bluuebunny/crossref_metadata_2025 huggingface dataset:
Key phosphorylation events in Spc29 and Spc42 guide multiple steps of yeast centrosome duplication
Authors: Jones Michele Haltiner , O’Toole Eileen T. , Fabritius Amy S. , Muller Eric G. , Meehl Janet B. , Jaspersen Sue L. , Winey Mark
Published: July 2018

Phosphorylation modulates many cellular processes during cell cycle progression. The yeast centrosome (called the spindle pole body, SPB) is regulated by the protein kinases Mps1 and Cdc28/Cdk1 as it nucleates microtubules to separate chromosomes during mitosis. Previously we completed an SPB phosphoproteome, identifying 297 sites on 17 of the 18 SPB components. Here we describe mutagenic analysis of phosphorylation events on Spc29 and Spc42, two SPB core components that were shown in the phosphoproteome to be heavily phosphorylated. Mutagenesis at multiple sites in Spc29 and Spc42 suggests that much of the phosphorylation on these two proteins is not essential but enhances several steps of mitosis. Of the 65 sites examined on both proteins, phosphorylation of the Mps1 sites Spc29-T18 and Spc29-T240 was shown to be critical for function. Interestingly, these two sites primarily influence distinct successive steps; Spc29-T240 is important for the interaction of Spc29 with Spc42, likely during satellite formation, and Spc29-T18 facilitates insertion of the new SPB into the nuclear envelope and promotes anaphase spindle elongation. Phosphorylation sites within Cdk1 motifs affect function to varying degrees, but mutations only have significant effects in the presence of an MPS1 mutation, supporting a theme of coregulation by these two kinases.
What is ‘the best and most perfect virtue’?
Authors: Baker Samuel H
Published: July 2018

We can clarify a certain difficulty with regard to the phrase ‘the best and most perfect virtue’ in Aristotle’s definition of the human good in Nicomachean Ethics I 7 if we make use of two related distinctions: Donnellan’s attributive–referential distinction and Kripke’s distinction between speaker’s reference and semantic reference. I suggest that Aristotle is using the phrase ‘the best and most perfect virtue’ attributively, not referentially, and further that even though the phrase may refer to a specific virtue (semantic reference), Aristotle is not using the phrase to refer to a specific virtue (speaker’s reference).
The Role of Low-level First Language Skills in Second Language Reading, Reading-While-Listening and Listening Performance: A Study of Young Dyslexic and Non-dyslexic Language Learners
Authors: Kormos Judit , Košak Babuder Milena , Pižorn Karmen
Published: July 2018

Our study investigated the differences in low-level L1 skills and L2 reading, listening, and reading-while-listening outcomes between young dyslexic and non-dyslexic Slovenian learners of English. The research, in which children completed four language assessment tasks in three modes in a carefully counter-balanced order, also examined the relationship between low-level L1 skills and L2 reading, listening, and reading-while-listening performance. The findings show that, in Slovenian, which is a transparent language, dyslexic students are behind their non-dyslexic peers in word-level L1 skills after five years of literacy instruction. The results also call attention to the fact that students with weak L2 reading and listening skills might not always be at risk of, or diagnosed as having, dyslexia. Importantly, the findings suggest that the accuracy and speed of real and non-word reading in L1 might serve as useful indicators of L2 reading difficulties of young language learners. Furthermore, L1 dictation tests were also found to yield diagnostic information on young L2 learners’ listening and reading-while-listening problems.
Utilization of dried and long-term stored polyacrylamide gels for the advanced proteomic profiling of mitochondrial contact sites from rat liver
Authors: Murphy Sandra , Henry Michael , Meleady Paula , Ohlendieck Kay
Published: July 2018

Following subcellular fractionation, the complexity of proteins derived from a particular cellular compartment is often evaluated by gel electrophoretic analysis. For the proteomic cataloguing of these distinct protein populations and their biochemical characterization, gel electrophoretic protein separation can be conveniently combined with liquid chromatography mass spectrometry. Here we describe a gel-enhanced liquid chromatography mass spectrometry (GeLC-MS)/MS approach with a new bioanalytical focus on the proteomic profiling of mitochondrial contact sites from rat liver using the highly sensitive Orbitrap Fusion Tribrid mass spectrometer for optimum protein identification following extraction from dried and long-term stored gels. Mass spectrometric analysis identified 964 protein species in the mitochondrial contact site fraction, whereby 459 proteins were identified by ≥3 unique peptides. This included mitochondrial components of the supramolecular complexes that form the ATP synthase, the respiratory chain, ribosomal subunits and the cytochrome P450 system, as well as crucial components of the translocase complexes translocase of the inner membrane (TIM) and translocase of the outer membrane (TOM) of the two mitochondrial membranes. Proteomics also identified contact site markers, such as glutathione transferase, monoamine oxidase and the pore protein voltage dependent anion channel (VDAC)-1. Hence, this report demonstrates that the GeLC-MS/MS method can be used to study complex mixtures of proteins that have been embedded and stored in dried polyacrylamide gels for a long period of time. Careful re-swelling and standard in-gel digestion is suitable to produce peptide profiles from old gels that can be used to extract sophisticated proteomic maps and enable the subsequent bioinformatics analysis of the distribution of protein function and the determination of potential protein clustering within the contact site system.
Clinker: visualizing fusion genes detected in RNA-seq data
Authors: Schmidt Breon M , Davidson Nadia M , Hawkins Anthony D K , Bartolo Ray , Majewski Ian J , Ekert Paul G , Oshlack Alicia
Published: July 2018

Background

Genomic profiling efforts have revealed a rich diversity of oncogenic fusion genes. While there are many methods for identifying fusion genes from RNA-sequencing (RNA-seq) data, visualizing these transcripts and their supporting reads remains challenging.

