bluuebunny/crossref_metadata_2025 huggingface dataset:
Nonlinear Wave Simulation on the Xeon Phi Knights Landing Processor
Authors: Hristov Ivan , Goranov Goran , Hristova Radoslava
Published: February 2018

We consider an interesting from computational point of view standing wave simulation by solving coupled 2D perturbed Sine-Gordon equations. We make an OpenMP realization which explores both thread and SIMD levels of parallelism. We test the OpenMP program on two different energy equivalent Intel architectures: 2× Xeon E5-2695 v2 processors, (code-named “Ivy Bridge-EP”) in the Hybrilit cluster, and Xeon Phi 7250 processor (code-named “Knights Landing” (KNL). The results show 2 times better performance on KNL processor.
Short-Range Interaction Impact on Two-Dimensional Dipolar Scattering
Authors: Koval Eugene A. , Koval Oksana A.
Published: February 2018

We report numerical investigation of the short range interaction influence on the two-dimensional quantum scattering of two dipoles. The model simulates two ultracold polar molecules collisions in two spatial dimensions. The used algorithm allows us to quantitatively analyse the scattering of two polarized dipoles with account for strongly anisotropic nature of dipolar interaction. The strong dependence of the scattering total cross section on the short range interaction radius was discovered for threshold collision energies. We also discuss differences of calculated scattering cross section dependencies for different polarisation axis tilt angles.
Optimizing the User Experience: Identifying Opportunities to Improve Use of an Inpatient Portal
Authors: Walker Daniel , Menser Terri , Yen Po-Yin , McAlearney Ann
Published: February 2018

Background Patient portals specifically designed for the inpatient setting have significant potential to improve patient care. However, little is known about how the users of this technology, the patients, may interact with the inpatient portals. As a result, hospitals have limited ability to design approaches that support patient use of the portal.

Objectives This study aims to evaluate the user experience associated with an inpatient portal.

Methods We used a Think-Aloud protocol to study user interactions with a commercially available inpatient portal—MyChart Bedside (MCB). Study participants included 19 English-speaking adults over the age of 18 years. In one-on-one sessions, participants narrated their experience using the MCB application and completing eight specific tasks. Recordings were transcribed and coded into three dimensions of the user experience: physical, cognitive, and sociobehavioral.

Results Our analysis of the physical experience highlighted the navigational errors and technical challenges associated with the use of MCB. We also found that issues associated with the cognitive experience included comprehension problems that spurred anxiety and uncertainty. Analysis of the sociobehavioral experience suggested that users have different learning styles and preferences for learning including self-guided, handouts, and in-person training.

Conclusion Inpatient portals may be an effective tool to improve the patient experience in the hospital. Moreover, making this technology available to inpatients may help to foster ongoing use of technology across the care continuum. However, deriving the benefits from the technology requires appropriate support. We identified multiple opportunities for hospital management to intervene. In particular, teaching patients to use the application by making a variety of instructional materials available could help to reduce several identified barriers to use. Additionally, hospitals should be prepared to manage patient anxiety and increased questioning arising from the availability of information in the inpatient portal application.
BCR-ABL Tyrosine Kinase Inhibitors: Which Mechanism(s) May Explain the Risk of Thrombosis?
Authors: Haguet Hélène , Douxfils Jonathan , Chatelain Christian , Graux Carlos , Mullier François , Dogné Jean-Michel
Published: February 2018

Imatinib, the first-in-class BCR-ABL tyrosine kinase inhibitor (TKI), had been a revolution for the treatment of chronic myeloid leukemia (CML) and had greatly enhanced patient survival. Second- (dasatinib, nilotinib, and bosutinib) and third-generation (ponatinib) TKIs have been developed to be effective against BCR-ABL mutations making imatinib less effective. However, these treatments have been associated with arterial occlusive events. This review gathers clinical data and experiments about the pathophysiology of these arterial occlusive events with BCR-ABL TKIs. Imatinib is associated with very low rates of thrombosis, suggesting a potentially protecting cardiovascular effect of this treatment in patients with BCR-ABL CML. This protective effect might be mediated by decreased platelet secretion and activation, decreased leukocyte recruitment, and anti-inflammatory or antifibrotic effects. Clinical data have guided mechanistic studies toward alteration of platelet functions and atherosclerosis development, which might be secondary to metabolism impairment. Dasatinib, nilotinib, and ponatinib affect endothelial cells and might induce atherogenesis through increased vascular permeability. Nilotinib also impairs platelet functions and induces hyperglycemia and dyslipidemia that might contribute to atherosclerosis development. Description of the pathophysiology of arterial thrombotic events is necessary to implement risk minimization strategies.
Endoscopic Endonasal Resection of Tuberculum Sellae Meningioma with Utilization of Indocyanine Green
Authors: Shahein Mostafa , Montaser Alaa , Todeschini Alexandre , Revuelta Barbero Juan , Otto Bradley , Carrau Ricardo , Prevedello Daniel
Published: February 2018

We present the case of a 67-year-old female with an incidental finding of a left-sided tuberculum sellae meningioma on a brain magnetic resonance imaging (MRI) for an unrelated complaint. Formal visual field testing showed a small defect in the inferior nasal and temporal fields of the left eye, compatible with mass effect on the optic nerve by the tumor.

