bluuebunny/crossref_metadata_2025 huggingface dataset:
Generation of synthetic dielectric dispersion logs in organic-rich shale formations using neural-network models
Authors: He Jiabo , Misra Siddharth
Published: February 2019

Dielectric dispersion (DD) logs acquired in subsurface geologic formations generally are composed of conductivity ([Formula: see text]) and relative permittivity ([Formula: see text]) measurements at four discrete frequencies in the range of 10 MHz to 1 GHz. Acquisition of DD logs in subsurface formations is operationally challenging, and it requires a hard-to-deploy infrastructure. We developed three supervised neural-network-based predictive methods to process conventional, easy-to-acquire subsurface logs for generating the eight DD logs acquired at four frequencies. These predictive methods will improve reservoir characterization in the absence of a DD logging tool. The predictive methods are tested in three wells intersecting organic-rich shale formations of the Permian Basin and the Bakken Shale. The first method predicts the eight dispersion logs simultaneously using a single artificial neural network (ANN) model, whereas the second method simultaneously predicts the four conductivity dispersion logs using one ANN model, followed by simultaneous prediction of four permittivity dispersion logs using a second ANN model. The third method sequentially predicts the eight dispersion logs, one at a time using eight sequential ANN models, based on a predetermined ranking of the prediction accuracy for each of the eight DD logs when simultaneously generated. Considering that the conventional and DD logs are recorded more than 10,000 ft deep in the subsurface using logging tools that are run at different times in rugose boreholes for sensing the near-wellbore geologic formation, the data used in this predictive work is prone to noise and biases that tend to adversely affect the prediction performances of the proposed methods. In terms of normalized root-mean square error (Nrms error), the prediction performances of the second predictive method are 8.5% worse and 6.2% better for the conductivity and permittivity dispersion logs, respectively, as compared with those of the first predictive method. The third method has best prediction performance for permittivity dispersion logs, which is 0.089 in terms of the Nrms error.
Conformal Radiation Therapy for Pediatric Ependymoma, Chemotherapy for Incompletely Resected Ependymoma, and Observation for Completely Resected, Supratentorial Ependymoma
Authors: Merchant Thomas E. , Bendel Anne E. , Sabin Noah D. , Burger Peter C. , Shaw Dennis W. , Chang Eric , Wu Shengjie , Zhou Tianni , Eisenstat David D. , Foreman Nicholas K. , Fuller Christine E. , Anderson Edwina Templeton , Hukin Juliette , Lau Ching C. , Pollack Ian F. , Laningham Fred H. , Lustig Robert H. , Armstrong Floyd D. , Handler Michael H. , Williams-Hughes Chris , Kessel Sandra , Kocak Mehmet , Ellison David W. , Ramaswamy Vijay
Published: February 2019

PURPOSE

The Children’s Oncology Group trial ACNS0121 estimated event-free survival (EFS) and overall survival for children with intracranial ependymoma treated with surgery, radiation therapy, and—selectively—with chemotherapy. Treatment was administered according to tumor location, histologic grade, and extent of resection. The impacts of histologic grade, focal copy number gain on chromosome 1q, and DNA methylation profiles were studied for those undergoing surgery and immediate postoperative conformal radiation therapy (CRT).

METHODS

ACNS0121 included 356 newly diagnosed patients (ages 1 to 21 years). Patients with classic supratentorial ependymoma were observed after gross total resection (GTR). Those undergoing subtotal resection received chemotherapy, second surgery, and CRT. The remaining patients received immediate postoperative CRT after near-total resection or GTR. CRT was administered with a 1.0-cm clinical target volume margin. The cumulative total dose was 59.4 Gy, except for patients who underwent GTR and were younger than age 18 months (who received 54 Gy). Patients were enrolled between October 2003 and September 2007 and were observed for 5 years. Supratentorial tumors were evaluated for RELA fusion; infratentorial tumors, for chromosome 1q gain. Classification of posterior fossa groups A and B was made by methylation profiles.

RESULTS

The 5-year EFS rates were 61.4% (95% CI, 34.5% to 89.6%), 37.2% (95% CI, 24.8% to 49.6%), and 68.5% (95% CI, 62.8% to 74.2%) for observation, subtotal resection, and near-total resection/GTR groups given immediate postoperative CRT, respectively. The 5-year EFS rates differed significantly by tumor grade ( P = .0044) but not by age, location, RELA fusion status, or posterior fossa A/posterior fossa B grouping. EFS was higher for patients with infratentorial tumors without 1q gain than with 1q gain (82.8% [95% CI, 74.4% to 91.2%] v 47.4% [95% CI, 26.0% to 68.8%]; P = .0013).

CONCLUSION

The EFS for patients with ependymoma younger than 3 years of age who received immediate postoperative CRT and for older patients is similar. Irradiation should remain the mainstay of care for most subtypes.
The effects of quality of shelters and prior residence on Marmorkrebs (marbled crayfish)
Authors: Takahashi Kazuya , Yamaguchi Erika , Fujiyama Naoyuki , Nagayama Toshiki
Published: February 2019

