bluuebunny/crossref_metadata_2025 huggingface dataset:
Timing of Postoperative CSF Leak after Endoscopic Skull Base Surgery in Patients with Obstructive Sleep Apnea
Authors: Zimmermann Terence M. , Marcellino Chris R. , Choby Garret W. , Gompel Jamie J. Van , O'Brien Erin K. , Abel Katie M. Van , Janus Jeffrey R. , Link Michael J. , Frank Ryan D. , Stokken Janalee K.
Published: November 2018

Background There is little data regarding postoperative outcomes of patients with obstructive sleep apnea (OSA) undergoing skull base surgery. The purpose of this study is to determine an association between risk factors and proximity of cerebrospinal fluid (CSF) leak to surgery in patients with OSA undergoing endoscopic skull base surgery.

Methods A retrospective review of neurosurgical inpatients, with and without OSA, at a tertiary care institution from 2002 to 2015 that experienced a postoperative CSF leak after undergoing endoscopic skull base surgery.

Results Forty patients met inclusion criteria, 12 (30%) with OSA. OSA patients had significantly higher body mass index (BMI; median 39.4 vs. 31.7, p < 0.01) and were more likely to have diabetes (41.7 vs. 10.7%, p = 0.04) than non-OSA patients; otherwise there were no significant differences in clinical comorbidities. No patients restarted positive pressure ventilation (PPV) in the inpatient setting. The type of repair was not a significant predictor of the time from surgery to leak. Patients with OSA experienced postoperative CSF leak 49% sooner than non-OSA patients (Hazard Ratio 1.49, median 2 vs. 6 days, log-rank p = 0.20).

Conclusion Patients with OSA trended toward leaking earlier than those without OSA, and no OSA patients repaired with a nasoseptal flap (NSF) had a leak after postoperative day 5. Due to a small sample size this trend did not reach significance. Future studies will help to determine the appropriate timing for restarting PPV in this high risk population. This is important given PPV's significant benefit to the patient's overall health and its ability to lower intracranial pressure.
The behavior of sound absorption coefficient for binary mixture nitroethane-isooctane above critical temperature and concentration
Authors: Sadeq Rowaida M. , Abdelraziq Issam , Abu-Jafar Mohammed S. , Bilous Oksana
Published: November 2018

The temperature dependence of the sound absorption coefficient at critical composition and above critical temperature Tc for the binary mixture nitroethane-isooctane at 5, 7, 10, 15, 21, and 25 MHz frequencies (f) is investigated. The frequency dependence of the absorption coefficient (α) for the same critical binary mixture at different temperatures above critical temperature is studied. In addition, the linear relation of the sound absorption coefficient at critical point (αc)/f2 versus f−1.06 showed an excellent agreement with the dynamic scaling theory of Ferrell and Bhattacharjee, Physical Review A 31, 1788 (1985). The experimental values of (αf−2αcf−2) for nitroethane-isooctane binary mixture are plotted as a function of reduced frequency Ω and it showed a good agreement with the theoretical scaling function F(Ω).
Sub-50 picosecond to microsecond carrier transport dynamics in pentacene thin films
Authors: Adhikari Pan , Kobbekaduwa Kanishka , Shi Ying , Zhang Jianbing , Al Abass Nawal , He Jian , Rao Apparao , Gao Jianbo
Published: November 2018

Carrier transport dynamics from sub-50 ps to ∼μs over five temporal decades in pentacene films was studied by transient photoconductivity. The behavior of the temperature independent photocurrent peak suggests that the photogenerated carriers exhibit pre-trapping transport in extended states upon pulsed laser excitation. From 300 ps to ∼30 ns, the carriers thermalize and fall into shallow band tail states, and multiple-trapping and release transport dominates. From ∼30 ns to ∼μs, the weak temperature dependence of power-law photocurrent decay and the linear relation of logarithmic photocurrent with T−1/4 suggest a variable range hopping transport in deep trap states.
Application of Tip-Enhanced Raman Spectroscopy for the nanoscale characterization of flooded chalk
Authors: Borromeo Laura , Toccafondi Chiara , Minde Mona Wetrhus , Zimmermann Udo , Andò Sergio , Madland Merete Vadla , Korsnes Reidar Inge , Ossikovski Razvigor
Published: November 2018

One of the most challenging goals of flooded chalk analyses used in Enhanced Oil Recovery (EOR) is to reach high-resolution mineralogical data, in order to detect the composition of new crystals grown after brine injections, with ≤1 μm grain size. Understanding how flooding affects chemical induced compaction, mechanical strength permeability, and porosity is paramount in EOR related investigations. Magnesite formation is the most pervasive process when MgCl2 is injected into chalk, and the submicrometric grain size of the new minerals requires a high performing imaging technique and a new methodological approach: in our study, we present the first attempt of applying Tip-Enhanced Raman Spectroscopy (TERS) to rock and mineral samples. It is a new frontier technique that couples Raman Spectroscopy with Atomic Force Microscopy, allowing impressively high-resolution topography and mineralogical maps. Two long term experiments have been analyzed, where chalk cores were flooded for 718 days and 1072 days, at reservoir conditions comparable to hydrocarbon reservoirs in chalk at the Norwegian continental shelf. Few microns squared areas have been imaged by Atomic Force Microscopy using ultra-polished thin sections. First analyses identified a less pervasive secondary growth of magnesite in the 718 days test and an almost pure magnesite composition in the 1072 days test. Transmission Electron Microscopy (TEM) has been employed to confirm the results of TERS and add dark and bright field grain imaging to the investigations. This confirms the need for high-resolution methodologies such as TERS and TEM to fully understand the EOR effects at submicron-scale.
Observation of multipath effects in the detection of RF-modulated x-rays
Authors: Harris J. R. , Miller R. B. , McChesney P. D. , Lewellen J. W.
Published: November 2018