An endoscopic endonasal transtuberculum approach with decompression of the left optic nerve was performed using a standard binostril four-hand technique, with the patient positioned supine with the head turned to the right side and tilted to the left, fixed in a three-pin head clamp, under imaging guidance. After exposure, we drilled the tuberculum sellae and the floor of the sella and after opening the dura, the tumor and optic nerve came into view. The tumor was completely removed and we confirmed the patency of all perforating vessels using indocyanine green. Reconstruction was done in a multilayered fashion, using collagen matrix and a nasoseptal flap.

Patient had an uneventful postoperative stay and was discharged on postoperative day 3, neurologically stable with no new hormonal deficits. Pathology report confirmed a WHO Grade I meningioma with K
i-67 of 1% and 3-month postoperative MRI confirmed a gross total resection and visual fields exam showed a complete recovery.

The link to the video can be found at: https://youtu.be/zRmt2aIvX5c.
Endoscopic Endonasal Resection of a Suprasellar Pituitary Adenoma Mimicking Tuberculum Sellae Meningioma in a Patient with an Intrasellar Persistent Trigeminal Artery
Authors: Montaser Alaa , Todeschini Alexandre , Revuelta  Barbero Juan , Shahein Mostafa , Chiocca E. , Otto Bradley , Carrau Ricardo , Prevedello Daniel
Published: February 2018

A 50-year-old female with an incidentally diagnosed suprasellar lesion was initially managed conservatively due to the presence of an intrasellar persistent trigeminal artery going through the dorsum sellae and fundamentally forming the blood supply of the entire posterior circulation. Serial follow-up brain magnetic resonance imaging (MRI) revealed progressive enlargement of the suprasellar lesion over 4 years period. Surgery was indicated after the initial tumor growth; however, the patient refused surgery for fear of complications related to the persistent trigeminal artery. Two-and-a-half years later, she presented with deterioration of vision. Formal visual field testing revealed a right temporal field defect. Brain MRI demonstrated significantly enlarged suprasellar lesion, most consistent with tuberculum sellae meningioma, exerting mass effect on the optic apparatus.

The patient underwent endoscopic endonasal resection of the lesion through a transplanum/transtuberculum approach. Intraoperatively, absence of hypertrophic McConnel arteries, hyperostosis, and the fact that the dura was soft and not under tension was against the diagnosis of tuberculum sellae meningioma. Additionally, the tumor consistency was similar to a pituitary adenoma. A complete resection was accomplished and multilayer skull base reconstruction was performed with no complications. On postoperative day 1 (POD 1), she was operated upon for the evacuation of small suprasellar hematoma associated with vision deterioration. Histopathological examination confirmed the diagnosis of atypical pituitary adenoma with K
i-67 labeling index of 4 to 5%. The patient ultimately recovered well with improved vision, and was discharged on POD 4 with no new neurological deficits. At 4 years follow-up, her vision was normalized and brain MRI showed no residual or recurrent lesion.

The link to the video can be found at: https://youtu.be/QZmzctjAEbw.
Functional Regions of the Medial Patellofemoral Ligament
Authors: Ji Gang , Sun Yifei , Lu Jiangfeng , Niu Yingzhen , Wang Fei
Published: February 2018

The purpose of this study was to explore the anatomy and discuss functional regions of the medial patellofemoral ligament (MPFL). Twelve fresh-frozen knees specimens were dissected. All medial surfaces of knees were intact and did not have indication of injury. General feature of the MPFL were observed. All anatomical landmarks were carefully identified and marked. The length of the two functional regions were conducted and recorded. All data were obtained, described, and analyzed in the form of mean ± standard deviation. The MPFL was found in all specimens we dissected. Closed to the patellar insertion, it adheres to the deep surface of the vastus medialis obliquus (VMO). Due to the VMO, the MPFL is divided into two functional regions: overlap region and nonoverlap region. Anatomically, the overlap region and nonoverlap region of 25.43 ± 2.0 and 44.85 ± 3.04 mm, the width of VMO insertion is 13.94 ± 2.03 mm, and the width of patellar insertion is 22.91 ± 3.46 mm. We divide the MPFL into two anatomical functional regions, demarcated by the meshing points of fibers between the MPFL and VMO: overlap region and nonoverlap region. This finding provides the theoretical foundation for the treatment of the MPFL injury and shed lights on the future researches.
Relationships between maximal strength of lower limb, anthropometric characteristics and fundamental explosive performance in handball players
Authors: Hermassi Souhail , Chelly Mohamed Souhaiel , Wagner Herbert , Fieseler Georg , Schulze Stephan , Delank Karl-Stefan , Shephard Roy J. , Schwesig René
Published: February 2018

Background The purpose of this study was to examine relationships between lower body muscular strength, anthropometric characteristics and several measures of explosive performance in elite team-handball players.

Methods 22 male elite team-handball players (age: 19.1 ± 1.7 years) were studied during the competitive season. Standard anthropometric and body composition measures included body mass index, lower limb and thigh muscle volume, and body fat percentage. Maximal leg strength was determined by a one-repetition maximum (1-RM) half back-squat. Vertical jump performance was assessed using a squat jump (SJ) and a counter movement jump (CMJ). Repeated shuttle-sprint ability (RSA) was tested by 6 (2 × 15 m) shuttle sprints with 20 s of active recovery intervals. The best time in a single shuttle sprint (30m; RSAbest), fastest total time (RSATT) and RSA test performance decrement (RSAdec) were recorded. Agility was measured using a modified T-half test (MAT). Throwing velocities of jump shooting and 3-step throwing were recorded by digital video camera.

