bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of buoyancy-driven vortices in inducing different modes of coupled behaviour in candle-flame oscillators
Authors: Dange Suraj , Pawar Samadhan A. , Manoj Krishna , Sujith R. I.
Published: January 2019

We investigate the coupled behaviour of two oscillatory flames produced by separate bundles of candles, referred to as candle-flame oscillators, as the distance between them is varied. Each bundle consists of four candles whose individual flames are fused so that the resultant flame produces self-sustained limit cycle oscillations. The recent study by Manoj et al. [Scientific Reports 8, 11626 (2018)] has reported the occurrence of four different modes of coupled behaviour, which include in-phase synchronization, amplitude death, anti-phase synchronization, and desynchronization by observing the flame dynamics of such coupled candle-flame oscillators. Here, we investigate the physical mechanism behind the occurrence of these different dynamical modes. Towards this purpose, we perform simultaneous measurements of the flow field around the candle flames using high-speed shadowgraph and of the reaction zone of each flame using high-speed CH* chemiluminescence imaging. We notice that these modes are distinguished by the distinct features of the flame dynamics and the corresponding buoyancy-induced flows surrounding the flames. We observe that the difference in the interaction of vortices, formed due to the instability of buoyancy-induced flows around each flame at various distances, plays a significant role in inducing different modes of coupled dynamics between the oscillators. Furthermore, we find that the change in the length scales of vortices shed around the flames is a contributing factor in increasing the frequency of the oscillators during the transition from in-phase to anti-phase mode of synchronization.
Review of Scientific Instruments New Products
Authors: Mandelis Andreas
Published: January 2019

In order to supplement manufacturers’ information, this Department will welcome the submission by our readers of brief communications reporting measurements on the physical properties of materials which supersede earlier data or suggest new research applications.
Phytoplankton–zooplankton relationships based on phytoplankton functional groups in two tropical reservoirs
Authors: Diniz Anamaria S. , Severiano Juliana S. , Melo Júnior Mauro , Dantas Ênio W. , Moura Ariadne N.
Published: January 2019

The aim of this study was to evaluate the phytoplankton–zooplankton interaction, using phytoplankton morphology-based functional groups, in two reservoirs that have different trophic state indices (TSIs). We hypothesised that the herbivorous relationships of zooplankton with the phytoplankton community would differ between reservoirs with different TSIs. In order to test this hypothesis, field collections to study the phytoplankton, zooplankton and abiotic variables were undertaken between July 2016 and April 2017 from the subsurface layer and in situ experiments were conducted using biomanipulation of the micro- and mesozooplankton. In situ experiments consisted of 18 microcosms in 5-L transparent plastic bottles (in triplicate). The mesotrophic reservoir showed predominance of chlorophytes (Group IV) and mesozooplankton during the study period. In the presence of zooplankton, all phytoplankton groups showed negative growth rates and higher ingestion values, mainly Group IV. In the supereutrophic reservoir, ingestion rates showed that micro- and mesozooplankton reduced the biomass of colonial (Group VII) and filamentous (Group III) cyanobacteria respectively. The findings of the present study reveal that Copepoda Calanoida, as well as small cladocerans, may be the most suitable zooplankton groups for biomass biomanipulation of different morphofunctional phytoplankton groups in mesotrophic reservoirs, and for the control of cyanobacteria in supereutrophic reservoirs.
Taming autoimmunity: Translating antigen-specific approaches to induce immune tolerance
Authors: Carballido José M. , Santamaria Pere
Published: January 2019

José M. Carballido, Executive Director at Novartis Institutes for BioMedical Research, and Pere Santamaria, Professor of Immunology at the University of Calgary and Founder of Parvus Therapeutics Inc., discuss the opportunities and challenges of translating antigen-specific approaches for autoimmunity with an emphasis on the need for scientific rigor in the preclinical stage.
Biological growth and synthetic fabrication of structurally colored materials
Authors: McDougal Anthony , Miller Benjamin , Singh Meera , Kolle Mathias
Published: January 2019

Nature’s light manipulation strategies—in particular those at the origin of bright iridescent colors—have fascinated humans for centuries. In recent decades, insights into the fundamental concepts and physics underlying biological light-matter interactions have enabled a cascade of attempts to copy nature’s optical strategies in synthetic structurally colored materials. However, despite rapid advances in bioinspired materials that emulate and exceed nature’s light manipulation abilities, we tend to create these materials via methods that have little in common with the processes used by biology. In this review, we compare the processes that enable the formation of biological photonic structures with the procedures employed by scientists and engineers to fabricate biologically inspired photonic materials. This comparison allows us to reflect upon the broader strategies employed in synthetic processes and to identify biological strategies which, if incorporated into the human palette of fabrication approaches, could significantly advance our abilities to control material structure in three dimensions across all relevant length scales.
Towards an orbifold generalization of Zvonkine’s 𝑟-ELSV formula
Authors: Kramer R. , Lewanski D. , Popolitov A. , Shadrin S.
Published: January 2019

We perform a key step towards the proof of Zvonkine’s conjectural

r
r

-ELSV formula that relates Hurwitz numbers with completed

(
r
+
1
)

(r+1)