Findings

Clinker is a bioinformatics tool written in Python, R, and Bpipe that leverages the superTranscript method to visualize fusion genes. We demonstrate the use of Clinker to obtain interpretable visualizations of the RNA-seq data that lead to fusion calls. In addition, we use Clinker to explore multiple fusion transcripts with novel breakpoints within the P2RY8-CRLF2 fusion gene in B-cell acute lymphoblastic leukemia.

Conclusions

Clinker is freely available software that allows visualization of fusion genes and the RNA-seq data used in their discovery.
Case-based review: ependymomas in adults
Authors: Cachia David , Johnson Derek R , Kaufmann Timothy J , Lowe Stephen , Andersen Samuel , Olar Adriana , Cooper Samuel Lewis , Frankel Bruce M , Gilbert Mark R
Published: July 2018

Ependymomas are rare primary central nervous system (CNS) tumors in adults. They occur most commonly in the spinal cord, and have classically been graded histologically into World Health Organization (WHO) grades I, II, or III based on the level of anaplasia. Recent data are showing that genetic heterogeneity occurs within the same histological subgroup and that ependymomas arising from different CNS locations have different molecular signatures. This has renewed interest in developing targeting therapies based on molecular profiles especially given the variable outcomes with radiation and the poor results with cytotoxic agents. In this paper, we present the case of a 46-year-old woman with a classic presentation of spinal cord ependymoma and discuss the current histopathological and molecular classification for ependymomas as well as current guidelines for patient management.
Association between early prenatal exposure to ambient air pollution and birth defects: evidence from newborns in Xi’an, China
Authors: Wang Lingling , Xiang Xiaomei , Mi Baibing , Song Hui , Dong Min , Zhang Shuiping , Bi Yuxue , Zhao Yaling , Li Qiang , Zhang Qi , Zhang Li , Yan Hong , Wang Duolao , Dang Shaonong
Published: July 2018

Background

The aim of this study was to investigate an association between birth defects and exposure to sulfur dioxide (SO2), nitrogen dioxide (NO2) and particles ≤10 μm in an aerodynamic diameter (PM10) during early pregnancy in Xi’an, China.

Methods

Birth defect data were from the Birth Defects Monitoring System of Xi’an, and data on ambient air pollutants during 2010–15 were from the Xi’an Environmental Protection Bureau. A generalized additive model (GAM) was used to investigate the relationship between birth defects and ambient air pollutants.

Results

Among the 8865 cases with birth defects analyzed, the overall incidence of birth defects was 117.33 per 10 000 infants. Ambient air pollutant exposure during the first trimester increased the risk of birth defects by 10.3% per 10 μg/m3 increment of NO2 and 3.4% per 10 μg/m3 increment of PM10. No significant association was found between birth defects and SO2. Moreover, NO2 increased risk of neural tube defects, congenital heart disease, congenital polydactyly, cleft palate, digestive system abnormalities and gastroschisis, and PM10 was associated with congenital heart disease and cleft lip with or without cleft palate.

Conclusions

Chinese women should avoid exposure to high levels of NO2 and PM10 during the first 3 months of pregnancy.
Varieties of top incomes?
Authors: Hager Sandy Brian
Published: July 2018

Focusing on the advanced political economies, this article critically reviews the recent scholarship on the evolution of top incomes over the past few decades. The existing literature shows that the determination of top incomes is complex, multifaceted and bound up with factors associated with both politics and economics. Technological change and globalization are vital sources of change in contemporary capitalism, but the continued diversity in top income shares across the advanced capitalist world suggests that these forces alone cannot account for the empirical patterns. Instead, there is compelling evidence that power and politics, including government policy, trade union and left party strength, institutions and financialization, all play a pivotal role in regulating distributive outcomes. It is argued that future research will require a plurality of methodological approaches in order to clarify the complex causal process that drives top-end income concentration.
Organizational factors related to the adoption of an injury prevention program by U.S. children’s hospitals
Authors: Weaver Nancy L , Buskirk Trent D , Jupka Keri , Williams Janice
Published: July 2018

Most childhood injuries can be prevented with the correct use of safety devices and appropriate supervision. Children’s hospitals are well positioned to promote these behaviors with evidence-based programming; however, barriers exist to adopting such programs. The purpose of this study was to describe organizational and administrative factors related to the adoption of an efficacious injury prevention (IP) program by children’s hospitals in the USA. IP specialists at 232 U.S. children’s hospitals were invited to complete a baseline survey, and then offered Safe N’ Sound (SNS), an efficacious computer IP program targeting parents of young children. Following this promotion period, specialists were surveyed again to assess their level of SNS adoption. Organizational and administrative factors associated with SNS adoption were identified using conditional random forest models (n = 93). Random forests identified a set of six predictors with potential utility for classifying hospitals as having SNS adoption activity or not; the final pruned classification tree indicated that four of these were best able to differentiate hospitals with and without adoption activity—having a medical director, having other hospital units that provided IP programming, the number of requests the IP unit received within the past year, and the belief of administrative leaders in their responsibility to develop programming all influence decisions. Hospitals without a medical director were most likely to demonstrate adoption activity. Medical directors, or other organizational leaders, can facilitate the adoption process for evidence-based intervention, but may need to be engaged intentionally when disseminating new products, tools, or approaches.
An Evidence-Based Scoring System for Prioritizing Mosaic Aneuploid Embryos Following Preimplantation Genetic Screening
Authors: Romana Grati Francesca , Gallazzi Gloria , Branca Lara , Maggi Federico , Simoni Giuseppe , Yaron Yuval
Published: July 2018