Results The explained variance of 1-RM half-back-squats ranged from 0.2 % (RSA% Fatigue Index) to 70.1 % (CMJ). Four out of 8 variables (RSA Best Time, CMJ, SJ, throwing velocity of jump shoot) demonstrated an r2 > 0.5. Jump performances seemed closely related to 1-RM half-back-squats. Furthermore, 1-RM half-back-squats were positively correlated with leg and thigh muscle volumes (r = 0.652, r = 0.768).

Conclusion The anthropometric characteristics and some physical performance tests are closely related to the maximal strength performance of handball players. Coaches should focus on maximal strength training programs for the lower limbs when seeking improvements in the throwing velocity and jump performance of handball players.
Saccharin and tert-Butyl Nitrite: Cheap and Efficient Reagents for the Synthesis of 1,2,3-Benzotriazine-4-(3H)-ones from 2-Aminobenzamides under Metal-Free Conditions
Authors: Khaligh Nader Ghaffari , Johan Mohad Rafie , Ching Juan Joon
Published: February 2018

A mild and eco-friendly protocol for the synthesis of 1,2,3-benzotriazine-4-(3H)-ones is described using saccharin as a cheap and efficient catalyst and tert-butyl nitrite as a diazotization reagent for the first time. The current method has advantages such as cost effectiveness, energy efficiency, and simple experimental procedure, good yield of the desired product, and metal-free and environmentally benign conditions.
Humans quickly learn to blink strategically in response to environmental task demands
Authors: Hoppe David , Helfmann Stefan , Rothkopf Constantin A.
Published: February 2018

Significance

Eye blinks serve the purpose of maintaining healthy vision but during a blink visual information processing is interrupted. While a multitude of medical, cognitive, and psychological factors have been shown to influence blinking, the present study establishes quantitatively how human blinking behavior is dynamically adapted to environmental task demands. In our experiment participants quickly learned to blink strategically. A minimal computational model captures the observed behavior as a trade-off between internal, physiological benefits and external, task-related costs given perceptual uncertainties. Crucially, the model allows predicting an individual subject’s temporal dynamics of blinking and provides an explanation of the long-known distribution of interblink intervals. Taken together, this provides a basis for future research using blinking as a behavioral marker.
Open-source recombinant monoclonal secondary nanobodies
Authors: Ewers Helge
Published: February 2018

Secondary antibodies are everyday reagents in biomedical research that are generated in animals. In this issue, Pleiner et al. (2018. J. Cell Biol. https://doi.org/10.1083/jcb.201709115) describe several single domain antibody fragments against antibodies from mouse and rabbit, so-called nanobodies that are easily produced recombinantly, and characterize their use in Western blotting, enzyme-linked immunosorbent assay, and immunofluorescence assays.
Wandering Montel theorems for Hilbert space valued holomorphic functions
Authors: Agler Jim , McCarthy John
Published: February 2018

We prove that if

{

u
k

}

\{ u^k \}

is a sequence of holomorphic functions that takes values in an infinite dimensional Hilbert space

H

\mathcal {H}

, there are unitaries

{

U
k

}

\{ U^k \}

on

H

\mathcal {H}

so that

U
k

u
k

U^k u^k

has a subsequence that converges locally uniformly. We also prove a non-commutative version of this result.
Short laws for finite groups and residual finiteness growth
Authors: Bradford Henry , Thom Andreas
Published: February 2018

We prove that for every

n
∈

N

n \in \mathbb {N}

and

δ
>
0

\delta >0

there exists a word

w
n

∈

F
2

w_n \in F_2

of length

O
(

n

2

/

3

log
⁡
(
n

)

3
+
δ

)

O(n^{2/3} \log (n)^{3+\delta })

which is a law for every finite group of order at most

n
n

. This improves upon the main result of Andreas Thom [Israel J. Math. 219 (2017), pp. 469–478] by the second named author. As an application we prove a new lower bound on the residual finiteness growth of non-abelian free groups.
Twisted Lefschetz number formula and 𝑝-adic trace formula
Authors: Xiang Zhengyu
Published: February 2018

For a reductive group

G

/

Q

G_{/\mathbb {Q}}

, we interpolate Arthurs

L
2

L^2

-Lefschetz number formula

p
p

-adically and give a geometric expansion of Urbans

p
p

-adic trace formula on overconvergent cuspidal representations. If

G

/

Q

G_{/\mathbb {Q}}

is anisotropic at infinity and

H
H

is a Weil restriction of

G
G

, we give a twisted version of Arthur’s

L
2

L^2

-Lefschetz number formula for

H
H

, and we set up both the spectral side and the geometric side of a twisted

p
p

-adic trace formula for 

H
H

.
Cdc48 and ubiquilins confer selective anterograde protein sorting and entry into the multivesicular body in yeast
Authors: Kama Rachel , Gabriely Galina , Kanneganti Vydehi , Gerst Jeffrey E.
Published: February 2018