-cycles to the geometry of the moduli spaces of the

r
r

-spin structures on curves: we prove the quasi-polynomiality property prescribed by Zvonkine’s conjecture. Moreover, we propose an orbifold generalization of Zvonkine’s conjecture and prove the quasi-polynomiality property in this case as well. In addition to that, we study the

(
0
,
1
)

(0,1)

- and

(
0
,
2
)

(0,2)

-functions in this generalized case, and we show that these unstable cases are correctly reproduced by the spectral curve initial data.
The unramified Brauer group of homogeneous spaces with finite stabilizer
Authors: Lucchini Arteche Giancarlo
Published: January 2019

We give formulas for calculating the unramified Brauer group of a homogeneous space

X
X

of a semisimple simply connected group

G
G

with finite geometric stabilizer

F
¯

\bar F

over a wide family of fields of characteristic

0
0

. When

k
k

is a number field, we use these formulas in order to study the Brauer–Manin obstruction to the Hasse principle and weak approximation. We prove in particular that the Brauer-Manin pairing is constant on

X
(

k
v

)

X(k_v)

for every

v
v

outside of an explicit finite set of nonarchimedean places of

k
k

.
Interactions of the dynein-2 intermediate chain WDR34 with the light chains are required for ciliary retrograde protein trafficking
Authors: Tsurumi Yuta , Hamada Yuki , Katoh Yohei , Nakayama Kazuhisa
Published: January 2019

The dynein-2 complex drives retrograde ciliary protein trafficking by associating with the intraflagellar transport (IFT) machinery, containing IFT-A and IFT-B complexes. We recently showed that the dynein-2 complex, which comprises 11 subunits, can be divided into three subcomplexes: DYNC2H1–DYNC2LI1, WDR34–DYNLL1/DYNLL2–DYNLRB1/DYNLRB2, and WDR60–TCTEX1D2–DYNLT1/DYNLT3. In this study, we demonstrated that the WDR34 intermediate chain interacts with the two light chains, DYNLL1/DYNLL2 and DYNLRB1/DYNLRB2, via its distinct sites. Phenotypic analyses of WDR34-knockout cells exogenously expressing various WDR34 constructs showed that the interactions of the WDR34 intermediate chain with the light chains are crucial for ciliary retrograde protein trafficking. Furthermore, we found that expression of the WDR34 N-terminal construct encompassing the light chain–binding sites but lacking the WD40 repeat domain inhibits ciliary biogenesis and retrograde trafficking in a dominant-negative manner, probably by sequestering WDR60 or the light chains. Taken together with phenotypic differences of several WDR34-knockout cell lines, these results indicate that incorporation of DYNLL1/DYNLL2 and DYNLRB1/DYNLRB2 into the dynein-2 complex via interactions with the WDR34 intermediate chain is crucial for dynein-2 function in retrograde ciliary protein trafficking.
Tropomyosin isoforms differentially tune actin filament length and disassembly
Authors: Jansen Silvia , Goode Bruce L.
Published: January 2019

Cellular actin networks exhibit diverse filamentous architectures and turnover dynamics, but how these differences are specified remains poorly understood. Here, we used multicolor total internal reflection fluorescence microscopy to ask how decoration of actin filaments by five biologically prominent Tropomyosin (TPM) isoforms influences disassembly induced by Cofilin alone, or by the collaborative effects of Cofilin, Coronin, and AIP1 (CCA). TPM decoration restricted Cofilin binding to pointed ends, while not interfering with Coronin binding to filament sides. Different isoforms of TPM provided variable levels of protection against disassembly, with the strongest protection by Tpm3.1 and the weakest by Tpm1.6. In biomimetic assays in which filaments were simultaneously assembled by formins and disassembled by CCA, these TPM isoform–specific effects persisted, giving rise to filaments with different lengths and treadmilling behavior. Together, our data reveal that TPM isoforms have quantitatively distinct abilities to tune actin filament length and turnover.
From Islamic reform to Muslim activism : The evolution of an Islamist ideology in Kenya
Authors: Chome Ngala
Published: January 2019

This article traces the evolution of an Islamist ideology in Kenya’s public discourse, putting Islamist ideas within a longer history of Muslim politics than most other studies. Specifically, it examines internal debates amongst the minority Muslim population of Kenya, and debates between Muslims and the state and Muslims and the wider Christian public, regarding how to improve the Muslim condition in a Christian-dominated country. The immediate background for the emergence of Islamist ideas is then discussed through an examination of trends since the 1990s, including increased contestations of religious and political authority, and responses to Muslim activism by the state and the wider Christian public. The article concludes that Islamist politics in Kenya, and elsewhere, are more often than not a result of local histories as much as they are part of a global Muslim ‘victimization’ narrative.
Regularity of contact with GPs: Measurement approaches to improve valid associations with hospitalization
Authors: Youens David , Harris Mark , Robinson Suzanne , Preen David B , Moorin Rachael E
Published: January 2019

Background

Studies examine longitudinal continuity of GP contact though few consider ‘regularity of GP contact’, i.e., the dispersion of contacts over time. Increased regularity may indicate planned ongoing care. Current measures of regularity may be correlated with the number of contacts and may not isolate the phenomenon of interest.

