bluuebunny/crossref_metadata_2025 huggingface dataset:
A high-sensitivity zero-biased magnetoelectric sensor using five-phase laminate composites based on FeCoV nanocrystalline soft magnetic alloy
Authors: Qiu Jing , Gao Yuan , Xu Xiaoyu , Liu Xin , Hu Zhenwen , Tang Xiaosheng , Hu Wei , Yang Jin , Wen Jing
Published: January 2017

This paper present a high-sensitivity zero-biased ME sensor consists of FeCoV/Terfenol-D/Pb(Zr1-x,Tix)O3(PZT)/Terfenol-D/FeCoV (FMPMF), whose magnetoelectric (ME) coupling characteristics and ME sensing performance have been investigated. Compared to traditional Terfenol-D/PZT/Terfenol-D (MPM) sensor, the zero-biased ME coupling characteristics of FMPMF sensor were significantly improved. Meanwhile, the induced zero-biased ME voltage of FMPMF sensor shows an excellent linear relationship to ac magnetic field both at the low frequency (1kHz) and the resonant frequency (115.14 kHz). The measured sensitivity at resonance is 1.95 V/Oe and the output resolution is approximately 2.43×10-8T. The proposed FMPMF sensors still have very good performance in the current sensing. The measured results shows an average sensitivity of 1.14 mV/A with highly linear behavior in the current range 1 A to 10 A at 50 Hz. Remarkably, it indicates that the proposed zero-biased miniature ME sensor give the prospect of being able to applied to the field of highly sensitive current sensing for the electricity monitoring in electric power grid.
A compact physical model for the simulation of pNML-based architectures
Authors: Turvani G. , Riente F. , Plozner E. , Schmitt-Landsiedel D. , Breitkreutz-v. Gamm S.
Published: January 2017

Among emerging technologies, perpendicular Nanomagnetic Logic (pNML) seems to be very promising because of its capability of combining logic and memory onto the same device, scalability, 3D-integration and low power consumption. Recently, Full Adder (FA) structures clocked by a global magnetic field have been experimentally demonstrated and detailed characterizations of the switching process governing the domain wall (DW) nucleation probability Pnuc and time tnuc have been performed. However, the design of pNML architectures represent a crucial point in the study of this technology; this can have a remarkable impact on the reliability of pNML structures. Here, we present a compact model developed in VHDL which enables to simulate complex pNML architectures while keeping into account critical physical parameters. Therefore, such parameters have been extracted from the experiments, fitted by the corresponding physical equations and encapsulated into the proposed model. Within this, magnetic structures are decomposed into a few basic elements (nucleation centers, nanowires, inverters etc.) represented by the according physical description. To validate the model, we redesigned a FA and compared our simulation results to the experiment. With this compact model of pNML devices we have envisioned a new methodology which makes it possible to simulate and test the physical behavior of complex architectures with very low computational costs.
Experiment-based thermal micromagnetic simulations of the magnetization reversal for ns-range clocked nanomagnetic logic
Authors: Ziemys Grazvydas , Breitkreutz-v. Gamm Stephan , Csaba Gyorgy , Schmitt-Landsiedel Doris , Becherer Markus
Published: January 2017

Extensive thermal micromagnetic simulations, based on experimental data and parameters, were performed to investigate the magnetization reversal in Co/Pt nanomagnets with locally reduced perpendicular anisotropy on the nanosecond range. The simulations were supported by experimental data gained on manufactured Co/Pt nanomagnets, as used in nanomagnetic logic. It is known that magnetization reversal is governed by two mechanisms. At pulse lengths longer than 100 ns, thermal activation dominates the magnetization reversal processes and follows the common accepted Arrhenius law. For pulse lengths shorter than 100 ns, the dynamic reversal dominates. With the help of thermal micro-magnetic simulations we found out that the point where the both mechanisms meet is determined by the damping constant α of the multilayer film stack. The optimization of ferromagnetic multilayer film stacks enables higher clocking rates with lower power consumption and, therefore, further improve the performance of pNML.
Magneto-optic Kerr effect CCD imaging with polarization modulation technique
Authors: Nakayama Satoru , Okano Makoto , Nozaki Yukio , Watanabe Shinichi
Published: January 2017

We have developed a magneto-optic Kerr effect (MOKE) imaging system with a charge-coupled-device (CCD) camera by using the rotating compensator technique. We chose optimal conditions of the rotation frequency of the compensator with stable rotation along with a CCD camera frame rate that allowed precise control of the exposure timing in order to link with the angle of the compensator. Precise timing management of the CCD exposure enables us to carry out repeated experiments, which greatly improves the signal-to-noise ratio of the longitudinal MOKE signal. We applied the technique to the material characterization of the Ni81 Fe19 thin film and its microstructure, and succeeded in evaluating the spatial variation of the complex magneto-optic constant Q of the sample. Because of its attractive advantages such as high-speed and compactness, the present method provides a novel platform for investigating the domain structures in various magnetic materials.
Shifting from acquisitive to conservative: the effects of Phoradendron affine (Santalaceae) infection in leaf morpho-physiological traits of a Neotropical tree species
Authors: Scalon Marina Corrêa , Alves dos Reis Sabrina , Rossatto Davi Rodrigo
Published: January 2017

