bluuebunny/crossref_metadata_2025 huggingface dataset:
Ceramics-bonded Nd-Fe-B-type magnet with high electrical resistivity
Authors: Kang M. S. , Kwon H. W. , Kim D. H. , Lee J. G. , Yu J. H.
Published: January 2018

Ceramics-bonded magnet with remarkably high electrical resistivity was fabricated by hot-pressing the mixture of Nd13.6Fe73.6Co6.6Ga0.6B5.6 alloy melt-spun flakes and dielectric Bi2O3-SiO2-B2O3 ceramics powder with low melting point. Coercivity of the ceramics-bonded magnet decreased with increasing the addition of ceramics binder, and this was attributed to the increased demagnetizing factor. Thin oxidized layer on the flake surface formed by reaction between the flake and oxide binder also contributed to reducing coercivity in the ceramics-bonded magnet. Highly resistive ceramics-bonded magnet containing 30 vol% ceramics binder still had good magnetic performance and high mechanical strength at 175 oC: iHc = 5 kOe, Mr = 4.8 kG, (BH)max = 4.3 MGOe, and over 900 MPa.
Interaction of C2H with molecular hydrogen: Ab initio potential energy surface and scattering calculations
Authors: Dagdigian Paul J.
Published: January 2018

The potential energy surface (PES) describing the interaction of the ethynyl (C2H) radical in its ground X̃2Σ+ electronic state with molecular hydrogen has been computed through restricted coupled cluster calculations including single, double, and (perturbative) triple excitations [RCCSD(T)], with the assumption of fixed molecular geometries. The computed points were fit to an analytical form suitable for time-independent quantum scattering calculations of rotationally inelastic cross sections and rate constants. A representative set of energy dependent state-to-state cross sections is presented and discussed. The PES and cross sections for collisions of H2(j = 0) are compared with a previous study [F. Najar et al., Chem. Phys. Lett. 614, 251 (2014)] of collisions of C2H with H2 treated as a spherical collision partner. Good agreement is found between the two sets of calculations when the H2 molecule in the present calculation is spherically averaged.
Superconducting, magnetic and magnetotransport properties of FeTe1-xSex single crystals
Authors: Kumar Rohit , Sudesh  , Varma G. D.
Published: January 2018

The single crystalline samples with compositions FeTe1-xSex (0.25 ≤ x ≤ 0.50) have been prepared via self-flux method and the superconducting, magnetic and magnetotransport properties of the grown crystals were investigated. The superconducting onset temperatures have been determined from the measurements of zero field cooled magnetization and resistance with temperatures. In the present case, highest superconducting transition temperature TC (onset) ∼ 15 K has been obtained for x=0.5. The HC2 (T=0 K) values have been estimated by fitting the experimental HC2 - T plots with WHH model. The highest HC2(0) has been obtained for x=0.5. The activation energy of the thermally activated flux flow has been found from the broadening of superconducting transition in an applied magnetic field using the Arrhenius law. Our results show that the activation energy (U0) decreases with the increasing magnetic field. Furthermore, the magnetization measurements for x=0.4 and 0.5 samples have been performed at T=5 K in the magnetic field range ±7 T to estimate critical current density at different applied magnetic fields using Bean formula. We see that the sample x=0.5 has higher values of JC as compared to that of x=0.4 at all magnetic fields. This is in conformity with the behavior of U0–H plots.
Characterization of the magnetic properties of NdFeB thick films exposed to elevated temperatures
Authors: Fujiwara Ryogen , Devillers Thibaut , Givord Dominique , Dempsey Nora M.
Published: January 2018

Hard magnetic films used in magnetic micro-systems may be exposed to elevated temperatures during film and system fabrication and also during use of the micro-system. In this work, we studied the influence of temperature on the magnetic properties of 10 μm thick out-of-plane textured NdFeB films fabricated by high rate triode sputtering. Out-of-plane hysteresis loops were measured in the range 300K – 650K to establish the temperature dependence of coercivity, magnetization at 7 T and remanent magnetization. Thermal demagnetization was measured and magnetization losses were recorded from 350K in films heated under zero or low (-0.1 T) external field and from 325 K for films heated under an external field of -0.5 T. The effect of thermal cycling under zero field on the remanent magnetization was also studied and it was found that cycling between room temperature and 323 K did not lead to any significant loss in remanence at room temperature, while a 4% drop is recorded when the sample is cycled between RT and 343K. Measurement of hysteresis loops at room temperature following exposure to elevated temperatures reveals that while remanent magnetisation is practically recovered in all cases, irreversible losses in coercivity occur (6.7 % following heating to 650K, and 1.3 % following heating to 343K). The relevance of these results is discussed in terms of system fabrication and use.
Magnetic properties of Co/Ni grain boundaries after annealing
Authors: Coutts Chris , Arora Monika , Hübner René , Heinrich Bret , Girt Erol
Published: January 2018

