bluuebunny/crossref_metadata_2025 huggingface dataset:
Band gap engineering of ZnSnN2/ZnO (001) short-period superlattices via built-in electric field
Authors: Fang D. Q. , Zhang Y. , Zhang S. L.
Published: December 2016

Using density-functional-theory calculations combined with hybrid functional, we investigate the band gaps and built-in electric fields of ZnSnN2/ZnO (001) short-period superlattices. The band gap of ZnSnN2/ZnO (001) superlattice can be tuned from 1.9 eV to 0 eV by varying the thickness of both the ZnSnN2 and ZnO regions. Compared to the III-nitride superlattices, stronger built-in electric fields, induced by the polarizations, form inside the ZnSnN2/ZnO superlattices. The lowest electron and uppermost hole states are mainly localized at the two opposite interfaces of the superlattice, but the tails of the lowest electron states extend over several atomic layers. Based on the electrostatic argument, we demonstrate that variations of the band gap are approximately described by a geometric factor. The influence of the in-plane strain is also discussed. The results will be valuable in the design of ZnSnN2/ZnO heterostructures for electronics and optoelectronics applications.
Vapor bridges between solid substrates in the presence of the contact line pinning effect: Stability and capillary force
Authors: Liu Yawei , Zhang Xianren
Published: December 2016

In this work, we focus on investigating how nanobubbles mediate long-range interaction between neighboring solid substrates in the presence of the contact line pinning effect caused by surface heterogeneities. Using the constrained lattice density functional theory (LDFT), we prove that the nanobubbles, which take the form of vapor bridges here, are stabilized by the pinning effect if the separation between two substrates is less than a critical distance. The critical distance strongly depends on the chemical potential (i.e., the degree of saturation) and could become extremely long at a special chemical potential. Moreover, under the pinning effect, the substrate chemistry only determines the stability of the vapor bridges and the range of the capillary force, but has less influences on the magnitude of the capillary force, indicating that the substrate chemistry or the apparent contact angle for droplets or bubbles on the substrates is no longer a direct parameter to determine the magnitude of capillary force. A qualitative analysis for the two dimensional vapor bridges by considering the feedback mechanism can explain the results from the LDFT calculations.
Stability of finitely incompressible magnetized plasma layer through porous fluids
Authors: Hoshoudy G. A.
Published: December 2016

The combined effect of horizontal and vertical magnetic fields on the instability of the incompressible plasma layer of finite thickness through porous medium is investigated. The layer is confined between two rigid boundaries. The basic Magnetohydrodynamics set of equations have been constructed and linearized. The dispersion relation is obtained by applying the appropriate boundary conditions and solved numerically. The results show that the presence of both magnetic field components besides the resistive and convective terms will bring about more stability on the considered system.
Hybrid simulations of a parallel collisionless shock in the large plasma device
Authors: Weidl Martin S. , Winske Dan , Jenko Frank , Niemann Chris
Published: December 2016

We present two-dimensional hybrid kinetic/magnetohydrodynamic simulations of planned laser-ablation experiments in the Large Plasma Device. Our results, based on parameters that have been validated in previous experiments, show that a parallel collisionless shock can begin forming within the available space. Carbon-debris ions that stream along the magnetic-field direction with a blow-off speed of four times the Alfvén velocity excite strong magnetic fluctuations, eventually transferring part of their kinetic energy to the surrounding hydrogen ions. This acceleration and compression of the background plasma creates a shock front, which satisfies the Rankine–Hugoniot conditions and can therefore propagate on its own. Furthermore, we analyze the upstream turbulence and show that it is dominated by the right-hand resonant instability.
The influence of laser ablation plume at different laser incidence angle on the impulse coupling coefficient with metal target
Authors: Zhao Xiong-Tao , Tang Feng , Han Bing , Ni Xiao-Wu
Published: December 2016

A calibrated pendulum measuring device and a dimensionless analysis method were used to measure the impulse coupling coefficient at different laser intensities with aluminum, steel, and iron targets. The experiment was performed with a pulsed laser with the wavelength of 1.06 μm and the pulse duration of 7 ns. The experimental measurements of the variation of the impulse coupling coefficient versus the laser energy density agree with the theoretical prediction, and the optimum laser energy density correlated with the maximum impulse coupling coefficient corresponding to the theoretical predictions. The impulse coupling coefficients with laser incidence angles of 0° and  45° are compared for understanding of the effects of the ablation plume on the impulse coupling effect, and the experimental result shows that the impulse coupling effect grows as the incidence angle changes from  0° to 45°. Furthermore, the transmittance of the incident laser through the ablation plume in front of the target is deduced from the impulse measurements, and the effect of the ablation plume on the impulse coupling at high laser intensity is discussed. In order to investigate the weak impulse coupling effect, which is difficult to obtain from the experiments, the impulse coupling coefficient at low laser energy density was calculated by the finite element simulation.
In-situ transmission electron microscopy study of oxygen vacancy ordering and dislocation annihilation in undoped and Sm-doped CeO2 ceramics during redox processes
Authors: Ding Yong , Chen Yu , Pradel Ken C. , Liu Meilin , Lin Wang Zhong
Published: December 2016