Objectives

To compare two published and one newly developed regularity index in terms of their ability to measure regularity of GP contacts independently of the number of contacts and the impact on their association with hospitalization.

Methods

A cohort at risk of diabetes-related hospitalization in Western Australia from 1990 to 2004 was identified using linked administrative data. For each regularity index, relationships with number of GP contacts were assessed. Hospitalization was then regressed on each index with and without number of contacts as a covariate.

Results

Among 153,414 patients the new regularity index showed a reduced association with number of contacts compared with existing indices. Associations with hospitalization differed between measures; for previously published indices, there were no significant associations between regularity and hospitalization, whereas on the new index, most regular GP contact was associated with reduced hospitalization (IRR = 0.90, 95% CI = 0.88–0.93). When number of contacts was added as a covariate, point estimates for this index showed little change, whereas for existing measures this addition changed point estimates.

Conclusion

A new measure of regularity of GP contact was less correlated with the number of contacts than previously published measures and better suited to estimating unconfounded relationships of regularity with hospitalization.
New order-statistics-based ranking models and faster computation of outcome probabilities
Authors: Baker Rose
Published: January 2019

In sport, order-statistics-based models such as Henery’s gamma model and the Thurstone–Mosteller type V model are useful in estimating competitor strengths from observed performance of players in competitions between two or more players. They can also be applied in many other areas, such as analysis of consumer preference data, which would be useful to marketing management. Two new families of such models derived from the exponentiated exponential, and Pareto distributions are introduced. Use of order-statistics-based models when there are more than two competitors has been hampered by lack of an efficient method of computation of outcome probabilities as a function of competitor strengths, and a fast method of computation of outcome probabilities is presented, which exploits the fact that the integral to be evaluated is an iterated integral.
The Best Laid Plans: Why New Parents Fail to Habituate Practices
Authors: Thomas Tandy Chalmers , Epp Amber M
Published: January 2019

Consumers regularly fail to habituate newly adopted practices. In contrast to established practices, this often occurs because understanding a practice is different from actually doing it. Our work explores this “messiness of doing” and explains why consumers successfully habituate some newly adopted practices after experiencing obstacles (i.e., misaligned practice elements) but not others. Utilizing a longitudinal approach that follows first-time parents from pregnancy through the first eight months postpartum, we track how parents plan for practices and how those plans unfold. We document a process whereby parents first engage in extensive planning and preparation prior to the birth of their child, during which parents build two realignment capabilities (anticipation and integration). After the baby’s arrival, some practices invariably do not work. Parents respond to these misalignments by following one of five paths—differentiated by the capabilities parents build while planning—that result in practice abandonment, vulnerable habituation, or habituation. Our work highlights the challenges associated with translating a social practice into an enacted practice and the corresponding importance of accumulating realignment capabilities during planning. To facilitate habituation of newly adopted practices, how consumers make plans for these practices may ultimately matter more than what they actually plan to do.
Population Genomic Evidence Reveals Subtle Patterns of Differentiation in the Trophically Polymorphic Cuatro Ciénegas Cichlid, Herichthys minckleyi
Authors: Bell Katherine L , Nice Chris C , Hulsey Darrin
Published: January 2019

In recent decades, an increased understanding of molecular ecology has led to a reinterpretation of the role of gene flow during the evolution of reproductive isolation and biological novelty. For example, even in the face of ongoing gene flow strong selection may maintain divergent polymorphisms, or gene flow may introduce novel biological diversity via hybridization and introgression from a divergent species. Herein, we elucidate the evolutionary history and genomic basis of a trophically polymorphic trait in a species of cichlid fish, Herichthys minckleyi. We explored genetic variation at 3 hierarchical levels; between H. minckleyi (n = 69) and a closely related species Herichthys cyanoguttatus (n = 10), between H. minckleyi individuals from 2 geographic locations, and finally between individuals with alternate morphotypes at both a genome-wide and locus-specific scale. We found limited support for the hypothesis that the H. minckleyi polymorphism is the result of ongoing hybridization between the 2 species. Within H. minckleyi we found evidence of geographic genetic structure, and using traditional population genetic analyses found that individuals of alternate morphotypes within a pool appear to be panmictic. However, when we used a locus-specific approach to examine the relationship between multi-locus genotype, tooth size, and geographic sampling, we found the first evidence for molecular genetic differences between the H. minckleyi morphotypes.
“We Just Can’t Afford to Be Democratic”: Liberals, Integrationists, and the Postwar Suburb of Park Forest
Authors: Cooley Will
Published: January 2019

Park Forest, Illinois, emerged as a prototype suburb in the post–World War II era. Scholars have devoted considerable attention to Park Forest but have not thoroughly explored the efforts of the American Friends Service Committee to integrate this village outside of Chicago in the 1950s. Philip Klutznick, the lead developer of Park Forest, advertised the suburb as a melting pot for a new America, drawing the interest of open housing advocates wanting to include African Americans in this mix. Klutznick and most villagers resisted racial integration, but activists persisted, and by the mid-1960s, the suburb became an interracial community. The exhausting and intricate efforts to realize and sustain integration, however, demonstrated the struggles of the open housing campaign.
Development of the Mitochondrial Intermembrane Space Disulfide Relay Represents a Critical Step in Eukaryotic Evolution
Authors: Backes Sandra , Garg Sriram G , Becker Laura , Peleh Valentina , Glockshuber Rudi , Gould Sven B , Herrmann Johannes M
Published: January 2019