Mistletoes are parasitic plants that penetrate the host branches through a modified root and connect to their xylem to acquire nutrients and water. Under mistletoe infection, resources that would otherwise be used by the host are stolen by the parasite. Our aim was to compare leaf morpho-physiological traits between healthy uninfected branches and mistletoe-infected branches of a Neotropical tree species (Handroanthus chrysotrichus (Mart. ex DC.) Mattos – Bignoniaceae). We also investigated differences between mistletoe and host leaf traits. Morphological (petiole length and thickness, leaf area and thickness, and specific leaf area) and physiological leaf traits (pre-dawn and midday water potential) were measured in 10 individuals infected with the mistletoe Phoradendron affine (Pohl ex DC.) Engl. & K.Krause (Santalaceae). Mistletoes showed smaller and thicker leaves with lower pre-dawn and midday water potential, suggesting that mistletoes are more profligate water users than the host. Host leaves from infected branches were scleromorphic and showed stronger water-use control (less negative water potential) than host leaves from uninfected branches. Our results indicated that leaves from infected branches shifted to a more conservative resource-use strategy as a response to a water and nutrient imbalance caused by mistletoe infection.
Selecting soybeans for sulfonylurea herbicide tolerance: a comparative proteomic study of seed germinations
Authors: Yu Xingwang , Yang Aijun , James Andrew T.
Published: January 2017

Sulfonylurea herbicides have attracted renewed interest as an alternative for weed management and control of weed resistance in soybean production. In this proteomic study, we compared changes in the protein profiles in 10-day-old seedlings from a simple roll-paper germination method treated with 0.1 µm metsulfuron methyl (MSM), a compound from the sulfonylurea family. Seeds from susceptible or tolerant soybeans, four lines each, were treated with 0, 0.01, 0.1, 1 or 10 µm MSM and the number of normal seeds germinating was counted after 10 days. MSM at ≥0.1 µm significantly reduced normal germination in the sulfonylurea-susceptible group. Comparative proteomic analysis of the proteins extracted from the germinations treated with 0 or 0.1 µm MSM revealed a much greater number of proteins affected in the sulfonylurea-susceptible genotype than the tolerant type. From a total 227 protein spots with significant differential (>2-fold) accumulation, 142 unique proteins were identified. Functional analysis revealed that about one-third of these proteins were associated with metabolism, followed by energy (24.3%), defence–stress response (22.9%), and protein synthesis and storage (16.7%). Sulfonylurea herbicides, specifically MSM, greatly affected these metabolic pathways in the susceptible genotype through changed accumulation of many enzymes and proteins.
Ion exchange technique (IET) to characterise Ag+ exposure in soil extracts contaminated with engineered silver nanoparticles
Authors: Schwertfeger Dina , Velicogna Jessica , Jesmer Alexander , McShane Heather , Scroggins Richard , Princz Juliska
Published: January 2017

Environmental contextBiosolid-amended soils are likely sinks for manufactured silver nanoparticles, the environmental toxicity of which is believed to be related to the release and accumulation of Ag+ ions. This study demonstrates how an ion exchange technique can be applied to soil extracts to provide Ag+ measurements at low, environmentally relevant levels. The technique is a valuable addition to existing analytical methods for tracking the behaviour of Ag nanoparticles and Ag+ ions in the terrestrial environment.
AbstractThe lack of silver speciation exposure data in toxicity studies investigating the effects of manufactured silver nanoparticles (AgNPs) in natural soil media limits the ability to discern nano-specific effects from effects of the toxic Ag+ form, which may be released from the manufactured AgNPs contained in wastewater, biosolids or soil environment. Using samples containing Ag+ or mixtures of Ag+ and AgNPs, ranging in total Ag concentrations of 10–5 to 10–9 M, and prepared in de-ionised water and filtered soil extracts, the validity of the ion exchange technique (IET) to quantify Ag+ was investigated by comparing measurements to those of an Ag+ ion selective electrode (ISE) and to the dissolved fraction from single particle inductively coupled plasma–mass spectrometry (SP-ICP-MS) analysis (SP-dissolved). When analysing samples in the filtered soil extract, IET and ISE gave comparable results down to 10–7 M, below which Ag+ activities were below the ISE detection limit. For water samples, SP-dissolved values were generally comparable or slightly greater (on average 65%) compared with IET-Ag+ at all concentrations. The high bias was likely due to inclusion of unresolved particles below the SP-ICP detection limit of 19nm. However, when analysing samples in the soil extract, SP-dissolved values were on average eight-fold greater than IET-Ag+, highlighting the effect that natural colloidal and dissolved soil constituents have on complexing Ag+, as well as the lack of specificity of the SP-dissolved analysis for the Ag+ species. IET is shown here to be a valid procedure to quantify Ag+ activity in soil extracts, and while the study highlights the limitations of using the SP-dissolved fraction to estimate this biologically relevant Ag fraction, it shows that combined, IET and SP-ICP-MS provide a valuable approach for investigating the behaviour of manufactured AgNPs in different matrixes.
Climatic regulation of the neurotoxin domoic acid
Authors: McKibben S. Morgaine , Peterson William , Wood A. Michelle , Trainer Vera L. , Hunter Matthew , White Angelicque E.
Published: January 2017