As part of the Air Force Research Laboratory’s ongoing research in particle accelerators and beams, we recently began investigating the interaction of RF-modulated x-ray beams with RF structures. These bremsstrahlung x-rays, produced using an S-band RF electron linac and tungsten foil, were able to drive RF signals at the linac frequency and its integer harmonics in an S-band waveguide. This was interpreted as a result of secondary electron production inside the waveguide by the modulated x-ray beam and implied that the primary electron beam RF modulation was preserved, to at least some degree, through both the processes of x-ray and secondary electron production. The strength of these signals induced on the waveguide varied as the distance of the waveguide from the tungsten foil changed, with the nature of these changes suggesting the existence of an interference process resulting from multipath propagation of the modulated x-rays. Here, we report on our initial attempt to verify this multipath propagation by altering the configuration of shielding and reflective masses in the environment of the waveguide. These measurements support the existence of a multipath propagation effect and further indicate that the RF modulation of the x-rays is preserved as they undergo scattering events inside the accelerator vault.
Morphologies, metastability, and coarsening of quantum nanoislands on the surfaces of the annealed Ag(110) and Pb(111) thin films
Authors: Price Donald L. , Henner Victor , Khenner Mikhail
Published: November 2018

Morphological evolution of heteroepitaxial nanoislands toward equilibrium (coarsening) is computed using the detailed continuum model that incorporates the quantum size effect. The results reveal the metastability of the “magic” heights, show the morphological transitions and the surface diffusion routes by which a quantum island reaches its stable height, and provide the coarsening laws for the island density and area, thus clarifying the kinetic morphology pathways in the growth of an ultrathin metal film.
Gaussian-based multiconfiguration time-dependent Hartree: A two-layer approach. II. Application to vibrational energy transport in a molecular chain
Authors: Eisenbrandt P. , Ruckenbauer M. , Römer S. , Burghardt I.
Published: November 2018

We report on first applications of the Two-Layer Gaussian-based Multi-Configuration Time-Dependent Hartree (2L-GMCTDH) method [Römer et al., J. Chem. Phys. 138, 064106 (2013)] for high-dimensional quantum propagation using variational Gaussian basis sets. This method circumvents the limitations of conventional variational Gaussian wavepacket (GWP) methods by introducing a hierarchical wavefunction representation with a fully flexible first layer composed of orthogonal single-particle functions, which are in turn expressed as superpositions of GWPs of fixed width. The method is applied to a model Hamiltonian describing vibrational energy transport through a molecular chain. The model combines bilinear site-to-site couplings with site-local couplings induced by cubic anharmonicities. We report on simulation results for realizations comprising 5 sites with 35 vibrational modes and 18 sites with 90 vibrational modes, which are shown to be in excellent agreement with reference calculations by the Multi-Layer MCTDH method.
Gaussian-based multiconfiguration time-dependent Hartree: A two-layer approach. III. Application to nonadiabatic dynamics in a charge transfer complex
Authors: Eisenbrandt P. , Ruckenbauer M. , Burghardt I.
Published: November 2018

In this paper, we report on first applications of the Two-Layer Gaussian-based Multi-Configuration Time-Dependent Hartree (2L-GMCTDH) method to nonadiabatic dynamics. Simulations of ultrafast, coherent charge transfer dynamics are performed for a two-state linear vibronic coupling model describing an oligothiophene-fullerene charge transfer complex, for system dimensions ranging from 20 to 100 modes. Different variants of the state-dependent 2L-GMCTDH propagation are assessed, notably single-set and multi-set versions, along with a third hybrid variant. It is shown that the method is suitable to perform accurate and efficient nonadiabatic dynamics simulations in many dimensions.
Perspective: Dynamics of confined liquids
Authors: Thompson Ward H.
Published: November 2018

Liquids confined on nanometer lengthscales are ubiquitous in chemistry, occurring in systems ranging from mesoporous catalysts to the crowded interior of a cell. Understanding how the properties of the liquid in these environments differs from that in the corresponding bulk is key to interpreting measurements, developing methods for theoretical predictions, and controlling chemical pathways. This area has received significant attention in recent years, resulting in notable progress. In this perspective, we discuss the advances in understanding the dynamics of confined liquids as well as the nontrivial remaining challenges.
Contract lecturers are a growing yet precarious population in higher education
Authors: Feder Toni
Published: November 2018

Some institutions seek better career paths for non-tenure-stream teachers.
Superfluid helium-3 in confined quarters
Authors: Halperin William P. , Parpia Jeevak M. , Sauls James A.
Published: November 2018

Disorder, confinement, and symmetry breaking contribute to the formation of new phases when liquid helium-3 is infused in a highly porous random solid such as a silica aerogel.
A concise overview on tick-borne human infections in Europe: a focus on Lyme borreliosis and tick-borne Rickettsia spp.
Authors: Abou Abdallah Rita , Raoult Didier , Fournier Pierre-Edouard
Published: November 2018