The mitochondrial intermembrane space evolved from the bacterial periplasm. Presumably as a consequence of their common origin, most proteins of these compartments are stabilized by structural disulfide bonds. The molecular machineries that mediate oxidative protein folding in bacteria and mitochondria, however, appear to share no common ancestry. Here we tested whether the enzymes Erv1 and Mia40 of the yeast mitochondrial disulfide relay could be functionally replaced by corresponding components of other compartments. We found that the sulfhydryl oxidase Erv1 could be replaced by the Ero1 oxidase or the protein disulfide isomerase from the endoplasmic reticulum, however at the cost of respiration deficiency. In contrast to Erv1, the mitochondrial oxidoreductase Mia40 proved to be indispensable and could not be replaced by thioredoxin-like enzymes, including the cytoplasmic reductase thioredoxin, the periplasmic dithiol oxidase DsbA, and Pdi1. From our studies we conclude that the profound inertness against glutathione, its slow oxidation kinetics and its high affinity to substrates renders Mia40 a unique and essential component of mitochondrial biogenesis. Evidently, the development of a specific mitochondrial disulfide relay system represented a crucial step in the evolution of the eukaryotic cell.
Providing Compassionate Off-Ramps for Medical Students Is a Moral Imperative
Authors: Bellini Lisa M. , Kalet Adina , Englander Robert
Published: January 2019

It is highly unusual for learners to leave medical training in the United States even though some individuals’ goals may change and others may not achieve expected competence. There are a number of possible reasons for this: (1) Students may feel that they have progressed too far into their careers and amassed too much debt to leave medical training; (2) students may be allowed to graduate despite marginal performance; and (3) students may have entered medical training with risk factors for poor performance that were not addressed. As stewards of the educational process, medical educators have an ethical obligation to students and the public to create off-ramps, or points along the educational continuum at which learners can reassess their goals and educators can assess competence, that allow students to leave medicine.

Given the nationwide focus on physician health and wellness, the authors believe the creation of options to leave medical training without compromising one’s self-esteem or incurring unmanageable debt (i.e., compassionate off-ramps) is a moral imperative. The practice of medicine should not be an exercise in survival; it should allow people to develop and thrive over the course of their careers. Offering students options to make use of the medical competencies they have accumulated in other attractive careers would enable medical educators to behave compassionately toward individual students and fulfill their societal obligation to graduate competent and committed physicians. To this end, the authors present six recommendations for consideration.
Does Performance on Evidence-Based Medicine and Urgent Clinical Scenarios Assessments Deteriorate During the Fourth Year of Medical School? Findings From One Institution
Authors: Heidemann Lauren A. , Keilin Charles A. , Santen Sally A. , Fitzgerald James T. , Zaidi Nikki L. , Whitman Laurie , Jones Elizabeth K. , Lypson Monica L. , Morgan Helen K.
Published: January 2019

Purpose

The fourth year of medical school (M4) should prepare students for residency yet remains generally unstructured, with ill-defined goals. The primary aim of this study was to determine whether there were performance changes in evidence-based medicine (EBM) and urgent clinical scenarios (UCS) assessments before and after M4 year.

Method

University of Michigan Medical School graduates who matched into internship at Michigan Medicine completed identical assessments on EBM and UCS at the beginning of M4 year and 13 months later during postgraduate year 1 (PGY1) orientation. Individual scores on these assessments were compared using paired t test analysis. The associations of academic performance, residency specialty classification, and initial performance on knowledge changes were analyzed.

Results

During academic years 2014 and 2015, 76 students matched into a Michigan Medicine internship; 52 completed identical EBM stations and 53 completed UCS stations. Learners’ performance on the EBM assessment decreased from M4 to PGY1 (mean 93% [SD = 7%] vs. mean 80% [SD = 13%], P < .01), while performance on UCS remained stable (mean 80% [SD = 9%] vs. mean 82% [SD = 8%], P = .22). High M4 performers experienced a greater rate of decline in knowledge level compared with low M4 performers for EBM (−20% vs. −4%, P = .01). Residency specialty and academic performance did not affect performance.

