bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the influence of capillary waves on solvation at the liquid-vapor interface
Authors: Rane Kaustubh , van der Vegt Nico F. A.
Published: March 2016

This work investigates the question if surface capillary waves (CWs) affect interfacial solvation thermodynamic properties that determine the propensity of small molecules toward the liquid-vapor interface. We focus on (1) the evaluation of these properties from molecular simulations in a practical manner and (2) understanding them from the perspective of theories in solvation thermodynamics, especially solvent reorganization effects. Concerning the former objective, we propose a computational method that exploits the relationship between an external field acting on the liquid-vapor interface and the magnitude of CWs. The system considered contains the solvent, an externally applied field (f) and the solute molecule fixed at a particular location. The magnitude of f is selected to induce changes in CWs. The difference between the solvation free energies computed in the presence and in the absence of f is then shown to quantify the contribution of CWs to interfacial solvation. We describe the implementation of this method in the canonical ensemble by using a Lennard-Jones solvent and a non-ionic solute. Results are shown for three types of solutes that differ in the nature of short-ranged repulsive (hard-core) interactions. Overall, we observe that CWs have a negligible or very small effect on the interfacial solvation free energy of a solute molecule fixed near the liquid-vapor interface for the above systems. We also explain how the effects of pinning or dampening of CWs caused by a fixed solute are effectively compensated and do not contribute to the solvation free energy.
Microwave spectra, molecular structure, and aromatic character of 4a,8a-azaboranaphthalene
Authors: Pejlovas Aaron M. , Daly Adam M. , Ashe Arthur J. , Kukolich Stephen G.
Published: March 2016

The microwave spectra for seven unique isotopologues of 4a,8a-azaboranaphthalene [hereafter referred to as BN-naphthalene] were measured using a pulsed-beam Fourier transform microwave spectrometer. Spectra were obtained for the normal isotopologues with 10B, 11B, and all unique single 13C and the 15N isotopologue (with 11B), in natural abundance. The rotational, centrifugal distortion and quadrupole coupling constants determined for the 11B14N isotopologue are A = 3042.712 75(43) MHz, B = 1202.706 57(35) MHz, C = 862.220 13(35) MHz, DJ = 0.06(1) kHz, 1.5χaa (14N) = 2.5781(61) MHz, 0.25(χbb − χcc) (14N) = − 0.1185(17) MHz, 1.5χaa (11B) = − 3.9221(75) MHz, and 0.25(χbb − χcc) (11B) = − 0.9069(24) MHz. The experimental inertial defect is Δ = − 0.159 amu Å2, which is consistent with a planar structure for the molecule. The B—N bond length from the experimentally determined structure is 1.47 Å, which indicates π-bonding character between the B and N. The measured quadrupole coupling strengths provide important and useful information about the bonding, orbital occupancy, and aromatic character for this aromatic molecule. Extended Townes-Dailey analyses were used to determine the B and N electron sp2-hybridized and p-orbital occupations. These results are compared with electron orbital occupations from the natural bond orbital option in theoretical calculations. From the analyses, it was determined that BN-naphthalene has aromatic character similar to that of other N-containing aromatics. The results are compared with similar results for B—N bonding in 1,2-dihydro-1,2-azaborine and BN-cyclohexene. Accurate and precise structural parameters were obtained from the microwave measurements on seven isotopologues and from high-level G09 calculations.
State-of-the-art ab initio potential energy curve for the krypton atom pair and thermophysical properties of dilute krypton gas
Authors: Jäger Benjamin , Hellmann Robert , Bich Eckard , Vogel Eckhard
Published: March 2016

A new reference krypton-krypton interatomic potential energy curve was developed by means of quantum-chemical ab initio calculations for 36 interatomic separations. Highly accurate values for the interaction energies at the complete basis set limit were obtained using the coupled-cluster method with single, double, and perturbative triple excitations as well as t-aug-cc-pV5Z and t-aug-cc-pV6Z basis sets including mid-bond functions, with the 6Z basis set being newly constructed for this study. Higher orders of coupled-cluster terms were considered in a successive scheme up to full quadruple excitations. Core-core and core-valence correlation effects were included. Furthermore, relativistic effects were studied not only at a scalar relativistic level using second-order direct perturbation theory, but also utilizing full four-component and Gaunt-effect computations. An analytical pair potential function was fitted to the interaction energies, which is characterized by a depth of 200.88 K with an estimated standard uncertainty of 0.51 K. Thermophysical properties of low-density krypton were calculated for temperatures up to 5000 K. Second and third virial coefficients were obtained from statistical thermodynamics. Viscosity and thermal conductivity as well as the self-diffusion coefficient were computed using the kinetic theory of gases. The theoretical results are compared with experimental data and with results for other pair potential functions from the literature, especially with those calculated from the recently developed ab initio potential of Waldrop et al. [J. Chem. Phys. 142, 204307 (2015)]. Highly accurate experimental viscosity data indicate that both the present ab initio pair potential and the one of Waldrop et al. can be regarded as reference potentials, even though the quantum-chemical methods and basis sets differ. However, the uncertainties of the present potential and of the derived properties are estimated to be considerably lower.
Calculating splittings between energy levels of different symmetry using path-integral methods
Authors: Mátyus Edit , Althorpe Stuart C.
Published: March 2016

