bluuebunny/crossref_metadata_2025 huggingface dataset:
Strain fields in graphene induced by nanopillar mesh
Authors: Milovanović S. P. , Covaci L. , Peeters F. M.
Published: January 2019

The mechanical and electronic properties of a graphene membrane placed on top of a triangular superlattice of nanopillars are investigated. We use molecular dynamics simulations to access the deformation fields and the tight-binding approaches to calculate the electronic properties. Ripples form in the graphene layer that span across the unit cell, connecting neighboring pillars, in agreement with recent experiments. We find that the resulting pseudo-magnetic field (PMF) varies strongly across the unit cell. We investigate the dependence of PMF on unit cell boundary conditions, height of the pillars, and the strength of the van der Waals interaction between graphene and the substrate. We find direct correspondence with typical experiments on pillars, showing intrinsic “slack” in the graphene membrane. PMF values are confirmed by the local density of states calculations performed at different positions of the unit cell showing pseudo-Landau levels with varying spacings. Our findings regarding the relaxed membrane configuration and the induced strains are transferable to other flexible 2D membranes.
Cluster expansion based configurational averaging approach to bandgaps of semiconductor alloys
Authors: Xu Xi , Jiang Hong
Published: January 2019

Configurationally disordered semiconducting materials including semiconductor alloys [e.g., (GaN)1−x(ZnO)x] and stoichiometric materials with fractional occupation (e.g., LaTiO2N) have attracted a lot of interest recently in search for efficient visible light photo-catalysts. First-principles modeling of such materials poses great challenges due to the difficulty in treating the configurational disorder efficiently. In this work, a configurational averaging approach based on the cluster expansion technique has been exploited to describe bandgaps of ordered, partially disordered (with short-range order), and fully disordered phases of semiconductor alloys on the same footing. We take three semiconductor alloys [Cd1−xZnxS, ZnO1−xSx, and (GaN)1−x(ZnO)x] as model systems and clearly demonstrate that semiconductor alloys can have a system-dependent short-range order that has significant effects on their electronic properties.
Application of the Cauchy integral formula as a tool of analytic continuation for the resummation of divergent perturbation series
Authors: Mihálka Zsuzsanna É. , Szabados Ágnes , Surján Péter R.
Published: January 2019

Previous attempts to the resummation of divergent power series by means of analytic continuation are improved applying the Cauchy integral formula for complex functions. The idea is tested on divergent Møller-Plesset perturbation expansions of the electron correlation energy. In particular, the potential curve of the LiH molecule is computed from single reference MPn results which are divergent for bond distances larger than 3.6 Å. Preliminary results for the Hartree-Fock molecule are also tabulated.
Persistent Müllerian duct syndrome: an update
Authors: Picard Jean-Yves , Josso Nathalie
Published: January 2019

Male sex differentiation is driven by two hormones, testosterone and anti-Müllerian hormone (AMH), responsible for regression of Müllerian ducts in male fetuses. Mutations inactivating AMH or AMH receptor type 2 (AMHR2) are responsible for persistent Müllerian duct syndrome (PMDS) in otherwise normally virilised 46,XY males. This review is based on published cases, including 157 personal ones. PMDS can present in one of three ways: bilateral cryptorchidism, unilateral cryptorchidism with contralateral hernia and transverse testicular ectopia. Abnormalities of male excretory ducts are frequent. Testicular malignant degeneration occurs in 33% of adults with PMDS. Cancer of Müllerian derivatives is less frequent. Fertility is rare but possible if at least one testis is scrotal and its excretory ducts are intact. Up to January 2019, 81 families with 65 different mutations of the AMH gene, mostly in exons 1, 2 and 5, have been identified. AMHR2 gene mutations comprising 64 different alleles have been discovered in 79 families. The most common mutation, a 27-bp deletion in the kinase domain, was found in 30 patients of mostly Northern European origin. In 12% of cases, no mutation of AMH or AMHR2 has been detected, suggesting a disruption of other pathways involved in Müllerian regression.
Room temperature nanoindentation creep of nitrocarburised AISI 4140 steel
Authors: Xiao Jichang , Huang Yanyan , Zhou Qinghua , Wang Jiaxu , He Xiaofei
Published: January 2019

Room temperature indentation creep behaviour of different regions of nitrocarburised AISI 4140 steel is investigated by employing the nanoindentation creep testing method in the present study. A structure consisting of a compound layer, a diffusion layer and a substrate is observed in the nitrocarburised AISI 4140 steel. The stress exponents are calculated from the loading curve produced by nanoindentation during the holding time. The results indicate that with the increase in distance from the material surface, the obtained stress exponent decrease. From the compound layer to the diffusion layer to the substrate, the stress exponent decreases rapidly first, and then decreases gradually revealing a deeper test point that yields a lower creep resistance. The correlations between the room temperature creep behaviour and the corresponding microstructure of nitrocarburising surface are discussed.
The adaptor protein Ste50 directly modulates yeast MAPK signaling specificity through differential connections of its RA domain
Authors: Sharmeen Nusrat , Sulea Traian , Whiteway Malcolm , Wu Cunle
Published: January 2019