Cdc48/p97 is known primarily for the retrotranslocation of misfolded proteins in endoplasmic reticulum (ER)-associated protein degradation (ERAD). Here we uncover a novel function for both Cdc48 and the conserved ubiquitin-associated/ubiquitin-like ubiquitin receptor (ubiquilin) proteins in yeast (e.g., Ddi1, Dsk2, and Rad23), which deliver ubiquitinated proteins to the proteasome for degradation. We show that Cdc48, its core adaptors Npl4 and Ufd1, and the ubiquilins confer the constitutive anterograde delivery of carboxypeptidase S (Cps1), a membranal hydrolase, to the multivesicular body (MVB) and vacuolar lumen. Cdc48 and Ddi1 act downstream of Rsp5-dependent Cps1 ubiquitination to facilitate the disassembly of insoluble Cps1 oligomers and upstream of ESCRT-0 to facilitate the entry of soluble protein into the MVB. Consequentially, detergent-insoluble Cps1 accumulates in cells bearing mutations in CDC48, DDI1, and all three ubiquilins (ddi1Δ, dsk2Δ, rad23Δ). Thus, Cdc48 and the ubiquilins have ERAD- and proteasome-independent functions in the anterograde delivery of specific proteins to the yeast vacuole for proteolytic activation. As Cdc48/p97 and the ubiquilins are major linkage groups associated with the onset of human neurodegenerative disease (e.g., amytrophic lateral sclerosis, Alzheimer’s, and Paget’s disease of the bone), there may be a connection between their involvement in anterograde protein sorting and disease pathogenesis.
Bioeconomics of the Allee effect in fisheries targeting sedentary resources
Authors: González-Durán Enrique , Hernández-Flores Alvaro , Seijo Juan Carlos , Cuevas-Jiménez Alfonso , Moreno-Enriquez Angélica
Published: February 2018

The improvement of survival in some species due to the close coexistence between individuals is a concept that has caught the attention of scientists over the years. This behaviour has been documented in many taxa, including species which support commercial fisheries. In recent years, a better understanding of the mechanisms associated with the Allee effect has shown its importance in population dynamics and probably plays a more important role than previously thought. In this article, the Allee effect was analysed by means of a spatial bioeconomic model. The Allee effect component was the positive relationship between the mating probability and the density of spawners. A depensation function with an offset to the right side of the origin represented the fraction of females that mated based on density. When the model did not include the Allee effect, the fishery reached the bioeconomic equilibrium; however, when the Allee effect was considered, the fishery did not reach equilibrium, but the stock collapsed in 15 years. Fishing mortality altered the spatial distribution of the stock, causing depensation in recruits per spawner. These results may contribute to a better understanding of the Allee effect on sedentary resources and can be used to explore new models.
Anticipating and Training the Physician of the Future: The Importance of Caring in an Age of Artificial Intelligence
Authors: Johnston S. Claiborne
Published: February 2018

Artificial intelligence and other forms of information technology are only just beginning to change the practice of medicine. The pace of change is expected to accelerate as tools improve and as demands for analyzing a rapidly growing body of knowledge and array of data increase. The medical students of today will practice in a world where information technology is sophisticated and omnipresent. In this world, the tasks of memorization and analysis will be less important to them as practicing physicians. On the other hand, the nonanalytical, humanistic aspects of medicine—most importantly, the art of caring—will remain a critical function of the physician, and facility with improving systems of care will be required. Communication, empathy, shared decision making, leadership, team building, and creativity are all skills that will continue to gain importance for physicians. These skills should be further prioritized in medical school curricula to produce an even more effective physician for the future.
The Time Is Now: Using Graduates’ Practice Data to Drive Medical Education Reform
Authors: Triola Marc M. , Hawkins Richard E. , Skochelak Susan E.
Published: February 2018

Medical educators are not yet taking full advantage of the publicly available clinical practice data published by federal, state, and local governments, which can be attributed to individual physicians and evaluated in the context of where they attended medical school and residency training. Understanding how graduates fare in actual practice, both in terms of the quality of the care they provide and the clinical challenges they face, can aid educators in taking an evidence-based approach to medical education. Although in their infancy, efforts to link clinical outcomes data to educational process data hold the potential to accelerate medical education research and innovation. This approach will enable unprecedented insight into the long-term impact of each stage of medical education on graduates’ future practice. More work is needed to determine best practices, but the barrier to using these public data is low, and the potential for early results is immediate. Using practice data to evaluate medical education programs can transform how the future physician workforce is trained and better align continuously learning medical education and health care systems.
Time for an Acute Focus on Chronic Care in Undergraduate Medical Education
Authors: Shi Connie R. , Nambudiri Vinod E.
Published: February 2018

As the burdens of chronic disease rise in the United States, both undergraduate and graduate medical education must adapt to adequately equip future physicians with the skills to manage the increasingly complex health needs affecting the population. However, traditional models of undergraduate medical education (UME) have made focusing on chronic care education challenging. In this Invited Commentary, the authors advocate for strengthening UME based on five approaches to engage trainees in learning about chronic care across both the preclinical and clinical phases of their education: (1) introducing chronic care in the preclinical years; (2) prioritizing chronic care education across all specialties; (3) maximizing the fourth year of medical school through a chronic care focus; (4) creating chronic-disease-focused advanced clerkships; and (5) leveraging technology for education. These five approaches call for restructuring of both preclinical and clinical education to more comprehensively emphasize the skills and knowledge needed for trainees to manage chronic diseases. Such efforts will ensure that graduating medical students are well versed in the competencies needed to effectively care for patients with chronic conditions in advance of their transition to graduate medical education and clinical practice.
Association of Polypharmacy with Survival, Complications, and Healthcare Resource Use after Elective Noncardiac Surgery
Authors: McIsaac Daniel I. , Wong Coralie A. , Bryson Gregory L. , van Walraven Carl
Published: February 2018

Background

Polypharmacy is increasingly prevalent in older patients and is associated with adverse events among medical patients. The impact of polypharmacy on outcomes after elective surgery is poorly described. The authors’ objective was to measure the association of polypharmacy with survival, complications, and resource use among older patients undergoing elective surgery.