It is well known that path-integral methods can be used to calculate the energy splitting between the ground and the first excited state. Here we show that this approach can be generalized to give the splitting patterns between all the lowest energy levels from different symmetry blocks that lie below the first-excited totally symmetric state. We demonstrate this property numerically for some two-dimensional models. The approach is likely to be useful for computing rovibrational energy levels and tunnelling splittings in floppy molecules and gas-phase clusters.
Double emulsion formation through hierarchical flow-focusing microchannel
Authors: Azarmanesh Milad , Farhadi Mousa , Azizian Pooya
Published: March 2016

A microfluidic device is presented for creating double emulsions, controlling their sizes and also manipulating encapsulation processes. As a result of three immiscible liquids’ interaction using dripping instability, double emulsions can be produced elegantly. Effects of dimensionless numbers are investigated which are Weber number of the inner phase (Wein), Capillary number of the inner droplet (Cain), and Capillary number of the outer droplet (Caout). They affect the formation process, inner and outer droplet size, and separation frequency. Direct numerical simulation of governing equations was done using volume of fluid method and adaptive mesh refinement technique. Two kinds of double emulsion formation, the two-step and the one-step, were simulated in which the thickness of the sheath of double emulsions can be adjusted. Altering each dimensionless number will change detachment location, outer droplet size and droplet formation period. Moreover, the decussate regime of the double-emulsion/empty-droplet is observed in low Wein. This phenomenon can be obtained by adjusting the Wein in which the maximum size of the sheath is discovered. Also, the results show that Cain has significant influence on the outer droplet size in the two-step process, while Caout affects the sheath in the one-step formation considerably.
Note: Gaussian mixture model for event recognition in optical time-domain reflectometry based sensing systems
Authors: Fedorov A. K. , Anufriev M. N. , Zhirnov A. A. , Stepanov K. V. , Nesterov E. T. , Namiot D. E. , Karasik V. E. , Pnev A. B.
Published: March 2016

We propose a novel approach to the recognition of particular classes of non-conventional events in signals from phase-sensitive optical time-domain-reflectometry-based sensors. Our algorithmic solution has two main features: filtering aimed at the de-nosing of signals and a Gaussian mixture model to cluster them. We test the proposed algorithm using experimentally measured signals. The results show that two classes of events can be distinguished with the best-case recognition probability close to 0.9 at sufficient numbers of training samples.
Structure alterations in Al-Y-based metallic glasses with La and Ni addition
Authors: Shi X. M. , Wang X. D. , Yu Q. , Cao Q. P. , Zhang D. X. , Zhang J. , Hu T. D. , Lai L. H. , Xie H. L. , Xiao T. Q. , Jiang J. Z.
Published: March 2016

The atomic structures of Al89Y11, Al90Y6.5La3.5, and Al82.8Y6.07Ni8La3.13 metallic glasses have been studied by using high energy X-ray diffraction, X-ray absorption fine structure combined with the ab initio molecular dynamics and reverse Monte Carlo simulations. It is demonstrated that the partial replacement of Y atoms by La has limited improvement of the glass forming ability (GFA), although La atoms reduce the ordering around Y atoms and also the fractions of icosahedron-like polyhedra centered by Al atoms. In contrast, Ni atoms can significantly improve the GFA, which are inclined to locate in the shell of polyhedra centered by Al, Y, and La atoms, mainly forming Ni-centered icosahedron-like polyhedra to enhance the spatial connectivity between clusters and suppress the crystallization.
Domain wall depinning from notches using combined in- and out-of-plane magnetic fields
Authors: Goertz Jelle J. W. , Ziemys Grazvydas , Eichwald Irina , Becherer Markus , Swagten Henk J. M. , Breitkreutz-v. Gamm Stephan
Published: March 2016

Controlled domain wall motion and pinning in nanowires with perpendicular magnetic anisotropy are of great importance in modern magnetic memory and logic devices. Here, we investigate by experiment the DW pinning and depinning from a notch in a magnetic nanowire, under the influence of combined in- and out-of-plane magnetic fields. In our experiment, the perpendicular magnetization of the Co/Pt nanowires is tilted with the help of sub-μs in-plane field pulses generated by an on-chip coil. Consequently, the energy density of the DW is decreased and the depinning field of the notch is reduced. A theoretical model is applied and compared to the measurement results. The DW depinning mechanism and the DW type are further investigated by micromagnetic simulations.
Dielectric properties of highly resistive GaN crystals grown by ammonothermal method at microwave frequencies
Authors: Krupka Jerzy , Zając Marcin , Kucharski Robert , Gryglewski Daniel
Published: March 2016

Permittivity, the dielectric loss tangent and conductivity of semi-insulating Gallium Nitride crystals have been measured as functions of frequency from 10 GHz to 50 GHz and temperature from 295 to 560 K employing quasi TE0np mode dielectric resonator technique. Crystals were grown using ammonothermal method. Two kinds of doping were used to obtain high resistivity crystals; one with deep acceptors in form of transition metal ions, and the other with shallow Mg acceptors. The sample compensated with transition metal ions exhibited semi-insulating behavior in the whole temperature range. The sample doped with Mg acceptors remained semi-insulating up to 390 K. At temperatures exceeding 390 K the conductivity term in the total dielectric loss tangent of Mg compensated sample becomes dominant and it increases exponentially with activation energy of 1.14 eV. It has been proved that ammonothermal method with appropriate doping allows growth of high quality, temperature stable semi-insulating GaN crystals.
Nanoscopic insights into seeding mechanisms and toxicity of α-synuclein species in neurons
Authors: Pinotsi Dorothea , Michel Claire H. , Buell Alexander K. , Laine Romain F. , Mahou Pierre , Dobson Christopher M. , Kaminski Clemens F. , Kaminski Schierle Gabriele S.
Published: March 2016