Many animals fight over a limited valuable resource. In Marmorkrebs (marbled crayfish), large animals usually defeated small opponents but they were frequently beaten by small opponents who were shelter owners. A prior residence effect of marbled crayfish was analyzed quantitatively. More than 2 hr of residency in a shelter was sufficient for small owners to defeat large intruders. Small animals that stayed in a shelter for 24 hr still tended to win following removal of the shelter 10 min before pairing with large intruders, but 2 hr residents were occasionally beaten by large intruders without the support of shelters during pairings. The prior residence effect thus developed depending on the time of residency. To clarify whether the strength of the prior residence effect was affected by the quality of a shelter, large and small owners with different combinations of two high and low quality of shelters were paired. When both large and small owners possessed a high quality shelter, the frequency of agonistic bouts was reduced. Even if agonistic bouts occurred, the win frequency of small owners was almost equal to that of large owners. Thus, the residence effect on small owners was sufficiently strong to overcome the physical disadvantage of small animals to large opponents. By contrast, small owners of low quality shelters were frequently beaten by large owners with the shelters of same or better quality. We conclude that the outcomes of fighting over the resource shelter are highly dependent on both the perception of shelter quality and body size differences.
3D ultrastructural organisation of calcium release units in the avian sarcoplasmic reticulum
Authors: Sheard Thomas M. D. , Kharche Sanjay R. , Pinali Christian , Shiels Holly A.
Published: February 2019

Excitation-contraction coupling in vertebrate hearts is underpinned by calcium (Ca2+) release from Ca2+ release units (CRUs). CRUs are formed by clusters of channels called ryanodine receptors on the sarcoplasmic reticulum (SR) within the cardiomyocyte. Distances between CRUs influence the diffusion of Ca2+, thus influencing the rate and strength of excitation-contraction coupling. Avian myocytes lack T-tubules, thus Ca2+ from surface CRUs (peripheral couplings, PCs), must diffuse to internal CRU sites of the corbular SR (cSR) during centripetal propagation. Despite this, avian hearts achieve higher contractile rates and develop greater contractile strength than many mammalian hearts, which have T-tubules to provide simultaneous activation of the Ca2+ signal through the myocyte. We used 3D electron tomography to test the hypothesis that the intracellular distribution of CRUs in the avian heart permits faster and stronger contractions despite the absence T-tubules. Nearest edge-edge distances between PCs and cSR, and geometric information including surface area and volumes of individual cSR, were obtained for each cardiac chamber of the White Leghorn chicken. Computational modelling was then used to establish a relationship between CRUs distances and cell activation time in the avian heart. Our data suggest that cSR clustered close together along the Z-line is vital for rapid propagation of the Ca2+ signal from the cell periphery to the cell centre which would aid in the strong and fast contractions of the avian heart.
Theoretical Study on Hydrogen-Tritium Exchange Reactions between Several Organic and HTO Molecules: A Multicomponent QM Study
Authors: Ishibashi Rina , Tachikawa Masanori , Udagawa Taro
Published: February 2019

Hydrogen-tritium (H-T) exchange reactions between several organic and HTO molecules have been investigated using multicomponent M06-2X (MC_M06-2X)/6-311++G(d,p) method, which can directly take account of the nuclear quantum effect (NQE) of hydrogen nuclei. Transition state (TS) structures on the MC_M06-2X effective potential energy hypersurface are found with the aid of MC_M06-2X-climing image-nudged elastic band method. The relative energies of hydrogen-bonded complexes and the TS structures in hydrogen transfer reactions are clearly lowered by including NQE of proton or triton, while NQE of hydrogen nuclei hardly affects the potential energy profile along C-C or C-O rotational isomerization. Such difference arises from the different behaviors of the changes in spatial distribution of nuclear wavefunctions during reactions. Our present study clearly demonstrates that including NQE of hydrogen nuclei is indispensable to adequately analyze H-T exchange reactions between several organic and HTO molecules, or some reaction energy profiles cannot be represented even qualitatively.
A Special Connection between Nanofabrication and Analytical Devices: Chemical Lift-Off Lithography
Authors: Chen Chong-You , Wang Chang-Ming , Liao Wei-Ssu
Published: February 2019

Chemical lift-off lithography (CLL) is a chemo-topographical nanopatterning technique developed in 2012 which provides not only precise geometry control with sub-20 nm resolution, but also sharp material interface environment adjustments. Unlike most fabrication techniques, this approach builds a straightforward bridge between structure generation and analytical device designs. This property lies on a direct molecular pattern creation on a metal surface, where the produced unique interface environment acts as a supporting matrix for diverse analytical tools. Operation of CLL includes stamp activation, self-assembled monolayer formation, conformal sealing, and finally interface molecule lift-off. Creation of molecular patterns is achieved by using stamps casting with structures, and a featureless master generates active surfaces capable of arbitrary functionalization. The post lift-off areas present an environment distributed with residual molecules, and its composition can be well-tuned by interface reaction conditions and monolayer selection. Connections between CLL and analytical devices initiate from this point, where tools such as functional probe anchoring, microscopy, high-throughput microfluidics, and spectroscopy can all be integrated. This paper outlines the ideas behind CLL and connections to analytical devices, where invention background introduction, unique molecular environment discussion, modern platform demonstration, challenges in the future, and exciting perspective work in coming years are all included.
Is breast-conserving therapy adequate in BRCA 1/2 mutation carriers? The radiation oncologist’s point of view
Authors: Vallard Alexis , Magné Nicolas , Guy Jean-Baptiste , Espenel Sophie , Rancoule chloé , diao peng , Deutsch Eric , Rivera Sofia , Chargari Cyrus
Published: February 2019