Significance

We investigate regulation of domoic acid, a potent marine phycotoxin, at the climate scale. Due to the threat domoic acid can pose to public health, marine wildlife, and coastal economies, decades of laboratory experiments have examined controls on domoic acid production without reaching consensus on reliable toxin-producing conditions. Our findings reveal an association between domoic acid in shellfish and climate-scale warm ocean conditions, a unique, large-scale perspective relative to previous work.
Cluster analysis and topoclimate modeling to examine bristlecone pine tree-ring growth signals in the Great Basin, USA
Authors: Tran Tyler J , Bruening Jamis M , Bunn Andrew G , Salzer Matthew W , Weiss Stuart B
Published: January 2017

Tree rings have long been used to make inferences about the environmental factors that influence tree growth. Great Basin bristlecone pine is a long-lived species and valuable dendroclimatic resource, but often with mixed growth signals; in many cases, not all trees at one location are limited by the same environmental variable. Past work has identified an elevational threshold below the upper treeline above which trees are limited by temperature, and below which trees tend to be moisture limited. This study identifies a similar threshold in terms of temperature instead of elevation through fine-scale topoclimatic modeling, which uses a suite of topographic and temperature-sensor data to predict temperatures across landscapes. We sampled trees near the upper limit of growth at four high-elevation locations in the Great Basin region, USA, and used cluster analysis to find dual-signal patterns in radial growth. We observed dual-signal patterns in ring widths at two of those sites, with the signals mimicking temperature and precipitation patterns. Trees in temperature-sensitive clusters grew in colder areas, while moisture-sensitive cluster trees grew in warmer areas. We found thresholds between temperature- and moisture-sensitivity ranging from 7.4°C to 8°C growing season mean temperature. Our findings allow for a better physiological understanding of bristlecone pine growth, and seek to improve the accuracy of climate reconstructions.
Clinical Utility of the Nonstructural 1 Antigen Rapid Diagnostic Test in the Management of Dengue in Returning Travelers With Fever
Authors: Huits Ralph , Soentjens Patrick , Maniewski-Kelner Ula , Theunissen Caroline , Van Den Broucke Steven , Florence Eric , Clerinx Jan , Vlieghe Erika , Jacobs Jan , Cnops Lieselotte , Van Den Bossche Dorien , Van Esbroeck Marjan , Bottieau Emmanuel
Published: January 2017

Background

Rapid diagnostic test (RDT) detecting the nonstructural 1 (NS1) antigen is increasingly used for dengue diagnosis in endemic and nonendemic settings, but its clinical utility has not been studied in travel clinic practice.

Methods

From August 2012 to July 2016, travelers returning from the tropics with fever were evaluated in the Institute of Tropical Medicine (Antwerp, Belgium) with the routine use of NS1 antigen RDT that provided results within 1 hour. We determined the diagnostic performance, assessed the management of patients with a positive RDT result, and compared it with that of historical cases of dengue diagnosed from 2000 to 2006, when only antibody detection assays were available.

Results

Of 335 travelers evaluated for fever, 54 (16%) were diagnosed with dengue, including 1 severe case. Nonstructural 1 antigen RDT was performed in 308 patients. It was truly positive in 43 of 52 tested dengue cases and falsely positive in only 1 of the 256 nondengue cases; therefore, sensitivity was 82.7% (95% confidence interval [CI], 74.4%–93.0%) and specificity was 99.6% (95% CI, 98.8%–100%). Only 3 (7%) of the 43 febrile travelers “immediately” diagnosed by RDT were admitted, and only 2 (5%) were given empirical antibacterial treatment, without adverse outcome. Admission and antibiotic prescription rates were significantly higher in the historical cases (n = 43) diagnosed by antibody detection (33%, P = .006 and 26%, P = .014, respectively), although the frequency of severe dengue was similar.

Conclusions

In our practice, the diagnostic performance of NS1 antigen RDT substantially contributed in withholding unnecessary hospitalization and antibiotherapy in dengue patients.
In Vivo Correlation of Radiographic Scoring (Radiographic Union Scale for Tibia Fractures) and Biomechanical Data in a Sheep Osteotomy Model: Can We Define Union Radiographically?
Authors: Litrenta Jody , Tornetta Paul , Ricci William , Sanders Roy W. , O'Toole Robert V. , Nascone Jason W. , Faber Henry , Wilson Darren
Published: January 2017

Objective:

To determine (1) the reliability of the standard and modified Radiographic Union Scale for Tibia fractures (RUST) score in a sheep osteotomy model, and (2) the standard and modified RUST scores that represent biomechanical union.

Design:

The tibia cortices in a sheep osteotomy model treated by intramedullary nails were radiographically evaluated using standard and modified RUST scores. Scores that correlated with biomechanical union, based on the torsional stiffness of the contralateral tibia, were determined.

Intervention:

Two groups of sheep had transverse midshaft osteotomies treated with 10-mm nails after reaming to 11.5 mm. Weight-bearing was allowed as tolerated. Anteroposterior and lateral radiographs were taken at standard intervals from 4 to 12 weeks. The tibial cortices at each time interval were evaluated in a random order by 5 senior orthopaedic trauma surgeons. Each tibia was scored using the standard and modified RUST methods and was assessed for union.