Conclusions

This study demonstrated degradation of performance in EBM during the fourth year and adds to the growing literature that highlights the need for curricular reform during this year.
A Reflection Upon the Impact of Early 21st-Century Technological Innovations on Medical School Admissions
Authors: Hanson Mark D. , Eva Kevin W.
Published: January 2019

The authors describe influences associated with the incorporation of modern technologies into medical school admissions processes. Their purpose is not to critique or support specific technologies but, rather, to prompt reflection on the evolution that is afoot. Technology is now integral to the administration of multiple admissions tools, including the Medical College Admission Test, situational judgment tests, and standardized video interviews. Consequently, today’s admissions landscape is transforming into an online, globally interconnected marketplace for health professions admissions tools. Academic capitalism and distance-based technologies combine to enable global marketing and dissemination of admissions tests beyond the national jurisdictions in which they are designed. As predicted by disruptive business theory, they are becoming key drivers of transformative change. The seeds of technological disruption are present now rather than something to be wary of in the future. The authors reflect on this transformation and the need for tailoring test modifications to address issues of medical student diversity and social responsibility. They comment on the online assessment of applicants’ personal competencies and the potential detriments if this method were to replace admissions methods involving human contact, thanks to the ease with which institutions can implement them without cost to themselves and without adequate consideration of measurement utility or contextual appropriateness. The authors advocate for socially responsible academic capitalism within this interconnected admissions marketplace: Attending to today’s transformative challenges may inform how health professions education responds to tomorrow’s admissions technologies and, in turn, how tomorrow’s health professionals respond to their patients’ needs.
Effect of Eyelid Crease Formation on Aesthetic Outcomes post Frontalis Suspension for Unilateral Ptosis
Authors: Shome Debraj , Mittal Shilpa Taneja , Kapoor Rinky
Published: January 2019

Background:

The eyelid crease plays a very important role in determining eyelid symmetry. This study was performed to compare the cosmetic results post silicone rod frontalis suspension surgery, performed with and without eyelid crease formation, for correction of unilateral, congenital ptosis.

Methods:

Prospective, interventional study. One hundred patients with unilateral, congenital ptosis, with poor levator muscle action, operated on by a single facial plastic surgeon, over 5-year duration (2011–2016). Group I had 50 patients, who underwent silicone sling (Bvi Visitec) frontalis suspension surgery. Group II had 50 patients, who underwent frontalis suspension silicone sling (Bvi Visitec) surgery, in combination with eyelid crease formation and levator muscle excision (when required). The cosmetic outcomes were evaluated by the patients themselves and by 3 blinded physician observers and recorded objectively via a 5-point questionnaire, after a 1-year follow-up.

Results:

Patients in group II were much more satisfied than the patients in group I, as confirmed by the subjective and objective evaluations.

Conclusion:

The silicone sling frontalis suspension surgery, when combined with eyelid crease creation and levator excision procedure (when required), provides better symmetry, superior cosmesis, and excellent patient satisfaction.
Association between Stenosing Tenosynovitis and Dupuytren’s Contracture in the Hand
Authors: Yang Kai , Gehring Michael , Bou Zein Eddine Savo , Hettinger Patrick
Published: January 2019

Background:

Both stenosing tenosynovitis and Dupuytren’s contracture are common conditions encountered in hand surgery. Connections between 2 diseases have been suggested in literature. The purpose of this study was to examine whether there’s an association between the 2 processes.

Methods:

A retrospective chart review was performed to include all patients seen by a single surgeon between 2014 and 2017 with the diagnosis of either trigger finger or Dupuytren’s contracture in the same hand. Patients’ demographics, medical history, social and surgical histories are recorded. Univariate and multivariate analysis were conducted.

Results:

A cohort of 238 patients was identified. One hundred ninety-two patients were diagnosed with trigger finger. Eighty-nine patients were diagnosed with Dupuytren’s contracture. Forty-three patients carried both diagnoses. Median age was 61.6 (56–72). Half were male (50.4%) and 66.8% reported current alcohol intake. Other factors include history of former or current tobacco use (52.9%), diabetes (23.9%), and manual labor (31.1%). In the univariate model, trigger finger, sex, and age were significantly associated with the diagnosis of Dupuytren’s contracture, and Dupuytren’s contracture and sex were significantly associated with the trigger finger diagnosis. Diabetes, manual labor, use of alcohol and tobacco were not significant. In the multivariate model, age and trigger finger were significantly associated with Dupuytren’s contracture.

Conclusions:

Significant association between stenosing tenosynovitis and Dupuytren’s contracture was identified in our patient cohort. Patients with stenosing tenosynovitis may be at an increased risk of developing Dupuytren’s contracture or vice versa.
Traditional Chinese Medicine and Intestinal Microbiota
Authors: Liang Yinji , Lin Chenli , Huang Shuxin , Xu Yun
Published: January 2019

The incidence of obesity and obesity-related diseases, such as type 2 diabetes mellitus and nonalcoholic fatty liver disease, is increasing worldwide, which threatens quality of life and human health. “The toxins in the stool enter the body and blood and then cause a variety of diseases”; this quote illustrates that the Chinese ancients recognized the negative effects of harmful intestinal metabolites on the body. As the largest microecosystem in the human body, intestinal microbiota and their metabolites affect the nutrition, metabolism, and immune function of the host, which is an important pathogenic factor in obesity and obesity-related diseases. Herbal-based supplements are used for many years in the treatment of obesity, type 2 diabetes mellitus, and nonalcoholic fatty liver disease in China. Traditional herbal medicine contains fiber, polyphenols, and polysaccharides that exert prebiotics-like activities in the prevention and treatment of obesity-related diseases. This article provides a systematic mini-review of the literature concerning traditional Chinese medicine for modulation of the intestinal microbiota to ameliorate obesity, type 2 diabetes mellitus, and nonalcoholic fatty liver disease in China. Initially, the relationship between traditional Chinese medicine and intestinal microbiota was introduced, followed by specific research results on this relationship based on 25 original articles. Therefore, this mini-review will provide a complementary and integrative approach for the treatment of these obesity-related diseases.
ELONGATED PHOTORECEPTOR OUTER SEGMENT LENGTH AND PROGNOSIS OF CHRONIC CENTRAL SEROUS CHORIORETINOPATHY
Authors: Asano Kimiko Shimizu , Asaoka Ryo , Asano Shotaro , Azuma Keiko , Inoue Tatsuya , Obata Ryo
Published: January 2019