Ticks are blood-feeding external parasites of mammals. Almost all ticks belong to one of two major families, the Ixodidae or hard ticks, and the Argasidae or soft ticks. Ticks are responsible of transmitting many diseases called ‘tick-borne diseases'. Borrelia and Rickettsia spp., are the most important tick-transmitted bacterial pathogens circulating in Europe. In this review we will focus on the two tick-borne diseases caused by these bacterial pathogens, their vector, epidemiology, clinical diagnosis and symptoms.
Ocean circulation, ice shelf, and sea ice interactions explain Dansgaard–Oeschger cycles
Authors: Boers Niklas , Ghil Michael , Rousseau Denis-Didier
Published: November 2018

Significance

Paleoclimatic proxy records from Greenland ice cores show that the last glacial interval was punctuated by abrupt climatic transitions called Dansgaard–Oeschger (DO) events. These events are characterized by temperature increases over Greenland of up to

15
°

C within a few decades. The cause of these transitions and their out-of-phase relationship with corresponding records from Antarctica remains unclear. Based on earlier hypotheses, we propose a model focusing on interactions between ice shelves, sea ice, and ocean currents to explain DO events in Greenland and their Antarctic counterparts. Our model reproduces the main features of the observations. Our study provides a potential explanation of DO events and could help assess more accurately the risk of abrupt climatic transitions in the future.
Situating Valency Theory in functional-cognitive space
Authors: Gonzálvez-García Francisco , Butler Christopher S.
Published: November 2018

This article builds on the work reported inButler and Gonzálvez-García (2014), in which 16 functional and/or cognitive/constructionist theories were compared on the basis of questionnaires completed by experts and a reading of the literature on each approach. The aim is to extend this work to cover Valency Theory (VT henceforth), arguably the most widely used approach to the study of German syntax. We first report on a statistical analysis (correlation, multidimensional scaling and hierarchical cluster analysis) of the data from the questionnaires completed by two VT experts, in relation to those completed by experts in other approaches. We then present an analysis of each item in the questionnaire in relation to VT, leading to a positive or negative evaluation for each questionnaire item. The results are again analysed statistically. The picture that emerges is of a theory which, though distinctive, has clear relationships with a broad group of cognitively-oriented approaches.
Influence of nickel on microstructure and mechanical properties of medium-manganese steels
Authors: Cai Z. H. , Zhang K. M. , Jing S. Y. , Ding H.
Published: November 2018

To combine the advantage of density reduction and excellent performance, nanometer-sized B2 particles were introduced into the δ ferrite matrix of high-aluminium low-density steel by the addition of nickel (Fe–0.2C–11Mn–6Al–4/8Ni). Compared to Fe–0.2C–11Mn–6Al (0Ni) steel, the hardness and tensile strength of 4Ni and 8Ni steels are significantly improved. The improvement of tensile strength in 4Ni and 8Ni steels was primarily contributed by the precipitation strengthening or solution strengthening of B2 particles in δ ferrite. At the higher annealing temperature, the original dislocation density in δ ferrite is lower. However, dislocation multiplication during tensile deformation was more significant in the sample annealed at higher temperature, which was responsible for a higher work hardening rate.
Viscosities of diethylene glycol (DEG) + 2-amino-2-methyl-1-propanol (AMP) + water
Authors: Gurylev V , Soriano A N , Caparanga A R , Li M-H , Adornado A P
Published: November 2018

In this study, the viscosities (η) of the aqueous mixed-solvent system of diethylene glycol (DEG) and 2-amino-2-methyl-1-propanol (AMP) were investigated at normal atmospheric pressure over the range of temperature of 303.15 - 343.15 K and across varying component mole fractions range [0.02 to 0.60 for DEG (x1
), 0.02 to 0.60 for AMP (x2
), and 0.20 to 0.80 for H2O (x3
)]. The calculated properties were fitted to a modified equation originally proposed by Grunberg and Nissan for the viscosity of liquid mixtures to correlate temperature and composition dependency of the measured property. In comparison to literature values, the uncertainty of the kinematic viscosities was approximated to be + 1.0 %, and that the correlations used satisfactorily represent the effects of temperature and composition on the viscosities of the considered mixed-solvent system as shown by the low overall average absolute deviations obtained in the calculations. The properties obtained and reported in this work are, in general, of adequate correctness for most engineering-design calculations, such as the design of absorption process for carbon dioxide capture using mixed-solvents as absorbents.
Reoperation Rate After Primary Augmentation With Smooth, Textured, High Fill, Cohesive, Round Breast Implants (RANBI-I Study)
Authors: Khanna Julie , Mosher Mathew , Whidden Paul , Nguyen Sébastien , Garzon Diego , Bhogal Meetu
Published: November 2018

Background

Reoperation after primary breast augmentation remains an important clinical issue.

Objective

The authors sought to evaluate incidence and causes of reoperation in patients who underwent primary augmentation.

Methods

This retrospective, noninterventional study conducted at 16 Canadian sites reviewed medical records and patient-completed questionnaires of women who underwent primary breast augmentation with smooth or textured Natrelle Inspira implants containing TruForm 1 or TruForm 2 gel. Patients were aged ≥22 years, received implants via inframammary fold incision, and returned for follow-up at 2 to 4 years.