Methods

After registration (NCT03133182), the authors identified all individuals older than 65 yr old having their first elective noncardiac surgery in Ontario, Canada, between 2002 and 2014. Using linked administrative data, the authors identified all prescriptions dispensed in the 90 days before surgery and classified people receiving five or more unique medications with polypharmacy. The associations of polypharmacy with 90-day survival (primary outcome), complications, length of stay, costs, discharge location, and readmissions were estimated after multilevel, multivariable adjustment for demographics, comorbidities, previous healthcare use, and surgical factors. Prespecified and post hoc sensitivity analyses were also performed.

Results

Of 266,499 patients identified, 146,026 (54.8%) had polypharmacy. Death within 90 days occurred in 4,356 (3.0%) patients with polypharmacy and 1,919 (1.6%) without (adjusted hazard ratio = 1.21; 95% CI, 1.14 to 1.27). Sensitivity analyses demonstrated no increase in effect when only high-risk medications were considered and attenuation of the effect when only prescriptions filled in the 30 preoperative days were considered (hazard ratio = 1.07). Associations were attenuated or not significant in patients with frailty and higher comorbidity scores.

Conclusions

Older patients with polypharmacy represent a high-risk stratum of the perioperative population. However, the authors’ findings call into question the causality and generalizability of the polypharmacy-adverse outcome association that is well documented in nonsurgical patients.
POSTERIOR PRECORTICAL VITREOUS POCKETS IN HIGH MYOPIA OBSERVED BY ENHANCED VITREOUS IMAGING OF SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY
Authors: Wang Xiaohan , Shen Mengxi , Wang Ruoshi , Zhou Yanping , Li Tong , Xiao Meichun , Song Minlu , Sun Xiaodong , Wang Fenghua
Published: February 2018

Purpose:

To observe the vitreous in highly myopic eyes with posterior precortical vitreous pockets (PPVPs) using enhanced vitreous imaging of spectral domain optical coherence tomography.

Methods:

Fifty-two highly myopic eyes with PPVPs of 36 patients were included in this study. All subjects underwent enhanced vitreous imaging optical coherence tomography. The size of PPVPs was measured, and the frequency of imaging features was recorded.

Results:

Nine imaging features of the vitreous in highly myopic eyes with PPVPs were found. The average age of subjects was 38.1 ± 10.8 years. The mean height of PPVPs was 1,177 ± 704 μm, and the mean width was 7,440 ± 755 μm. Hyperreflective line and the interlayer were observed in 30 (57.7%) eyes. Hyperreflective dots were found in 37 (71.2%) eyes. More central vitreous space was more frequently detected in younger patients. Prevascular vitreous fissure was detected in 7 (13.5%) eyes. W-shaped cavity, identified as an empty space with a smooth W-shaped edge, was demonstrated to be the fusion of Cloquet's canal and the extension of PPVPs. Perpendicular hyperreflective parallel strands were detected in 3 (5.8%) eyes. Hyperreflective network was observed in 10 (19.2%) eyes. Hyperreflective parapapillary tubercle was found in 7 (13.5%) eyes.

Conclusion:

Nine imaging features of the vitreous in highly myopic eyes with PPVPs were visualized by enhanced vitreous imaging optical coherence tomography.
MULTIMODAL IMAGING OF ANGIOID STREAKS ASSOCIATED WITH TURNER SYNDROME
Authors: Chiu Bing Q. , Tsui Edmund , Hussnain Syed Amal , Barbazetto Irene A. , Smith R. Theodore
Published: February 2018

Purpose:

To report multimodal imaging in a novel case of angioid streaks in a patient with Turner syndrome with 10-year follow-up.

Methods:

Case report of a patient with Turner syndrome and angioid streaks followed at Bellevue Hospital Eye Clinic from 2007 to 2017. Fundus photography, fluorescein angiography, and optical coherence tomography angiography were obtained.

Results:

Angioid streaks with choroidal neovascularization were noted in this patient with Turner syndrome without other systemic conditions previously correlated with angioid streaks.

Conclusion:

We report a case of angioid streaks with choroidal neovascularization in a patient with Turner syndrome. We demonstrate that angioid streaks, previously associated with pseudoxanthoma elasticum, Ehlers–Danlos syndrome, Paget disease of bone, and hemoglobinopathies, may also be associated with Turner syndrome, and may continue to develop choroidal neovascularization, suggesting the need for careful ophthalmic examination in these patients.
Association Between Visual Acuity and the Corneal Area Occupied by Granular Lesions, Linear Lesions, or Diffuse Haze in Patients With Granular Corneal Dystrophy Type 2
Authors: Kim Hong Seok , Rim Tyler Hyungtaek , Kim Tae-im , Kim Eung Kweon
Published: February 2018

Purpose:

In granular corneal dystrophy type 2 (GCD2), corneal deposits containing fragments of transforming growth factor-β–induced protein appear in sequence as granular lesions (GLs), linear lesions (LLs), and diffuse haze (DH). We aimed to investigate the association between visual acuity and age-related changes in lesion types in patients with GCD2.

Methods:

We retrospectively evaluated the medical records and slit-lamp photographs of 533 patients (1066 eyes) with genetically confirmed GCD2 (heterozygous). Deposits were classified into GLs, LLs, and DH, after which the area occupied by each lesion type was measured. The associations between visual acuity and each lesion area were also evaluated using univariable and multivariable models.