Significance

The self-assembly of normally soluble proteins into fibrillar amyloid structures is associated with a range of neurodegenerative disorders. Here, we monitor the fate of different forms of α-synuclein (AS), a protein implicated in Parkinson’s disease, via optical nanoscopy directly in neuronal cells. We show that exogenously added preformed AS fibrils elongate by the addition of endogenous AS, naturally present in neurons. In contrast, exogenously added monomeric AS induces aggregate formation within the cells and leads to apoptosis. The latter is significantly reduced by the addition of preformed fibrils, suggesting a neuroprotective role of fibrillar species. The visualization of these effects at the nanoscale shown here opens up new avenues for understanding the links between AS aggregation and neuronal toxicity.
SharpViSu: integrated analysis and segmentation of super-resolution microscopy data
Authors: Andronov Leonid , Lutz Yves , Vonesch Jean-Luc , Klaholz Bruno P.
Published: March 2016

Summary: We introduce SharpViSu, an interactive open-source software with a graphical user interface, which allows performing processing steps for localization data in an integrated manner. This includes common features and new tools such as correction of chromatic aberrations, drift correction based on iterative cross-correlation calculations, selection of localization events, reconstruction of 2D and 3D datasets in different representations, estimation of resolution by Fourier ring correlation, clustering analysis based on Voronoi diagrams and Ripley’s functions. SharpViSu is optimized to work with eventlist tables exported from most popular localization software. We show applications of these on single and double-labelled super-resolution data.

Availability and implementation: SharpViSu is available as open source code and as compiled stand-alone application under https://github.com/andronovl/SharpViSu.

Contact:  klaholz@igbmc.fr

Supplementary information:  Supplementary data are available at Bioinformatics online.
Effect of Real-Time Feedback on Screw Placement Into Synthetic Cancellous Bone
Authors: Gustafson Peter A. , Geeslin Andrew G. , Prior David M. , Chess Joseph L.
Published: March 2016

Objectives:

The objective of this study is to evaluate whether real-time torque feedback may reduce the occurrence of stripping when inserting nonlocking screws through fracture plates into synthetic cancellous bone.

Methods:

Five attending orthopaedic surgeons and 5 senior level orthopaedic residents inserted 8 screws in each phase. In phase I, screws were inserted without feedback simulating conventional techniques. In phase II, screws were driven with visual torque feedback. In phase III, screws were again inserted with conventional techniques. Comparison of these 3 phases with respect to screw insertion torque, surgeon rank, and perception of stripping was used to establish the effects of feedback.

Results:

Seventy-three of 239 screws resulted in stripping. During the first phase, no feedback was provided and the overall strip rate was 41.8%; this decreased to 15% with visual feedback (P < 0.001) and returned to 35% when repeated without feedback. With feedback, a lower average torque was applied over a narrower torque distribution. Residents stripped 40.8% of screws compared with 20.2% for attending surgeons. Surgeons were poor at perceiving whether they stripped.

Conclusions:

Prevention and identification of stripping is influenced by surgeon perception of tactile sensation. This is significantly improved with utilization of real-time visual feedback of a torque versus roll curve. This concept of real-time feedback seems beneficial toward performance in synthetic cancellous bone and may lead to improved fixation in cancellous bone in a surgical setting.
“Fracturoscopy” is Superior to Fluoroscopy in the Articular Reconstruction of Complex Tibial Plateau Fractures—An Arthroscopy Assisted Fracture Reduction Technique
Authors: Krause Matthias , Preiss Achim , Meenen Norbert M. , Madert Jürgen , Frosch Karl-Heinz
Published: March 2016

Objective:

To analyze the anatomic accuracy of fracture reduction controlled by fluoroscopy as compared with arthroscopically assisted reduction (“fracturoscopy”) in patients with complex tibial plateau fractures (AO/OTA 41-C). Quality of fracturoscopy-guided reduction was checked with postoperative computed tomography.

Design:

Prospective observational study.

Setting:

Urban level 1 trauma center.

Patients:

Seventeen consecutive patients, with a complex, bicondylar tibial plateau fracture.

Intervention:

The intraoperative, open insertion of an arthroscope (2.4-mm or 2.8-mm optics), to visualize the articular surface and fracture reduction.

Main Outcome Measurements:

Ability to detect residual fracture depression or gap after previous open reduction under fluoroscopic guidance.