Main Outcome Measures:

The intraclass correlation coefficient (ICC) was determined for standard and modified RUST scores at each time interval and for the assessment of union. The percentages of fractures that were defined as united by the surgeons were tabulated by RUST and modified RUST scores. The torsional stiffness of each tibia was tested at 12 weeks and expressed as a percentage of the contralateral side. We considered biomechanical union to be ≥90% of the torsional stiffness of the normal side.

Results:

The modified RUST score demonstrated consistently higher ICCs than the standard RUST. All reviewers considered a standard RUST of 10 and a modified RUST of 14 to represent radiographic union. The standard RUST was 10.4 (range: 8.6–12) and modified RUST was 14.2 (range: 12.2–16) for tibiae that were biomechanically united.

Conclusions:

The modified RUST score has a slightly higher ICC than the standard RUST. A standard RUST of 10 and a modified RUST of 14 provide an excellent definition of union based on surgeons' opinion and biomechanical testing for a transverse fracture.
Is Early Definitive Fixation of Bicondylar Tibial Plateau Fractures Safe? An Observational Cohort Study
Authors: Unno Florence , Lefaivre Kelly A. , Osterhoff Georg , Guy Pierre , Broekhuyse Henry M. , Blachut Piotr A. , O'Brien Peter
Published: January 2017

Objectives:

The optimal treatment protocol for bicondylar plateau fractures remains controversial. Contrary to popular practice which favors a staged protocol in many high-energy fracture patterns, we have used early single-stage open reduction and internal fixation (ORIF) to treat these injuries whenever possible. The purpose of this study was to determine the complication rate and the functional and radiographic outcomes of this strategy.

Design:

Retrospective cohort study and prospective data collection.

Setting:

Level I trauma center.

Patients/Participants:

One hundred one patients with 102 OTA/AO type 41-C bicondylar tibial plateau fractures were treated with early definitive ORIF, defined as nonstaged surgery performed within 72 hours from injury. A subset of patients was part of a longitudinal study and reported functional outcomes at 1 year.

Intervention:

Early definitive ORIF.

Main Outcome Measurement:

Primary outcome: reoperation rate, defined as any surgery within 12 months after the index operation; secondary outcomes: quality and stability of radiographic fracture reduction; and functional outcome [Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and short musculoskeletal functional assessment (SMFA)].

Results:

Nonstaged operative treatment of bicondylar plateau fractures was performed in 91.3% of the fractures during the study period. For those, early definitive ORIF (surgery within 72 hours from injury) was performed in 82.3% fractures. Mean time from injury to ORIF, for closed fractures, was 29.8 hours. Sixteen (15.7%) fractures, which were treated with early definitive ORIF, required an additional surgical procedure within 12 months. Complications included wound infection requiring surgical management, compartment syndrome requiring fasciotomies, nonunion, early fixation failure, and implant removal for discomfort. The reoperation rate was 12.7% if implant removal was excluded. At least 3 of the 4 radiographic criteria used to assess the adequacy of reduction were achieved in 95.1% of cases, and all 4 criteria were met in 59.8% of fractures. The Physical Component of the SF-36 at 12 months was 42.6, which is comparable to values reported in previous studies for operative treatment of bicondylar plateau fractures.

Conclusions:

In a model where surgery is performed without delay by experienced orthopaedic trauma surgeons, a large proportion of bicondylar tibial plateau fractures can be safely treated with early definitive ORIF. Early surgery was associated with satisfactory postoperative radiographic reductions.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Management of pediatric open tibia fractures with supracutaneous locked plates
Authors: Radhakrishna Veerappa N. , Madhuri Vrisha
Published: January 2017

We evaluated the novel application of supracutaneous locked plates in pediatric open tibia fractures. Pediatric open tibia fractures stabilized with a locked supracutaneous plate from January 2011 to December 2014 were reviewed. Twenty-eight children, mean age 8.9 years, with 29 open tibia fractures were included. Nine of these children who had metaphyseal or metadiaphyseal fractures did not require joint spanning. The mean follow-up duration was 13.5 months. The mean time to uneventful union was 11.46 weeks, with no unacceptable malunion. Supracutaneous locked plates showed early union and no refractures. They could favorably replace tubular external fixators in stabilizing pediatric open tibia fractures.
Normal radiographic parameters in paediatric pelvic radiographs from a Chinese population
Authors: Kuong Evelyn E. , Gardner William T. , Koljonen Paul A. , Mahapatra Sudhir K. , Chow Wang
Published: January 2017

Paediatric pelvic and hip radiographs are a common investigation used when assessing a child for suspected developmental dysplasia of the hip. This report describes an attempt to establish normal values of medial joint space, acetabular index and centre edge angle according to specific age groups and sex in a Chinese population. Patients who had undergone a pelvic radiograph as part of their assessment, but were subsequently found to have normal hips were recruited retrospectively. These patients were grouped according to sex and age; medial joint space, acetabular index and centre edge angle were measured in all radiographs. A mean±SD was calculated for each group, and then each age group was tested for statistical significance between the male and the female groups. A total of, 98 patients were recruited, who underwent 188 pelvic radiographs, resulting in images of 376 ‘normal’ hips. The results for medial joint space, acetabular index and centre edge angle for each age and sex group are described. Only the acetabular index requires different reference ranges for male and female patients because of consistent statistical significance between the two groups. It was found that medial joint space remained fairly constant throughout the age groups, whereas the acetabular index decreased and the centre edge angle increased slightly. The reference ranges for the parameters described here are quite different from those established previously in a population of Northern-European descent, which could be because of a variety of reasons including genetics, body habitus and measurement technique. We believe that it would be prudent to implement these different ranges when assessing patients of Chinese heritage to optimize care of patients who may suffer as a consequence of not receiving treatment for missed hip dysplasia. Level of Evidence: Diagnostic Study Level III – Study of nonconsecutive patients (without consistently applying the reference ‘gold’ standard).
Cardiac Arrest: Obstetric CPR/ACLS
Authors: COBB BENJAMIN , LIPMAN STEVEN
Published: January 2017