Ceria (CeO2) based ceramics have been widely used for many applications due to their unique ionic, electronic, and catalytic properties. Here, we report our findings in investigating into the redox processes of undoped and Sm-doped CeO2 ceramics stimulated by high-energy electron beam irradiation within a transmission electron microscope (TEM). The reduced structure with oxygen vacancy ordering has been identified as the CeO1.68 (C-Ce2O3+δ) phase via high-resolution TEM. The reduction of Ce4+ to Ce3+ has been monitored by electron energy-loss spectroscopy. The decreased electronic conductivity of the Sm-doped CeO2 (Sm0.2Ce0.8O1.9, SDC) is revealed by electron holography, as positive electrostatic charges accumulated at the surfaces of SDC grains under electron beam irradiation, but not at CeO2 grains. The formation of the reduced CeO1.68 domains corresponds to lattice expansion compared to the CeO2 matrix. Therefore, the growth of CeO1.68 nuclei builds up strain inside the matrix, causing annihilation of dislocations inside the grains. By using in-situ high-resolution TEM and a fast OneView camera recording system, we investigated dislocation motion inside both CeO2 and SDC grains under electron beam irradiation. The dislocations prefer to dissociate into Shockley partials bounded by stacking faults. Then, the partials can easily glide in the {111} planes to reach the grain surfaces. Even the Lomer-Cottrell lock can be swept away by the phase change induced strain field. Our results revealed the high mobility of dislocations inside CeO2 and SDC grains during their respective redox processes.
Are organisational factors affecting the emotional withdrawal of community nurses?
Authors: Karimi Leila , Leggat Sandra G. , Cheng Cindy , Donohue Lisa , Bartram Timothy , Oakman Jodi
Published: December 2016

Objective
The aim of the present study was to investigate the effects of work organisation on the emotional labour withdrawal behaviour of Australian community nurses.

Methods
Using a paper-based survey, a sample of 312 Australian community nurses reported on their emotional dissonance, withdrawal behaviours (i.e. job neglect, job dissatisfaction, stress-related presenteeism) and work organisation. A model to determine the partial mediation effect of work organisation was developed based on a literature review. The fit of the proposed model was assessed via structural equation modelling using Analysis of Moment Structures (AMOS; IMB).

Results
Community nurses with higher levels of emotional dissonance were less likely to be satisfied with their job and work organisation and had a higher tendency to exhibit withdrawal behaviours. Work organisational factors mediated this relationship.

Conclusion
Emotional dissonance can be a potential stressor for community nurses that can trigger withdrawal behaviours. Improving work organisational factors may help reduce emotional conflict and its effect on withdrawal behaviours.

What is known about the topic?
Although emotional labour has been broadly investigated in the literature, very few studies have addressed the effect of the quality of work organisation on nurses’ withdrawal behaviours in a nursing setting.

What does this paper add?
This paper provides evidence that work organisation affects levels of emotional dissonance and has an effect on job neglect through stress-related presenteeism.

What are the implications for practitioners?
In order to minimise stress-related presenteeism and job neglect, healthcare organisations need to establish a positive working environment, designed to improve the quality of relationships with management, provide appropriate rewards, recognition and effective workload management and support high-quality relationships with colleagues.
Factors affecting job satisfaction of Aboriginal mental health workers working in community mental health in rural and remote New South Wales
Authors: Cosgrave Catherine , Maple Myfanwy , Hussain Rafat
Published: December 2016

Objective
The aim of the present study was to identify factors affecting the job satisfaction and subsequent retention of Aboriginal mental health workers (AMHWs).

Methods
Five AMHWs working in New South Wales (NSW) for NSW Health in rural and remote community mental health (CMH) services participated in in-depth, semi-structured interviews to understand how employment and rural living factors affected workers’ decisions to stay or leave their CMH positions.

Results
Using a constructivist grounded theory analysis, three aspects negatively impacting the job satisfaction of AMHWs were identified: (1) difficulties being accepted into the team and organisation; (2) culturally specific work challenges; and (3) professional differences and inequality.

Conclusions
Policy and procedural changes to the AMHW training program may address the lower remuneration and limited career opportunities identified with regard to the Bachelor Health Sciences (Mental Health) qualification. Delivering training to increase levels of understanding about the AMHW training program, and cultural awareness generally, to CMH staff and NSW Health management may assist in addressing the negative team, organisational and cultural issues identified.

What is known about the topic?
The Bachelor Health Sciences (Mental Health) qualification and traineeship pathway undertaken by AMHWs differs significantly from that of other health professionals working in NSW Health’s CMH services. The health workforce literature identifies that each health professional group has its own culture and specific values and that forming and maintaining a profession-specific identity is an extremely important aspect of job satisfaction for health workers.