Breast conserving therapy (BCT) is currently a recognized alternative to mastectomy for early BC patients. However, the therapeutic index of BCT was considered controversial for decades in BRCA1/2 mutation carriers. The aim of the present review was to investigate the outcome of mutation carriers undergoing BCT regarding local and distant endpoints. A short review was performed from the point of view of the radiation oncologist. Only retrospective data were available regarding local outcome assessment. They generated conflicting results. In studies with limited follow-up, BCT did not increase the risk of local recurrence in BRCA1/2 mutation carriers versus non-carriers. Conversely, some studies with longer follow-up supported that local relapse was increased in mutation carriers. Yet, according to some publications, their long-term risk of ipsilateral recurrence post-BCT was not different from general population cohorts. Besides, overall and metastasis-free survivals were the same after BCT regardless of the BRCA1/2 mutation status. Similar survival rates were also reported when BCT and mastectomy were compared in mutation carriers. Regarding acute or late toxicity, normal rates were reported in BRCA mutation carriers after breast radiotherapy. The BRCA1/2 mutation does not seem to widely alter the therapeutic index (efficacy/toxicity ratio) of modern adjuvant breast irradiation. Although the long term equivalence of BCT/mastectomy on local control is still not clearly recognised, BCT can be considered an adequate option for BRCA1/2 mutation carriers. This review highlights that BCT is a reasonable option for BRCA1/2 mutation carriers however litterature is controversial concerning long-term local outcome and results of a large prospective cohort are needed.
Comparison of the effectiveness of high resolution ultrasound with MRI in patients with temporomandibular joint dısorders
Authors: Yılmaz Dilek , Kamburoğlu Kıvanç
Published: February 2019

Objectives:

To assess the effectiveness of a high resolution ultrasound for temporomandibular joint (TMJ) evaluation in comparison to MRI in patients with TMJ disorders.

Methods:

Our study comprised 50 patients (35 female and 15 male) with a mean age of 30.61. Clinical examination was performed. Bilateral imaging of TMJ was conducted by using a high-resolution ultrasound and 1.5 Tesla MR. Diagnostic accuracy of ultrasound was assessed for disc displacement and joint effusion in comparison to MRI. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and accuracy (Ac) were calculated for ultrasound. Measurements were compared by Bland & Altman and intraclass correlation coefficient (ICC). Significance level was set at p < 0.05.

Results:

Most frequent complaints were noise 42 (84%) and 34 (68%) pain. For disc position assessment with ultrasound for both sides and closed-open mouth, sensitivity, specificity, PPV, NPV and accuracy ranged between, 0.88 – 1, 0.60 – 0.87, 0.70 – 0.97, 0.75 – 1, and 0.84 – 0.98, respectively. For the diagnosis of effusion with ultrasound for both sides, sensitivity, specificity, PPV, NPV and accuracy ranged between 0.65 – 0.81, 0.91 – 1, 0.96 – 1, 0.45 – 0.46 and 0.72 – 0.84, respectively. ICC values calculated for intraobserver agreement for right and left TMJ for all measurements were found to be statistically significant (p < 0.001). ICC values ranged between 0.964 and 0.995 suggesting excellent correlation among ultrasound and MRI. In general, for ultrasound measurements we found a mean difference ranging between −0.182 and +0.130 mm in comparison to MRI.

Conclusion:

Ultrasound can be suggested as an adjunct to common imaging modalities in the assessment of TMJ.
Pentraxin-3 and inflammatory biomarkers related to posterolateral thoracotomy in Thoracic Surgery
Authors: Dongel Isa , Gökmen Ayşegül Aksoy , Gönen Ibak , Kaya Selçuk
Published: February 2019

Objective: Posterolateral thoracotomy is the most frequently used operation in thoracic surgery, and may initiate an inflammatory process. We aimed to evaluate inflammatory response of the body to posterolateral thoracotomy.

Methods: This study was conducted between January 2013 and June 2014. Blood samples were drawn from 36 patients who underwent posterolateral thoracotomy preoperatively, and on postoperative days one, three and seven The levels of PTX-3,CRP and WBC in the serums of the patients were identified. All the results were recorded and analyzed.

Results: PTX-3 levels were found statistically significantly higher in patients with lung cancer and/or aged above 65 years. There were significant differences in WBC and CRP levels between preoperative levels and on those on postoperative days one, three and seven but not for PTX-3. The area under the curve(AUC) levels in the receiver operating characteristics(ROC) analysis, which was performed to estimate the strength of PTX-3 in the differentiation of malignant and benign patients was found statistically significant(p<0.05).

Conclusions: The present study suggests that the novel inflammatory marker PTX-3 may be used in the diagnosis and follow-up of prognosis as a biomarker of inflammatory response in patients with lung cancer. However, it showed that PTX-3 levels are insignificant to identify the levels of inflamatuar response due to posterolateral thoracotomy in thoracic surgery.

How to cite this:Dongel I, Gokmen AA, Gonen I, Kaya S. Pentraxin-3 and inflammatory biomarkers related to posterolateral thoracotomy in Thoracic Surgery. Pak J Med Sci. 2019;35(2):464-469.   doi: https://doi.org/10.12669/pjms.35.2.181

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The relationship between premenstrual syndrome and anger
Authors: Yeşildere Sağlam Havva , Basar Fatma
Published: February 2019

Objective: Premenstrual Syndrome (PMS) is a significant disorder affecting the daily life of women of reproductive age. The aims of this study was to determine the PMS prevalence and the examination of the relationship between PMS and anger.

Methods: This was a cross sectional study. The study was carried out with 720 women between the ages of 15-49 living in the province of Kutahya, Turkey. A Personal Information Form, the Premenstrual Syndrome Scale (PMSS) and the State-Trait Anger Scale (STAS) were used to collect data.