Purpose:

To evaluate the effect of elongated photoreceptor outer segment length on the visual prognosis of patients with chronic central serous chorioretinopathy after treatment using half-dose and half-fluence photodynamic therapy (reduced PDT).

Methods:

The study included 36 eyes of 36 patients with chronic central serous chorioretinopathy who underwent reduced PDT and were followed up for at least 1 year. Spectral domain optical coherence tomography measurement was conducted at baseline and 12 months after reduced PDT. Thereafter, the association between the best-corrected visual acuity (BCVA) at 12 months after reduced PDT and 7 baseline variables (age, symptom duration, BCVA, outer nuclear layer thickness, elongated photoreceptor outer segment length, height of subretinal detachment, and subfoveal choroidal thickness) was evaluated. Multivariate analyses using the model selection with the corrected Akaike Information Criterion index were performed.

Results:

The optimal model for BCVA at 12 months only included baseline BCVA (coefficient = 0.90, P < 0.0001) and baseline elongated photoreceptor outer segment length (coefficient = −0.0016, P = 0.034), but not outer nuclear layer thickness.

Conclusion:

Elongated photoreceptor outer segment length was significantly associated with BCVA prognosis in patients with chronic central serous chorioretinopathy after reduced PDT and can be useful for predicting residual photoreceptor function during the active phase of chronic central serous chorioretinopathy.
SWEPT-SOURCE AND SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY VERSUS DYE ANGIOGRAPHY IN THE MEASUREMENT OF TYPE 1 NEOVASCULARIZATION
Authors: Cicinelli Maria Vittoria , Cavalleri Michele , Consorte Andrea Celestino , Rabiolo Alessandro , Sacconi Riccardo , Bandello Francesco , Querques Giuseppe
Published: January 2019

Purpose:

To compare the area of Type 1 neovascularization in patients with age-related macular degeneration calculated on spectral domain optical coherence tomography angiography (SD-OCTA), swept-source OCTA, and indocyanine green angiography (ICGA).

Methods:

Cross-sectional study enrolling patients with neovascular age-related macular degeneration with Type 1 neovascularization. During the same visit, ICGA (Spectralis HRA, Heidelberg, Germany), 3 × 3-mm or 6 × 6-mm SD-OCTA (CIRRUS AngioPlex model 5000; Carl Zeiss Meditec, Inc, Dublin, OH), and 3 × 3-mm or 6 × 6-mm swept-source OCTA (Plex Elite 9000; Carl Zeiss Meditec, Inc) were performed. Neovascularization areas were compared among the three instruments. The degree of consistency between measurements was investigated through the two-way mixed intraclass correlation, whereas the intermethod agreement was expressed by the Bland–Altman analysis. Mean difference and 95% confidence intervals are provided.

Results:

Eighteen eyes of 14 white patients (10 females, 83.3%) were included in the study. The neovascularization area measured on ICGA was higher compared to that measured on both SD-OCTA (P = 0.008) and swept-source OCTA (P = 0.008), whereas no differences were found between the two OCTA. Similar results were achieved analyzing 3 × 3-mm and 6 × 6-mm scan separately. Lowest reliability resulted from the ICGA versus SD-OCTA pair (intraclass correlation = 0.786, confidence interval = 0.500–0.915). Spectral domain OCTA and swept-source OCTA exhibited an excellent agreement (mean difference = 0.2). Swept-source OCTA offered qualitatively better images of the neovascularization, compared with SD-OCTA.

Conclusion:

Better visualization of the extent of neovascularization is obtained using SS-OCT or SD-OCT compared with ICGA, which may be influenced by choroidal permeability and dye leakage. Neovascularization area on OCTA may become an objective parameter in the follow-up of age-related macular degeneration patients, along with traditional imaging techniques.
The Role of Soft Contact Lens Wear on Meibomian Gland Morphology and Function
Authors: Uçakhan Ömür , Arslanturk-Eren Mehtap
Published: January 2019

Purpose:

To evaluate the impact of soft contact lens (CL) wear on the morphology and function of the meibomian glands (MG).

Methods:

One hundred seventy-three eyes of 87 soft CL wearers and 103 eyes of 55 age-matched healthy volunteers were included into this study. The patients were divided into 3 groups according to the total duration of lens wear: less than 3 years, 3 to 7 years, and more than 7 years. Ocular Surface Disease Index (OSDI) scores, slitlamp biomicroscopy findings, fluorescein staining of the ocular surface, tear film break-up time (BUT), Schirmer I test, and meibography findings were recorded in all patient eyes and were compared with controls.