Results

A total of 319 women received Inspira implants (smooth TruForm 2, n = 205; textured TruForm 2, n = 99; smooth or textured TruForm 1, n = 15). At follow-up, 30 women (9.4%) had undergone reoperation, including 19 (9.3%) in the smooth TruForm 2 subgroup and 9 (9.1%) in the textured TruForm 2 subgroup. The mean time to reoperation was 1.2 years; the risk rate for reoperation was 9.9% at 3 years. The most common reasons for reoperation were implant malposition (36.7%), capsular contracture (33.3%), and the patient’s request for a change in implant size or style (20.0%). Most women were very or somewhat satisfied with the initial surgery (89.3% overall; 90.7% smooth TruForm 2; 86.9% textured TruForm 2). Thirty-four women (10.7%) reported adverse events, including 20 (9.8%) in the smooth TruForm 2 subgroup and 14 (14.1%) in the textured TruForm 2 subgroup.

Conclusions

This analysis suggests that Natrelle Inspira TruForm 2 implants are safe when used in primary breast augmentation, resulting in low reoperation rates that are consistent with those for other breast implants.

Level of Evidence: 4
Antibody interface prediction with 3D Zernike descriptors and SVM
Authors: Daberdaku Sebastian , Ferrari Carlo
Published: November 2018

Motivation

Antibodies are a class of proteins capable of specifically recognizing and binding to a virtually infinite number of antigens. This binding malleability makes them the most valuable category of biopharmaceuticals for both diagnostic and therapeutic applications. The correct identification of the antigen-binding residues in the antibody is crucial for all antibody design and engineering techniques and could also help to understand the complex antigen binding mechanisms. However, the antibody-binding interface prediction field appears to be still rather underdeveloped.

Results

We present a novel method for antibody interface prediction from their experimentally solved structures based on 3D Zernike Descriptors. Roto-translationally invariant descriptors are computed from circular patches of the antibody surface enriched with a chosen subset of physico-chemical properties from the AAindex1 amino acid index set, and are used as samples for a binary classification problem. An SVM classifier is used to distinguish interface surface patches from non-interface ones. The proposed method was shown to outperform other antigen-binding interface prediction software.

Availability and implementation

Linux binaries and Python scripts are available at https://github.com/sebastiandaberdaku/AntibodyInterfacePrediction. The datasets generated and/or analyzed during the current study are available at https://doi.org/10.6084/m9.figshare.5442229.

Supplementary information

Supplementary data are available at Bioinformatics online.
ASSESSMENT OF TERRESTRIAL RADIATION BY DIRECT MEASUREMENT OF AMBIENT DOSE EQUIVALENT RATE OF BACKGROUND RADIATION
Authors: Kardan Mohammad Reza , Sadeghi Nahid , Fathabadi Nasrin , Attarilar Ali
Published: November 2018

Estimation of terrestrial external radiation is essential for assessment of public exposure to natural radiation. During national survey of natural radionuclide in soil in Iran, 979 soil samples were collected from different locations, in the same time ambient dose equivalent rate was measured by a scintillator detector. In this work, terrestrial radiation was estimated by direct measurement of ambient dose equivalent rate of background radiation. The response of dose measuring instrument to cosmic radiation at ground level was measured and other components were discussed and estimated. For verification, terrestrial radiation derived from this method was compared with those calculated from activity concentration of natural radionuclides in soil. The averages of ambient dose equivalent rate derived from activity concentration of by natural radionuclide in soil and from direct measurement are 55.07 and 62.57 nSv/h, respectively. The source of statistical and systematic uncertainties are introduced and discussed.
Effects of Acute Deltamethrin Exposure in Adult and Developing Sprague Dawley Rats on Acoustic Startle Response in Relation to Deltamethrin Brain and Plasma Concentrations
Authors: Williams Michael T , Gutierrez Arnold , Vorhees Charles V
Published: November 2018

Deltamethrin (DLM) is a commonly used pesticide that helps to control crop destruction, disease, and nuisance insects. In rodents DLM can produce choreoathetosis, salivation, and decreased acoustic startle responses (ASR). Herein, adult Sprague Dawley rats were assessed for ASR 2 h after DLM delivered in 5 ml/kg corn oil, however no decrease was observed. Therefore, a test-retest protocol was used to reduce variability, and the effects on ASR on postnatal day 15 (P15) and adult rats were assessed 2, 4, 6, and 8 h after DLM administration (0, 1, 2, or 4 mg/kg for P15 rats and 0, 2, 8, or 25 mg/kg for adults). In a separate set of rats identically treated, DLM levels were determined in blood and brain. DLM (8 or 25 mg/kg) in adult rats decreased ASR up to 4 h, whereas in P15 rats decreases were observed between 2 and 8 h. The adult 25 mg/kg group showed consistent signs of salivation and tremor, whereas in P15 rats salivation was observed in the 2 and 4 mg/kg groups and tremor was observed at all doses over the 8-h period. Mortality was observed in all P15 dose groups but not in adults. Dose-dependent increases of DLM in blood and brain regardless of age were observed. At approximately equivalent whole brain concentrations, effects were more pronounced in P15 rats than in adult rats. Comparable brain levels of DLM do not explain differences in ASR and tremor between the P15 and adult rats. These data indicate age-dependent differences in sensitivity to DLM.
Blood Pressure and End-tidal Carbon Dioxide Ranges during Aneurysm Occlusion and Neurologic Outcome after an Aneurysmal Subarachnoid Hemorrhage
Authors: Akkermans Annemarie , van Waes Judith A. , Peelen Linda M. , Rinkel Gabriel J. , van Klei Wilton A.
Published: November 2018