Results: The PMS prevalence was 48.75%. There was a statistically significant difference between the groups in terms of constant anger, anger-in, anger-out and anger control subscales (p <0.001). The average scores of women with PMS for constant anger anger-in and anger-out was significantly higher. The anger control scores were at a significantly lower level.

Conclusion: Women with PMS had higher anger and lower anger control levels. It should be advisable to recommend anger control management and provide social support so these women can cope with the symptoms. The result of our study emphasizes the importance of careful assessment of anger in women with premenstrual symptoms.

How to cite this:Saglam HY, Basar F. The relationship between premenstrual syndrome and anger. Pak J Med Sci. 2019;35(2):515-520.  doi: https://doi.org/10.12669/pjms.35.2.232

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Neonatal Vitamin D status and the risk of neonatal sepsis
Authors: Ozdemir Abdurrahman Avar , Cag Yakup
Published: February 2019

Objective: To evaluate the maternal and neonatal 25-hydroxyvitamin D [25(OH)D] levels and the effect of 25(OH)D levels on the development of neonatal sepsis.

Methods: This prospective study was performed in the neonatal intensive care unit of Medicine Hospital/Biruni University between November 2017 and September 2018. Fifty one term infants with sepsis group and 56 term infants with control group were included in this study. Blood samples for whole blood count, CRP, Ca, P, ALP, 25(OH)D and culture were obtained from all neonates.

Results: Mean vitamin D levels for the neonates and their mothers were found to be 12.4±8.5 ng/ml and 13±8.7 ng/ml, respectively. There was a significant correlation between maternal and newborn 25(OH)D levels (r=0.72, p<0.01). The number of the newborns with vitamin D deficiency was significantly higher in the sepsis group (n=31, 60.8%) than in the control group (n=30, 53.6%; p=0.00), corresponding to significantly lower levels of vitamin D in the sepsis group (11±5.5 ng/ml vs. 13.8±10.6 ng/ml; p=0.012). Similarly, maternal vitamin D levels was significantly lower in the sepsis group than in the control group (10.8±5.6 ng/ml vs. 14.9±10 ng/ml; p=0.001).

Conclusion: Our findings suggest that there may be an association between vitamin D deficiency and neonatal sepsis.

How to cite this:Ozdemir AA, Cag Y. Neonatal Vitamin D status and the risk of neonatal sepsis. Pak J Med Sci. 2019;35(2):-420-425.  doi: https://doi.org/10.12669/pjms.35.2.342

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Expression of CD44v6 and lymphatic vessel density in early gastric cancer tissues and their clinical significance
Authors: Sun Yuting , Yu Xiaowei , Li Mengdi , Zou Zhenhong
Published: February 2019

Objective: To explore the relationships between expression of CD44v6, lymphatic vessel density (LVD) and the clinicopathological parameters of patients.

Methods: One hundred early gastric cancer tissues, 55 high-grade gastric intraepithelial neoplasia (HGIN) tissues, 60 low-grade gastric intraepithelial neoplasia (LGIN) tissues and 60 chronic superficial gastritis tissues were collected and set as gastric cancer group, HGIN group, LGIN group and gastritis group respectively. The expression of CD44v6 and LVD of patients in all the groups were detected using two-step immunohistochemical method to analyze the relationships between the expression of CD44v6 and lymphatic vessel density in early gastric cancer tissues and their relationships with the clinicopathological parameters of patients. The values of LVD in predicting lymph node metastasis in early gastric cancer were evaluated using receiver operating characteristic (ROC) curve.

Results: The positive expression of CD44v6 and LVD in the gastritis group, LGIN group, HGIN group and gastric cancer group gradually increased. The positive expression of CD44v6 and LVD in early gastric cancer tissues were in no correlation with the gender, age, tumor site, maximum diameter, differentiation degree and invasion depth (P>0.05) and in a correlation with lymphatic metastasis and lymphatic vessel invasion (P<0.06). The positive expression of CD44v6 in the early gastric cancer tissues was in a positive correlation with LVD (P<0.05). The analysis of ROC curves suggested that the area under ROC curve of predicting lymphatic metastasis of early gastric cancer with LVD was 0.837 (95% CI: 0.756~0.910), and the cut-off value was 14; the corresponding sensitivity and specificity were 63.6% and 90.2 respectively.

Conclusion: The expression of CD44v6 and LVD in early gastric cancer tissues are in a close correlation with the clinicopathologic features, and joint detection of expression of CD44v6 and LVD can be taken as the indicator of gastric cancer metastasis.

How to cite this:Sun Y, Yu X, Li M, Zou Z. Expression of CD44v6 and lymphatic vessel density in early gastric cancer tissues and their clinical significance. Pak J Med Sci. 2019;35(2):549-554. doi: https://doi.org/10.12669/pjms.35.2.464

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The outcomes of transobturator tape intervention in the treatment of stress urinary incontinence: Two years’ follow-up
Authors: Şık Bulat Aytek , Copur Hanife , Aba Yılda Arzu
Published: February 2019

Objective: To evaluate the clinical outcomes and the effects on quality of life of transobturator tape surgery during a 2-year follow-up period in our clinics.