In contrast with other high-resource countries, maternal mortality has seen an increase in the United States. Caring for pregnant women in cardiac arrest may prove uniquely challenging given the rarity of the event coupled by the physiological changes of pregnancy. Optimization of resuscitative efforts warrants special attention as described in the 2015 American Heart Association’s “Scientific Statement on Maternal Cardiac Arrest.” Current recommendations address a variety of topics ranging from the basic components of chest compressions and airway management to some of the logistical complexities and operational challenges involved in maternal cardiac arrest.
Barriers to Glaucoma Medication Compliance Among Veterans: Dry Eye Symptoms and Anxiety Disorders
Authors: Stringham Jack , Ashkenazy Noy , Galor Anat , Wellik Sarah R.
Published: January 2017

Objective:

To identify barriers to compliance of medical treatment for glaucoma among veterans.

Methods:

Patients with glaucoma from the Miami Veterans Affairs Eye Clinic (n=74) filled out a 63-question survey regarding dry eye symptoms, concurrent systemic disease, and medications. The association between glaucoma medical compliance was defined as self-reported adherence to drop regimens greater than 75% of the time.

Results:

Eighty percent of veterans (n=59) reported compliance with glaucoma therapy. Dry eye symptoms (as defined by Dry Eye Questionnaire 5 score ≥6) were reported by 39% (n=29), and their presence was associated with decreased compliance (63% vs. 89%, P=0.007). Anxiety and posttraumatic stress syndrome (PTSD) were also associated with significant noncompliance (64% vs. 83%, P=0.05 and 58% vs. 84%, P=0.02, respectively). Other studied factors including demographics, depression (P=0.11), and glaucoma regimens did not play a significant role in glaucoma medication compliance.

Conclusions:

Dry eye symptoms, PTSD, and anxiety were associated with decreased compliance to medical treatment of glaucoma. Identifying and treating underlying ocular surface disease and anxiety disorders may lead to increased adherence to glaucoma treatment.
Severe Dry Eye in CD25 Deficiency Syndrome
Authors: Baş Zeynep , Bayraktutar Betül N. , Uçakhan Ömür Ö.
Published: January 2017

CD25 deficiency (Interleukin-2 receptor alpha deficiency) is a rare subtype of combined B- and T-cell immunodeficiency. Recurrent infections and lymphocyte infiltration of multiple tissues are the main clinical presentations. Only four patients have been reported in whom ophthalmological findings were not described. In this article, ocular findings of CD25 deficiency in a 12-year-old child are highlighted.
Diagnostic Capability of Peripapillary Retinal Volume Measurements in Glaucoma
Authors: Simavli Huseyin , Poon Linda Yi-Chieh , Que Christian J. , Liu Yingna , Akduman Mustafa , Tsikata Edem , de Boer Johannes F. , Chen Teresa C.
Published: January 2017

Purpose:

To determine the diagnostic capability of spectral domain optical coherence tomography peripapillary retinal volume (RV) measurements.

Materials and Methods:

A total of 156 patients, 89 primary open-angle glaucoma and 67 normal subjects, were recruited. Spectral domain optical coherence tomography peripapillary RV was calculated for 4 quadrants using 3 annuli of varying scan circle diameters: outer circumpapillary annuli of circular grids 1, 2, and 3 (OCA1, OCA2, OCA3). Area under the receiver operating characteristic curves and pairwise comparisons of receiver operating characteristic (ROC) curves were performed to determine which quadrants were best for diagnosing primary open-angle glaucoma. The pairwise comparisons of the best ROC curves for RV and retinal nerve fiber layer (RNFL) were performed. The artifact rates were analyzed.

Results:

Pairwise comparisons showed that the smaller annuli OCA1 and OCA2 had better diagnostic performance than the largest annulus OCA3 (P<0.05 for all quadrants). OCA1 and OCA2 had similar diagnostic performance, except for the inferior quadrant which was better for OCA1 (P=0.0033). The pairwise comparisons of the best ROC curves for RV and RNFL were not statistically significant. RV measurements had lower rates of artifacts at 7.4% while RNFL measurements had higher rates at 42.9%.

Conclusions:

Peripapillary RV measurements have excellent ability for diagnosing not only glaucoma patients but also a subset of early glaucoma patients. The inferior quadrant of peripapillary annulus OCA1 demonstrated the best diagnostic capability for both glaucoma and early glaucoma. The diagnostic ability of RV is comparable with that of RNFL parameters in glaucoma but with lower artifact rates.
Correlation Between Critical Thinking Disposition and Mental Self-Supporting Ability in Nursing Undergraduates: A Cross-Sectional Descriptive Study
Authors: Wu Defang , Luo Yang , Liao Xinyu
Published: January 2017

Background:

There is universal agreement on the essential role of critical thinking in nursing practice. Most studies into this topic have provided descriptive statistical information and insights on related external factors such as educational environment and teaching strategies. However, there has been limited research into the psychological factors that may predict the disposition of students toward critical thinking.