Results:

The area occupied by GLs increased beginning in the teen years, whereas the area occupied by DH began to increase after age 40. However, the area occupied by LLs increased until patients had reached their 40s, after which no further increases occurred. Multivariable analyses revealed no association between GLs and low visual acuity after adjusting for age and sex. Increases in the LL area were associated with lower odds for low visual acuity (adjusted odds ratio = 0.4 for the third tertile, 95% confidence interval, 0.2–0.97), whereas increases in the DH area were positively associated with low visual acuity (adjusted odds ratio = 3.3 for the third tertile of the DH area, 95% confidence interval, 1.3–8.3).

Conclusions:

Our findings indicated that LLs associated with GCD2 do not produce significant decreases in visual acuity, whereas DH exerts the most significant negative impact on visual acuity. Late-onset DH may be associated with the termination of LL formation.
Human Immunodeficiency Virus Partner Notification Services Among a Representative Sample of Young Black Men Who Have Sex With Men Demonstrates Limited Service Offering and Potential Benefits of Clinic Involvement
Authors: Gore Daniel , Ferreira Matthew , Khanna Aditya S. , Schneider John
Published: February 2018

Background

Partner notification (PN) is commonly offered to persons recently diagnosed with human immunodeficiency virus (HIV) to improve linkage to care and prevent onward transmission. Yet, much remains unknown about the factors associated with successful PN participation in populations at highest risk.

Methods

Data were collected during the first 2 waves (2013–2015) of “uConnect,” a population-based cohort study of young black men who have sex with men in Chicago (N = 618). Participants completed a biobehavioral survey and were tested for HIV. Among HIV-infected participants (N = 187), weighted logistic regression models examined the relationship between participant characteristics and being offered PN and providing partner names.

Results

30.3% (n = 187) of the sample was HIV-positive, of which 71.7% (n = 134) were offered PN, including: 8.2% (n = 11) by the city health department; 51.5% (n = 69) by health care providers; and 40.3% (n = 54) by both. Being offered PN was significantly associated with criminal justice involvement history (adjusted odds ratio [aOR], 2.49; 95% confidence interval [CI], 1.38–4.49), volatile nitrates usage (aOR, 2.88; 95% CI, 1.20–6.94), and recent conversations with HIV outreach workers (aOR, 2.68; 95% CI, 1.25–5.77). Providing partner names was significantly associated with intermittent (aOR, 7.26; 95% CI, 1.75–30.07) and heavy (aOR, 11.47; 95% CI, 2.57–51.22) marijuana use, and being offered PN by both the city health department and health care provider (aOR, 8.36; 95% CI, 2.73–25.62).

Conclusions

A substantial proportion of HIV-diagnosed individuals were never offered PN. Being offered PN by multiple sources is associated with participation, and improved collaboration within health systems may improve participation rates.
Spontaneous Clearance of Pharyngeal Gonococcal Infections: A Retrospective Study in Patients of the Sexually Transmitted Infections Clinic; Amsterdam, the Netherlands; 2012 to 2015
Authors: Hananta I Putu Yuda , de Vries Henry John Christiaan , van Dam Alje Pieter , van Rooijen Martijn Sebastiaan , Soebono Hardyanto , Schim van der Loeff Maarten Franciscus
Published: February 2018

Introduction

Pharyngeal Neisseria gonorrhoeae infections are mostly asymptomatic, yet sustain ongoing gonococcal transmission. We assessed the proportion of pharyngeal gonorrhea that spontaneously clears and identified determinants of clearance.

Methods

At the sexually transmitted infections clinic Amsterdam, at-risk women and men who have sex with men were routinely screened for pharyngeal N. gonorrhoeae using an RNA-based nucleic acid amplification test (NAAT; Aptima Combo 2).

We retrospectively examined medical records of pharyngeal gonorrhea patients (January 2012–August 2015). We included patients who returned for antibiotic treatment and had a new sample taken for NAAT before treatment. Spontaneous clearance was defined as a negative NAAT result at the follow-up visit.

Results

During the study period, 1266 cases with a pharyngeal gonorrhea were not treated at the first consultation and returned for a follow-up visit. Median (interquartile range) time between the first consultation and follow-up was 10 (7–14) days. Spontaneous clearance was found in 139 cases (11.0%) and was associated with age at least 45 years (vs. 16–24 years; adjusted odds ratio, 2.02 [95% confidence interval, 1.09–3.75]) and with time from the first consultation to follow-up (adjusted odds ratio, 1.08 [1.06–1.10], per extra day).

Conclusions

Eleven percent of pharyngeal gonorrhea cases cleared spontaneously. Spontaneous clearance of pharyngeal gonorrhea was more often seen among older patients.
Trauma-induced insurance instability: Variation in insurance coverage for patients who experience readmission after injury
Authors: Rajasingh Charlotte Mary , Weiser Thomas G. , Knowlton Lisa M. , Tennakoon Lakshika , Spain David A. , Staudenmayer Kristan L.
Published: February 2018

BACKGROUND

Traumatic injuries result in a significant disruption to patients' lives, including their ability to work, which may place patients at risk of losing insurance coverage. Our objective was to evaluate the impact of injury on insurance status. We hypothesized that trauma patients with ongoing health needs experience changes in coverage.

METHODS

We used the Nationwide Readmission Database (2013–2014), a nationally representative sample of readmissions in the United States. We included patients aged 27 years to 64 years admitted with any diagnosis of trauma with at least one readmission within 6 months. Patients on Medicare and with missing payer information were excluded. The primary outcome was payer status.