Results:

The mean meiboscores of the upper and lower eyelids were significantly higher in CL wearers compared with controls (P<0.05). The mean BUT and the mean MG expressibility were significantly lower, whereas the mean OSDI score, corneal staining scores, percentage of partial/complete gland loss, and percentage of thickened and curled MG in upper/lower lids were statistically significantly higher in CL wearers (P<0.05). Meiboscores were significantly higher in patients with a total lens wear duration of more than 3 years compared to those with less than 3 years of lens wear for both upper/lower lids (P<0.05). The earliest morphological change in the MG of CL wearers was MG thickening, and this parameter was the only meibography finding that had the highest diagnostic ability for MG dysfunction.

Conclusion:

Soft CL wear causes significant morphological and functional changes in MG with thickening of MG presenting an early diagnostic finding of MG dysfunction on meibography.
Improving Nonvocal Critical Care Patients' Ease of Communication Using a Modified SPEACS-2 Program
Authors: Trotta Rebecca L. , Hermann Robin M. , Polomano Rosemary C. , Happ Mary Beth
Published: January 2019

Objective:

To evaluate the feasibility and impact of implementing the “study of patient–nurse effectiveness with assisted communication strategies-2” (SPEACS-2); a program to facilitate communication with nonvocal patients.

Study Design:

The plan-do-study-act quality improvement methodology guided the implementation of a modified SPEACS-2 program within a pre and posttest design. The Ease of Communication Scale (ECS) measured patients' communication difficulty, and care processes measured the program's success.

Study Population:

Nurses (N = 385) across 5 intensive care units were trained in SPEACS-2. We assessed 354 nonvocal patients (aged 18–95 years) requiring continued mechanical ventilation after withdrawal of heavy sedation. Patients were evaluated over one 2-week preintervention (n = 163) and two 3-week postintervention periods (n = 128; n = 63). A subsample of intervention patients (n = 204) completed the ECS.

Results:

Ease of Communication Scale scores improved significantly (p = .027) from baseline (mean 25.86 ± 12.2, n = 71) to postintervention period 2 (21.22 ± 12.2, n = 63). Nurses' use of communication techniques and compliance with communication plans of care incrementally increased after training.

Conclusions:

Implementing SPEACS-2 demonstrated positive changes in patients' ease of communication and feasibility of incorporating evidence-based communication strategies into practice.
Falls in Hospital Causing Injury
Authors: Trinh Lieu Thi Thuy , Assareh Hassan , Wood Michael , Addison-Wilson Cathleen , Sathiyaseelan Yasoda
Published: January 2019

Aims:

To describe falls causing injury, types of injuries, and the reporting of these falls.

Methods:

Administrative and incident reporting datasets between July 2012 and June 2017 were analyzed.

Results:

Using both datasets, 5,653 falls were identified (3.7 per 1,000 bed-days). Administrative and incident datasets accounted for 40.8% (2,299) and 84.4% (4,752) of falls, respectively. More than half the falls in the administrative data required only observation/examination (1,221 falls; 53.1%, 0.8 per 1,000 bed-days). The remaining 1,078 falls (46.9%; 0.7 per 1,000 bed-days) caused 1,533 injuries (1.0 per 1,000 bed-days). Most injuries happened in patients who were 65 years or older (73.9%), during the first episode of care (79.0%), in the acute care setting (70.4%), or on the same level (60.1%). The most common injuries were to the head (33.3%). Some injuries were serious (169; 11.0%; 0.11 per 1,000 bed-days). Falls resulting in injury in older patients, with a more severe medical condition and at smaller hospitals, were more likely to be recorded in the incident reporting system whereas subsequent falls were less likely to be recorded.

Conclusions:

Fewer than half of the falls recorded in administrative data resulted in injuries. A tenth of all falls caused serious injuries.
Chronic Distal Sensory Polyneuropathy Is a Major Contributor to Balance Disturbances in Persons Living With HIV
Authors: Sakabumi Duaa Z. , Moore Raeanne C. , Tang Bin , Delaney Patrick A. , Keltner John R. , Ellis Ronald J.
Published: January 2019

Background:

Medical comorbidities accumulate in older persons living with HIV (PLWH), causing disability and reduced quality of life. Sensory neuropathy and polypharmacy may contribute to balance difficulties and falls. The contribution of neuropathy is understudied.

Objective:

To evaluate the contribution of chronic distal sensory polyneuropathy (cDSPN) to balance disturbances among PLWH.

Methods:

Ambulatory PLWH and HIV− adults (N = 3379) were prospectively studied. All participants underwent a neurologic examination to document objective abnormality diagnostic of cDSPN and reported neuropathy symptoms including pain, paresthesias, and numbness. Participants provided detailed information regarding balance disturbance and falls over the previous 10 years. Balance disturbances were coded as minimal or none and mild-to-moderate. Covariates included age, HIV disease, and treatment characteristics and medications (sedatives, opioids, and antihypertensives).