(Abstracted from Reprod Biomed Online 2018;36:442–449)

Human blastocyst embryos after preimplantation genetic screening (PGS) are comprised of mostly euploid embryos and some mosaic embryos. When there are no euploid cells following PGS, only mosaic embryos are available for transfer.
Association of the Affordable Care Act Dependent Coverage Provision With Prenatal Care Use and Birth Outcomes
Authors: Daw Jamie R. , Sommers Benjamin D.
Published: July 2018

(Abstracted from JAMA 2018;319:579–587)

The dependent coverage provision of the Affordable Care Act, implemented in September 2010, allows young adults to remain on their parent’s health insurance plan until their 26th birthday. Studies have found that this provision increased preventative care, expanded insurance, and increased self-reported health among young adults.
Patient Perspectives on the Use of Categories of Conditions for Decision Making About Genomic Carrier Screening Results
Authors: Kraft Stephanie A. , McMullen Carmit K. , Porter Kathryn M. , Kauffman Tia L. , Davis James V. , Schneider Jennifer L. , Goddard Katrina A. B. , Wilfond Benjamin S.
Published: July 2018

(Abstracted from Am J Med Genet 2018;176A:376–385)

Rapid, affordable genome sequencing in reproductive medicine continues to increase in availability and popularity, with some commercial laboratories now offering expanded carrier panels for all patients. This trend presents clinicians with new challenges in presentation and supporting patients’ decisions as they decide whether to receive expanded, genome-scale carrier screening.
Five and 10 Minute Apgar Scores and Risks of Cerebral Palsy and Epilepsy: Population Based Cohort Study in Sweden
Authors: Persson Martina , Razaz Neda , Tedroff Kristina , Joseph K. S. , Cnattingius Sven
Published: July 2018

(Abstracted from BMJ 2018;360:k207)

Population-based studies have found an increased risk of epilepsy and cerebral palsy (CP) associated with infants found to have a low Apgar score. Research has found a temporal association, as a low Apgar score at 5 minutes has been found to confer a higher risk than a correspondingly low Apgar score at 1 minute.
Critical Role of the Surgeon–Anesthesiologist Relationship for Patient Safety
Authors: Cooper Jeffrey B.
Published: July 2018

Teamwork is now recognized as important for safe, high-quality perioperative care. The relationship in each surgeon–anesthesiologist dyad is perhaps the most critical element of overall team performance. A well-functioning relationship is conducive to safe, effective care. A dysfunctional relationship can promote unsafe conditions and contribute to an adverse outcome. Yet, there is little research about this relationship, about what works well or not well, what can be done to optimize it. This article explores functional and dysfunctional aspects of the relationship, identifies some negative stereotypes each profession has of the other and calls for research to better characterize and understand how to improve working relationships. Suggestions are given for what an ideal relationship might be and actions that surgeons and anesthesiologists can take to improve how they work together. The goal is safer care for patients, and more joy and meaning in work for surgeons and anesthesiologists.
Standardized Unloading of Respiratory Muscles during Neurally Adjusted Ventilatory Assist
Authors: Campoccia Jalde Francesca , Jalde Fredrik , Wallin Mats K. E. B. , Suarez-Sipmann Fernando , Radell Peter J. , Nelson David , Eksborg Staffan , Sackey Peter V.
Published: July 2018

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Currently, there is no standardized method to set the support level in neurally adjusted ventilatory assist (NAVA). The primary aim was to explore the feasibility of titrating NAVA to specific diaphragm unloading targets, based on the neuroventilatory efficiency (NVE) index. The secondary outcome was to investigate the effect of reduced diaphragm unloading on distribution of lung ventilation.

Methods

This is a randomized crossover study between pressure support and NAVA at different diaphragm unloading at a single neurointensive care unit. Ten adult patients who had started weaning from mechanical ventilation completed the study. Two unloading targets were used: 40 and 60%. The NVE index was used to guide the titration of the assist in NAVA. Electrical impedance tomography data, blood-gas samples, and ventilatory parameters were collected.

Results

The median unloading was 43% (interquartile range 32, 60) for 40% unloading target and 60% (interquartile range 47, 69) for 60% unloading target. NAVA with 40% unloading led to more dorsal ventilation (center of ventilation at 55% [51, 56]) compared with pressure support (52% [49, 56]; P = 0.019). No differences were found in oxygenation, CO2, and respiratory parameters. The electrical activity of the diaphragm was higher during NAVA with 40% unloading than in pressure support.