Results:

An open fracture reduction with fluoroscopic guidance was performed in all cases. In 7 cases, open reduction and fluoroscopy resulted in satisfactory fracture reduction (fluoroscopy group). In 10 of 17 cases, subsequent “fracturoscopy” showed persistent fracture depression (≥2 mm, fracturoscopy group) with the need for intraoperative correction. Patients in the fracturoscopy group demonstrated significantly greater preoperative fragment depression (12.55 ± 6.56 mm) and a larger preoperative fracture gap (7.83 ± 5.49 mm) compared with patients with a satisfactory reduction under fluoroscopy (depression 4.97 ± 4.02 mm, P = 0.016; gap 2.47 ± 1.07 mm, P = 0.023). Fluoroscopy was not successful in achieving satisfactory reduction in cases in which the postero-latero-central region was affected (P = 0.004, χ2 test). Postoperative computed tomography demonstrated satisfactory articular reconstruction in all cases.

Conclusions:

Intraoperative fracturoscopy permitted a significantly improved visualization of fracture fragment displacement, specifically in the postero-latero-central region of the tibial plateau, as compared with fluoroscopy. Fracturoscopy is recommended for fractures involving the postero-latero-central region of the tibial plateau.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Biomechanical Contribution of Tension-Reducing Rotator Cuff Sutures in 3-Part Proximal Humerus Fractures
Authors: Arvesen John E. , Gill Stephen W. , Sinatra Philip M. , Eng Michael , Bledsoe Gary , Kaar Scott G.
Published: March 2016

Objectives:

Using a cadaveric 3-part fracture model and cyclic loading protocol, our study objectives were to quantify the stabilizing effect of tension-reducing rotator cuff sutures in terms of fracture displacement across the surgical neck and greater tuberosity compared with a control group in which no sutures were used.

Methods:

Six matched pairs of fresh frozen specimens underwent a standardized, 3-part, proximal humerus fracture and were split into 2 groups. The control group had the fracture fixed with a plate and screw construct only while the experimental group had additional suture fixation through the plate to each rotator cuff tendon. Active abduction through the rotator cuff was simulated for 100, 200, 300, and 400 cycles and to failure at 1000 N. A Mann–Whitney U test compared cyclic displacement of the greater tuberosity and surgical neck fracture gaps and load to failure between the 2 groups.

Results:

There was no significant difference (P > 0.05) in fracture gap between fixation methods at the surgical neck at 100 (P = 0.13), 200 (P = 0.07), 300 (P = 0.49), and 400 (P = 0.07) cycles. There was no significant difference (P > 0.05) between fixation methods in the fracture gap at the greater tuberosity at 100 (P = 0.39), 200 (P = 1.00), 300 (P = 0.31), and 400 (P = 0.59) cycles. There was no significant difference (P > 0.5) at 1000 N at the surgical neck (P = 0.70) or the greater tuberosity (P = 0.39).

Conclusions:

Tension-relieving rotator cuff sutures do not add stability to the repair of 3-part proximal humerus fractures. Varus collapse and greater tuberosity displacement are common complications associated with 3-part fractures. No mechanical data exist to demonstrate benefit of adding suture to a plate and screw construct for limiting fracture displacement.
Comminuted long bone fractures in children. Could combined fixation improve the results?
Authors: El-Alfy Barakat , Ali Ayman M. , Fawzy Sallam I.
Published: March 2016

Comminuted diaphyseal fractures in the pediatric age group represent a major orthopedic problem. It is associated with a high incidence of complications and poor outcomes because of the instability and difficulty in treatment. The aim of this study was to evaluate the efficacy of combined external skeletal fixation and flexible intramedullary nails in reconstruction of comminuted diaphyseal fracture in skeletally immature patients. Combined external fixator and elastic stable intramedullary nails were used in the management of 27 pediatric patients (15 males and 12 females) with unstable comminuted diaphyseal fractures of the tibia and femur. There were 19 fractures of the femur and eight fractures of the tibia. The average age of the patients was 8.7 years (range 7–14 years) for the femur and 10.8 years (range 6–15 years) for the tibia. Fractures were classified according to the system of Winquist and Hansen as grade II (five cases), grade III (nine cases), and grade IV (13 cases). All cases were operated within 6 days (range 0–6 days) after injury. The mean follow-up period was 2.8 years (range 2–3.5 years). The average duration of the external fixation was 1.6 months for fractures of the tibia, whereas it was 1.4 months for fractures of the femur. The average time for tibia fracture union was 2.8 months for fractures of the tibia, whereas it was 1.9 months for fractures of the femur. Malalignment in varus less than 5° was noted in one patient. One patient had a limb-length discrepancy of 1.5 cms. There were five cases (18.5%) with pin-tract infection. According to the Association for the Study and Application of the Methods of Ilizarov evaluation system, bone results were excellent in 23 cases (85.2%), good in three cases (11.1%), and poor in one case (3.7%). Functional results were excellent in 22 (81.5%) cases and good in five (18.5%) cases. Combined use of external fixators and elastic intramedullary nails is a good method for the treatment of comminuted long bone fractures in children.
Humeral lateral condyle fractures in children: redefining the criteria for displacement
Authors: Bakarman Khalid A. , Alsiddiky Abdul Monem M. , Alzain Kholoud O. , Alkhawashki Hazem M. , Bin Nasser Ahmed S. , Alsaleh Khalid A. , Al-Jassir Fawzi F. , Zamzam Mohamed M.
Published: March 2016