What does the paper add?
AMHWs working in rural and remote NSW CMH services commonly experience low levels of job satisfaction, especially while undertaking the embedded training program. Of particular concern is the health sciences qualification not translating into NSW Health’s ‘professionalised’ workplace, as well as having negative effects with regard to remuneration and career opportunities within NSW Health. In addition, role challenges involving cultural differences and managing additional professional and personal boundaries negatively affects the job satisfaction of AMHWs.

What are the implications for practice?
The current structure of the AMHW training program creates workplace conditions that contribute to job dissatisfaction among rural and remote-based AMHWs. Many issues could be rectified by NSW Health making changes to the degree qualification obtained under the training program, as well as raising the level of understanding about the program and Indigenous cultural awareness generally among CMH staff and NSW Health management.
Quantifying predation attempts on arboreal marsupials using wildlife crossing structures above a major road
Authors: Soanes Kylie , Mitchell Briony , van der Ree Rodney
Published: December 2016

We review eight years of monitoring data to quantify the number of predation attempts on arboreal marsupials using canopy bridges and glider poles across a major road in south-east Australia. We recorded 13 488 detections of arboreal marsupials on the structures, yet only a single (and unsuccessful) predation attempt was recorded.
Comparing non-occupational post-exposure prophylaxis drug regimens for HIV: insights from a linked HIV surveillance system
Authors: Pierce Anna B. , El-Hayek Carol , McCarthy Damien , Armishaw Jude , Watson Kerrie , Wilkinson Anna , Price Brian , Wright Edwina J. , Hoy Jennifer F. , Stoové Mark A.
Published: December 2016

Background
International non-occupational post-exposure prophylaxis (NPEP) guidelines recommend routine use of three drug NPEP regimens, despite absence of evidence for greater prevention efficacy compared with two drug regimens. This study examines the potential for excess HIV seroconversions among high-risk men who have sex with men (MSM) reporting receptive anal intercourse with a source of unknown HIV serostatus (RAIU) following a two-drug versus a three-drug NPEP regimen. Methods: Data for MSM in the Victorian NPEP service database between 10 August 2005 and 31 December 2012 were linked with all Victorian HIV notifications up to 31 December 2013. The primary outcome was NPEP failure following NPEP presentation among MSM reporting RAIU, stratified by the number of drugs prescribed. Results: Among 1482 MSM reporting 2002 episodes of RAIU and prescribed two- or three-drug NPEP, 70 seroconverted to HIV, but only 19 were considered possible NPEP failures. HIV diagnosis incidence among men reporting RAIU was 1.2/100 person years (PY) (95%CI = 1.0–1.6); 1.1/100 PY (95%CI = 0.8–1.4) among MSM prescribed two drugs and 2.2/100 PY (95%CI = 1.4–3.7) among MSM prescribed three drugs (P < 0.01). Of the 19 possible NPEP failures, 13 (0.7%) were prescribed two drugs and six (2.7%) three drugs (P < 0.001). Conclusions: This study suggests that two-drug NPEP regimens do not result in excess seroconversions compared with three-drug regimens when used following RAIU. Clinical services should carefully consider their use of three drug NPEP and whether resources might be better invested in other prevention strategies, particularly pre-exposure prophylaxis (PrEP).
Characterisation of soil organic matter in a semi-arid fluvic Entisol fertilised with cattle manure and/or gliricidia by spectroscopic methods
Authors: Primo Dário C. , Menezes Rômulo S. C. , Silva Wilson T. L. , Oliveira Fabio F. , Júnior José C. B. D. , Sampaio Everardo V. S. B.
Published: December 2016

The stable fraction of soil organic matter (SOM) has received considerable attention due to concerns about the sustainability of agricultural systems. The main structural characteristics of the SOM of an Entisol in the semi-arid region of Paraíba state, Brazil, after 6 years of cultivation of annual crops with different organic fertiliser treatments, were determined. Six different treatments were evaluated, as follows: (1) gliricidia prunings (Gliricidia sepium Jacq. Walp) incorporated into the soil before planting (GI); (2) cattle manure incorporated before planting (MI); (3) gliricidia applied after planting (GS); (4) manure and gliricidia incorporated before planting (MI+GI); (5) manure incorporated before planting and gliricidia applied after planting (MI+GS); and (6) a control treatment. Spectroscopic techniques were used to analyse carbon in whole soil samples (0–20cm), as well as in fulvic acid (FA) and humic acid (HA) extracts. Surface-applied gliricidia resulted in the highest SOM content. Laser-induced fluorescence spectroscopy showed that MI+GS contributed to increases in the degree of humification, whereas for the HA fraction, the highest degree of humification occurred with the GS treatment. The ultraviolet–visible absorbance spectra of FA fractions indicated the presence of fresh soluble SOM in all treatments except GS, and mid-infrared region spectra revealed no differences in the chemical structure of the HA fractions. Application of gliricidia prunings (GI and GS), which are nitrogen rich and highly labile, resulted in low HA transformations compared with the control based on nuclear magnetic resonance analysis. Therefore, gliricidia, whether incorporated before planting or applied after planting, decreases the labile fractions of SOM, probably because of its higher decomposition rates.
How a risk focus in emergency management can restrict community resilience – a case study from Victoria, Australia
Authors: Paschen Jana-Axinja , Beilin Ruth
Published: December 2016