Magnetic and microstructural properties of 111 textured Cu/N×[Co/Ni] films are studied as a function of the number of bilayer repeats N and annealing temperature. M(H) loop measurements show that coercivity, Hc, increases with annealing temperature and that the slope of the saturation curve at Hc has a larger reduction for smaller N. An increase of the magnetic anisotropy (Ku) to saturation magnetization (Ms) ratio after annealing N×[Co/Ni] with N < 15 only partially describes the increase to Hc. Energy-dispersive X-ray spectroscopy analyses performed in scanning transmission electron microscopy mode across cross-sections of as-deposited and annealed Cu/16×[Co/Ni] films show that Cu diffuses from the seed layer into grain boundaries of Co/Ni. Diffusion of Cu reduces exchange coupling (Hex) between the magnetic grains and explains the increase in Hc. Additionally, the difference in the slope of the M(H) curves at Hc between the thick (N = 16) and thin (N = 4) magnetic multilayers is due to Cu diffusion more effectively decoupling magnetic grains in the thinner multilayer.
Lithium ion intercalation in thin crystals of hexagonal TaSe2 gated by a polymer electrolyte
Authors: Wu Yueshen , Lian Hailong , He Jiaming , Liu Jinyu , Wang Shun , Xing Hui , Mao Zhiqiang , Liu Ying
Published: January 2018

Ionic liquid gating has been used to modify the properties of layered transition metal dichalcogenides (TMDCs), including two-dimensional (2D) crystals of TMDCs used extensively recently in the device work, which has led to observations of properties not seen in the bulk. The main effect comes from the electrostatic gating due to the strong electric field at the interface. In addition, ionic liquid gating also leads to ion intercalation when the ion size of the gate electrolyte is small compared to the interlayer spacing of TMDCs. However, the microscopic processes of ion intercalation have rarely been explored in layered TMDCs. Here, we employed a technique combining photolithography device fabrication and electrical transport measurements on the thin crystals of hexagonal TaSe2 using multiple channel devices gated by a polymer electrolyte LiClO4/Polyethylene oxide (PEO). The gate voltage and time dependent source-drain resistances of these thin crystals were used to obtain information on the intercalation process, the effect of ion intercalation, and the correlation between the ion occupation of allowed interstitial sites and the device characteristics. We found a gate voltage controlled modulation of the charge density waves and a scattering rate of charge carriers. Our work suggests that ion intercalation can be a useful tool for layered materials engineering and 2D crystal device design.
Electrical properties of surface and interface layers of the N- and In-polar undoped and Mg-doped InN layers grown by PA MBE
Authors: Komissarova T. A. , Kampert E. , Law J. , Jmerik V. N. , Paturi P. , Wang X. , Yoshikawa A. , Ivanov S. V.
Published: January 2018

Electrical properties of N-polar undoped and Mg-doped InN layers and In-polar undoped InN layers grown by plasma-assisted molecular beam epitaxy (PA MBE) were studied. Transport parameters of the surface and interface layers were determined from the measurements of the Hall coefficient and resistivity as well as the Shubnikov-de Haas oscillations at magnetic fields up to 60 T. Contributions of the 2D surface, 3D near-interface, and 2D interface layers to the total conductivity of the InN films were defined and discussed to be dependent on InN surface polarity, Mg doping, and PA MBE growth conditions.
Polymer/metal multi-layers structured composites: A route to high dielectric constant and suppressed dielectric loss
Authors: Feng Yu , Li Meng-Lu , Li Wei-Li , Zhang Tian-Dong , Zhao Yu , Fei Wei-Dong
Published: January 2018

In order to obtain polymer-based composites with a high dielectric constant and suppressed dielectric loss, polyvinylidene fluoride (PVDF)/silver (Ag) multi-layer structured composites were fabricated via vacuum evaporation and hot-press methods. The dielectric constant of the PVDF/Ag(5/4) composite (including five PVDF layers and four Ag layers) is up to 31, and dielectric loss can be suppressed below 0.02 (smaller than that of pure PVDF) at 1 kHz. The enhanced interfacial polarization in multi-layer structured composites is determined via temperature dependence of electrical modulus, which is regarded as the origin of dielectric constant enhancement. The suppressed dielectric loss at low frequency is attributed to the difficulty in the formation of a percolation conductive network in this multi-layer system. This promising multi-layer strategy could be generalized to a variety of polymers to develop polymer-based composites with a high dielectric constant and low dielectric loss.
Cloning of a novel lectin from Artocarpus lingnanensis that induces apoptosis in human B-lymphoma cells
Authors: Luo Yu , Liu Xiaoqin , Lin Faquan , Liao Liejun , Deng Yong , Zeng Linjie , Zeng Qiyan
Published: January 2018

We isolated a novel lectin (Artocarpus nitidus subsp. lingnanensis lectin, ALL) from Artocarpus nitidus subsp. lingnanensis and showed its mitogenic activities. In this study, we determined the amino acid sequence of ALL by cDNA sequencing. ALL cDNA (933 bp) contains a 657-bp open reading frame (ORF), which encodes a protein with 218 amino acids. ALL shares high sequence similarities with Jacalin and Morniga G and belongs to jacalin-related lectin family. We also examined the antitumor activity of ALL using Raji, a human B-lymphoma cell line. ALL exhibits a strong binding affinity to cell membrane, which can be effectively inhibited by N-acetyl-D-galactosamine (GalNAc). ALL inhibits Raji cell proliferation in a time- and dose-dependent manner through apoptosis, evidenced by morphological changes, phosphatidylserine externalization, poly ADP-ribose polymerase (PARP) cleavage, Bcl-2 down-regulation, and caspase-3 activation. We further showed that the activation of p38 mitogen-activated protein kinase (MAPK) signaling pathways is required for the pro-apoptotic activity of ALL.
Sensitive and specific post-call filtering of genetic variants in xenograft and primary tumors
Authors: Mannakee Brian K , Balaji Uthra , Witkiewicz Agnieszka K , Gutenkunst Ryan N , Knudsen Erik S
Published: January 2018

Motivation

Tumor genome sequencing offers great promise for guiding research and therapy, but spurious variant calls can arise from multiple sources. Mouse contamination can generate many spurious calls when sequencing patient-derived xenografts. Paralogous genome sequences can also generate spurious calls when sequencing any tumor. We developed a BLAST-based algorithm, Mouse And Paralog EXterminator (MAPEX), to identify and filter out spurious calls from both these sources.