Methods: Eighty-seven patients with stress or mixed urinary incontinence who underwent transobturator tape surgery were included in the study conducted in Istanbul. Taksim. Training. and Research Hospital Gynecology and Obstetrics Clinic, between 2011 and 2013. The patients’ demographic features, incontinence questionnaires, quality of life scores [Incontinence Impact Questionnaire (IIQ-7) and urinary distress inventories (UDI-6)], examination findings, urodynamic results, stress tests, Q tip tests, number of daily pads, ultrasonography, surgery, and cystoscopy results were recorded. Patients were evaluated 23-27 months (mean: 25.40±1.31 months) after their discharge in terms of symptoms, quality of life scores, urodynamic findings, complications, and stress test.

Results: Sixty-three (72.4%) patients had stress incontinence and 24 (27.6%) patients had mixed urinary incontinence. No perioperative complications were observed in our study. After a follow-up period of two years, a significant improvement was detected in the IIQ-7 and UDI-6 questionnaires when compared with the preoperative period. Moreover, the objective cure rate was found as 88.5% (n=77). De novo urge incontinence was obtained in 5.7% (n=5) of patients and was treated with anticholinergics. Perineal pain was present in 3 (3.44%) patients and was treated with analgesics and cold packs. In 2 (2.29%) patients, vaginal mesh erosion was detected and full recovery was achieved with an excision. Urinary retention and bladder perforation was not seen in any patients.

Conclusion: Our study revealed a high objective cure rate, and an improvement in symptoms and quality of life with the transobturator tape operation.

How to cite this:Sik BA, Copur H, Yilda Arzu ABA. The outcomes of transobturator tape intervention in the treatment of stress urinary incontinence: Two years’ follow-up. Pak J Med Sci. 2019;35(2):477-482. doi: https://doi.org/10.12669/pjms.35.2.603

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effectiveness of SIESTA on Objective and Subjective Metrics of Nighttime Hospital Sleep Disruptors
Authors: Arora Vineet M , Machado Nolan , Anderson Samantha L. , Desai Nimit , Marsack William , Blossomgame Stephenie , Tuvilleja Ambrosio , Ramos Jacqueline , Francisco Mary Ann , LaFond Cynthia , Leung Edward KY , Valencia Andres , Martin Shannon K , Meltzer David O , Farnan Jeanne M , Balachandran Jay , Knutson Kristen L , Mokhlesi Babak
Published: February 2019

We created Sleep for Inpatients: Empowering Staff to Act (SIESTA), which combines electronic “nudges” to forgo nocturnal vitals and medications with interprofessional education on improving patient sleep. In one “SIESTA‐enhanced unit,” nurses received coaching and integrated SIESTA into daily huddles; a standard unit did not. Six months pre‐ and post‐SIESTA, sleep‐friendly orders rose in both units (foregoing vital signs: SIESTA unit, 4% to 34%; standard, 3% to 22%, P < .001 both; sleep‐promoting VTE prophylaxis: SIESTA, 15% to 42%; standard, 12% to 28%, P < .001 both). In the SIESTA‐enhanced unit, nighttime room entries dropped by 44% (‐6.3 disruptions/room, P < .001), and patients were more likely to report no disruptions for nighttime vital signs (70% vs 41%, P = .05) or medications (84% vs 57%, P = .031) than those in the standard unit. The standard unit was not changed. Although sleep‐friendly orders were adopted in both units, a unit‐based nursing empowerment approach was associated with fewer nighttime room entries and improved patient experience.
The Association of Discharge Before Noon and Length of Stay in Hospitalized Pediatric Patients
Authors: James Hailey J , Steiner Michael J , Holmes George M , Stephens John R
Published: February 2019

BACKGROUND AND OBJECTIVES

To optimize patient throughput, many hospitals set targets for discharging patients before noon (DCBN). However, it is not clear whether DCBN is an appropriate measure for an efficient discharge. This study aims to determine whether DCBN is associated with shorter length of stay (LOS) in pediatric patients and whether that relationship is different between surgical and medical discharges.

METHODS

From May 2014 to April 2017, we performed a retrospective data analysis of pediatric medical and surgical discharges belonging to a single academic medical center. Patients were included if they were 21 years or younger with at least one night in the hospital. Propensity score weighted multivariate ordinary least squares models were used to evaluate the association between DCBN and LOS.

RESULTS

Of the 8,226 pediatric hospitalizations, 1,531 (18.61%) patients were DCBN. In our multivariate model of all the discharges, DCBN was associated with an average of 0.27 day (P = .014) shorter LOS when compared to discharge in the afternoon. In our multivariate medical discharge model, DCBN was associated with an average of 0.30 (P = .017) day decrease in LOS while the association between DCBN and LOS was not significant among surgical discharges.

CONCLUSIONS

On average, at a single academic medical center, DCBN was associated with a decreased LOS for medical but not surgical pediatric discharges. DCBN may not be an appropriate measure of discharge efficiency for all services.
Things We Do For No Reason: Contact Precautions for MRSA and VRE
Authors: Young Kristen , Doernberg Sarah B , Snedecor Ruth Franks , Mallin Emily
Published: February 2019

Inspired by the ABIM Foundation's Choosing Wisely® campaign, the “Things We Do for No Reason” (TWDFNR) series reviews practices that have become common parts of hospital care but may provide little value to our patients. Practices reviewed in the TWDFNR series do not represent “black and white” conclusions or clinical practice standards but are meant as a starting place for research and active discussions among hospitalists and patients. We invite you to be part of that discussion.
Outpatient Parenteral Antimicrobial Therapy in Vulnerable Populations— People Who Inject Drugs and the Homeless
Authors: Beieler Alison , Magaret Amalia , Zhou Yuan , Schleyer Anneliese , Wald Anna , Dhanireddy Shireesha
Published: February 2019