EDITOR’S PERSPECTIVE

What We Already Know about This Topic

It remains unknown what end-tidal carbon dioxide and mean arterial pressure are optimal for surgical management of patients with an aneurysmal subarachnoid hemorrhage

What This Article Tells Us That Is New

The investigators retrospectively evaluated 1,099 patients who had endovascular coiling or surgical clipping for subarachnoid hemorrhages

There were no clinically important or statistical significant associations between either end-tidal carbon dioxide or mean arterial pressure thresholds and Glasgow Outcome Scale at discharge or three months

Other prognostic factors are more important than carbon dioxide and blood pressure, at least within the observed clinical ranges

Background

Hypocapnia, hypotension, and hypertension during aneurysm occlusion in patients with an aneurysmal subarachnoid hemorrhage may lead to a poor prognosis, but evidence for end-tidal carbon dioxide (ETco
2) and mean arterial pressure (MAP) targets is lacking. Within the ranges of standardized treatment, the authors aimed to study the association between hypocapnia (Paco
2 < 35 mmHg), hypotension (MAP < 80 mmHg), and hypertension (MAP >100 mmHg) during general anesthesia for aneurysm occlusion and neurologic outcome.

Methods

This retrospective observational study included patients who underwent early aneurysm occlusion after an aneurysmal subarachnoid hemorrhage under general anesthesia. ETco
2 and MAP were summarized per patient as the mean and time-weighted average area under the curve for various absolute (ETco
2 < 30, < 35, < 40, < 45 mmHg; and MAP < 60, < 70, < 80, > 90, > 100 mmHg) and relative thresholds (MAP < 70%, < 60%, < 50%). Clinical outcome was assessed with the Glasgow Outcome Scale at discharge and at three months, as primary and secondary outcome measure, respectively.

Results

Endovascular coiling was performed in 578 patients, and 521 underwent neurosurgical clipping. Of these 1,099 patients, 447 (41%) had a poor neurologic outcome at discharge. None of the ETco
2 and MAP ranges found within the current clinical setting were associated with a poor neurologic outcome at discharge, with an adjusted risk ratio for any ETco
2 value less than 30 mmHg of 0.95 (95% CI, 0.81 to 1.10; P < 0.496) and an adjusted risk ratio for any MAP less than 60 mmHg of 0.94 (95% CI, 0.78 to 1.14; P < 0.530). These results were not influenced by preoperative neurologic condition, treatment modality and timing of the intervention. Comparable results were obtained for neurologic outcome at three months.

Conclusions

Within a standardized intraoperative treatment strategy in accordance with current clinical consensus, hypocapnia, hypotension, and hypertension during aneurysm occlusion were not found to be associated with a poor neurologic outcome at discharge in patients with an aneurysmal subarachnoid hemorrhage.
Epidemiology of Spinal Fractures in a Level One Trauma Center in the Netherlands
Authors: den Ouden Lars P. , Smits Arjen J. , Stadhouder Agnita , Feller Ricardo , Deunk Jaap , Bloemers Frank W.
Published: November 2018

Study Design.

Retrospective epidemiological study.

Objective.

To describe the epidemiology of spinal fractures over a 10 years period in a level one trauma center in the Netherlands.

Summary of Background Data.

Spinal fractures may have large socioeconomic consequences. The prevalence and outcomes likely change over the years owing to improved traffic safety, increasing population age and improved medical treatment. This is the first study to address the epidemiology of spinal fractures over a large period in the Netherlands.

Methods.

All patients with a cervical, thoracic, or lumbar spine fracture admitted to a level one trauma center from 2007 to 2016 were prospective registered and retrospectively analyzed. In addition to patient, accident, and associated injury characteristics, radiological and surgery data were obtained from the hospital's Electronic Patient File system.

Results.

Between 2007 and 2016, 1479 patients with a total of 3029 spinal fractures were admitted. Approximately 40.8% were female and 59.2% were male, with a mean age of 52.0 years; 4.9% of fractures occurred at a juvenile age (0–18 years) and 63.6% at the age of 19 to 64 years. Most fractures occurred in the thoracic spine, followed by the lumbar and cervical spine. The most common cause of injury was a fall from height, followed by traffic accidents. Spinal cord injury occurred in 8.5% and associated injuries were reported in 73% of the patients. Sixteen percent of the admitted patients were treated operatively. Over time, there was a larger increase in amount of spine fractures in elderly (≥ 65 years) compared with younger people.

Conclusion.

The total amount of spine fractures per year increased over time. In addition, there was a larger increase in amount of spine fractures in patients over 65 years of age compared with younger patients. Despite this increase, a considerable amount of spine fractures still occur in the age-group of 19 to 64 years. Most fractures were located in the thoracic spine. This study might stimulate development of policy on precautionary actions to prevent spine fractures.