Results

When calling variants from xenografts, MAPEX has similar sensitivity and specificity to more complex algorithms. When applied to any tumor, MAPEX also automatically flags calls that potentially arise from paralogous sequences. Our implementation, mapexr, runs quickly and easily on a desktop computer. MAPEX is thus a useful addition to almost any pipeline for calling genetic variants in tumors.

Availability and implementation

The mapexr package for R is available at https://github.com/bmannakee/mapexr under the MIT license.

Supplementary information

Supplementary data are available at Bioinformatics online.
Dual Antiplatelet Therapy Combining Aspirin and Ticagrelor for Intracranial Stenting Procedures: A Retrospective Single Center Study of 154 Consecutive Patients With Unruptured Aneurysms
Authors: Narata Ana Paula , Amelot Aymeric , Bibi Richard , Herbreteau Denis , Angoulvant Denis , Gruel Yves , Janot Kevin
Published: January 2018

BACKGROUND

Dual antiplatelet therapy (DAPT) associating aspirin + clopidogrel is commonly utilized in neurovascular interventions despite unpredictable clopidogrel efficacy with 4% to 50% of patients considered nonresponders. Ticagrelor is an antiplatelet agent with low resistance rates but unknown efficacy and safety in neurovascular patients.

OBJECTIVE

To evaluate frequency of ischemic and hemorrhagic events in patients treated with aspirin and ticagrelor when associated with perioperative heparin bolus for unruptured aneurysms treated with intracranial stents.

METHODS

One hundred fifty-four consecutive patients with unruptured intracranial aneurysms treated by stent procedures (113 = flow diverter stent [FDS], 41 = stent-assisted coiling) were retrospectively analyzed. All patients received aspirin and ticagrelor without platelet function testing. Patients were separated in 2 groups following perioperative heparin dose: group I = 70 U/kg; group II = 50 U/kg. FDS versus stent-assisted coiling procedures were also separately analyzed.

RESULTS

Nine patients (5.8%) presented symptomatic neurological complications poststenting (3 ischemic, 6 hemorrhagic): 8 patients received 70 U/kg of heparin (11.1%) and 1 patient received 50 U/kg (1.2%; P < .009). Four patients died (2.6%) during the 3-mo follow-up period—all deaths were correlated to intracranial hemorrhage: 3 at group I and 1 at group II (P < .251). No difference in complications or death was observed considering separately FDS and stent-assisted coiling procedures.

CONCLUSION

This study did not find more neurological complications than in previous neurointerventional reports using DAPT with aspirin + ticagrelor or aspirin + clopidogrel. Overall number of neurological complications was lower when a lower dose of heparin was administered. Neurovascular studies comparing clopidogrel to ticagrelor and different doses of heparin are necessary to demonstrate which association is more efficient with lower complication rates.
Immunogenicity of high-dose influenza vaccination in patients with primary central nervous system malignancy
Authors: Strowd Roy E , Russell Gregory , Hsu Fang-Chi , Carter Annette F , Chan Michael , Tatter Stephen B , Laxton Adrian W , Alexander-Miller Martha A , High Kevin , Lesser Glenn J
Published: January 2018

Background

For cancer patients, rates of influenza-associated hospitalization and death are 4 times greater than that of the general population. Previously, we reported reduced immunogenicity to the standard-dose influenza vaccine in patients with central nervous system malignancy. In other poorly responding populations (eg, elderly patients), high-dose vaccination has improved efficacy and immunogenicity.

Methods

A prospective cohort study was designed to evaluate the immunogenicity of the Fluzone® high-dose influenza vaccine in brain tumor patients. Data on diagnosis, active oncologic treatment, and immunologic status (eg, CD4 count, CD8 count, CD4:CD8 ratio) were collected. All patients received the high-dose vaccine (180 µg). Hemagglutination inhibition titers were measured at baseline, day 28, and 3 months following vaccination to determine seroconversion (≥4-fold rise) and seroprotection (titer ≥1:40), which were compared to our prior results.

Results

Twenty-seven patients enrolled. Diagnoses included high-grade glioma (85%), CNS lymphoma (11%), and meningioma (4%). Treatment at enrollment included glucocorticoids (n = 8, 30%), radiation (n = 2, 7%), and chemotherapy (n = 9, 33%). Posttreatment lymphopenia (PTL, CD4 ≤ 200) was observed in 4 patients (15%). High-dose vaccination was well tolerated with no grade III-IV toxicity. Overall, seroconversion rates for the A/H1N1, A/H3N2, and B vaccine strains were significantly higher than in our prior study: 65% vs 37%, 69% vs 23%, and 50% vs 23%, respectively (all P < .04). Seroconversion was universally poor in patients with PTL. While seroprotection at 3 months declined in our prior study, no drop was observed following high-dose vaccination in this cohort.