Conclusions

In this pilot study, NAVA could be titrated to different diaphragm unloading levels based on the NVE index. Less unloading was associated with greater diaphragm activity and improved ventilation of the dependent lung regions.
Humeral Head Ossification Predicts Peak Height Velocity Timing and Percentage of Growth Remaining in Children
Authors: Li Don T. , Cui Jonathan J. , DeVries Stephen , Nicholson Allen D. , Li Eric , Petit Logan , Kahan Joseph B. , Sanders James O. , Liu Raymond W. , Cooperman Daniel R. , Smith Brian G.
Published: July 2018

Background:

Understanding skeletal maturity is important in the management of idiopathic scoliosis. Iliac apophysis, triradiate cartilage, hand, and calcaneal ossification patterns have previously been described to assess both peak height velocity (PHV) and percent growth remaining; however, these markers may not be present on standard spine radiographs. The purpose of this study was to describe a novel maturity assessment method based on proximal humeral epiphyseal ossification patterns.

Methods:

Ninety-four children were followed at least annually throughout growth with serial radiographs and physical examinations. The PHV of each child was determined by measuring the change in height observed at each visit and adjusting for the interval between visits. Percent growth remaining was determined by comparing current to final standing height. The humeral head periphyseal ossification was grouped into stages by 8 investigators ranging from medical student to attending surgeon.

Results:

The morphologic changes involving the proximal humeral physis were categorized into 5 stages based on development of the humeral head epiphysis and fusion of the lateral margin of the physis. Our novel classification scheme was well distributed around the PHV and reliably correlated with age of peak growth and percent growth remaining with >70% nonoverlapping interquartile ranges. Furthermore, the scheme was extremely reliable with intraclass correlation coefficients of 0.96 and 0.95 for intraobserver and interobserver comparisons, respectively.

Conclusions:

The humeral head classification system described here was strongly correlated with age of PHV as well as percentage growth remaining. Furthermore, the staging system was extremely reliable in both interobserver and intraobserver correlations suggesting that it can be easily generalized.

Clinical Relevance:

As a view of the humeral head is almost always present on standard scoliosis spine x-ray at our institution, our classification can be easily adapted by surgeons to gain additional insight into skeletal maturity of patients with scoliosis. We believe that our method will significantly improve the evaluation of the child with scoliosis without increasing radiation exposure, time, or cost.
Force Testing of Explanted Magnetically Controlled Growing Rods
Authors: Rushton Paul R.P. , Smith Simon L. , Forbes Liam , Bowey Andrew J. , Gibson Michael J. , Joyce Thomas J.
Published: July 2018

Study Design.

Laboratory analysis of explanted MAGnetic Expansion Control (MAGEC) growing rods.

Objective.

The aim of this study was to measure the force produced by explanted MAGEC rods compared with new rods and assess the influence of clinical variables.

Summary of Background Data.

MAGEC rods are increasingly used in early-onset scoliosis. Some data are available describing the structure of explanted MAGEC rods, but to date, no study has assessed their function.

Methods.

Explanted MAGEC rods were received from seven UK and one Danish center. The force produced by explanted rods on activation with the external remote controller was measured using a dedicated jig. Forces were compared with two unused rods as well as the manufacturer's defined standard (42 Ibf). Clinical variables were collected from contributing centers where possible and correlated with the force measurements.

Results.

Forty-five MAGEC rods from 25 cases were received for analysis. The mean age at insertion was 8.6 years and rods were in vivo for a mean of 2.7 years in predominantly dual rod constructs. Two unused MAGEC rods produced a mean force of 45.3 (0.25) and 50.2 (1.4) Ibf, above the manufacturer's stated standard. Of the 45 explanted rods, 10 (22%) produced force greater or equal to manufacturer's standard, mean 46.7 (2.7) Ibf. Six rods (13%) produced some force but less than the manufacturer's standard, mean 34.8 (3.6) Ibf. Twenty-nine rods (64%) produced no force. The duration the rods were in vivo was significantly negatively correlated with the force produced on testing (r = −0.63, P < 0.005). Of the 12 rods implanted longer than 38 months, none produced any force.

Conclusion.

This is the first study of the force, and hence likely function, of explanted MAGEC rods. The majority of explanted rods produced no force, while others produced reduced force. These findings raise questions regarding the longevity of the implant and further clinical outcome studies are recommended.

Level of Evidence: 4
Radiological Characteristics and Clinical Outcome of Ossification of Posterior Longitudinal Ligament Involving C2 After Posterior Laminoplasty and Instrumented Fusion Surgery
Authors: Wang Liang , Jiang Yunpeng , Li Mu , Si Haipeng , Li Le , Qi Lei
Published: July 2018

Study Design.

Retrospective study.

Objective.

To analyze the radiological characteristics and surgical outcome of cervical ossification of posterior longitudinal ligament (OPLL) involving C2 level.

Summary of Background Data.

The study and report focused on the OPLL involving C2 level are rare. Therefore, the radiological characteristics and surgical outcome remain unclear.

Methods.

The records of the patients with OPLL involving C2 level who underwent posterior surgery from July 2006 through October 2015 were retrospectively reviewed. The types, longitudinal and transverse extent, occupation ratio, K-line classification of OPLL, and high-intensity zone of spine cord on magnetic resonance imaging were analyzed to evaluate the radiological characteristics. All the cases received posterior open-door laminoplasty and instrumented fusion surgery. The Japanese Orthopedic Association (JOA) score and recovery rate (RR) were used to evaluate neurological function after surgery.

Results.