Level of Evidence: 4
Impact of initial stage on metastatic melanoma survival
Authors: Wilson Melissa A. , Zhong Judy , Rosenbaum Brooke E. , Utter Kierstin , Moran Una , Darvishian Farbod , Polsky David , Berman Russell S. , Shapiro Richard L. , Pavlick Anna C. , Osman Iman
Published: November 2018

Patients diagnosed with metastatic melanoma have varied clinical courses, even in patients with similar disease characteristics. We examine the impact of initial stage of melanoma diagnosis, BRAF status of primary melanoma, and receiving adjuvant therapy on postmetastatic overall survival (pmOS). We studied melanoma patients presenting to Perlmutter Cancer Center at New York University and prospectively enrolled in New York University melanoma biospecimen database and followed up on protocol-driven schedule. Patients were stratified by stage at initial melanoma diagnosis as per AJCC 7th ed. guidelines. pmOS was determined using the Kaplan–Meier method and Cox’s proportional hazards models were used to assess hazard ratios (HRs). Three hundred and four out of 3204 patients developed metastatic disease over the time of follow-up (median follow-up 2.2 years, range: 0.08–35.2 years). Patients diagnosed with stage I (n=96) melanoma had longer pmOS (29.5 months) than those diagnosed with stage II (n=99, pmOS 14.9 months) or stage III (n=109, pmOS 15.1 months) melanoma (P=0.036). Initial stage of diagnosis remained significant in multivariate analysis when controlling for lactate dehydrogenase and site of metastases [primary diagnosis stage II (HR 1.44, P=0.046), stage III (HR 1.5, P=0.019)]. Adjuvant treatment was associated with better survival but BRAF mutation status did not show an association. Our data challenge the general assumption that primary melanomas converge upon diagnosis of metastatic disease and behave uniformly. Primary stage of melanoma at the time of diagnosis may be prognostic of outcome, similar to lactate dehydrogenase and metastatic disease sites.
Topical Ganciclovir for Prophylaxis of Cytomegalovirus Endotheliitis in Endothelial Keratoplasty
Authors: Basilious Alfred , Chew Hall F.
Published: November 2018

Purpose:

To describe the presentation and management of 2 cases of Descemet stripping automated endothelial keratoplasty (DSAEK) with failure secondary to cytomegalovirus (CMV) infection and prophylaxis with topical ganciclovir to prevent repeat failure of Descemet membrane endothelial keratoplasty (DMEK) regrafts.

Methods:

A retrospective chart review was conducted for 2 patients with DSAEK failure secondary to CMV infection.

Results:

A 70-year-old immunocompetent man (case 1) and a 53-year-old immunocompromised man (case 2) received DSAEK for presumed pseudophakic bullous keratopathy and endothelial decompensation secondary to recurrent uveitis, respectively. Case 1 had first graft failure at 10 months and case 2 at 21 months with inferior edema and keratic precipitates. Both failed to respond to topical steroid drops, and case 1 had 3 subsequent failed DSAEKs. Anterior chamber paracentesis confirmed CMV DNA. Neither had a clinical response to 6 weeks of oral valganciclovir. They were then administered topical ganciclovir (0.15% ophthalmic gel), and repeat endothelial transplant (DMEK) was performed for both patients. They were again administered topical ganciclovir 4 times daily after surgery because aqueous samples remained positive for CMV. Both remain free of inflammation or failure on topical ganciclovir for 21 months (case 1) and 29 months (case 2) with uncorrected visual acuities of 20/40 and 20/25, respectively.

Conclusions:

Long-term topical ganciclovir use can prevent recurrence of CMV-associated graft failure even in immunocompromised hosts without side effects of systemic antivirals. DMEK may have advantages over DSEK in eyes with previous CMV infection and in eyes prone to inflammation.
The Dangers of Influenza and Benefits of Vaccination in Adults With Chronic Health Conditions
Authors: Schaffner William , McElhaney Janet , Rizzo Albert A. , Savoy Margot , Taylor Allen J. , Young Melissa
Published: November 2018

Influenza (flu) is a serious health concern in adults with certain chronic health conditions including diabetes, lung disease, and cardiovascular disease. Flu-related inflammation may exacerbate chronic lung diseases and has been shown to increase the risk of myocardial infarction and stroke long after resolution of the acute illness. Data from the 2017–2018 flu season show a disproportionate impact on adults with chronic health conditions. Despite strong evidence to support the benefits of annual flu vaccination in mitigating disease severity, reducing hospitalization rates, and disrupting viral transmission, vaccination rates remain suboptimal. Health care professionals play a key role in communicating the known benefits of flu vaccination and improving patient outcomes in adults with chronic health conditions.
Treatment of ACL Tears in the Skeletally Immature Patient
Authors: Joseph Sheeba M. , Huleatt Joel B. , Vogel-Abernathie Laura A. , Pace J. Lee
Published: November 2018

The understanding and treatment of anterior cruciate ligament tears in skeletally immature patients continues to evolve. While conservative management was a mainstay of treatment, poor outcomes have led to several surgical techniques aimed at stabilizing the knee, optimizing outcome, and minimizing the chance of growth disturbance. Current techniques have, in large part, accomplished these goals but challenges remain. Looking to the future, different graft options, primary repair techniques, and rigorous prospective studies will help improve outcomes for this challenging patient population.
The Surgical Applications of Biologics in Sports Medicine
Authors: Barber F. Alan
Published: November 2018

Over the past 25 years an increased appreciation of the positive impact of biologic interventions has driven significant advances in the surgical treatment of shoulder and knee conditions. These biologic adjuncts to treatment promote improved outcomes and have set the stage and increased research and development in this arena.
Elbow Surgery in Athletes
Authors: Cain Edward Lyle , Moroski Nathan M.
Published: November 2018