The aim of this study is to define paediatric lateral humeral condyle fractures prone to later displacement. The authors reviewed 106 children who were treated surgically for this fracture. There were 74 boys and 32 girls with an age range of 3–10 years. The study included 27 minimally displaced and 79 displaced fractures. The average follow-up was 50 months. Binary logistic regression model indicated that 6–8-year-old children with minimally displaced fractures and who underwent immediate surgery have a better chance for satisfactory results. The authors concluded that routine use of 2 mm displacement for treatment decisions should be changed to avoid delayed surgery.
High Intracranial Pressure Induced Injury in the Healthy Rat Brain
Authors: Dai Xingping , Bragina Olga , Zhang Tongsheng , Yang Yirong , Rao Gutti R. , Bragin Denis E. , Statom Gloria , Nemoto Edwin M.
Published: March 2016

Objectives:

We recently showed that increased intracranial pressure to 50 mm Hg in the healthy rat brain results in microvascular shunt flow characterized by tissue hypoxia, edema, and increased blood-brain barrier permeability. We now determined whether increased intracranial pressure results in neuronal injury by Fluoro-Jade stain and whether changes in cerebral blood flow and cerebral metabolic rate for oxygen suggest nonnutritive microvascular shunt flow.

Design:

Intracranial pressure was elevated by a reservoir of artificial cerebrospinal fluid connected to the cisterna magna. Arterial blood gases, cerebral arterial-venous oxygen content difference, and cerebral blood flow by MRI were measured. Fluoro-Jade stain neurons were counted in histologic sections of the right and left dorsal and lateral cortices and hippocampus.

Setting:

University laboratory.

Subjects:

Male Sprague Dawley rats.

Interventions:

Arterial pressure support if needed by IV dopamine infusion and base deficit corrected by sodium bicarbonate.

Measurements and Main Results:

Fluoro-Jade stain neurons increased 2.5- and 5.5-fold at intracranial pressures of 30 and 50 mm Hg and cerebral perfusion pressures of 57 ± 4 (mean ± sem) and 47 ± 6 mm Hg, respectively (p < 0.001) (highest in the right and left cortices). Voxel frequency histograms of cerebral blood flow showed a pattern consistent with microvascular shunt flow by dispersion to higher cerebral blood flow at high intracranial pressure and decreased cerebral metabolic rate for oxygen.

Conclusions:

High intracranial pressure likely caused neuronal injury because of a transition from normal capillary flow to nonnutritive microvascular shunt flow resulting in tissue hypoxia and edema, and it is manifest by a reduction in the cerebral metabolic rate for oxygen.
An Exploratory Study of Long-Term Outcome Measures in Critical Illness Survivors: Construct Validity of Physical Activity, Frailty, and Health-Related Quality of Life Measures*
Authors: McNelly Angela S. , Rawal Jai , Shrikrishna Dinesh , Hopkinson Nicholas S. , Moxham John , Harridge Stephen D. , Hart Nicholas , Montgomery Hugh E. , Puthucheary Zudin A.
Published: March 2016

Objective:

Functional capacity is commonly impaired after critical illness. We sought to clarify the relationship between objective measures of physical activity, self-reported measures of health-related quality of life, and clinician reported global functioning capacity (frailty) in such patients, as well as the impact of prior chronic disease status on these functional outcomes.

Design:

Prospective outcome study of critical illness survivors.

Setting:

Community-based follow-up.

Patients:

Participants of the Musculoskeletal Ultrasound Study in Critical Care: Longitudinal Evaluation Study (NCT01106300), invasively ventilated for more than 48 hours and on the ICU greater than 7 days.

Interventions:

None.

Measurements and Main Results:

Physical activity levels (health-related quality of life [36-item short-form health survey] and daily step counts [accelerometry]) were compared to norm-based or healthy control scores, respectively. Controls for frailty (Clinical Frailty Score) were non-morbid, age- and gender-matched to survivors. Ninety-one patients were recruited on ICU admission: 41 were contacted for post-discharge assessment, and data were collected from 30 (14 female; mean age, 55.3 yr [95% CI, 48.3–62.3]; mean post-discharge, 576 d [95% CI, 539–614]). Patients’ mean daily step count (5,803; 95% CI, 4,792–6,813) was lower than that in controls (11,735; 95% CI, 10,928–12,542; p < 0.001), and lower in those with preexisting chronic disease than without (2,989 [95% CI, 776–5,201] vs 7,737 [95% CI, 4,907–10,567]; p = 0.013). Physical activity measures (accelerometry, health-related quality of life, and frailty) demonstrated good construct validity across all three tools. Step variability (from sd) was highly correlated with daily steps (r
2 = 0.67; p < 0.01) demonstrating a potential boundary constraint.

Conclusions:

Subjective and objective measures of physical activity are all informative in ICU survivors. They are all reduced 18 months post-discharge in ICU survivors, and worse in those with pre-admission chronic disease states. Investigating interventions to improve functional capacity in ICU survivors will require stratification based on the presence of premorbidity.
Long-Term Survival, Quality of Life, and Quality-Adjusted Survival in Critically Ill Patients With Cancer*
Authors: Normilio-Silva Karina , de Figueiredo Adelaide Cristina , Pedroso-de-Lima Antonio Carlos , Tunes-da-Silva Gisela , Nunes da Silva Adriana , Delgado Dias Levites Andresa , de-Simone Ana Tereza , Lopes Safra Patrícia , Zancani Roberta , Tonini Paula Camilla , Vasconcelos de Andrade e Silva Ulysses , Buosi Silva Thiago , Martins Giorgi Juliana , Eluf-Neto José , Costa Anderson , Abrahão Hajjar Ludhmila , Biasi Cavalcanti Alexandre
Published: March 2016

Objectives:

To assess the long-term survival, health-related quality of life, and quality-adjusted life years of cancer patients admitted to ICUs.