A total of 45 patients with OPLL involving C2 level were enrolled in the study. Their radiological data were carefully analyzed. The mixed (73.3%) and continuous type (24.5%) were observed. The mean number of involved segments was 5.1. The narrowest spinal canal mostly located in the level of C3-C4 and mean occupying ratio was 65.3%. Thirty-two patients were followed up for at least 2 years and the mean follow-up time was 46.2 months. The mean JOA score was 10.3 preoperatively and 15.2 at the final follow-up and the mean RR was 70.7%. The K-line (+) and (−) subgroups showed similar preoperative JOA score and RR. The high-intensity zone (+) subgroup showed lower preoperative JOA score but equal RR with (−) subgroup.

Conclusion.

When OPLL involve C2 level, it often presented different radiological characteristics. The posterior open-door laminoplasty and instrumented fusion surgery could achieve favorable clinical outcomes. Further researches and long-term clinical follow-up are needed to better appreciate the OPLL involving C2 level.

Level of Evidence: 4
Avoiding Obsolescence in Mobile Health
Authors: Tu Ming-Hsiang , Chang Polun , Lee Ying-Li
Published: July 2018

This study examined staff perceptions of planned obsolescence during a transition from old to new handheld devices for long-term mobile healthcare. Questionnaires based on the technology acceptance model were used to evaluate perceived ease of use and usefulness. This study recruited 120 staff from 26 long-term care facilities who used the old device and 86 staff from nine of the 26 original facilities who used the new device. Although the new devices with advanced features scored significantly higher in acceptance ratings, users still expressed high acceptance of, satisfaction with, and willingness to use the old device, which featured an effective and carefully designed user interface. Usability design plays an essential role in preventing the obsolescence of mobile handheld technology.
Traumatic Neuroma With Melanoma Perineural Invasion
Authors: Al-Zaid Tariq , Salah Haneen Thabit
Published: July 2018

Traumatic neuroma is a reactive non-neoplastic neural proliferation that results from trauma. Although such type of lesions found surgical scars due to different reasons, its involvement by residual or recurrent malignancies is rarely reported. In this article, we describe an unusual case of traumatic neuroma with perineural invasion by invasive melanoma.
The boundary-spanning behavior of nurses: The role of support and affective organizational commitment
Authors: De Regge Melissa , Van Baelen Freek , Aerens Sander , Deweer Tine , Trybou Jeroen
Published: July 2018

Aim:

The aim of this study was to examine the relationship between organizational, supervisor, and coworker support, as perceived by registered nurses and their boundary-spanning behaviors. Furthermore, this article examines the mediating role of the affective organizational commitment of nurses in these relationships.

Background:

Registered nurses play a key role in hospitals, as they have an important impact on the quality of the services delivered. For nurses to perform at their best, they need organizational, leader, and coworker support. To date, few studies have explored the link between nurses’ perceived support, affective organizational commitment, and boundary-spanning behaviors.

Methods:

This cross-sectional research used a questionnaire survey to explore the hypothesized relationships in a sample of 273 nurses from a hospital in Belgium. Structural equation modeling was used for statistical analysis of the mediation model.

Results:

One hundred forty-seven (53.5%) nurses responded to the survey. Perceived support from the organization, supervisors, and coworkers positively influences nurses’ boundary-spanning behaviors. Affective organizational commitment was found to mediate the positive relationship between perceived organization support, perceived coworker support, and boundary-spanning behaviors. Perceived supervisor support and boundary-spanning behaviors showed a direct relationship not mediated by affective organizational commitment.

Conclusions:

Perceived support has an important influence on the boundary-spanning behavior of nurses. This study emphasizes the importance on how support exerts an influence on boundary-spanning behavior and underscores the importance of affective organizational commitment. Health care organizations, supervisors, and coworkers are essential in fostering boundary-spanning behaviors of nurses, both directly and through the development of affective organizational commitment. These actors should therefore be aware of the way they behave and the implications their behavior may have.
Compliance with the U.S. Nuclear Regulatory Commission Revised Licensing Guidance for Radioactive Seed Localization
Authors: Sheetz Michael , Steiner Cynthia
Published: July 2018

The use of radioactive seed localization (RSL) as a reliable alternative to wire localization (WL) for guiding the surgical excision of non-palpable lesions has become more popular because of its demonstrated advantages for both the patient and surgeon. RSL is regulated under 10 CFR 35.1000 (Other Medical Uses) for which the U.S. Nuclear Regulatory Commission (U.S. NRC) issued its original licensing guidance entitled “I-125 and Pd-103 Low Dose Rate Brachytherapy Seeds Used for Localization of Non-palpable Lesions” in 2006. At that time, RSL was performed as an off-label use of the same radioactive 125I seeds used for brachytherapy, so the focus of this initial guidance was to establish the same requirements for RSL as for brachytherapy. Strict compliance with the licensing guidance was burdensome and made it difficult for some licensees to implement an RSL program. In response to a request from the user community and recommendations from an Advisory Committee on the Medical Use of Isotopes (ACMUI) subcommittee, the U.S. NRC formed a working group to consider revisions to its RSL guidance to make it more relevant to the conduct of the procedure. On October 7, 2016, the U.S. NRC issued a revised licensing guidance document titled “Low Activity Radioactive Seeds Used for Localization of Non-Palpable Lesions and Lymph Nodes.” This manuscript highlights the changes in the latest U.S. NRC licensing guidance for RSL, including authorized user training and experience, written directives, surveys, instrumentation, and medical event criteria, and presents practical ways to satisfy the new requirements.
Real-Time Monitoring of Gross Beta Radioactivity in Tap Water and Committed Effective Dose
Authors: Lv Wen-hui , Zeng Zhi , Yi Hongchang , Ma Hao , Li Jun-li , Zhang Hui
Published: July 2018