The research investigated understandings of risk and resilience in emergency management (EM) policy and practice. The core findings illustrate how a complex of institutionalised socio-cultural expectations and standardised processes – that is, evidence-based response models to deal with and communicate uncertainty – influence the operationalisation of resilience in EM. We observe that a focus on disaster risk as a quantifiable product of physical hazards is an attempt to control uncertainty and leads to engineered or technology-centred response solutions. Accordingly, community resilience is principally seen as the product of risk reduction, incident response and recovery interventions. The research shows that resultant command and control management practices produce limited – and limiting – interpretations of community resilience as disaster resilience. This can restrict existing and emergent community responses to risk, and the ability to imagine and enact more systemic types of community resilience. For instance, the short-term disaster focus tends to neglect the social and institutional root causes of community vulnerability and generic risk information is detached from everyday community experience. Using wildfire in Australia as its case study, this paper discusses the social, cultural and practical challenges of operationalising social–ecological resilience in EM.
The right incentives enable ocean sustainability successes and provide hope for the future
Authors: Lubchenco Jane , Cerny-Chipman Elizabeth B. , Reimer Jessica N. , Levin Simon A.
Published: December 2016

Healthy ocean ecosystems are needed to sustain people and livelihoods and to achieve the United Nations Sustainable Development Goals. Using the ocean sustainably requires overcoming many formidable challenges: overfishing, climate change, ocean acidification, and pollution. Despite gloomy forecasts, there is reason for hope. New tools, practices, and partnerships are beginning to transform local fisheries, biodiversity conservation, and marine spatial planning. The challenge is to bring them to a global scale. We dissect recent successes using a complex adaptive-systems (CAS) framework, which acknowledges the interconnectedness of social and ecological systems. Understanding how policies and practices change the feedbacks in CASs by altering the behavior of different system components is critical for building robust, sustainable states with favorable emergent properties. Our review reveals that altering incentives—either economic or social norms, or both—can achieve positive outcomes. For example, introduction of well-designed rights-based or secure-access fisheries and ecosystem service accounting shifts economic incentives to align conservation and economic benefits. Modifying social norms can create conditions that incentivize a company, country, or individual to fish sustainably, curb illegal fishing, or create large marine reserves as steps to enhance reputation or self-image. In each example, the feedbacks between individual actors and emergent system properties were altered, triggering a transition from a vicious to a virtuous cycle. We suggest that evaluating conservation tools by their ability to align incentives of actors with broader goals of sustainability is an underused approach that can provide a pathway toward scaling sustainability successes. In short, getting incentives right matters.
Nicotinic receptors in mouse prefrontal cortex modulate ultraslow fluctuations related to conscious processing
Authors: Koukouli Fani , Rooy Marie , Changeux Jean-Pierre , Maskos Uwe
Published: December 2016

Significance

The human brain exhibits ongoing spontaneous activity characterized by very slow frequency fluctuations. These synchronously firing populations are considered to play a key role in conscious processes. We identified ultraslow fluctuations (USFs) in awake and anesthetized mice using two-photon imaging in the prefrontal cortex, a brain region involved in cognitive processes. Using transgenic mice, we demonstrate a crucial role for nicotinic acetylcholine receptors (nAChRs) in the generation of ultraslow fluctuations and their synchronicity, processes that are affected by deletion of nAChR subunits and general anesthetics like isoflurane. This work allows further dissection of the underlying mechanisms, and predicts that in humans with nAChR polymorphisms or copy number variation these processes might be altered, resulting in neuropsychiatric disorders.
How valid are wearable physical activity trackers for measuring steps?
Authors: An Hyun‐Sung , Jones Gregory C. , Kang Seoung‐Ki , Welk Gregory J. , Lee Jung‐Min
Published: December 2016

Wearable activity trackers have become popular for tracking individual's daily physical activity, but little information is available to substantiate the validity of these devices in step counts. Thirty‐five healthy individuals completed three conditions of activity tracker measurement: walking/jogging on a treadmill, walking over‐ground on an indoor track, and a 24‐hour free‐living condition. Participants wore 10 activity trackers at the same time for both treadmill and over‐ground protocol. Of these 10 activity trackers three were randomly given for 24‐hour free‐living condition. Correlations of steps measured to steps observed were r = 0.84 and r = 0.67 on a treadmill and over‐ground protocol, respectively. The mean MAPE (mean absolute percentage error) score for all devices and speeds on a treadmill was 8.2% against manually counted steps. The MAPE value was higher for over‐ground walking (9.9%) and even higher for the 24‐hour free‐living period (18.48%) on step counts. Equivalence testing for step count measurement resulted in a significant level within ±5% for the Fitbit Zip, Withings Pulse, and Jawbone UP24 and within ±10% for the Basis B1 band, Garmin VivoFit, and SenseWear Armband Mini. The results show that the Fitbit Zip and Withings Pulse provided the most accurate measures of step count under all three different conditions (i.e. treadmill, over‐ground, and 24‐hour condition), and considerable variability in accuracy across monitors and also by speeds and conditions.
TRFBA: an algorithm to integrate genome-scale metabolic and transcriptional regulatory networks with incorporation of expression data
Authors: Motamedian Ehsan , Mohammadi Maryam , Shojaosadati Seyed Abbas , Heydari Mona
Published: December 2016

Motivation: Integration of different biological networks and data-types has been a major challenge in systems biology. The present study introduces the transcriptional regulated flux balance analysis (TRFBA) algorithm that integrates transcriptional regulatory and metabolic models using a set of expression data for various perturbations.