Outpatient parenteral antimicrobial therapy (OPAT) programs can provide high‐value care but may be challenging in people who inject drugs (PWID) and homeless individuals. We conducted a single‐center, retrospective, cohort study of adults who received OPAT at an urban, public health hospital from January 1, 2015 to April 30, 2016, grouped by PWID and housing status. Outcomes included clinical cure, length of stay, secondary bacteremia, line‐tampering, and readmission. A total of 596 patients (homeless PWID (9%), housed PWID (8%), homeless non‐PWID (8%), and housed non‐PWID (75%), received OPAT. Assuming that patients lost to follow‐up failed therapy, homeless PWID were least likely to achieve cure compared with housed non‐PWID, (odds ratio [OR] = 0.33, 95% CI 0.18‐0.59; P < .001). Housed PWID were also less likely to achieve cure (OR = 0.37, 95% CI 0.20‐0.67; P = .001). Cure rates did not differ in patients not lost to follow‐up. OPAT can be effective in PWID and the homeless, but loss to follow‐up is a significant barrier.
Adherence to Recommended Inpatient Hepatic Encephalopathy Workup
Authors: Kumral Dennis , Qayyum Rehan , Roseff Susan , Sterling Richard K , Siddiqui Mohammad S
Published: February 2019

Hepatic encephalopathy (HE) is characterized by altered sensorium and is the most common indication for hospitalization among patients with cirrhosis. Liver societal guidelines for inpatient HE revolve around identification of potential precipitants. In this retrospective study, we aimed to determine adherence to societal guidelines for evaluation of HE in 78 inpatients. The adherence rate to societal recommended guidelines for workup of HE was low, with only 17 (22%) patients having complete diagnostic workup within 24 hours of admission. Notably, 23 (30%) patients were not subjected to blood culture analysis, 16 (21%) were missing urinalysis, and 15 (20%) were missing chest radiograph. In patients with ascites (N = 34), 26 (77%) did not have a diagnostic paracentesis to exclude spontaneous bacterial peritonitis. In contrast, serum ammonia determination, a laboratory test not endorsed by societal guidelines for workup of HE, was ordered in 74 (95%) patients. These findings underscore the limited adherence to societal guidelines in hospitalized patients with HE.
Hire Hard, Manage Easy
Authors: Chopra Vineet , Saint Sanjay
Published: February 2019

The socio‐adaptive (or “nontechnical”) aspects of healthcare including leadership, followership, mentorship, culture, teamwork, and communication are not formally taught in medical training. Yet, they are critical to our daily lives as Hospitalists. The LPD series features brief “pearls of wisdom” that highlight these important lessons.
Risk factors for the development of oedema and lymphoedema
Authors: Woods Mary
Published: February 2019

An important symptom of ill health in clinical medicine is the development of oedema, which represents an imbalance in the amount of fluid entering and leaving the tissues of the body. Although medical treatment for the underlying cause of oedema is required, in both cancer and non-cancer settings risk factors that may increase or decrease the potential for oedema to develop or worsen can be identified. For the patient who has risk factors for the development of oedema, advice and education can enable the risk to be modified. Reducing the risk of oedema formation will help avoid long-term problematic oedema and complex skin conditions, as well as maintaining the patient's quality of life. This article discusses some of the risk factors for oedema and lymphoedema and concludes with an outline of how the risk can be managed.
View from the top: the health secretary's views on patient safety
Authors: Tingle John
Published: February 2019

John Tingle discusses issues raised in a recent speech on patient safety by the Secretary of State for Health and Social Care, Matt Hancock
Self-care is a vital part of safe care
Authors: Foster Sam
Published: February 2019

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the need for those involved in frontline care to be empowered to look after their own wellbeing, in order to provide high-quality care for patients
Cheek augmentation with dermal fillers: considerations for optimal results
Authors: Dennison Tracey
Published: February 2019

The popularity of dermal filler injections to treat a range of aesthetic concerns continues to rise worldwide. One area that can be effectively treated using dermal fillers is the cheeks. A lifted, rounded and volumised cheek can help to reflect ambient light to the eyes and restore a youthful look to the face. However, it is important that the rest of the face is considered when planning treatment, as treating one area and neglecting others can lead to an unbalanced look. Furthermore, female and male patients may desire different treatment outcomes, and it is important that this is considered when developing a treatment plan.

This article explores the factors that must be considered when volumising the cheeks using dermal fillers. This includes patient assessment, skin quality, predicting outcomes, managing expectations, and product and volume selection. Differences between treating male and female patients are discussed.
Body dysmorphic disorder and aesthetic procedures
Authors: Gorbis Eda
Published: February 2019

Aesthetic practitioners treat all kinds of people, and each one is motivated to seek treatment for different reasons. In some cases, patients may have underlying issues that encourage them to seek aesthetic procedures. In this comment piece, Eda Gorbis explores the issue of body dysmorphic disorder in aesthetic patients, and provides recommendations on how to identify and treat this psychiatric disorder
Time to think about the role of ethics in aesthetics
Authors: Collier Helena
Published: February 2019