RESULTS

57,281 patients met inclusion criteria, 11,006 (19%) changed insurance payer at readmission. Of these, 21% (n = 2,288) became uninsured, 25% (n = 2,773) gained coverage, and 54% (n = 5,945) switched insurance. Medicaid and Medicare gained the largest fraction of patients (from 16% to 30% and 0% to 18%, respectively), with a decrease in private payer coverage (37% to 17%). In multivariate analysis, patients who were younger (27–35 years vs. 56–64 years; odds ratio [OR], 1.30; p < 0.001); lived in a zip code with average income in the lowest quartile (vs. the highest quartile; OR, 1.37; p < 0.001); and had three or more comorbidities (vs. none; OR, 1.61; p < 0.001) were more likely to experience a change in insurance.

CONCLUSION

Approximately one fifth of trauma patients who are readmitted within 6 months of their injury experience a change in insurance coverage. Most switch between insurers, but nearly a quarter lose their insurance. The government adopts a large fraction of these patients, indicating a growing reliance on government programs like Medicaid. Trauma patients face challenges after injury, and a change in insurance may add to this burden. Future policy and quality improvement initiatives should consider addressing this challenge.

LEVEL OF EVIDENCE

Epidemiologic, level III.
Continuous remote ischemic conditioning attenuates cognitive and motor deficits from moderate traumatic brain injury
Authors: Pandit Viraj , Khan Muhammad , Zakaria El Rasheid , Largent-Milnes Tally M. , Hamidi Mohammad , O’Keeffe Terence , Vanderah Todd W. , Joseph Bellal
Published: February 2018

BACKGROUND

While studies show that single-dose remote ischemic conditioning (RIC) improves outcomes, the effect of continuous (daily) RIC is unknown. Thus, we aimed to investigate the role of continuous RIC on cognitive and motor function following traumatic brain injury (TBI).

METHODS

We subjected 24 male C57BL mice to a cortical-controlled TBI. Two hours after TBI, the animals were randomly allocated to the RIC group (n = 12) or the sham group (n = 12). Remote ischemic conditioning was induced by noninvasive external compression of the hind limb using an occlusive band (six 4-minute cycles/24 hours) for six consecutive days. Before TBI, a baseline rotarod test and novel object recognition were performed. Post-TBI rotarod and novel object recognition tests were performed on Days 1 to 5, 7, 14, and 21. After the animals were sacrificed on Day 21, brain sections were analyzed using hematoxylin and eosin and glial fibrillary acidic protein staining to evaluate the hippocampal CA1 area for neuronal injury.

RESULTS

Both the RIC and sham groups had lower latency to fall compared with the baseline post-TBI. The RIC animals had a higher latency to fall compared with the sham animals at all time points, statistically significant after Day 3, until Day 21 post-TBI. Both the RIC and sham groups had lower recognition index compared with the baseline post-TBI. The RIC animals had a significantly higher recognition index than the sham animals after Day 1, until Day 21 post-TBI. Hematoxylin and eosin and glial fibrillary acidic protein staining of the brain samples of the sham group revealed that more neurons in the hippocampal CA1 area appeared shrunken with eosinophilic cytoplasm and pyknotic nuclei compared with the brain samples of the RIC group.

CONCLUSION

Postinjury continuous RIC resulted in improved cognitive functions and motor coordination in a mouse model of moderate TBI. Further studies are required to determine optimum dosage and frequency of this novel therapy to maximize its beneficial effects following TBI.
Overresuscitation with plasma is associated with sustained fibrinolysis shutdown and death in pediatric traumatic brain injury
Authors: Leeper Christine M. , Neal Matthew D. , Billiar Timothy R. , Sperry Jason L. , Gaines Barbara A.
Published: February 2018

BACKGROUND

Elevated International Normalized Ratio (INR) is a marker of poor outcome but not necessarily bleeding or clinical coagulopathy in injured children. Conversely, children with traumatic brain injury (TBI) tend to be hypercoagulable based on rapid thromboelastography (rTEG) parameters. Many clinicians continue to utilize INR as a treatment target.

METHODS

Prospective observational study of severely injured children age < 18 with rTEG on arrival and daily thereafter for up to 7 days. Standard rTEG definitions of hyperfibrinolysis (LY30 ≥ 3), fibrinolysis shutdown (SD) (LY30 ≤ 0.8), and normal (LY30 = 0.9-2.9) were applied. The first 24-hour blood product transfusion volumes were documented. Abbreviated Injury Scale score ≥ 3 defined severe TBI. Sustained SD was defined as two consecutive rTEG with SD and no subsequent normalization. Primary outcomes were death and functional disability, based on functional independence measure score assessed at discharge.

RESULTS

One hundred one patients were included: median age, 8 years (interquartile range, 4–12 years); Injury Severity Score, 25 (16–30); 72% blunt mechanism; 47% severe TBI; 16% mortality; 45% discharge disability. Neither total volume nor any single product volume transfused (mL/kg; all p > 0.1) differed between TBI and non-TBI groups. On univariate analysis, transfusion of packed red blood cells (p = 0.016), plasma (p < 0.001), and platelets (p = 0.006) were associated with sustained SD; however, in a regression model that included all products (mL/kg) and controlled for severe TBI (head Abbreviated Injury Scale score ≥ 3), admission INR, polytrauma, and clinical bleeding, only plasma remained an independent predictor of sustained SD (odds ratio, 1.17; p = 0.031). Patients with both severe TBI and plasma transfusion had 100% sustained SD, 75% mortality, and 100% disability in survivors. Admission INR was elevated in TBI patients, but did not correlate with rTEG activated clotting time (p = NS) and was associated with sustained SD (p = 0.006).