Injuries and disorders of the elbow in athletes are common especially among throwing athletes. Common injuries encountered in the throwing athlete include ulnar collateral ligament injuries, ulnar neuritis, capitellar osteochondritis dissecans, valgus extension overload with posterior olecranon impingement, olecranon stress fracture, and loose bodies. A thorough knowledge of both the functional anatomy as well as throwing biomechanics are required to properly diagnosis and treat these problems. Nonoperative and surgical techniques have continued to advance over the last 25 years allowing for improved prognosis and return to play for athletes affected with elbow pathology.
Geographical mapping of advanced practice registered nurses in Louisiana: Leveraging the power of data display
Authors: Becnel Brent J. , Pearce Patricia F. , Eiswirth Emily
Published: November 2018

Background and purpose:

Identifying the locations of advanced practice registered nurses (APRNs) in the state is challenging without data readily available, which can adversely affect stakeholder initiatives. The purpose of this project was to develop an online interactive map reflecting distribution of APRNs licensed by the Louisiana State Board of Nursing (LSBN), heightening APRN visibility and improving usability of data for policy, education, practice, and research initiatives.

Methods:

A descriptive design with development of a graphical interactive map showing all Louisiana parishes with integrated distribution summaries of APRNs was made. Work proceeded from paper to higher fidelity simulations to the final interactive web page. Compatibility with LSBN's web page and annual data upload were ensured.

Conclusion:

The project was done in collaboration with LSBN, an academic institution, and a privately hired web designer. The principals of Louisiana State Board of Nursing approved the final product. The product meets and exceeds the expectations for mapping. Evaluation of use and usability will be done at the discretion of LSBN.

Implications for practice:

The outcome of this project will serve to heighten visibility of the distribution of APRNs in the state of Louisiana, enhancing opportunities for APRNs and for patients. Furthermore, those interested in leveraging the information in policy, education, or research initiatives will be served.
Deliberate Practice Mock Codes for New Graduate Nurses
Authors: McPhee Kim
Published: November 2018

New graduate nurses frequently identify mock codes as anxiety-provoking events for them. Mock codes practiced in a safe environment can help ease nurses’ anxiety and build confidence. Although one academic medical center has provided mock code experiences for several years, the new graduate nurses requested more practice time. Recent evidence identified deliberate practice as an alternative way to practice skills repeatedly and efficiently. Deliberate practice for mock codes was implemented and has been evaluated positively.
Opioid Misuse Among HIV-Positive Adults in Medical Care: Results From the Medical Monitoring Project, 2009–2014
Authors: Lemons Ansley , DeGroote Nicholas , Peréz Alejandro , Craw Jason , Nyaku Margaret , Broz Dita , Mattson Christine L. , Beer Linda
Published: November 2018

Background:

People living with HIV are prescribed opioids more often and at higher doses than people who do not have HIV, and disproportionately experience risk factors for substance use disorder, which suggests they could be at increased risk of the misuse of opioids. Researchers also suggest that opioid misuse negatively affects various HIV clinical outcomes, increasing the risk of transmission to partners with an HIV-negative status.

Methods:

We calculated weighted percentages and 95% confidence intervals to estimate substance use characteristics among a probability sample of 28,162 HIV-positive adults receiving medical care in the United States who misused opioids (n = 975). Then, we used Rao-Scott χ2 tests to assess bivariate associations between opioid misuse and selected characteristics.

Results:

In all, 3.3% misused opioids. Misuse was more common among young adults, males, and non-Hispanic whites. Persons who misused opioids were less likely to: have been prescribed antiretroviral therapy (ART) (88.7%), report being adherent to ART medications in the past 3 days (78.1%), and have durable viral suppression (54.3%) than persons who did not misuse opioids (92.5%, 87.7%, and 64.7%, respectively). Persons who misused opioids were more likely to report condomless sex with partners of negative or unknown HIV status while not durably virally suppressed (11.7% vs 3.4%) than persons who did not misuse opioids.

Conclusions:

Opioid misuse among adults receiving HIV medical care is associated with inadequate ART adherence, insufficient durable viral suppression, and higher risk of HIV transmission to sexual partners.
Preputial Grafts
Authors: Ehrlichman Richard J. , Driscoll Daniel N. , Cornejo Kristine , Upton Joseph
Published: November 2018

Background

The prepuce is an excellent donor site for skin grafts with minimal donor site morbidity. Full-thickness grafts are often required for correction of congenital syndactyly and in burn contractures.

Methods

Preputial skin was used for grafting in 18 children: 5 with burn contractures and 13 with congenital syndactyly.

Results

Excellent graft take was achieved with appropriate postoperative care. Postoperatively, there were occasional milia (42%) and hyperpigmentation. These grafts were noted to have superior mobility and elasticity. There was no donor site morbidity.

Conclusions

Preputial skin is accessible, easy to harvest, and hairless and has minimal donor site morbidity. It is especially well suited for the hands and fingers when elasticity of the graft is beneficial.
An Evidence-Based Approach to Management of Pectus Excavatum and Carinatum
Authors: Buziashvili David , Gopman Jared M. , Weissler Hope , Bodenstein Lawrence , Kaufman Andrew J. , Taub Peter J.
Published: November 2018

Pectus excavatum (PE) and pectus carinatum (PC) are the most common congenital chest wall anomalies. Current research suggests that PE and PC may result from overgrowth of the sternocostal cartilages. This can produce a deformation that displaces the sternum inward as in PE or outward as in PC. The etiology, clinical presentation, evaluation, and management of PE and PC are reviewed. Varied clinical presentations, cardiopulmonary effects, and psychosocial aspects are described.
Perceiving Hesitation requires both the Motor and Mentalizing systems
Authors: Thioux Marc , Suttrup Judith , Keysers Christian
Published: November 2018