Results: TRFBA considers the expression levels of genes as a new continuous variable and introduces two new linear constraints. The first constraint limits the rate of reaction(s) supported by a metabolic gene using a constant parameter (C) that converts the expression levels to the upper bounds of the reactions. Considering the concept of constraint-based modeling, the second set of constraints correlates the expression level of each target gene with that of its regulating genes. A set of constraints and binary variables was also added to prevent the second set of constraints from overlapping. TRFBA was implemented on Escherichia coli and Saccharomyces cerevisiae models to estimate growth rates under various environmental and genetic perturbations. The error sensitivity to the algorithm parameter was evaluated to find the best value of C. The results indicate a significant improvement in the quantitative prediction of growth in comparison with previously presented algorithms. The robustness of the algorithm to change in the expression data and the regulatory network was tested to evaluate the effect of noisy and incomplete data. Furthermore, the use of added constraints for perturbations without their gene expression profile demonstrates that these constraints can be applied to improve the growth prediction of FBA.

Availability and Implementation: TRFBA is implemented in Matlab software and requires COBRA toolbox. Source code is freely available at http://sbme.modares.ac.ir.

Supplementary information:  Supplementary data are available at Bioinformatics online.
On structure-based priors in Bayesian geophysical inversion
Authors: de Pasquale G. , Linde N.
Published: December 2016

Bayesian methods are extensively used to analyse geophysical data sets. A critical and somewhat overlooked component of high-dimensional Bayesian inversion is the definition of the prior probability density function that describes the joint probability of model parameters before considering available data sets. If insufficient prior information is available about model parameter correlations, then it is tempting to assume that model parameters are uncorrelated. When working with a spatially gridded model representation, this overparametrization leads to posterior realizations with far too much variability to be deemed realistic from a geological perspective. In this study, we introduce a new approach for structure-based prior sampling with Markov chain Monte Carlo that is suitable when only limited prior information is available. We evaluate our method using model structure measures related to standard roughness and damping metrics for l1- and l2-norms. We show that our structure-based prior approach is able to adequately sample the chosen prior distribution of model structure. The usefulness and applicability of the methodology is demonstrated on synthetic and field-based crosshole ground penetrating radar data. We find that our method provides posterior model realizations and statistics that are significantly more satisfactory than those based on underlying assumptions of uncorrelated model parameters or on explicit penalties on model structure within an empirical Bayes framework.
Using knowledge-driven genomic interactions for multi-omics data analysis: metadimensional models for predicting clinical outcomes in ovarian carcinoma
Authors: Kim Dokyoon , Li Ruowang , Lucas Anastasia , Verma Shefali S , Dudek Scott M , Ritchie Marylyn D
Published: December 2016

It is common that cancer patients have different molecular signatures even though they have similar clinical features, such as histology, due to the heterogeneity of tumors. To overcome this variability, we previously developed a new approach incorporating prior biological knowledge that identifies knowledge-driven genomic interactions associated with outcomes of interest. However, no systematic approach has been proposed to identify interaction models between pathways based on multi-omics data. Here we have proposed such a novel methodological framework, called metadimensional knowledge-driven genomic interactions (MKGIs). To test the utility of the proposed framework, we applied it to an ovarian cancer dataset including multi-omics profiles from The Cancer Genome Atlas to predict grade, stage, and survival outcome. We found that each knowledge-driven genomic interaction model, based on different genomic datasets, contains different sets of pathway features, which suggests that each genomic data type may contribute to outcomes in ovarian cancer via a different pathway. In addition, MKGI models significantly outperformed the single knowledge-driven genomic interaction model. From the MKGI models, many interactions between pathways associated with outcomes were found, including the mitogen-activated protein kinase (MAPK) signaling pathway and the gonadotropin-releasing hormone (GnRH) signaling pathway, which are known to play important roles in cancer pathogenesis. The beauty of incorporating biological knowledge into the model based on multi-omics data is the ability to improve diagnosis and prognosis and provide better interpretability. Thus, determining variability in molecular signatures based on these interactions between pathways may lead to better diagnostic/treatment strategies for better precision medicine.
Automated classification of eligibility criteria in clinical trials to facilitate patient-trial matching for specific patient populations
Authors: Zhang Kevin , Demner-Fushman Dina
Published: December 2016

Objective:To develop automated classification methods for eligibility criteria in ClinicalTrials.gov to facilitate patient-trial matching for specific populations such as persons living with HIV or pregnant women.