Results:

Eleven percent of participants reported balance disturbances at some time during the last 10 years; the rate in PLWH participants exceeding that for HIV− [odds ratio 2.59, 95% confidence interval: 1.85 to 3.64]. Fifty-two percent met criteria for cDSPN. Balance problems were more common in those with cDSPN [odds ratio = 3.3 (2.6–4.3)]. Adjusting for relevant covariates, balance disturbances attributable to cDSPN were more frequent among HIV+ than HIV− (interaction P = 0.001). Among individuals with cDSPN, older participants were much more likely to report balance disturbances than younger ones.

Conclusions:

cDSPN contributes to balance problems in PLWH. Assessments of cDSPN in older PLWH should be a clinical priority to identify those at risk and to aid in fall prevention and the ensuing consequences, including bone fractures, subdural hematoma, hospital admissions, and fatal injury.
Surgical Management of Diastasis Recti
Authors: Rosen Carly M. , Ngaage Ledibabari M. , Rada Erin M. , Slezak Sheri , Kavic Stephen , Rasko Yvonne
Published: January 2019

Background

As elective surgery becomes more popular, the stringency of insurance coverage policies has increased exponentially. Many patients with diastasis recti (DR) are denied coverage of the corrective surgery that has been shown to improve function and quality of life in this patient population. Plastic surgeons are frustrated by the lack of guidelines and sparsity of coverage for surgical correction of DR.

Methods

Fifty-four US insurance companies and Medicare were reviewed to determine their policies of coverage. These policies were compared with the guidelines set forth by the American Society of Plastic surgery and current literature on DR.

Results

Insurance company policy for DR repair is not clear nor well established. Of the 55 policies reviewed in this study, 51 had an established policy. Forty of these companies would not cover abdominoplasty to repair DR under any circumstances. Eleven companies required preauthorization to ensure that the patient met the requirements of medical necessity. These requirements differed from company to company. A comprehensive list was compiled of details required for preauthorization.

Conclusions

Insurance company policies do not recognize the spectrum of patients with DR and the necessity of abdominoplasty to relieve symptoms of patients with severe debilitation. The current Common Procedural Terminology coding classifies abdominoplasty to repair DR solely as a cosmetic procedure. Policies for DR repair should be amended to include a functional procedure reimbursement for severe DR and include detailed guidelines for coverage requirements to simplify the reimbursement process.
Trichotillomania Triggered by Vitamin D Deficiency and Resolving Dramatically With Vitamin D Therapy
Authors: Akaltun İsmail
Published: January 2019

Trichotillomania (TTM) is a disorder characterized by the individual pulling out his hair in a repetitive manner, resulting in significant hair loss, a feeling of tension before the hair pulling, and pleasure during it. Our understanding of the neurobiological basis of TTM is limited. However, the condition in all likelihood involves multiple pathways and a complex interaction between various genetic, psychological, and social factors. Vitamin D deficiency is thought to be linked to rickets in children and to a range of different diseases in adults, including osteoporosis, osteomalacia, cardiovascular diseases, cancer, dermatological diseases, and psychiatric disorders. We report a case of a 4-year-old girl with TTM triggered by vitamin D deficiency resolving dramatically with vitamin D therapy.
Regulatory principles governing the maternal-to-zygotic transition: insights from
Drosophila melanogaster
Authors: Hamm Danielle C. , Harrison Melissa M.
Published: January 2019

The onset of metazoan development requires that two terminally differentiated germ cells, a sperm and an oocyte, become reprogrammed to the totipotent embryo, which can subsequently give rise to all the cell types of the adult organism. In nearly all animals, maternal gene products regulate the initial events of embryogenesis while the zygotic genome remains transcriptionally silent. Developmental control is then passed from mother to zygote through a process known as the maternal-to-zygotic transition (MZT). The MZT comprises an intimately connected set of molecular events that mediate degradation of maternally deposited mRNAs and transcriptional activation of the zygotic genome. This essential developmental transition is conserved among metazoans but is perhaps best understood in the fruit fly,
Drosophila melanogaster
. In this article, we will review our understanding of the events that drive the MZT in
Drosophila
embryos and highlight parallel mechanisms driving this transition in other animals.
Large landslides at the northeastern margin of the Bayan Har Block, Tibetan Plateau, China
Authors: Zhao Bo , Wang Yunsheng , Luo Yonghong , Liang Ruifeng , Li Jia , Xie Lili
Published: January 2019

Large landslides (volume greater than or equal to 10
6
m
3
) usually have disastrous consequences and clearly influence the evolution of the local landscape. In this study, a detailed investigation of large landslides, across 20 towns over an area of 5000 km
2
, was carried out on the northeastern margin of the Bayan Har Block, at the eastern margin of the Tibetan Plateau, China. The results show that there are 129 large landslides in this area. Among them, 79 landslides have volumes within 10
6
–10
7
m
3
, 52 landslides have volumes within 10
7
–10
8
m
3
and 2 landslides have volumes larger than 10
8
m
3
. Most of these landslides are distributed along rivers, and more than 32% are densely concentrated in three small regions. The landslides mainly occur in high slopes and exhibit obvious sturzstrom characteristics. Analysis of the factors controlling landslide occurrence shows that elevation, slope angle, slope aspect, lithology, faults and rivers (valley) clearly influence landslide occurrence, while rainfall has no obvious influence. Earthquakes are considered an important trigger of and contributor to landslide occurrence.