Design:

Prospective cohort.

Setting:

Two cancer specialized ICUs in Brazil.

Patients:

A total of 792 participants.

Interventions:

None.

Measurements and Main Results:

The health-related quality of life before ICU admission; at 15 days; and at 3, 6, 12, and 18 months was assessed with the EQ-5D-3L. In addition, the vital status was assessed at 24 months. The mean age of the subjects was 61.6 ± 14.3 years, 42.5% were female subjects and half were admitted after elective surgery. The mean Simplified Acute Physiology Score 3 was 47.4 ± 15.6. Survival at 12 and 18 months was 42.4% and 38.1%, respectively. The mean EQ-5D-3L utility measure before admission to the ICU was 0.47 ± 0.43, at 15 days it was 0.41 ± 0.44, at 90 days 0.56 ± 0.42, at 6 months 0.60 ± 0.41, at 12 months 0.67 ± 0.35, and at 18 months 0.67 ± 0.35. The probabilities for attaining 12 and 18 months of quality-adjusted survival were 30.1% and 19.1%, respectively. There were statistically significant differences in survival time and quality-adjusted life years according to all assessed baseline characteristics (ICU admission after elective surgery, emergency surgery, or medical admission; Simplified Acute Physiology Score 3; cancer extension; cancer status; previous surgery; previous chemotherapy; previous radiotherapy; performance status; and previous health-related quality of life). Only the previous health-related quality of life and performance status were associated with the health-related quality of life during the 18-month follow-up.

Conclusions:

Long-term survival, health-related quality of life, and quality-adjusted life year expectancy of cancer patients admitted to the ICU are limited. Nevertheless, these clinical outcomes exhibit wide variability among patients and are associated with simple characteristics present at the time of ICU admission, which may help healthcare professionals estimate patients’ prognoses.
Prediction of 60-Day Case Fatality After Aneurysmal Subarachnoid Hemorrhage: External Validation of a Prediction Model*
Authors: Dijkland Simone A. , Roozenbeek Bob , Brouwer Patrick A. , Lingsma Hester F. , Dippel Diederik W. , Vergouw Leonie J. , Vergouwen Mervyn D. , van der Jagt Mathieu
Published: March 2016

Objective:

External validation of prognostic models is crucial but rarely done. Our aim was to externally validate a prognostic model to predict 60-day case fatality after aneurysmal subarachnoid hemorrhage developed from the International Subarachnoid Aneurysm Trial in a retrospective unselected cohort of subarachnoid hemorrhage patients.

Design:

The model’s predictors were age, aneurysm size, Fisher grade, and World Federation of Neurological Surgeons grade. Two versions of the model were validated: one with World Federation of Neurological Surgeons grade scored at admission and the other with World Federation of Neurological Surgeons grade at treatment decision. The outcome was 60-day case fatality. Performance of the model was assessed by studying discrimination, expressed by the area under the receiver operating characteristic curve, and calibration.

Setting:

University hospital.

Patients:

We analyzed data from 307 consecutive aneurysmal subarachnoid hemorrhage patients admitted between 2007 and 2011 (validation cohort).

Interventions:

None.

Measurements and Main Results:

The observed 60-day case fatality rate was 30.6%. Discrimination was good, and differed between the model with World Federation of Neurological Surgeons grade at treatment decision (area under the receiver operating characteristic curve, 0.89) and at admission (area under the receiver operating characteristic curve, 0.82). Mean predicted probabilities were lower than observed: 17.0% (model with World Federation of Neurological Surgeons grade at admission) and 17.7% (model with World Federation of Neurological Surgeons grade at treatment decision).

Conclusions:

The model discriminated well between patients who died or survived within 60 days. In addition, we found that using World Federation of Neurological Surgeons grade at moment of treatment decision of the ruptured aneurysm improved model performance. However, since predicted probabilities were much lower than observed probabilities, the International Subarachnoid Aneurysm Trial prediction model needs to be adapted to be used in clinical practice.
Identifying Care Coordination Interventions Provided to Community-Dwelling Older Adults Using Electronic Health Records
Authors: Kim Tae Youn , Marek Karen D. , Coenen Amy
Published: March 2016

Although care coordination is a popular intervention, there is no standard method of delivery. Also little is known about who benefits most, or characteristics that predict the amount of care coordination needed, especially with chronically ill older adults. The purpose of this study was to identify types and amount of nurse care coordination interventions provided to 231 chronically ill older adults who participated in a 12-month home care medication management program in the Midwest. For each participant, the nurse care coordinator spent an average of 134 min/mo providing in-person home care, 48 min/mo of travel, and 18 min/mo of indirect care occurring outside the home visit. This accounted for 67.2%, 23.8%, and 9.0% of nursing time, respectively, for home visits, travel, and indirect care. Four of 11 nursing interventions focused on medication management were provided to all participants. Seven of the 11 main interventions were individualized according to each person’s special needs. Wide variations were observed in time provided with in-person home care and communications with multiple stakeholders. Study findings indicate the importance of individualizing interventions and the variability in the amount of nursing time needed to provide care coordination to chronically ill older adults.
Decreased tumor-infiltrating lymphocytes in nodular melanomas compared with matched superficial spreading melanomas
Authors: Lin Richard L. , Wang Thomas J. , Joyce Cara J. , Mihm Martin C. , Murphy George F. , Lian Christine G. , Lin Jennifer Y.
Published: March 2016