This month sees the start of the Journal of Aesthetic Nursing's ‘Ethics in Aesthetics’ campaign, which will run for the duration of 2019, and which aims to tackle a variety of ethical issues within the medical aesthetics field. In this article, Helena Collier explores the ethical issues that confront aesthetic healthcare professionals, and calls for greater consideration of ethics in aesthetic nursing
Studying the Mechanisms of Nitro Compounds Reduction (A-Review)
Authors: Sassykova L. R. , Aubakirov Y. A. , Sendilvelan S. , Tashmukhambetova Zh. Kh. , Zhakirova N. K. , Faizullaeva M. F. , Batyrbayeva A. A. , Ryskaliyeva R. G. , Tyussyupova B. B. , Abildin T. S.
Published: February 2019

The article describes some variants of mechanisms of nitro compounds reduction, offered by authors in the scientific literature. The focus is on the description of the work of Kazakh and Russian chemists working in the field of catalysis. In most of the works, the classical scheme of the mechanism of the hydrogenation of Haber-Lukashevich nitrobenzene is confirmed and detailed by experimental methods. One of the interesting aspect of the article is description the mechanism of Ya.A. Dorfman which used the orbital theory of catalysis. The orbital approach of the Ya.A. Dorfman mechanism is constructed in the light of modern orbital representations and is valid for the hydrogenation of the nitro group on various catalysts. Among the discussed mechanisms are ideas of Haber, Debus, Jungers, V.P. Shmonina, Lukashevich, M. Geirovsky, Yu. B. Vasilyev, M.V. Klyuev, E.F. Weinstein, E. Gelder, Ya.A. Dorfman and others.
Carbon Dots Modification for Escherichia coli Detection: Variation of Colistin Sulphate Concentration
Authors: Suherman Suherman , Audio Haryanto Nicko , Tri Wahyuni Endang , Ilmi Miftahul , Morita Kinichi , Oki Yuji
Published: February 2019

Escherichia coli (E. coli) bacteria widely recognize as a major treatment in water quality as diarrhea disease becoming one of leading causes of mortality worldwide. Carbon dots (CDs) modification study for detection of E. coli with the variation of colistin sulphate concentration has been conducted. The purpose of this research is to evaluate the effect of colistin sulphate concentration variation on fluorescence intensity for detecting E. coli bacteria in water samples. This study started by synthesizing CDs and CDs colistin variation concentrations of 1.0; 1.5; 2.0 and 2.5 mmol through carbonization of ammonium citrate and the addition of colistin. All precursors are characterized by using FT-IR. Morphological forms were evaluated with scanning emission microscopy (SEM) and transmission electron microscopy (TEM). CDs and CDs colistin solutions were measured their spectras with a UV-Vis spectrophotometer. Each of these CDs colistin was determined at the excitation wavelength ranges of 310-450 nm using a spectrofluorophotometer. Subsequently, CDs colistin was used for bacterial detection in samples with variation in E. coli bacteria concentration, thus analyzed by spectrofluorophotometer with an optimum excitation wavelength. The results showed that the highest intensity of fluorescence on CDs colistin occurred at the wavelength excitation of 360 nm. CDs colistin with the variation of colistin concentration 2.5 mmol revealed the highest fluorescence intensity. For the detection of E. coli, all CDs colistin produced the same trends of fluorescence spectra as the higher concentration of E. coli in the samples produced the higher intensity of emission.
Triterpenoids from the Bark of Aglaia glabrata and their In vitro Effects on P-388 Murine Leukemia Cells
Authors: Harneti Desi , Supriadin Asep , Maharani Rani , Nurlelasari Nurlelasari , Mayanti Tri , Tatang Hidayat Ace , Anwar Risyandi , Supratman Unang , Awang Khalijah , Shiono Yoshihito
Published: February 2019

Four dammarane-type triterpenoids, dammardienon (1), aglaiabbreviatin E (2), dammar-20,25-dien-3b,24-diol (3) and dammar-24-en-3b,20-diol (4) were isolated from methanolic extract of the bark of Aglaia glabrata. The structures of all triterpenoids were elucidated by 1D-, 2D-NMR, and comparison with previously reported data. All triterpenoids were applied into in vitro bioassay against P-388 murine leukemia cell. Dammar-24-en-3b,20-diol (4) has cytotoxic activity with IC50 value of 9.45 mM towards P-388 murine leukemia cell lines.
Synthesis and Spectroscopic Studies of New Palladium(II) Complexes of N-hydroxymethyl Saccharin (Sac-CH2OH) and Amines or Diaminas Ligands
Authors: S. Al-Janabi Ahmed , A. Al-Dulaimi Adnan , M. Gergees Hayfa , H. Saleh Mohammed
Published: February 2019

Treatment of the chelated palladium(II) complex, trans-[Pd(K2-Sac-CH2O)2].2H2O with one mole equivalent of the diammines (L-L), L-L = 2,2'-bipyridine (bipy),. ethylene diamine (en), 1,10-phenanthroline (phen), or N,N-dimethyl ethylene diammine (dmen) in EtOH solvent afforded mixed ligand complexes of the type [Pd(K1-Sac-CH2O)2(L-L)] in 82-93% yield. While treatment of trans-[Pd(K2-Sac-CH2O)2].2H2O with two mole equivalents of the monoamines (L), L=pyridine (py), 3-methylpyridine (3-mpy) or 3-aminopyridine (3-apy) in EtOH solvent gave trans-[Pd(K1-Sac-CH2O)2(L)2] complexes in 86-89% yield The prepared complexes were characterized by elemental CHN analysis, .conductivity measurements,. infrared and 1H nmr spectra.
Low Molecular Weight Chitosan from Shrimp Shell Waste using Steam-Explosion Process Under Catalyst of Phosphotungstic Acid
Authors: Sugiyanti Dina , Anggrahini Sri , Pranoto Yudi , Anwar Chairil , Santoso Umar
Published: February 2019