Conclusions

The immunologic response to HD influenza vaccination was higher in this cohort than standard-dose influenza vaccination in our prior report. These findings mirror those in elderly patients where high-dose vaccination is the standard of care and raise the possibility of an immunosenescence phenotype.
An Updated Review of Iclaprim: A Potent and Rapidly Bactericidal Antibiotic for the Treatment of Skin and Skin Structure Infections and Nosocomial Pneumonia Caused by Gram-Positive Including Multidrug-Resistant Bacteria
Authors: Huang David B , Strader Catherine D , MacDonald James S , VanArendonk Mark , Peck Richard , Holland Thomas
Published: January 2018

New antibiotics are needed because of the increased morbidity and mortality associated with multidrug-resistant bacteria. Iclaprim, a bacterial dihydrofolate reductase inhibitor, not currently approved, is being studied for the treatment of skin infections and nosocomial pneumonia caused by Gram-positve bacteria, including multidrug-resistant bacteria. Iclaprim showed noninferiority at –10% to linezolid in 1 of 2 phase 3 studies for the treatment of complicated skin and skin structure infections with a weight-based dose (0.8 mg/kg) but did not show noninferiority at –10% to linezolid in a second phase 3 study. More recently, iclaprim has shown noninferiority at –10% to vancomycin in 2 phase 3 studies for the treatment of acute bacterial skin and skin structure infections with an optimized fixed dose (80 mg). A phase 3 study for the treatment of hospital-acquired bacterial and ventilator-associated bacterial pneumonia is upcoming. If, as anticipated, iclaprim becomes available for the treatment of skin and skin structure infections, it will serve as an alternative to current antibiotics for treatment of severe infections. This article will provide an update to the chemistry, preclinical, pharmacology, microbiology, clinical and regulatory status of iclaprim.
The effects of physical activity on survival in patients with colorectal cancer
Authors: DeTroye Alisha , Christner Margaret , Eganhouse Danielle , Manning Brittany , Sunkin Emily , Gregory Tanya
Published: January 2018

Mortality from colorectal cancer has been declining over the past 20 years due to improvements in screening and treatment. Physical activity improves patient quality of life, slows functional decline, and reduces all-cause mortality. Although some patients may have difficulty participating in physical activity, clinicians should always try to incorporate exercise into a management plan for patients who have survived colorectal cancer.
Hearing Difficulty Is Associated With Injuries Requiring Medical Care
Authors: Mick Paul , Foley Danielle , Lin Frank , Pichora-Fuller M. Kathleen
Published: January 2018

Objective:

Injuries are responsible for 11% of global disability-adjusted life years. Hearing difficulty may be a modifiable risk factor for injury. The primary aim was to determine whether subjective hearing difficulty is associated with increased incidence of injuries (all-type, workplace, and nonworkplace) serious enough to require health care among Americans aged 18 years and older. The secondary aim was to determine whether hearing difficulty is associated with increased use of health care for injuries.

Design:

The analysis was performed using data from the 1999 to 2012 Medical Expenditure Panel Surveys–Household Component (MEPS-HC). Multivariable estimates are generalizable to the American noninstitutionalized adult population in 2006. Hearing difficulty was determined by computer-assisted personal interview. The primary outcome was number of separate injuries requiring health care (emergency department visits, hospital inpatient admissions, or medical office visits) during the follow-up period. Crude injury incidence rates were calculated with 95% confidence intervals (CIs). Multivariable negative binomial regression was performed to determine the relative incidence rate of injuries among the group reporting hearing difficulties relative to the group reporting no difficulty in hearing, adjusting for relevant confounders. Variance estimates were adjusted to take into account the complex sample design. Results were stratified by sex.

Results:

Of the 121,453 participants in MEPS-HC panels 6-16, 107,352 (88.4%) had complete data and were included in the analysis. The average follow-up was 1.27 years. Seven thousand six hundred and twenty-four participants (7.1%) reported hearing difficulty at baseline. During the follow-up period, 10,727 participants (10.0%) had one or more injuries. In multivariable analyses, hearing difficulty was significantly associated with increased incidence of all-type (males: incidence rate ratio [IRR] 1.31, 95% CI 1.18–1.45, p value < 0.001; females: IRR 1.21, 95% CI 1.07–1.36, p value < 0.001), workplace (males: IRR 1.42, 95% CI 1.16–1.75, p value 0.001; females: IRR 1.61, 95% CI 1.12–2.31, p value 0.010), and nonworkplace injuries (males: IRR 1.24, 95% CI 1.09–1.42, p value 0.001; females: IRR 1.17, 95% CI, 1.02–1.34, p value 0.023). In multivariable analyses, hearing difficulty was associated with increased incidence of emergency department use in males (IRR 1.36, 95% CI 1.13–1.62, p value 0.001) and medical office visits in females (IRR 1.52, 95% CI 1.12–2.05, p value 0.007).