Purpose:

This study explored the relationship between the disposition of nursing students toward critical thinking and their mental self-supporting ability to obtain a profile and determine the psychological predictors of critical thinking.

Methods:

A cross-sectional descriptive study was conducted in 2013 using a convenience sample from four nursing schools. Four hundred six Chinese nursing undergraduates completed two questionnaires including (a) the California Critical Thinking Disposition Inventory (Chinese version) and (b) the Mental Self-Supporting Questionnaire for University Students. Pearson’s correlation and linear regression analysis were used to investigate the relationship between these two variables and the predicted positive psychological qualities for the critical thinking disposition of participants.

Results:

Average participant scores for critical thinking disposition and mental self-supporting were 280.91 ± 28.43 and 76.40 ± 8.47, respectively. Positive correlations were observed between these two variables (r = .583, p < .01) and participants’ self-decision, self-cognition, self-confidence, and self-responsibility, which suggest that these factors play a significant role in critical thinking disposition (R
2 = .435, p < .01).

Conclusions:

The participants earned midlevel scores for both disposition toward critical thinking and mental self-supporting abilities.The four factors that had a major influence on critical thinking disposition included self-decision, self-cognition, self-confidence, and self-responsibility. Nursing educators should focus on improving the critical thinking ability of their students in these four aspects.
Pain, Anxiety, and Fatigue During Labor: A Prospective, Repeated Measures Study
Authors: Tzeng Ya-Ling , Yang Ya-Ling , Kuo Pi-Chao , Lin Ya-Chuan , Chen Shu-Ling
Published: January 2017

Background:

Pain, anxiety, and fatigue are known to significantly influence labor; however, the interacting relationships among the three symptoms have not been empirically shown.

Purpose:

The aim of this study was to investigate the interrelationships among intrapartum pain, anxiety, and fatigue relative to the mode of delivery, with or without epidural analgesia (EDA).

Methods:

A prospective, repeated measures design was adopted, and women with uncomplicated pregnancies at term (N = 186) were enrolled. Self-reported visual analog scales were used to assess pain, anxiety, and fatigue during the four phases of labor, as determined by cervical dilation (e.g., Phase 1 = 2–4 cm, Phase 2 = 4–6 cm, Phase 3 =10 cm, and Phase 4 = immediately after delivery of the placenta). Of the 186 participants, 48 received EDA when their cervical dilation was 3–4 cm.

Results:

Throughout the process of labor, pain, anxiety, and fatigue were significantly correlated, no matter whether participants had received EDA, especially during Phases 1 and 3. For the participants undergoing EDA, the level of fatigue decreased more slowly than the levels of pain and anxiety. The participants who received EDA had significantly greater pain and fatigue in Phase 1 of labor than those who did not receive EDA. Mode of delivery was correlated with age, parity, and pain level in Phase 2 of labor and anxiety level in Phase 2 of labor.

Conclusions/Implications for Practice:

Intrapartum pain, anxiety, and fatigue were strongly interrelated. Intrapartum pain management (EDA) led to a significant decline in anxiety and fatigue. Furthermore, fatigue accumulated during the course of labor and was not easily diminished. These findings provide a reference for maternity nurses to develop strategies for managing multiple symptoms.
Can an age-adjusted D-dimer level be adopted in managing venous thromboembolism in the emergency department? A retrospective cohort study
Authors: Jaconelli Tom , Eragat Mazin , Crane Steven
Published: January 2017

Introduction

Patients suspected of having venous thromboembolism (VTE), with a low pretest probability, undergo D-dimer testing. A negative D-dimer, in a low-risk patient rules out VTE with a high degree of certainty because of its high sensitivity. It is, however, a poorly specific test, and the absolute value increases with age. The aim of this study was to establish whether an age-adjusted D-dimer could be safely used instead of a standard cut-off level in low-risk patients over the age of 50 years.

Patients and methods

This was a retrospective review of 1649 patients with suspected VTE whose D-dimer levels were analysed. In low-risk patients (defined as ‘VTE unlikely’ using the dichotomized Wells’ scores), the outcomes in terms of confirmed VTE diagnosis, hospital admission and investigations using an age-adjusted D-dimer level (measured in D-dimer units) of 5× the age for patients over 50 years of age and 250 ng/ml for patients younger than 50 years of age, was compared with the cut-off standard level (230 ng/ml in all patients).

Results

Of the total group of patients in the VTE unlikely group, the proportion of patients with a negative D-dimer when using the standard cut-off was 64.9% (859/1324). A further 130 patients had a negative D-dimer when the age-adjusted cut-off was used, increasing the proportion of all patients in whom VTE could be excluded without imaging to 74.7% (989/1324).

For those patients of 75 years or older, the proportion of patients in whom VTE could be excluded without imaging increased from only 91/242 (37.6%) when using the standard D-dimer cut-off to 154/242 (63.6%) when the age-adjusted cut-off was used.