The limited solubility of chitosan had limiting its application in any fields. Low molecular weight chitosan (LWCS) potentially produced to improve its solubility and characteristics. Steam explosion process was used to breakdown the intermolecular hydrogen bonding and phosphotungstic acid used as catalyst to attact the glycosidic bond and produce shorter chain. The optimum temperature and phosphotungstic acid concentration on steam explosion process presented highest water solubility at T=160oC and 0.1%, respectively. It didn’t showed any change of functional group on FTIR analysis, no morphological damage by SEM analysis, and reduced the crystallinity. The particle size and molecular weight was reduced from 100 µm to 255 nm and 557 kDa to 4800 Da, respectively. It can be known that LWCS potentially produced with high solubility and fine characteristics through steam explosion process catalyzed by phosphotungstic acid.
Preliminary Column Study and Biosorption Kinetic Profile of Cadmium (II) by Epichlorohydrin-Crosslinked Lumbang (Aleurites molucanna) Chitosan Composite
Authors: R. Villarante Nelson , Jon D. Tumpalan Jeriel , Erl P. Sumalapao Derick
Published: February 2019

In this study, the biosorption potential of lumbang (Aleurites molucanna)-derived activated carbon towards Cd(II) in aqueous solution was investigated by coating and crosslinking the adsorbent with chitosan and epichlorohydrin, respectively. Batch adsorption studies were performed, and the effects of various parameters were evaluated. Results have shown that the optimum biosorption potential occurs at pH: 6.0, contact time: 45 min, temperature: 40°C, adsorbent dosage: 12 g/L, and initial Cd(II) concentration: 5 ppm. The biosorption kinetic profile obeyed the pseudo second-order kinetic model (R2=96.87%, p<0.001). Preliminary column study and waste water analysis revealed significant removal of Cd(II), with 89.59% and 49.08% of Cd(II) adsorbed and desorbed, respectively. There were significant reductions in the biochemical and chemical oxygen demand values of the waste water before and after passing through the column.
An Experimental Investigation of ZnO Nanoparticles Effect on the Acrylic Coatings
Authors: Khalaji Ghazaleh , Maleki Mostafa , `Memand Ashkan
Published: February 2019

In this study, the properties of acrylic coatings based on paraloid B-72 were improved by adding of ZnO nanoparticles. Steel plates were used as substrate. ZnO nanoparticles was analyzed by transmission electron microscopy (TEM). The effect of adding ZnO nanoparticles on the the coatings was investigated using contact angle measurements. The modified coating with a ZnO nanoparticles showed more efficient performance than the net coating after 30 days UV radiation. Generally, this work confirm the positive effect of adding ZnO nanoparticles on acrylic coatings.
‘Guilty’ pleasures are often worthwhile pleasures
Authors: Cooke Brandon
Published: February 2019

A guilty pleasure is something that affords pleasure while being held in low regard. Since there are more opportunities to experience worthwhile pleasures than one can experience in a finite life, it would be better to avoid guilty pleasures. Worse still, many guilty pleasures are thought to be corrupting in some way. In fact, many so-called guilty pleasures can contribute to a good life, because they are sources of pleasure and because they do not actually merit guilt. Taking pornography as a case study, I argue that in the absence of compelling evidence for its harmfulness, pornography can contribute to well-being by promoting autonomy, social recognition, knowledge and flourishing personal relationships. The case of pornography demonstrates an argumentative strategy for defending many so-called guilty pleasures as worthwhile elements of a flourishing life.
Using health as an argument: The Swedish porn debate 2013–18
Authors: Larsson Mariah
Published: February 2019

This short subject delineates the current Swedish debate about pornography’s harmful effects on children as a public health problem and situates it in a discursive and socio-geographical context. It describes how the arguments of the Swedish debate align with those of an international anti-porn discourse and cautions against normative assignations of sexual practices as ‘healthy’ or ‘unhealthy’.
Realism or ‘grotesque clichés’? Jan Halldoff’s The Corridor and the Swedish debate on abortion in the 1960s
Authors: Björklund Elisabet
Published: February 2019

Swedish filmmaker Jan Halldoff’s fiction film Korridoren (The Corridor) premiered in 1968 to a mainly positive Swedish reception. Shot at Karolinska Hospital and criticizing the Swedish healthcare system, the film became much debated and can furthermore be seen as a turning point in Swedish film history regarding the portrayal of medical institutions and professionals. In this article, the film and its reception are analysed in relation to the Swedish debate on abortion at the time. While the film is clearly critical of Swedish welfare society, the way it depicts abortion is more conservative. Highlighting this as well as the role of actual medical professionals in the film, the article demonstrates how the film relates to representations of abortion in the past and discusses connections between the film industry and medicine at this historical moment.
Evoking a shared past by enforcing nostalgia? On the role of media in nursing homes
Authors: Christensen Christa Lykke
Published: February 2019

Media serve different practical, social and emotional purposes in everyday life at nursing homes. Based on observational studies and interviews with care workers at Danish nursing homes for older people, this article describes how media are integrated in everyday activities in shared spaces at nursing homes with the intention to create a safe and comfortable atmosphere where the residents feel at home. In particular, the concept of mediated nostalgia is used to consider how care workers, to the benefit of the well-being of the elderly residents, screen popular comedies. In this way they aim to stimulate residents emotionally, to evoke their memories and to create a shared past among them.