Conclusions:

The study results suggest the need to investigate the mechanisms underlying the measured associations so that efforts may be directed toward reducing the risk of injury for individuals with hearing difficulties.
Tenets of flexor and extensor tendon repair
Authors: Schreck Mark , Hammert Warren C.
Published: January 2018

Injuries to the flexor and extensor tendons frequently are seen by hand and orthopaedic surgeons. The anatomical differences between flexor and extensor tendons are paramount when considering the diagnosis and treatment options. Treatment is largely dictated based on the zone of injury. Fundamental concepts have been established over the years regarding repair technique. These include size of core suture placement, suture configuration, location of suture placement, and addition of an epitendinous suture. Type of anesthesia is another factor to consider, as wide-awake surgery has recently become popular because the surgeon can assess tendon gliding and gap formation with active motion during surgery. Recent research has focused on the role of biologics. Growth factors and transcription factors including vascular endothelial growth factor (VEG-F), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB), transforming growth factor beta (TGF-B), matrix metallopeptidase 9 (MMP-9), and bone morphogenetic protein (BMP-12) have all been implicated in contributing to the tendon healing environment. Biologics represents a novel treatment modality aimed at altering the tendon healing environment to reduce adhesion formation to facilitate tendon gliding, while also allowing for a strong repair.
Prediction of Distal Radius Fracture Redisplacement: A Validation Study
Authors: Walenkamp Monique M. J. , Mulders Marjolein A. M. , van Hilst Jony , Goslings J. Carel , Schep Niels W. L.
Published: January 2018

Objective:

To externally validate the Edinburgh Wrist Calculator (EWC) in a population of patients with distal radius fractures at risk of loss of threshold alignment.

Design:

A retrospective cohort study.

Setting:

One academic hospital.

Patients/Participants:

All consecutive adult patients with a displaced distal radius fracture with initial dorsal angulation >10 degree and/or an ulnar variance of >3 mm who were treated with closed reduction and cast immobilization between 2009 and 2014.

Main Outcome Measurement:

The sensitivity and specificity for diagnosis of loss of threshold alignment within 2 weeks of injury was calculated at the 10%, 40%, and the original 70% probability thresholds. The area under receiver operating characteristic curve was calculated using 2 different thresholds for loss of alignment: Mackenney et al and the Dutch consensus standards.

Results:

The EWC predicted a greater than 70% chance of redisplacement for only 3 fractures. Redisplacement within 2 weeks occurred in 61 of 99 (62%) fractures according to the thresholds of Mackenney et al and in 18 of 99 (18%) fractures according to the Dutch thresholds. The sensitivity increased and the specificity decreased using a lower probability threshold for redisplacement. The area under the receiver operating characteristic curve of the EWC was poor the Mackenney's thresholds [0.47; 95% confidence interval (CI): 0.36–0.59] and adequate for the Dutch thresholds (0.71; 95% CI: 0.58–0.84).

Conclusions:

The EWC was a poor predictor of fracture redisplacement greater than threshold in displaced distal radius fractures in our patient population.
Objective Methodology to Assess Meaningful Research Productivity by Orthopaedic Residency Departments: Validation Against Widely Distributed Ranking Metrics and Published Surrogates
Authors: Jones Louis B. , Goel Sameer , Hung Leroy Y. , Graves Matthew L. , Spitler Clay A. , Russell George V. , Bergin Patrick F.
Published: January 2018

The mission of any academic orthopaedic training program can be divided into 3 general areas of focus: clinical care, academic performance, and research. Clinical care is evaluated on clinical volume, patient outcomes, patient satisfaction, and becoming increasingly focused on data-driven quality metrics. Academic performance of a department can be used to motivate individual surgeons, but objective measures are used to define a residency program. Annual in-service examinations serve as a marker of resident knowledge base, and board pass rates are clearly scrutinized. Research productivity, however, has proven harder to objectively quantify. In an effort to improve transparency and better account for conflicts of interest, bias, and self-citation, multiple bibliometric measures have been developed. Rather than using individuals' research productivity as a surrogate for departmental research, we sought to establish an objective methodology to better assess a residency program's ability to conduct meaningful research. In this study, we describe a process to assess the number and quality of publications produced by an orthopaedic residency department. This would allow chairmen and program directors to benchmark their current production and make measurable goals for future research investment. The main goal of the benchmarking system is to create an “h-index” for residency programs. To do this, we needed to create a list of relevant articles in the orthopaedic literature. We used the Journal Citation Reports. This publication lists all orthopaedic journals that are given an impact factor rating every year. When we accessed the Journal Citation Reports database, there were 72 journals included in the orthopaedic literature section. To ensure only relevant, impactful journals were included, we selected journals with an impact factor greater than 0.95 and an Eigenfactor Score greater than 0.00095. After excluding journals not meeting these criteria, we were left with 45 journals. We performed a Scopus search over a 10-year period of these journals and created a database of articles and their affiliated institutions. We performed several iterations of this to maximize the capture of articles attributed to institutions with multiple names. Based off of this extensive database, we were able to analyze all allopathic US residency programs based on their quality research productivity. We believe this as a novel methodology to create a system by which residency program chairmen and directors can assess progress over time and accurate comparison with other programs.
Toe Walking: A Neurological Perspective After Referral From Pediatric Orthopaedic Surgeons
Authors: Haynes Katherine B. , Wimberly Robert L. , VanPelt Jonathan M. , Jo Chan-Hee , Riccio Anthony I. , Delgado Mauricio R.
Published: January 2018

Background:

Toe walking (TW) in children is often idiopathic in origin. Our purpose was to determine the incidence of a neurological etiology for TW in patients seen in the neurology clinic after referral from pediatric orthopaedic surgeons.