Materials and Methods:We annotated 891 interventional cancer trials from ClinicalTrials.gov based on their eligibility for human immunodeficiency virus (HIV)-positive patients using their eligibility criteria. These annotations were used to develop classifiers based on regular expressions and machine learning (ML). After evaluating classification of cancer trials for eligibility of HIV-positive patients, we sought to evaluate the generalizability of our approach to more general diseases and conditions. We annotated the eligibility criteria for 1570 of the most recent interventional trials from ClinicalTrials.gov for HIV-positive and pregnancy eligibility, and the classifiers were retrained and reevaluated using these data.

Results:On the cancer-HIV dataset, the baseline regex model, the bag-of-words ML classifier, and the ML classifier with named entity recognition (NER) achieved macro-averaged F2 scores of 0.77, 0.87, and 0.87, respectively; the addition of NER did not result in a significant performance improvement. On the general dataset, ML + NER achieved macro-averaged F2 scores of 0.91 and 0.85 for HIV and pregnancy, respectively.

Discussion and Conclusion:The eligibility status of specific patient populations, such as persons living with HIV and pregnant women, for clinical trials is of interest to both patients and clinicians. We show that it is feasible to develop a high-performing, automated trial classification system for eligibility status that can be integrated into consumer-facing search engines as well as patient-trial matching systems.
Is It “In” or “Out”? The Optimal Fluoroscopic Views for Intraoperative Determination of Proper Lateral Mass Screw Placement
Authors: Kim Sang Bum , Rhee John M. , Oh Byung Hak , Won You Gun , Jung Yousun , Park Kun Young , Hutton William C. , Kim Chulmin
Published: December 2016

Study Design.

Cadaveric.

Objective.

Determine optimal fluoroscopic views for detecting cervical lateral mass screw (LMS) violations.

Summary of Background Data.

Single plane intraoperative x-rays are commonly used but frequently inadequate due to its complex trajectory. Fluoroscopy can be taken in multiple planes, but the ideal fluoroscopic view to assess malposition is not known: depending on the view, any given screw may look “in” or “out.”

Methods.

C3–6 LMS were inserted in three cadavers. To evaluate neuroforaminal violation, LMS were inserted into the foramen with the tip penetrating the anterior cortex by 0, 2, and 4 mm. To assess facet joint violation, LMS were inserted toward the subjacent facet joint with the tip penetrating the anterior cortex by 0 and 2 mm. Fluoroscopic views were taken 0°, 10°, 20°, 30°, and 40° to the lateral plane. Views were independently evaluated by three blinded spine surgeons.

Results.

Twenty-degree oblique view correctly identified a 2 mm penetration into the neuroforamen in 79%, and a 4 mm penetration in 86%, for a sensitivity of 83% and specificity of 90%. Thirty-degree view had lower sensitivity (76%) but slightly higher specificity (93%). Twenty-degree and 30° views were significantly more sensitive than the other views. Zero-degree view correctly identified a 2 mm penetration into the facet joint in 93%, for a sensitivity of 93% and specificity of 92%. Ten-degree view had lower sensitivity (72%) but higher specificity (100%). The 0° view was significantly more sensitive than the other views.

Conclusion.

Twenty-degree and 30° oblique views significantly provided the most sensitive assessment of LMS potentially violating the neuroforamen, whereas the 0° neutral lateral view significantly provided the most sensitive assessment of facet violations. The specificities were also high (in the 90% range) for these views. We recommend the use of these views intraoperatively when assessing proper placement of LMS fluoroscopically.

Level of Evidence: N/A
Pseudomeningocele Aspiration and Blood Patch Effectively Treats Positional Headache Associated With Postoperative Lumbosacral Pseudomeningocele
Authors: Sandwell Stephen , Walter Kevin , Westesson Per-Lennart
Published: December 2016

Study Design.

Retrospective chart review with limited prospective follow-up survey.

Objective.

To evaluate the efficacy and safety of blood patch injection for the treatment of positional headaches caused by postoperative lumbosacral pseudomeningoceles.

Summary of Background Data.

Pseudomeningocele is one of the most common complications after posterior lumbosacral spinal surgery. Common treatments include bedrest, abdominal binder use, subarachnoid lumbar drainage, and surgical re-exploration for durotomy closure. To date, only small case reports support the use of epidural blood patch injection for symptomatic pseudomeningocele treatment.

Methods.

A retrospective chart review analyzed the outcomes and complications of 19 consecutive patients who underwent blood patch injection, with and without pseudomeningocele aspiration, for symptomatic postoperative lumbosacral pseudomeningoceles between 2009 and 2015. An attempt was made to survey patients by phone regarding satisfaction.

Results.

As of last follow-up (average time = 22.3 months), 16 patients (84%) experienced headache resolution after blood patch injection and did not require further treatment of their pseudomeningocele. In addition to symptomatic improvement, 12 of the 16 successful patients had imaging, which demonstrated pseudomeningocele resolution. Persistent pseudomeningoceles were demonstrated on imaging among all three unsuccessful patients.