Melanoma causes over 9000 deaths annually in the USA. Among its subtypes, nodular melanoma leads to a disproportionate number of fatalities compared with superficial spreading melanoma, the most common subtype. Recent breakthroughs in melanoma research have indicated a strong connection between melanoma virulence and the immune system. We hypothesize that the aggression of nodular melanoma may, in part, be because of decreased recognition by the immune system, as represented by a decreased presence of tumor-infiltrating lymphocytes (TILs), compared with its superficial spreading counterpart. Indeed, TILs on a primary melanoma have been used as a marker for immune response and have prognostic value for survival and sentinel lymph node status. After matching melanoma cases by age, sex, and Breslow thickness, we found significantly fewer TILs in nodular melanomas than in superficial spreading melanomas. This association was prominent in thin (≤2 mm) melanomas and was no longer significant in thick (>2 mm) melanomas. In addition, this difference in TILs was only present in men and not in women. Our finding suggests that nodular melanomas are more frequently associated with absent TILs, providing an avenue for further investigation into differences in immunogenicity of the primary melanoma and whether they underlie the unique virulence of nodular melanoma.
Association Between Hay Fever and High Myopia in United States Adolescents and Adults
Authors: Shafer Brian M. , Qiu Mary , Rapuano Christopher J. , Shields Carol L.
Published: March 2016

Objectives:

To investigate the relationship between hay fever and refractive error in a representative sample of adolescents and adults in the United States.

Methods:

This cross-sectional study included 5,744 participants aged ≥12 years from the 2005 to 2006 National Health and Nutrition Examination Survey who participated in the allergy questionnaire, completed objective refraction and keratometry in both eyes, and had immunoglobulin E (IgE) serology. The primary predictor variable, refractive error, was classified as emmetropia (−0.99 to +0.99 diopters [D]), low myopia (−1.00 to −2.99 D), moderate myopia (−3.00 to −5.99 D), high myopia (≥−6.00 D), or hyperopia (≥1.00 D). Covariates included age, gender, race, asthma, eczema, total serum IgE ≥120 kU/L, corneal steepness, and corneal astigmatism. The primary outcome was hay fever.

Results:

The study population's mean age was 41.7 years; 48.8% of subjects were men and 51.2% were women. The prevalence of hay fever was 12.1% overall. High myopes had 2.7 times higher odds of hay fever compared to emmetropes (OR 2.67, CI, 1.57–4.51, P=0.001), which was independent of demographics, atopic conditions, IgE serology, and keratometry measurements.

Conclusions:

The association between hay fever and high myopia identified in this large cross-sectional study remains speculative and was not mediated through corneal steepness or corneal astigmatism. Further prospective studies may help elucidate the directionality of the association between hay fever and high myopia.
Organizational Silence Among Nurses: The Impact on Organizational Cynicism and Intention to Leave Work
Authors: Çaylak Esra , Altuntaş Serap
Published: March 2016

Background:

In recent years, organizational silence and organizational cynicism, factors that have been shown to inhibit the improvement of organizations, have been highlighted in the health sector. Nearly every aspect of these two issues has been studied.

Purpose:

This research was conducted to identify the relationship between the organizational silence, organizational cynicism, and intention to leave work of nurses.

Methods:

This descriptive and correlational study was carried out in August and September 2013 with 323 nurses at a university hospital in Ankara. A questionnaire that includes a personal information form, the Organizational Silence Scale, the Organizational Cynicism Scale, and a question about intention to leave work was used. Ethics committee approval and institutional permissions were obtained. A statistician analyzed the data.

Results:

The present research found administrative and organizational reasons to be the most important reason why participants remain silent (M = 35.4 ± 13.1), with the tendency not to speak up about ethics and responsibility issues the second most important reason (M = 17.3 ± 6.5). The organizational cynicism of participants is at an intermediate level (M = 36.4 ± 9.6) and may be characterized as cognitive (M = 14.6 ± 4.3). Approximately half of the participants had never considered leaving work. For the participants in this study, organizational silence particularly influences organizational cynicism. The reasons for organizational silence in conjunction with organizational cynicism increase intent to leave work (R = .395, R
2 = .156, p < .001).

Conclusions/Implications for Practice:

This study found that the reasons for organizational silence and organizational cynicism influence the intention of nurses to leave work. The reasons that lead nurses to become silent, to experience cynicism, and to leave work in healthcare environments should be identified. Programs and activities to replace negative ideas with positive ideas should be implemented.
Depression and Its Associated Factors Among Rural Diabetic Residents
Authors: Lee Chia-Mou , Chang Chyong-Fang , Pan Mei-Yu , Hsu Tsui-Hua , Chen Mei-Yen
Published: March 2016

Background:

Type 2 diabetes is a huge burden both for individuals and society as a whole. Although depression has been negatively associated with ideal glycemic control, little is known about the prevalence of depression or its associated factors among rural Taiwanese adults with Type 2 diabetes mellitus (type2 DM).