Methods:

We performed an Institutional Review Board approved retrospective review of 174 patients referred to the neurology clinic from orthopaedic surgeons at an academic pediatric tertiary care center between January 2010 and September 2015. Medical records were reviewed and data recorded including pertinent family history, birth history, age of initial ambulation, physical examination findings, and workup results including neuroimaging, neurophysiological studies, and findings of genetic testing and tissue biopsy.

Results:

Sixty-two percent (108/174) of patients were found to have a neurological etiology for TW. Final pathologic diagnoses were: 37% (40/108) previously undiagnosed cerebral palsy (CP), 16.7% (18/108) peripheral neuropathy, 15.7% (17/108) autism spectrum disorder, 13.9% (15/108) hereditary spastic paraparesis, 8.3% (9/108) attention deficit hyperactivity disorder, 5.6% (6/108) syndromic diagnosis, and 2.8% (3/108) spinal cord abnormality. Ankle equinus contractures were noted in idiopathic and neurological patients and did not indicate a pathologic origin. Seventy-one percent of unilateral toe walkers and 32% of bilateral but asymmetric toe walkers were diagnosed with CP (P<0.001). Twenty-six percent of 145 brain magnetic resonance imaging studies diagnosed CP. Of the 125 (72%) with spinal imaging, 3 had spinal pathology to account for TW. Fourteen percent of 87 subjects with an electromyography/nerve conduction study had abnormal results indicating a peripheral polyneuropathy.

Conclusions:

An underlying pathologic diagnosis was found in 62% of patients referred to neurology for TW. A concerning birth history, delayed initial ambulation, unilateral TW, upper or lower motor neuron signs on examination, or behavioral features may suggest a pathologic diagnosis. Ankle contracture is not predictive of an abnormal diagnosis and can be found in idiopathic patients. CP, peripheral neuropathy, autism spectrum disorder, and hereditary spastic paraparesis are the most common pathologic diagnoses identified in our population.

Level of Evidence:

Level III—retrospective cohort.
The Prevalence and Treatment of Hip Dysplasia in Prader-Willi Syndrome (PWS)
Authors: Trizno Anastasiya A. , Jones Alexander S. , Carry Patrick M. , Georgopoulos Gaia
Published: January 2018

Background:

Prader-Willi syndrome (PWS) is a genetic disorder with multisystem involvement. There are a number of associated orthopaedic manifestations, the most recognized of which is scoliosis. The aim of this study was to assess the prevalence of hip dysplasia and to investigate its treatment in patients with PWS.

Methods:

Following IRB approval, all patients seen at our institution’s Prader-Willi multidisciplinary clinic were retrospectively reviewed. Only patients with an ultrasound, anteroposterior (AP) spine, AP abdomen, AP hip radiograph, and/or skeletal survey were included in the study. The presence of hip dysplasia was determined based on ultrasonographic and/or radiographic measurements performed by a single fellowship trained pediatric orthopaedic surgeon. A multivariable logistic regression analysis was used to test the association between patient demographics and the prevalence of hip dysplasia. Age at diagnosis, treatment type, and outcomes were recorded for patients that underwent treatment for hip dysplasia.

Results:

Hip dysplasia was identified in 30% (27/90) of the patient population. Two of the 27 patients (7.4%) had normal films but had a history of resolved hip dysplasia. Prevalence was not associated with sex (P=0.7072), genetic subtype (P=0.5504), race (P=0.8537), ethnicity (P=0.2191), or duration of follow-up (P=0.4421). Eight of the 27 patients (30%) underwent hip treatment by Pavlik harness (2/8), Pavlik harness and closed reduction (1/8), closed reduction (3/8), open reduction (1/8), and unspecified hip surgery (1/8). The mean age at diagnosis was 2 months for the patients that were successfully treated for hip dysplasia (3/8) and 12 months for those who had residual dysplasia following the treatment (5/8).

Conclusions:

Our study demonstrates a higher prevalence of hip dysplasia in patients with PWS than previously documented. The age at which hip dysplasia develops remains unknown; therefore, we recommend an ultrasound screening for all infants with PWS at 6 weeks of age and subsequent radiographic studies at 1, 2, 5, 10, and 15 years of age to allow for early diagnosis and intervention.

Level of Evidence:

Level III—retrospective comparative study.
Cannulated System for Sequential Intramedullary Cement Extraction From Humerus During Revision Shoulder Arthroplasty
Authors: Berglund Derek D. , Kurowicki Jennifer , Rosas Samuel , Triplet Jacob J. , Horn Brandon , Formaini Nathan T. , Levy Jonathan C.
Published: January 2018

Removal of the cement mantle during revision shoulder arthroplasty is often challenging. Previous techniques utilizing a humeral window or split osteotomy have been described. These techniques can be technically challenging, put the patient at risk for nonunion or fracture, and require implants or sutures for fixation. Intramedullary techniques have been described including the use of specialized osteotomes or cement splitters as well as the use of ultrasonic cement extraction devices. However, concerns related to fracture and thermal damage to neurovascular structures remain a concern. Here we describe an intramedullary technique for cement removal utilizing a cannulated system for sequential removal of the cement mantle and cement plug from within the humeral canal after the cemented implant has been removed. This technique allows for a mechanical method of efficient cement extraction that utilizes common instruments and does not require an osteotomy or window, and has a limited risk of fracture and neurovascular damage.
Nonmelanoma Skin Cancer Risk in Patients With Inflammatory Bowel Disease Undergoing Thiopurine Therapy: A Systematic Review of the Literature
Authors: Hagen Joshua W. , Pugliano-Mauro Melissa A.
Published: January 2018