The mentalizing network and the putative mirror neuron system (pMNS) are two important large scale brain networks for social cognition, with very little overlap between them. Evidence suggests however that the two networks can collaborate for understanding the state of mind of others on the basis of their body movements. Here using fMRI we find that when participants view hand actions to detect hesitations they activate both their mentalizing and pMNS networks and information is exchanged across these networks. In a follow-up experiment using repetitive TMS we find that disturbing activity in either network slows hesitation attribution. In contrast, watching the same actions to determine the size of the object being grasped only triggered activity in the pMNS network, and rTMS over the mentalizing network then no longer slowed reactions. When we see others’ actions, we recruit our own motor system. Our results suggest that for detecting a simple mental state like hesitation, this pre-processed motor information becomes a necessary input into a mentalizing network that is essential for associating deviations from a predicted motor program with a specific mental state.
Human bone marrow disorders recapitulated in vitro using organ chip technology
Authors: Chou David B. , Frismantas Viktoras , Milton Yuka , David Rhiannon , Pop-Damkov Petar , Ferguson Douglas , MacDonald Alexander , Bölükbaşı Özge Vargel , Joyce Cailin E. , Teixeira Liliana S. Moreira , Rech Arianna , Jiang Amanda , Calamari Elizabeth , Jalili-Firoozinezhad Sasan , Ng Carlos F. , Choe Youngjae , Clauson Susan , Myers Kasiani , Hasserjian Robert P. , Novak Richard , Levy Oren , Prantil-Baun Rachelle , Novina Carl D. , Shimamura Akiko , Ewart Lorna , Ingber Donald E.
Published: November 2018

Understanding human bone marrow (BM) pathophysiology in the context of myelotoxic stress induced by drugs, radiation, or genetic mutations is of critical importance in clinical medicine. However, study of these dynamic cellular responses is hampered by the inaccessibility of living BMin vivo. Here, we describe a vascularized human Bone Marrow-on-a-Chip (BM Chip) microfluidic culture device for modeling bone marrow function and disease states. The BM Chip is comprised of a fluidic channel filled with a fibrin gel in which patient-derived CD34+ cells and bone marrow-derived stromal cells (BMSCs) are co-cultured, which is separated by a porous membrane from a parallel fluidic channel lined by human vascular endothelium. When perfused with culture medium through the vascular channel, the BM Chip maintains human CD34+ cells and supports differentiation and maturation of multiple blood cell lineages over 1 month in culture. Moreover, it recapitulates human myeloerythroid injury responses to drugs and gamma radiation exposure, as well as key hematopoietic abnormalities found in patients with the genetic disorder, Shwachman-Diamond Syndrome (SDS). These data establish the BM Chip as a new humanin vitromodel with broad potential utility for studies of BM dysfunction.
Wiring together large single-cell RNA-seq sample collections
Authors: Barkas Nikolas , Petukhov Viktor , Nikolaeva Daria , Lozinsky Yaroslav , Demharter Samuel , Khodosevich Konstantin , Kharchenko Peter V.
Published: November 2018

Single-cell RNA-seq methods are being increasingly applied in complex study designs, which involve measurements of many samples, commonly spanning multiple individuals, conditions, or tissue compartments. Joint analysis of such extensive, and often heterogeneous, sample collections requires a way of identifying and tracking recurrent cell subpopulations across the entire collection. Here we describe a flexible approach, called Conos (Clustering On Network Of Samples), that relies on multiple plausible inter-sample mappings to construct a global graph connecting all measured cells. The graph can then be used to propagate information between samples and to identify cell communities that show consistent grouping across broad subsets of the collected samples. Conos results enable investigators to balance between resolution and breadth of the detected subpopulations. In this way, it is possible to focus on the fine-grained clusters appearing within more similar subsets of samples, or analyze coarser clusters spanning broader sets of samples in the collection. Such multi-resolution joint clustering provides an important basis for downstream analysis and interpretation of sizeable multi-sample single-cell studies and atlas-scale collections.
Vector analysis of steerable mechanical tension across nuclear lamina
Authors: Chen TingTing , Wu HuiWen , Wang YuXuan , Shan JinJun , Zhang JiaRui , Zhao HuanHuan , Guo Jun
Published: November 2018

The nucleus is the most prominent organelle in eukaryotic cells, and its deformation depends on interactions between the nuclear lamina (NL) and cytoskeleton structural tensions. The structural tensions can be quantified at a pico-Newton (pN) level using a genetically encoded optical probe. In living cells, NL tensions countered the 4.26pN resting strain imposed competitively by cytoskeletal tension. The depolymerization of microfilaments or microtubules drove an aberrant increase in outward osmotic pressure through the production of mass protein-nanoparticles. The osmotic pressure also served as a directional converter of inward cytoskeletal force, and contributed to the outward expansion of NL via the passive pull of intermediate filaments (IFs). The NL, but not IFs, can remotely detect extracellular osmosis pressure alterations, which are closely associated with highly polarized microfilament and microtubule structures and their directional force activities. The oxidative-induced increase of NL tension results from intracellular hyper-osmosis, associated closely with protein-nanoparticles production elicited by cofilin and stathmin activation. These data reveal that intracellular steerable forces interact direction-dependently to control NL tension in terms of their magnitude and vectors.