To achieve real-time monitoring of gross beta radioactivity in drinking water, a scintillating fiber array system was developed. Using this system, the gross beta radioactivity in tap water at Tsinghua University campus in Beijing was monitored, and the same water samples were measured using the evaporation concentration method as a comparison experiment. Finally, the annual committed effective doses to children and adults who drank the tap water for a long time were estimated. The results showed that the gross beta radioactivity in tap water was 0.09 ± 0.03 Bq L−1 using the scintillating fiber array system and 0.076 ± 0.009 Bq L−1 using the evaporation concentration method. The annual committed effective dose values were less than the dose reference level of 0.1 mSv y−1, as suggested by the World Health Organization. The scintillating fiber array system can be used for measuring gross beta radioactivity in drinking water and protecting public health.
Balance and Mobility Improvements During Inpatient Rehabilitation Are Similar in Young-Old, Mid-Old, and Old-Old Adults With Traumatic Brain Injury
Authors: Perry Susan B. , Billek-Sawhney Barbara , Woollard Jason , Little Susan , Szalinski Amy
Published: July 2018

Objective:

To compare balance, mobility, and functional outcomes across 3 age groups of older adults with traumatic brain injury; to describe differences between those discharged to private residences versus institutional care.

Setting:

Acute inpatient rehabilitation facility.

Participants:

One hundred adults, mean age of 78.6 ± 7.9 years (range = 65-95 years), with an admitting diagnosis of traumatic brain injury.

Design:

Retrospective case series.

Main Measures:

Functional Independence Measure (FIM) for Cognition and Mobility; Berg Balance Scale; Timed Up and Go; and gait speed, at admission to and discharge from an inpatient rehabilitation facility.

Results:

Statistically significant improvements (P < .01) were made on the Timed Up and Go, Berg Balance Scale, and gait speed for young-old, mid-old, and old-old adults, with no differences among the 3 age groups. Substantial balance and mobility deficits remained. The FIM cognition (P = .013), FIM Walk (P = .009), and FIM Transfer (P = .013) scores were significantly better in individuals discharged home or home with family versus those discharged to an institution.

Conclusion:

Preliminary outcome data for specific balance and mobility measures are reported in 3 subgroups of older adults following traumatic brain injury, each of which made significant and similar improvements. Some FIM item scores discriminated between those discharged to a private residence versus a higher level of care.
A Review of Smartphone Applications for Persons With Traumatic Brain Injury: What Is Available and What Is the Evidence?
Authors: Kwan Vivian , Bihelek Nicoline , Anderson Vicki , Yeates Keith
Published: July 2018

Objectives:

To map the number and type of smartphone applications available for persons with traumatic brain injury (TBI), evaluate validity of app content, and investigate evidence for any claims made.

Methods:

We searched iTunes and Google Play and also completed a web search. The purpose of each app and any claims were extracted, and a search for best available evidence was performed.

Results:

Seventy apps met our inclusion criteria (35 related to assessment, 11 to education, 9 to treatment/management, 8 to impact sensors, and 7 to symptom tracking). To the best of our knowledge, no empirical research has been published to demonstrate that the use of any particular TBI-related app leads to clinically meaningful benefits compared with not using the app. Other problems include potential biases in self-report leading to possible app misuse, lack of references for app content, and inappropriate marketing to laypersons not trained to interpret the findings of tools validated for use by healthcare professionals.

Conclusions:

The current evidence for benefit from using TBI-related apps is minimal. More collaborative research is needed among clinicians, scientists, and app developers to determine whether, and how, apps may be helpful to individuals at risk for or following TBI.
Sleep Disturbance in Children With Moderate or Severe Traumatic Brain Injury Compared With Children With Orthopedic Injury
Authors: Bogdanov Stefan , Brookes Naomi , Epps Adrienne , Naismith Sharon L. , Teng Arthur , Lah Suncica
Published: July 2018

Objectives:

To characterize the sleep disturbance in children with moderate or severe traumatic brain injury (TBI), and to identify associated factors.

Setting:

An urban tertiary pediatric healthcare facility.

Participants:

Children aged 5 to 15 years with a moderate TBI (n = 21), severe TBI (n = 23), or an orthopedic injury (OI; n =38) comparable in age, gender, and socioeconomic status.

Design:

Cohort study.

Measures:

Primary: Sleep Disturbance Scale for Children (SDSC). Secondary: Injury-specific factors (TBI severity, age at injury, and time since injury), and other factors of interest (sleep hygiene; pain intensity; difficulties with internalizing, externalizing, or attention/hyperactivity; parental distress; and parental knowledge of TBI).

Results:

On the SDSC, parents rated children with moderate TBI (but not severe TBI) as experiencing greater overall sleep disturbance, as well as excessive somnolence and sleep breathing disturbance, relative to OI controls. Children with severe TBI (but not moderate TBI) were rated as experiencing greater disturbance with initiating and maintaining sleep. The moderate and severe TBI groups did not differ on any of the sleep outcomes. Only 3 factors were associated with sleep disturbance in the combined TBI group: (1) lower TBI severity with greater excessive somnolence; (2) greater internalizing difficulties with greater overall sleep disturbance, and disturbance with initiating and maintaining sleep specifically; and (3) younger age at injury with greater overall sleep disturbance, and sleep breathing disturbance specifically.