BACKGROUND

Azathioprine and 6-mercaptopurine (thiopurines) are common adjunct treatments for inflammatory bowel disease (IBD). Although thiopurine therapy in organ transplant recipients is known to increase nonmelanoma skin cancers (NMSCs), dermatologic literature yields less data regarding NMSC risk of thiopurine use in IBD.

OBJECTIVE

The aim of this study was to systematically review current literature on NMSC risk in patients with IBD using thiopurine therapy.

METHODS

Systematic review of PubMed was performed with keywords “inflammatory bowel disease,” “ulcerative colitis,” “Crohn's disease,” “thiopurine,” “azathioprine,” “6-mercaptopurine,” “skin cancer,” “non-melanoma,” “squamous cell carcinoma,” and “basal cell carcinoma.” All available publication years were included. Publications were evaluated using PRISMA guidelines.

RESULTS

The systematic review yielded 67 articles; 18 met final inclusion criteria.

LIMITATIONS

Heterogeneity of study designs limited direct comparisons of thiopurine exposure and NMSC risk.

CONCLUSION

Patients with IBD using thiopurines seem to have a moderately increased risk of NMSC that is proportional to therapy duration. Risk of NMSC seems to decrease or return to baseline after discontinuing therapy, although additional data are needed to support this trend. Younger patients with IBD using thiopurines seem to be at greater risk of NMSC. Appreciating NMSC risk in patients with IBD undergoing thiopurine therapy should help direct skin cancer screening recommendations and sun protective measures.
The Role of the Anesthesiologist in Preventing Severe Maternal Morbidity and Mortality
Authors: McQUAID EMILY , LEFFERT LISA R. , BATEMAN BRIAN T.
Published: January 2018

Anesthesiologists are responsible for the safe and effective provision of analgesia for labor and anesthesia for cesarean delivery and other obstetric procedures. In addition, obstetric anesthesiologists often have a unique role as the intensivists of the obstetric suite. The anesthesiologist is frequently the clinician with the greatest experience in the acute bedside management of a hemodynamically unstable patient and expertise in life-saving interventions. This review will discuss (1) risks associated with neuraxial and general anesthesia for labor and delivery, and (2) clinical scenarios in which the obstetric anesthesiologist is commonly called upon to function as a “peridelivery intensivist.”
Relapse Among Infants Hospitalized for Bronchiolitis in Finland
Authors: Toivonen Laura , Hasegawa Kohei , Espinola Janice A. , Camargo Carlos A. , Jartti Tuomas
Published: January 2018

In a prospective cohort of children hospitalized for bronchiolitis, we examined the rate of and characteristics associated with bronchiolitis relapse. Bronchiolitis relapse was documented in 22 (6%) of 391 children, and median time to relapse was 2 (interquartile range, 1–7) days. Relapse occurred more often in males. Prenatal smoking and smoke exposure in the home were also associated with relapse.
Mild Complications or Unusual Persistence of Porcine Collagen and Hyaluronic Acid Gel Following Periocular Filler Injections
Authors: Wolkow Natalie , Jakobiec Frederick A. , Dryja Thaddeus P. , Lefebvre Daniel R.
Published: January 2018

The purpose of this study was to describe the histopathologic appearance of dermal eyelid fillers that were unexpectedly encountered in ophthalmic plastic surgery samples from patients with mild eyelid disfigurements, and to review eyelid cases with complications that had previously been described in the literature. A retrospective histopathologic study with Alcian blue, elastic, and Masson trichrome stains of 2 cases that were submitted to the Ocular Pathology Department was conducted, and a critical review of previously published cases of the histopathologic characteristics of dermal filler material in the periocular region was also conducted. Two periocular tissue samples were found to contain dermal filler material. In one case, porcine collagen appeared as amorphous or indistinctly microfibrillar aggregates that stained light blue with the Masson trichrome method. In the other case, hyaluronic acid gel appeared as vivid blue amorphous pools of material in extracellular locules after staining with the Alcian blue method. An inflammatory response was not observed in either case. Patients who undergo facial filler procedures may, at a later time, require a surgical excisional procedure from which a specimen is generated. Previously injected dermal filler that the patient neglected to mention may be present in the pathologic sample, potentially perplexing the unsuspecting pathologist. Both ophthalmic plastic surgeons and ocular pathologists should be aware of the histopathologic features of dermal fillers. It is helpful if a surgeon who submits a specimen to the pathology service makes note of any known prior use of facial filler material or is alert to its possible presence when unfamiliar foreign material is discovered in the dermis of the eyelids.
The Effect of Chronic Musculoskeletal Pain on Sexual Function and Quality of Life of Cardiac Rehabilitation Patients
Authors: Wittkopf Pricilla Geraldine , Cardoso Allana Alexandre , de Carvalho Tales , Cardoso Fernando Luiz
Published: January 2018

Background:

Comorbidities are stressors to the body and have a negative impact on quality of life and sexual function.