Purpose:

The purposes of this study were to investigate the prevalence of depression in rural-dwelling sufferers of type2 DM and to highlight the relationships between their depression status and health promoting behaviors such as physical activity, keeping active in life, sleep sufficiency, and adopting a diabetic diet.

Methods:

A cross-sectional, correlational design was used to recruit 696 participants from local healthcare centers in rural areas of Chiayi County, Taiwan. Data were collected from March 30, 2010, to August 30, 2012. The Chinese version of the Geriatric Depression Scale and its associated physiological biomarkers were used as screening tools. Logistic regression was used to identify the factors that were associated with depression status.

Results:

The prevalence of depression in this study was 16.8%. Factors found to be associated with depression included being female, having a low level of education, receiving reduced family support, having little physical activity, failing to follow a diabetic diet, frequent inactivity, and having insufficient sleep. There were no significant differences in the physiological indicators between the depressive and nondepressive groups. After controlling for confounding factors, a logistic regression model showed that depression status was associated with a lack of sleep (OR = 2.85, p < .001), less frequent exercise (OR = 2.67, p < .001), and frequent inactivity (OR = 2.35, p = .001).

Conclusions/Implications for Practice:

This study showed that the prevalence of depression among adults with type2 DM living in rural areas is relatively high. From the perspective of health promotion, future research should focus on how to improve quality of sleep by enhancing daily physical activity and on investigating the effect of promoting a more active lifestyle among those at risk on depression.
Prehospital management and outcome of avalanche patients with out-of-hospital cardiac arrest: a retrospective study in Tyrol, Austria
Authors: Strapazzon Giacomo , Plankensteiner Judith , Mair Peter , Ruttmann Elfriede , Dal Cappello Tomas , Procter Emily , Brugger Hermann
Published: March 2016

Aim

The aim of this study is to describe the prehospital management and outcome of avalanche patients with out-of-hospital cardiac arrest in Tyrol, Austria, for the first time since the introduction of international guidelines in 1996.

Patients and methods

This study involved a retrospective analysis of all avalanche accidents involving out-of-hospital cardiac arrest between 1996 and 2009 in Tyrol, Austria.

Results

A total of 170 completely buried avalanche patients were included. Twenty-eight victims were declared dead at the scene. Of 34 patients with short burial, cardiopulmonary resuscitation (CPR) was performed in 27 (79%); 15 of these patients (56%) were transported to hospital with ongoing CPR and four patients were rewarmed with extracorporeal circulation; no patient survived. Of 108 patients with long burial, 49 patients had patent or unknown airway status; CPR was performed in 25 of these patients (51%) and 14 patients (29%) were transported to hospital. Four patients were rewarmed, but only one patient with witnessed cardiac arrest survived. Since the introduction of guidelines in 1996, there has been a marginally significant increase in the rate of documenting airway assessment, but no change in documenting the duration of burial or CPR.

Conclusion

CPR is continued to hospital admission in patients with short burial and asphyxial cardiac arrest, but withheld or terminated at the scene in patients with long burial and possible hypothermic cardiac arrest. Insufficient transfer of information from the accident site to the hospital may partially explain the poor outcome of avalanche victims with out-of-hospital cardiac arrest treated with emergency cardiac care.
Gut Microbiota Differences in Children From Distinct Socioeconomic Levels Living in the Same Urban Area in Brazil
Authors: Mello Carolina S. , Carmo‐Rodrigues Mirian S. , Filho Humberto B.A. , Melli Lígia C.F.L. , Tahan Soraia , Pignatari Antônio C.C. , de Morais Mauro B.
Published: March 2016

Objective:

To compare gut microbiota in impoverished children versus children of high socioeconomic status living in the same urban area in Brazil.

Methods:

A cross‐sectional study was conducted to evaluate 100 children living in a slum and 30 children from a private school, ages between 5 and 11 years old, in Sao Paulo State, Brazil. To characterize the groups, data based on socioeconomic status, sanitation, and housing conditions were collected. Anthropometric measurements and neonatal data were obtained from both groups. Gut microbiota were quantified in fecal samples by real‐time polymerase chain reaction.

Results:

The children in the private school group had higher rates of cesarean delivery and premature birth than the children in the slum group. Staphylococcus aureus (90% vs 48.0%) and Clostridium difficile (100% vs 43.0%) were more commonly found in the children from the private school than in the impoverished children (P < 0.0001). C perfringens was most frequently identified in the group of children from the slum (92.0% vs 80%; P = 0.064). Higher counts of total eubacteria, Firmicutes and Bacteroidetes phyla organisms, Escherichia coli, Lactobacillus spp., and Methanobrevibacter smithii were found in the children living in poverty, whereas higher counts of Salmonella spp., C difficile, and C perfringens were observed in the children living in satisfactory housing conditions (P < 0.05).

Conclusions:

Important differences were observed between the gut microbiota of children living under distinct socioeconomic and environmental conditions within the same city. Our findings suggest that children of high socioeconomic status have less favorable gut microbiota than do children who live in poverty.