These changes occurred without any additional false-negative findings.

Conclusion

For patients over the age of 50 years suspected of having VTE with a low pretest probability, increasing the D-dimer cut-off level to 5× the age increases the proportion of patients in whom VTE can safely be excluded without radiological imaging.
The Influence of the Practice Environment on Nurse Managers’ Job Satisfaction and Intent to Leave
Authors: Warshawsky Nora E. , Wiggins Amanda T. , Rayens Mary Kay
Published: January 2017

OBJECTIVE:

The aim of this study was to explore the influence of the practice environment on nurse managers’ (NMs’) job satisfaction and intent to leave.

BACKGROUND:

Nurse managers are a ready pool of talent to fill impending strategic leadership vacancies. Job satisfaction as an NM is a deciding factor for senior leadership aspirations.

METHODS:

This study used a secondary analysis of 2012 survey data of 355 NMs. The Nurse Manager Practice Environment Scale was used to identify organizational features that influence NMs’ job satisfaction and intent to leave.

RESULTS:

Mean (SD) job satisfaction was 4.5 (1.1) on a 6-point scale. Mean (SD) intent to leave was 5.0 (2.1) on a scale ranging from 3 to 9. The Nurse Manager Practice Environment Scale was a significant predictor of both job satisfaction and intent to leave.

CONCLUSIONS:

Features of the organizational context can be modified to improve job satisfaction and reduce intent to leave among NMs.
Reports From RNs on Safe Patient Handling and Mobility Programs in Acute Care Hospital Units
Authors: Choi JiSun , Cramer Emily
Published: January 2017

OBJECTIVE:

The aim of this study was to investigate the perceptions of RNs on the implementation of safe patient handling and mobility (SPHM) programs in states with and without SPHM legislation.

BACKGROUND:

Despite numerous strategies developed to reduce caregiver injuries, nurses are still experiencing work-related musculoskeletal injuries. A comprehensive SPHM program has been found to be effective in reducing patient handling injuries among nurses.

METHODS:

By using data from 143 480 RNs working in 321 acute care hospitals in 44 US states, RNs’ perceptions on 6 key aspects of SPHM programs were compared between states with and without SPHM legislation and among 11 unit types.

RESULTS:

Registered nurses in states with SPHM legislation are more likely to report the implementation of SPHM programs in contrast with those in comparison states. This finding was found for each of the 11 unit types.

CONCLUSIONS:

This study provides evidence to support the positive effect of state-based efforts for legislative actions on the development and implementation of SPHM programs.
Reducing Chronic Obstructive Pulmonary Disease 30-Day Readmissions
Authors: Agee Joan
Published: January 2017

Chronic obstructive pulmonary disease (COPD) is a debilitating disease resulting in frequent hospitalizations and increased healthcare costs. As leaders of multidisciplinary teams, acute care nurse leaders are challenged to reduce readmissions and costs. In October 2014, the Centers for Medicare and Medicaid Services expanded readmission penalties for 30-day readmissions to include COPD, making this an important issue for nurse leaders. This article describes how a regional medical center was able to decrease COPD readmissions.
Evaluation of Herpes Simplex Virus Type 2 Serological Tests for Use With Dried Blood Spots in Kenya
Authors: Hobbs Marcia M. , Mwanyumba Sophie W. , Luseno Winnie K. , Hartman Shane , Halpern Carolyn T. , Hallfors Denise D. , Cho Hyunsan
Published: January 2017

We evaluated 2 assays to detect antibodies to herpes simplex virus type 2 in dried blood spots prepared from blood specimens submitted to a reference laboratory in Kenya. Dried blood spots did not perform well with the Kalon herpes simplex virus type 2 assay. Focus HerpeSelect 2 was 98.8% sensitive and 98.9% specific with dried blood spots.
Cystic Biliary Atresia and Choledochal Cysts Are Distinct Histopathologic Entities
Authors: Lobeck Inna N. , Sheridan Rachel , Lovell Mark , Dupree Phylicia , Tiao Greg M. , Bove Kevin E.
Published: January 2017

Cystic biliary atresia (CBA), a rare cystic expansion of atretic extrahepatic bile ducts in young infants, overlaps in age at presentation and imaging features with early choledochal cysts (CC). Treatment and prognosis differ; histologic differences are unsettled. We compared 10 patients with CBA, 1975 to 2015, to an age-similar cohort of 13 infants, and to older patients who had surgery for CC. Operative details, imaging, and clinical courses were correlated to pathologic specimens. Immunostains for smooth muscle actin and myosin heavy chain were used to evaluate cyst walls and atretic segments. CBA cysts typically lacked epithelium and inflammation; cyst walls had an inner, dense cicatricial layer associated with myofibroblastic (MF) hyperplasia that often delaminated producing a grossly visible inner cyst wall. Seven proximal biliary remnants in CBA featured circumferential peribiliary MF hyperplasia/fibrosis with little or no inflammation, similar to isolated BA. Extrahepatic atresia was usually both proximal and distal to the cyst. Features in 10/13 CC from infants and 8/8 CC in older patients had mostly preserved uninjured epithelium and no subepithelial cicatrix. Mural smooth muscle (absent in CBA) was present to some extent in CC at all ages. Unexpectedly, focal MF hyperplasia and laminar sclerosis was present in a few CC in infants, resembling CBA. CBA and infant CC are distinct histologic entities that occasionally overlap. CBA bile duct injury mimics non-CBA. Cystification is an aberrant manifestation of stromal proliferation in BA. The current management approach assuming CBA and CC in infants are 2 separate disease processes is supported but caution is advised.
Idiopathic Unilateral Paralysis of the Palate in a Youth
Authors: Güngör Olcay , Kirik Serkan , Işikay Sedat , Güngör Gülay , Bilal Nagihan
Published: January 2017