Objective:

The objective of this study was to investigate the effect of the coexistence of coronary heart disease and chronic musculoskeletal pain on sexual function and quality of life of patients undergoing an exercise-based cardiac rehabilitation program.

Methods:

This cross-sectional observational study included 105 patients. Instruments used were the musculoskeletal system assessment inventory, Short-Form Health Survey quality-of-life questionnaire, International Index of Erectile Function, and Female Sexual Function Index.

Results:

There were no differences in male sexual function compared between participants with and without pain. Participants with pain had lower quality-of-life scores related to socioemotional aspects.

Conclusions:

The coexistence of coronary heart disease and musculoskeletal pain does not seem to affect patients' sexual function, but it negatively affects Patients' quality of life. This study emphasizes the importance of a multidisciplinary team working in a cardiac rehabilitation program addressing issues related to pain, sexual function, and quality of life.
Transition to Critical Care Practice Within an Academic–Service Partnership: A Case Report of the First 3 Years of Clinical Immersion in Trauma–Burn and Neuroscience Critical Care
Authors: Bay Esther , Sherzer Andrea , Darnbrook Emily
Published: January 2018

In response to regulators of nursing education and the Institute of Medicine, an academic–service partnership was formed between a research-intensive school of nursing and a tertiary health care facility. In that partnership, clinical experiences occurred mostly within 1 organization. This case report showcases the development, implementation, and revisions within our capstone immersion course, designed to ease the new graduates' transition into practice, including transitions to critical care nursing. Herein, we highlight our successes and challenges of implementing the clinical component within 2 critical care units focused on trauma and neurosurgical care of complex patients. Its purpose is to describe the planning and orientation phase, illustrate the mentoring processes used to achieve the educational outcomes, and describe the benefits and challenges of such an immersion experience. Our redesigned clinical immersion course in high-acuity nursing is facilitated by our partnership and resulted in improved RN-NCLEX rates, facilitation of best practices, and ease of transition into novice graduate nurse roles.
Burnout, Perceived Stress, and Job Satisfaction Among Trauma Nurses at a Level I Safety-Net Trauma Center
Authors: Munnangi Swapna , Dupiton Lynore , Boutin Anthony , Angus L. D. George
Published: January 2018

Nurses are at the forefront of our health care delivery system and have been reported to exhibit a high level of burnout. Burnout and stress in trauma nurses at a safety-net hospital can negatively impact patient care. Safety-net hospitals are confronted with unique social, financial, as well as resource problems that can potentially make the work environment frustrating. The purpose of this study was to explore the levels of burnout, stress, and job satisfaction in nurses providing care to trauma patients at a Level I safety-net trauma center. A cross-sectional survey design was used to investigate principal factors including personal and professional demographics, burnout, perceived stress, and job satisfaction. Trauma nurses working at a Level I safety-net trauma center are stressed and exhibited moderate degree of burnout. The extent of emotional exhaustion experienced by the nurses varied with work location and was highest in surgical intensive care unit nurses. The level of job satisfaction in terms of opportunities for promotion differed significantly by race and the health status of the nurses. Satisfaction with coworkers was lowest in those nurses between the ages of 60–69 years. Female nurses were more satisfied with their coworkers than male nurses. In addition, the study revealed that significant relationships exist among perceived stress, burnout, and job satisfaction. Work environment significantly impacts burnout, job satisfaction, and perceived stress experienced by trauma nurses in a safety-net hospital. Nursing administration can make an effort to understand the levels of burnout and strategically improve work environment for trauma nurses in order to minimize stressors leading to attrition and enhance job satisfaction.
Decreasing Radiation Exposure in Pediatric Trauma Related to Cervical Spine Clearance: A Quality Improvement Project
Authors: Waddell Valerie Ann , Connelly Susan
Published: January 2018

Study Design:

Quality improvement project.

Objectives:

Reduce the amount of radiation exposure in the pediatric trauma population 5 years of age and older in relation to cervical spine clearance.

Background:

The evaluation of pediatric cervical spine injuries must be accurate and timely to avoid missed injuries. The difficult clinical examination in pediatric trauma patients necessitates the use of radiologic examinations to avoid missing catastrophic injuries. However, exposure to radiation at an early age increases the pediatric patients' risk of developing cancer (R. A. Kleinerman, 2006).

Methods:

A retrospective chart review was conducted to assess radiation exposure in pediatric patients requiring evaluation for cervical spine clearance. Surgical staff and emergency department physicians received education on the risks related to pediatric radiation exposure and information related to the institution's diagnostic trends for cervical spine clearance. An algorithm was then developed to assist with determining the necessary imaging study for cervical spine clearance. Radiation exposure was monitored following initial education and use of the algorithm to determine its effect on radiation exposure.

Results:

The retrospective chart review identified cervical spine computed tomography (CT) in 34%, with an average radiation exposure of 3.5 mSv. Following education and introduction of an algorithm, 18% of patients underwent CT for cervical spine clearance with an average radiation exposure of 3.2 mSv, representing a 47% decrease in the use of CT.

Conclusion:

Staff education and the use of an algorithm show promise in the reduction of radiation exposure and provide safe, effective clearance of the cervical spine in pediatric trauma.