CONCLUSION

Plasma transfusion is independently associated with sustained fibrinolysis SD. Severe TBI is also associated with sustained SD; the combined effect of plasma transfusion and severe TBI is associated with extremely poor prognosis. Plasma transfusion should not be targeted to INR thresholds but rather to rTEG activated clotting time and clinical bleeding.

LEVEL OF EVIDENCE

Prognostic and epidemiological study, level III.
Ian William Murison Smith. 15 June 1937—8 November 2016
Authors: Hancock Gus
Published: February 2018

Ian Smith was one of the world-wide leading researchers into reaction kinetics, energy transfer and molecular dynamics in gas phase systems. He was able to span all of these aspects of collisional behaviour, and to form connections and insights that allowed him to make advances in all of them, advances which have stood the tests of time. His graduate work at the University of Cambridge was followed by academic positions in Cambridge and in Birmingham. He provided new insights into molecular energy transfer by systematically measuring how vibrational frequencies and multipole moments influenced the magnitude of the energy transfer cross sections. In reaction kinetics his detailed work on the OH radical has led to an understanding of the importance of its reactions not only in applied areas such as atmospheric and combustion chemistry, but also in fundamental dynamical studies of radical recombination and the effect of reagent energies on reactive processes. Of particular significance has been his development of both cryogenic and nozzle expansion methods of studying collisional processes at temperatures down to 10 K, with the discovery that reactions without activation barriers can get faster as the temperature decreases. The impact of this work upon astrochemistry has been profound, and has stimulated theoretical explanations of the effect. He was one of the first pioneers in the UK of the use of laser techniques to study collisional processes, using laser-induced fluorescence as a sensitive detection tool, UV laser photolysis to form reactive species and laser pumping to create excited state populations in order to observe their effect upon reaction pathways and vibrational relaxation.

Ian was devoted to his family—his wife Sue, their four children and 11 grandchildren. His research collaborators will always remember his scholarship, his unending suggestions of interesting problems to study, his deep integrity and humanity. His legacy lives on with his personal and academic families.
Peter Gavin Hall. 20 November 1951—9 January 2016
Authors: Robinson John , Welsh Alan H.
Published: February 2018

In the 40 years of his research career, Peter Hall produced work in both probability and statistics, the breadth and depth of which must be regarded as phenomenal. He displayed extraordinary technical skills together with remarkable intuition in developing and applying multifaceted mathematical approaches in the whole of his work. The impact of this wide-ranging use of powerful mathematical methods has had a profound effect on much of modern mathematical statistics. After completing his DPhil at Oxford, he remained in Australia for almost all of his career although he was renowned as one of the major international figures in probability and statistics. Peter was a mentor to a large group of postgraduate students and post-doctoral colleagues, giving encouragement and guidance, and he attracted many research visitors, contributing greatly to the whole of Australian statistical research. Remarkably, given his immense research output, he took a significant role both in editorial duties in major international journals and in advocacy for mathematics and statistics in Australia. Peter was a man of great charm whose modest demeanour belied his staggering abilities. His loss to mathematics and statistics is great, but is matched by the personal loss to us and to his many friends.
Adaptive phenotypic variation among clonal ant workers
Authors: Hasegawa Eisuke , Watanabe Saori , Murakami Yuuka , Ito Fuminori
Published: February 2018

Phenotypic variations are observed in most organisms, but their significance is not always known. The phenotypic variations observed in social insects are exceptions. Genetically based response threshold variances have been identified among workers and are thought to play several important adaptive roles in social life, e.g. allocating tasks among workers according to demand, promoting the sustainability of the colony and forming the basis of rationality in collective decision-making. Several parthenogenetic ants produce clonal workers and new queens by asexual reproduction. It is not clearly known whether such genetically equivalent workers show phenotypic variations. Here, we demonstrate that clonal workers of the parthenogenetic ant
Strumigenys membranifera
show large threshold variances among clonal workers. A multi-locus genetic marker confirmed that colony members are genetic clones, but they showed variations in their sucrose response thresholds. We examined the changing pattern of the thresholds over time generating hypotheses regarding the mechanism underlying the observed phenotypic variations. The results support the hypothesis that epigenetic modifications that occur after eclosion into the adult form are the cause of the phenotypic variations in this asexual species.
Implementing Parrondo’s paradox with two-coin quantum walks
Authors: Rajendran Jishnu , Benjamin Colin
Published: February 2018

Parrondo’s paradox is ubiquitous in games, ratchets and random walks. The apparent paradox, devised by J. M. R. Parrondo, that two losing games
A
and
B
can produce a winning outcome has been adapted in many physical and biological systems to explain their working. However, proposals on demonstrating Parrondo’s paradox using quantum walks failed for a large number of steps. In this work, we show that instead of a single coin if we consider a two-coin initial state which may or may not be entangled, we can observe a genuine Parrondo’s paradox with quantum walks. Furthermore, we focus on reasons for this and pin down the asymmetry in initial two-coin state or asymmetry in shift operator, either of which is necessary for observing a genuine Parrondo’s paradox. We extend our work to a three-coin initial state too with similar results. The implications of our work for observing quantum ratchet-like behaviour using quantum walks are also discussed.