engage middle managers and employees in problem solving and innovation.

Originality/value

This study demonstrates that leaders can benefit from innovative approaches to identifying and building work culture to achieve value-based leadership.
Causal paths to acceptance of technological innovations by individual employees
Authors: Talukder Majharul
Published: June 2018

Purpose

Despite much research on organizations’ adoption of innovation, little is currently known about individual employees have gone about it. The purpose of this paper is to empirically investigate the determinants that address individual employees’ decisions concerning innovation in the workplace.

Design/methodology/approach

Data were collected from 272 employees from a tertiary education institution in Australia using a structured instrument.

Findings

Results from the structural equation modeling analysis indicate that enjoyment and motivation impact significantly on attitudes to an innovation, which, in turn, affects how employees behave toward it.

Practical implications

Furthermore, organizational patronage, innovativeness and self-image have been found to influence the innovation adoption process. These findings have implications for the effective management and implementation of an innovation at the individual level.

Originality/value

Although innovation adoption has been studied extensively, drivers of adoption and research on individual innovation acceptance remain limited. Designing an effective approach for increasing end-user acceptance and subsequent use of innovation continues to be a fundamental challenge. The current literature indicates that we know relatively little about the ways in which individuals adopt and the factors that influence individual adoption of innovation. This study is designed to fill that gap. The identification of the factors is important to create a work environment that is conducive to individual adoption of innovation and thereby gain the expected benefits from the innovation.