Conclusion:

Children with moderate or severe TBI experience greater overall and/or specific forms of sleep disturbance. Different forms of sleep disturbance may be associated with different factors.
MINIMAL INVASIVE DRAINAGE TECHNIQUE FOR LARGE EXPANDING SUBRETINAL GAS BUBBLE
Authors: Ajlan Radwan , Arbour Jean-Daniel , Hammamji Karim
Published: July 2018

Purpose:

To report a minimally invasive drainage technique for large expanding subretinal gas bubble and conduct a review of the literature.

Methods:

Case report, with schematic diagrams and multimodal imaging including fundus photography and spectral domain optical coherence tomography. Controlled drainage of large subretinal gas bubble using a 30-gauge needle introduced through cryotherapy-treated area in office-based setting.

Results:

Forty-year-old male patient presented with bullous rhegmatogenous retinal detachment and had gas inadvertently injected into the subretinal space during cryo-pneumatic retinopexy. After successful drainage of subretinal gas in clinic, 0.3cc of perfluoropropane (C3F8) gas was injected in different quadrants near the attached retina. The macula remained attached on immediate fundus examination. The gas bubbles of fish eggs coalesced into a single large bubble within 1 week. Spectral domain optical coherence tomography showed unremarkable foveal scans. After 45 days, the gas bubble completely disappeared, the retina remained attached, and vision in the treated eye was 20/20.

Conclusion:

To the best of our knowledge, this is the first case report of a large expanding gas bubble injected into the subretinal spaces being drained successfully by the described minimal invasive technique. Although it may offer a possible office-based approach to a rare complication, it is generally recommended that surgeons capable of dealing with its possible complications may attempt such technique when immediate vitrectomy is not accessible.
OPTICALLY EMPTY CHOROIDAL SPACES IN HIGH HYPEROPIA
Authors: Pichi Francesco , Sarraf David
Published: July 2018

Purpose:

To describe the progressive optical coherence tomography findings of atypical choroidal cavitation in the inner choroid.

Methods:

Case report.

Results:

A 29-year-old asymptomatic woman was noted to display two flat translucent whitish subretinal lesions along the superotemporal arcade of the right eye, during routine retinal examination. Cross-sectional spectral domain optical coherence tomography of the choroid illustrated two hyporeflective lesions consistent with atypical choroidal cavitation of the Sattler layer, associated with corresponding thickening and bulging of the underlying choroid. En face optical coherence tomography through the lesions illustrated hyporeflectivity at the level of the inner choroid, compatible with choroidal cavitation. Progressive enlargement of these two choroidal lesions was noted with cross-sectional and en face optical coherence tomography.

Conclusion:

Intrachoroidal cavitation has been described in association with inferior peripapillary conus in myopic eyes. Progressive enlargement of these lesions has not been noted. The lesions reported herein are atypical for choroidal cavitation because they affect a young hyperopic woman and display progression. A common pathogenesis with myopic choroidal cavitation may be possible. These lesions may be secondary to a localized bulge in the sclera, or may be a “cavernous” space secondary to a congested choroid, that is, leaking fluid.
Indications and Outcomes of Penetrating Keratoplasty in Infants and Children of Beijing, China
Authors: Zhang Yingnan , Liu Yang , Liang Qingfeng , Miao Sen , Lin Qi , Zhang Jing , Pan Zhiqiang , Lu Qingxian
Published: July 2018

Purpose:

To retrospectively investigate the indications and outcomes of pediatric penetrating keratoplasty (PKP) and to explore factors that affect graft survival.

Methods:

Patients who had undergone PKP from May 2010 to December 2016, aged ≤12 years were categorized as infants (≥3 months and <4 years) or children (≥4 years and ≤12 years). Clinical data including patient demographics, indications, surgical procedures, postoperative follow-up, and graft clarity were recorded and analyzed.

Results:

Among 160 eyes of 146 patients, 79 eyes and 81 eyes were treated from the infant and child groups, respectively, and followed up for 33.7 ± 21.7 months (range, 6 months to 7 years). The most common indication for PKP was congenital corneal opacity (71.9%). The survival rate of all corneal grafts was 68.1%. The rejection reaction rate was 33.8%. More children than infants underwent PKP that was combined with other intraocular surgeries (P < 0.05). The graft failures were in the regraft (52.0%), congenital opacities (30.4%), and acquired opacities (15.0%) groups. The rate of graft failure in patients who received PKP combined with other intraocular surgery (40.0%) was higher than those who received PKP only (30.0%). The univariate logistic regression analysis revealed that the graft failure was associated with the graft indication (P < 0.05).

Conclusions:

The most common indication for PKP in children younger than 12 years was congenital corneal opacity in Beijing, China. The graft survival was 68.1%, with a mean follow-up of 33.7 months. Graft failure was associated with the indication.
Molecular Bioburden of the Lens Storage Case for Contact Lens–Related Keratitis
Authors: Hsiao Yu-Ting , Fang Po-Chiung , Chen Jiunn-Liang , Hsu Shiuh-Liang , Chao Tsai-Ling , Yu Hun-Ju , Lai Yu-Hsuan , Huang Yu-Ting , Kuo Ming-Tse
Published: July 2018

Purpose:

To elucidate the bioburden of a lens care system in patients with contact lens (CL)-related keratitis.