Conclusion.

Pseudomeningocele aspiration followed by blood patch is an effective treatment for symptomatic postoperative lumbosacral pseudomenigocele. This is a minimally invasive alternative to surgical re-exploration with durotomy closure. Injections are most effective when performed early after pseudomeningocele development.

Level of Evidence: 4
A Clinician’s Guide to Privacy and Communication in the ICU
Authors: Francis Leslie , Vorwaller Micah A. , Aboumatar Hanan , Frosch Dominick L. , Halamka John , Rozenblum Ronen , Rubin Eileen , Lee Barbara Sarnoff , Sugarman Jeremy , Turner Kathleen , Brown Samuel M.
Published: December 2016

Objective:

To review the legal issues concerning family members’ access to information when patients are in the ICU.

Data Sources:

U.S. Code, U.S. Code of Federal Regulations, and state legislative codes.

Data Extraction:

Relevant legal statutes and regulations were identified and reviewed by the two attorney authors (L. F., M. A. V.).

Study Selection:

Not applicable.

Data Synthesis:

Review by all coauthors.

Conclusions:

The Health Insurance Portability and Accountability Act and related laws should not be viewed as barriers to clinicians sharing information with ICU patients and their loved ones. Generally, under Health Insurance Portability and Accountability Act, personal representatives have the same authority to receive information that patients would otherwise have. Persons involved in the patient’s care also may be given information relevant to the episode of care unless the patient objects. ICUs should develop policies for handling the issues we identify about such information sharing, including policies for responding to telephone inquiries and methods for giving patients the opportunity to object to sharing information with individuals involved in their care. ICU clinicians also should be knowledgeable of their state’s laws about how to identify patients’ personal representatives and the authority of those representatives. Finally, ICU clinicians should be aware of any special restrictions their state places on medical information. In aggregate, these strategies should help ICU managers and clinicians facilitate robust communication with patients and their loved ones.
Effects of the 5-HT1A receptor agonists buspirone and 8-OH-DPAT on pupil size in common marmosets
Authors: Kotani Manato , Urushino Naoko , Natsutani Itaru , Ogi Yuji , Ikeda Kazuhito
Published: December 2016

As pupil size is affected by psychotropic drugs in all mammals, it has been used as a well-established clinical indicator for the preclinical and clinical development of novel drugs. It has been reported that activation of the serotonin (5-HT)1A receptor differently affects pupil response in rodents (mydriasis) and humans (miosis). Thus, it is important to establish a quantitative system for measuring pupil size using other species, such as nonhuman primates. Common marmosets have recently attracted a great deal of attention as suitable experimental animals in the psychoneurological field because of handling ease compared with other nonhuman primates and the requirement for small amounts of test drugs. In this study, we constructed a system for measuring changes in pupil size using an infrared eye-tracking camera and evaluated the effects on pupil size of the 5-HT1A receptor agonists buspirone, 8-OH-DPAT and buspirone active metabolite 1-(2-pyrimidinyl) piperazine. Our results show that both buspirone and 8-OH-DPAT significantly decrease pupil size in a dose-dependent manner. The 5-HT1A receptor antagonist WAY 100635 completely blocked both buspirone and 8-OH-DPAT-induced miosis, whereas 1-(2-pyrimidinyl) piperazine had no effect on pupil size. These results suggest that measurement of pupil size may be a useful biomarker for predicting the pharmacodynamics of new 5-HT1A receptor agonists.
Fostering evidence-based quality improvement for patient-centered medical homes: Initiating local quality councils to transform primary care
Authors: Stockdale Susan E. , Zuchowski Jessica , Rubenstein Lisa V. , Sapir Negar , Yano Elizabeth M. , Altman Lisa , Fickel Jacqueline J. , McDougall Skye , Dresselhaus Timothy , Hamilton Alison B.
Published: December 2016

Background:

Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation.

Purpose:

Our evaluation objectives were to (a) assess design element implementation, (b) describe implementation barriers and facilitators, and (c) assess successful quality improvement project completion and spread.

Methodology/Approach:

We analyzed administrative records and conducted interviews with 85 organizational leaders. We developed and applied criteria for assessing design element implementation using hybrid deductive/inductive analytic techniques.

Results:

All quality councils implemented interdisciplinary leadership and a structured quality improvement process, and all but one completed at least one quality improvement project and a toolkit for spreading improvements. Quality councils were perceived as most effective when service line leaders had well-functioning interdisciplinary communication. Matching positions within leadership hierarchies with appropriate supportive roles facilitated frontline quality improvement efforts. Two key resources were (a) a dedicated internal facilitator with project management, data collection, and presentation skills and (b) support for preparing customized data reports for identifying and addressing practice level quality issues.

Conclusions:

Overall, quality councils successfully cultivated interdisciplinary, multilevel primary care quality improvement leadership with accountability mechanisms and generated frontline innovations suitable for spread. Practice level performance data and quality improvement project management support were critical.