Unilateral isolated paralysis of the soft palate is a rare clinical entity that is associated with rhinolalia and the flow of nasal fluids from the nostril on the affected side. We report a case of a 17-year-old boy admitted complaining of nasal speech and drinks flowing into his right nostril. Most cases of soft palate palsy are idiopathic, whereas a few cases are caused by viral infections or tumors. We describe an isolated case of soft palate palsy with spontaneous recovery within 1 month.
The Use of Ultrasound-Measured Optic Nerve Sheath Diameter to Predict Ventriculoperitoneal Shunt Failure in Children
Authors: Lin Sophia D. , Kahne Kimberly R. , El Sherif Amira , Mennitt Kevin , Kessler David , Ward Mary J. , Platt Shari L.
Published: January 2017

Objective

The goal of this study was to assess the accuracy of ultrasound-measured optic nerve sheath diameter (ONSD) as a screen for ventriculoperitoneal shunt failure.

Methods

We prospectively enrolled a convenience sample of children presenting to the ED with suspected shunt failure. The ONSD was measured by ultrasound and compared with computed tomography/magnetic resonance imaging (CT/MRI) and neurosurgical impression. We defined shunt failure on ultrasound as an ONSD greater than 4.0 mm in infants 12 months and younger or greater than 4.5 mm in children older than 12 months. A single emergency radiologist at our institution read all CTs and MRIs for categorical determination of shunt failure. We defined shunt failure based on neurosurgical impression as a decision to admit and perform shunt revision. We report test characteristics and 95% confidence intervals of ONSD as a predictor for shunt failure.

Results

We enrolled 32 subjects. The sensitivities of ONSD compared with CT/MRI and neurosurgical impression, 60.0% and 75.0%, respectively, were low. However, the negative predictive values of ONSD compared with CT/MRI and neurosurgical impression were 90.0% and 95.0%, respectively.

Conclusions

Optic nerve sonography may be a useful tool to identify children presenting with suspected ventriculoperitoneal shunt failure who do not require further imaging. This would reduce the use of CT scan and exposure to ionizing radiation in children with suspected shunt malfunction who do not require neurosurgical intervention. Consideration of additional risk factors and a larger sample size may yield stronger results.
Sonographic Findings and Diagnostic Pitfalls in Evaluation for Uterine Rupture in a Case of Fetal Demise and Prior Cesarean Delivery of Unknown Type
Authors: Spain James Andrew , Shaikh Shehbaz , Sandberg Sharon A.
Published: January 2017

A 38-week pregnant patient with history of cesarean delivery was admitted to the hospital for induction of labor after diagnosis of fetal demise. When the clinical picture became concerning for uterine scar dehiscence, an ultrasound was ordered. After targeted ultrasound of the lower uterine segment, the sonographer initially reported thin but intact lower uterine segment and normal positioning of the fetus. By keeping a high level of suspicion, the radiologist analyzed the images submitted and found other clues suggesting possible dehiscence or rupture. Additional images were then obtained, ultimately demonstrating uterine rupture with fetus external to uterus.
Controlling light’s helicity at the source: orbital angular momentum states from lasers
Authors: Forbes Andrew
Published: January 2017

Optical modes that carry orbital angular momentum (OAM) are routinely produced external to the laser cavity and have found a variety of applications, thus increasing the demand for integrated solutions for their production. Yet such modes are notoriously difficult to produce from lasers due to the strict symmetry requirements for their creation, together with the need to break the degeneracy in helicity. Here, we review the progress made since 1992 in producing such twisted light modes directly at the source, from gas to solid-state lasers, bulk to integrated on-chip solutions, through to generic devices for on-demand OAM in both scalar and vector forms.

This article is part of the themed issue ‘Optical orbital angular momentum’.
Orbital angular momentum of photons and the entanglement of Laguerre–Gaussian modes
Authors: Krenn Mario , Malik Mehul , Erhard Manuel , Zeilinger Anton
Published: January 2017

The identification of orbital angular momentum (OAM) as a fundamental property of a beam of light nearly 25 years ago has led to an extensive body of research around this topic. The possibility that single photons can carry OAM has made this degree of freedom an ideal candidate for the investigation of complex quantum phenomena and their applications. Research in this direction has ranged from experiments on complex forms of quantum entanglement to the interaction between light and quantum states of matter. Furthermore, the use of OAM in quantum information has generated a lot of excitement, as it allows for encoding large amounts of information on a single photon. Here, we explain the intuition that led to the first quantum experiment with OAM 15 years ago. We continue by reviewing some key experiments investigating fundamental questions on photonic OAM and the first steps to applying these properties in novel quantum protocols. At the end, we identify several interesting open questions that could form the subject of future investigations with OAM.

This article is part of the themed issue ‘Optical orbital angular momentum’.