Methods:

In this prospective case–control study, the CL storage case was used as the target of bioburden assessment. Participants were CL wearers with (n = 26) or without (n = 24) keratitis in southern Taiwan. The case fluid sample was consecutively collected and assessed using a dot hybridization assay (DHA) for bioburden assessment. The DHA was composed of 3 universal bacterial probes for detecting all bacteria, genus-specific probes for Pseudomonas and Acinetobacter, and 1 probe for Acanthamoeba. The receiver operating characteristic curve was used to analyze the differentiating performance of a probe.

Results:

The storage case bioburden was significantly higher in those with CL-related keratitis than in control subjects; patients with CL-related keratitis had stronger standardized signals in all universal bacterial probes. Moreover, in the cases of these patients, the bioburden was significantly heavier in confirmed infectious keratitis than in presumed noninfectious keratitis. Receiver operating characteristic analysis showed that stronger signals in all 3 universal bacterial probes and the Pseudomonas probe might suggest that the wearers have infectious keratitis. Only the storage case of the Acanthamoeba keratitis case showed positive detection by the Acanthamoeba probe.

Conclusions:

A heavier bioburden in the lens storage case was associated with a higher risk of CL-related keratitis and infectious keratitis. Inappropriate maintenance of the CL will lead to microbial contamination and transfer the pathogen onto the ocular surface causing keratitis accordingly. The DHA assessment for the lens storage case might provide an alternative way to differentiate infectious from noninfectious CL-related keratitis.
Tumor Size at Magnetic Resonance Imaging Association With Lymph Node Metastasis and Lymphovascular Space Invasion in Resectable Cervical Cancer: A Multicenter Evaluation of Surgical Specimens
Authors: Chen Xiao-li , Chen Guang-wen , Xu Guo-hui , Ren Jing , Li Zhen-lin , Pu Hong , Li Hang
Published: July 2018

Objective

To determine whether gross tumor volume (GTV) and the maximum diameter of resectable cervical cancer at magnetic resonance imaging (MRI) could predict lymph node metastasis (LNM) and lymphovascular space invasion (LVSI).

Materials and Methods

A total of 315 consecutive patients with cervical cancer were retrospectively identified. Gross tumor volume and the maximum diameter of tumor were evaluated on MRI. Univariate and multivariate logistic regression analyses were performed to determine whether tumor size could predict LNM and LVSI. Cutoffs of GTV, maximum diameter, and the International Federation of Gynecology and Obstetrics (FIGO) classification of tumor were first investigated in 255 patients (group A) and then validated in an independent cohort of 60 patients (group B) using area under the receiver operating characteristic curve (AUC) analysis for predicting the presence of LNM and LVSI.

Results

Univariate analysis showed that GTV and the maximum diameter of tumor could predict LNM and LVSI (all P < 0.0001). Multivariate analyses indicated GTV as an independent risk factor of LNM and LVSI (all P < 0.0001). In group A, GTV, the maximum diameter, and the FIGO stage could identify LNM (AUC, 0.813, 0.741, and 0.69, respectively) and LVSI (AUC, 0.806, 0.751, and 0.684, respectively). In group B, GTV, the maximum diameter, and the FIGO stage could help identify LNM (AUC, 0.902, 0.825, and 0.759, respectively) and LVSI (AUC, 0.771, 0.748, and 0.700, respectively).

Conclusions

Gross tumor volume and the maximum diameter of resectable cervical cancer at MRI demonstrated capability in predicting LNM and LVSI, which were more accurate than FIGO stage.
Development of an Innovative Taxonomy and Matrix Through Examination of the Director of Clinical Education's Roles and Responsibilities
Authors: Engelhard Chalee , McCallum Christine , Applebaum Donna , Teglia Valerie
Published: July 2018

Background.

From the 2014 Clinical Education Summit, recommendations were made to strengthen physical therapist (PT) clinical education (CE). The Director of Clinical Education (DCE) is a key stakeholder in PT CE, and the roles and responsibilities of this position have come under review yet again. An investigation of this primary stakeholder is in alignment with the Summit's strategic plan and needed response to current inquiries.

Objectives.

To further the work of the study by McCallum et al
6
, the purpose of this study was to investigate and determine the evolution of DCE's roles and responsibilities, with the hypothesis that a new taxonomy would emerge, reflecting a distribution of responsibilities that would guide current and future roles of the DCE.

Design.

This study used a nonexperimental, descriptive, qualitative approach with a constructivist theoretical framework.

Methods:

The data set from the study by McCallum et al produced five primary themes. The fifth theme, studied in this report, produced three subthemes—improve efficiencies of systems, optimize clinical teaching, and collaboration with translational research. Watts' Taxonomy, as a foundational, theoretical construct, was the basis for the thematic analysis of these subthemes.

Results.

The development of an innovative DCE taxonomy with three responsibility levels—Processor, Coordinator, and Director emerged from the analysis of the fifth primary theme.

Conclusions.

Using the DCE taxonomy, DCE's roles and responsibilities matrix illustrates the importance of fitting tasks to the corresponding DCE's role and responsibility. The matrix shows how delegation of routine DCE tasks can promote the DCE's ability to engage in tasks higher in the taxonomy. This can lead to effective delivery of CE and DCE's engagement in strategic leadership in guiding the future direction of the CE aspect of the PT program.