Practice Implications:

In order to successfully facilitate systematic, sustainable primary care quality improvement, regional and executive health care system leaders should engage interdisciplinary practice level leadership in a priority-setting process that encourages frontline innovation and establish local structures such as quality councils to coordinate quality improvement initiatives, ensure accountability, and promote spread of best practices.
Resolution of Intractable Ventricular Tachycardia after Surgical Repositioning of a Heartmate II Inflow Cannula
Authors: Son Andre Y. , Reyentovich Alex , Pan Stephen , DeAnda Abe , Balsam Leora B.
Published: December 2016

Ventricular arrhythmias are common after left ventricular assist device implantation. Malposition of the inflow cannula is one of the few etiologies with a mechanically correctable defect. We present a case of intractable ventricular tachycardia that resolved after surgical repositioning of a HeartMate II inflow cannula. The diagnosis and management of this case demonstrate the utility of imaging studies for detecting inflow cannula malposition and the efficacy of inflow cannula repositioning for treatment.
Reliability and Validity of the Work and Social Adjustment Scale in Treatment-Seeking Problem Gamblers
Authors: Tolchard Barry
Published: December 2016

Background

Problem gambling is a growing concern as governments become more reliant on gambling revenue particularly from increases in gambling casinos. It is widely reported that problem gamblers experience both high levels of comorbid mental health issues and subsequent disability that comes with such. To date, there have been few measures tested with problem gamblers that are a good measure of this disability. The Work and Social Adjustment Scale (WSAS) is a five-item measure of disability, which is used widely in a number of clinical settings including gambling.

Method

The reliability and validity of the WSAS were examined in 171 outpatient problem gamblers who presented to a cognitive behavior therapy service in Adelaide, Australia. Subjects were assessed by trained cognitive behavior therapists and offered individual outpatient, group, or inpatient treatment. All subjects signed consent for their clinical data to be used and completed a battery of outcome measures at assessment, discharge, and 1-, 3-, and 6-month follow-up.

Results

The internal consistency of the WSAS was excellent among problem gamblers. A principal component analysis generated a single factor of disability. The WSAS has good concurrent validity with measures of gambling and comorbid anxiety and depression. The WSAS also shows promise as a measure of improvement in a clinical service.

Conclusion

The WSAS has excellent reliability and sound validity among a treatment-seeking problem gambling population. Understanding disability related to gambling may offer insights into the long-term success of gamblers completing treatment. This instrument needs further refinement in a more rigorous experimental setting.
Internal Consistency and Convergent Validity of the Portuguese Versions of the Global Appraisal of Individual Needs–Initial and Short Screener
Authors: Garcia Claro Heloísa , Ferreira de Oliveira Márcia Aparecida , de Almeida Lopes Fernandes Ivan Filipe , Titus Janet C. , Ribeiro Tarifa Rosana , Fernandes Rojas Thais , Hayasi Pinho Paula
Published: December 2016

The goal of this article is to present evidence on the internal consistency and convergent validity of the Brazilian Portuguese versions of the Global Appraisal of Individual Needs–“Initial” and “Short Screener” versions.

Methods

One hundred sixty-eight individuals from an inpatient service and/or a community-based outpatient service located in São Paulo were interviewed using the Brazilian Portuguese versions of the instruments. The internal consistency of the instruments scales was computed, along with evidence for the convergent validity between corresponding subscales of the Initial and Short Screener instruments.

Results

Cronbach’s alpha values for both instruments’ total scale scores were greater than .7. The Short Screener scales showed strong-to-moderate correlations with corresponding subscales of the Initial. The General Individual Severity Scale from the Initial and Total Disorder Screener from the Short Screener have convergent validity with each other (ρ = 0.801).

Conclusions

The Brazilian Portuguese instrument scales showed evidence for internal consistency and convergent validity performing similarly to the American English versions.
Perceptions of an Adapted Mindfulness Program for Persons Experiencing Substance Use Disorders and Traumatic Brain Injury
Authors: Kristofersson Gisli K. , Beckers Tom , Krueger Rick
Published: December 2016

Background

Of the 1.4 million Americans who sustain traumatic brain injuries (TBIs) each year up to half experience substance use disorders (SUDs). This often leads to various issues such as increased rates of mental health problems and delay or lack of return to full employment.

Aims

The purpose of this program evaluation was to describe Vinland National Center’s (Vinland’s) client and staff perceptions of a 4-week mindfulness-based intervention adapted from the original mindfulness-based stress reduction program for persons experiencing SUDs and TBIs. It focused on the possible relevance and applicability of mindfulness practice for this population.

Method

Four focus groups were conducted based on Krueger’s methods in conducting focus groups: two with Vinland staff members and two focus groups with residents.

Results

The analysis of staff focus groups revealed general staff satisfactions with the intervention. A general consensus was that the mindfulness intervention fitted well with the needs of Vinland’s clients and their current program. Client feedback further revealed general satisfaction with the mindfulness curriculum. No adverse effects were noted related to the mindfulness intervention.

Conclusions

The results of this program evaluation suggest that implementing a mindfulness-based intervention for persons experiencing SUDs/TBIs warrants further investigation.