Discriminating among diverse environmental stimuli is critical for organisms to ensure their proper development, homeostasis, and survival. Saccharomyces cerevisiae regulates mating, osmoregulation, and filamentous growth using three different MAPK signaling pathways that share common components and therefore must ensure specificity. The adaptor protein Ste50 activates Ste11p, the MAP3K of all three modules. Its Ras association (RA) domain acts in both hyperosmolar and filamentous growth pathways, but its connection to the mating pathway is unknown. Genetically probing the domain, we found mutants that specifically disrupted mating or HOG-signaling pathways or both. Structurally these residues clustered on the RA domain, forming distinct surfaces with a propensity for protein–protein interactions. GFP fusions of wild-type (WT) and mutant Ste50p show that WT is localized to the shmoo structure and accumulates at the growing shmoo tip. The specifically pheromone response–defective mutants are severely impaired in shmoo formation and fail to localize ste50p, suggesting a failure of association and function of Ste50 mutants in the pheromone-signaling complex. Our results suggest that yeast cells can use differential protein interactions with the Ste50p RA domain to provide specificity of signaling during MAPK pathway activation.
An environmental scan of medication history technician programs within the Veterans Health Administration
Authors: Presley Caroline A , Byerly Susan H , Aylor Amy R , Mixon Amanda S
Published: January 2019

Purpose

Results of a study to identify medication history technician (MHT) programs within the Veterans Health Administration (VHA) and to evaluate the personnel, structure, and scope of such programs are reported.

Methods

Specially trained pharmacy technicians can take accurate patient medication histories and contribute to the medication reconciliation process. An environmental scan of MHT programs within VHA was conducted via an email query of pharmacy personnel. Semistructured interviews of personnel at each responding site (an MHT, a pharmacist, or both) were conducted.

Results

Ten VHA sites had existing MHT programs; the earliest was initiated in 2010. Sites employed from 1 to 4 MHTs, who most commonly worked in the inpatient setting (7 sites). At most sites (9), MHTs obtained a “best possible medication history” through systematic collection of medication information using 2 reliable sources, such as patients, caregivers, and medical records. Survey respondents at all sites reported benefits of MHT programs, including dedicated time to obtain medication histories, allowing for more effective use of pharmacists’ time. Six sites were eager to increase the reach of their programs. MHT training, oversight, and quality assurance varied across the sites. The survey results indicated that there are opportunities nationally—within and outside VHA—to develop standardized training, competency assessments, and quality assurance measures for MHT programs.

Conclusion

Ten VHA sites with MHT programs were identified. MHTs most commonly worked in inpatient settings as part of admission medication reconciliation processes.
Urinary 1-hydroxypyrene and Skin Contamination in Firefighters Deployed to the Fort McMurray Fire
Authors: Cherry Nicola , Aklilu Yayne-abeba , Beach Jeremy , Britz-McKibbin Philip , Elbourne Rebecca , Galarneau Jean-Michel , Gill Biban , Kinniburgh David , Zhang Xu
Published: January 2019

Background

In May 2016, firefighters from the province of Alberta, Canada deployed to a fire that engulfed the urban area of Fort McMurray. During the first days of the fire, firefighters experienced heavy smoke exposures during greatly extended work shifts. Urinary samples were collected post-deployment from three fire services for estimation of 1-hydroxypyrene (1-HP) concentration, reflecting exposure to polycyclic aromatic hydrocarbons (PAHs), to determine the effects of respiratory protective equipment (RPE) and skin hygiene in reducing internal dose

Methods

Urine samples from one fire service (n = 62) were analyzed for 1-HP by two laboratories, using different assays (LC-MS/MS: GC-MS): remaining samples were analyzed just by LC-MS/MS. A Skin Exposure Mitigation Index (SEMI) was computed from questions on opportunities for changing clothing, showering, and washing during breaks. Regression analyses, using 1-HP ng/g creatinine as the dependent variable, assessed the effect of RPE and skin factors on PAH absorption, allowing for environmental exposure and potential confounders. Stratification identified key groups with equal delay in sample collection.

Results

1-HP was detected in 71.0% of 62 samples by LC-MS/MS and 98.4% by GC-MS, with good mutual agreement between the methods. In 171 post-fire samples, 1-HP corrected for creatinine was related to current cigarette smoking and recent barbeque. Among those with samples collected within 48 h, urinary 1-HP was correlated with estimated exposure(r = 0.53, P < 0.001). In those with only one rotation before urine sample collection, no effect was seen of RPE use but I-HP was significantly lower (P = 0.003) in those with those with a high score on the SEMI scale, indicating better access to factors mitigating skin absorption.

Conclusion

Skin exposure to PAHs is an important route of absorption in firefighters, which can be mitigated by good skin hygiene.
Rapid Molecular Tests for Influenza, Respiratory Syncytial Virus, and Other Respiratory Viruses: A Systematic Review of Diagnostic Accuracy and Clinical Impact Studies
Authors: Vos Laura M , Bruning Andrea H L , Reitsma Johannes B , Schuurman Rob , Riezebos-Brilman Annelies , Hoepelman Andy I M , Oosterheert Jan Jelrik
Published: January 2019

We systematically reviewed available evidence from Embase, Medline, and the Cochrane Library on diagnostic accuracy and clinical impact of commercially available rapid (results <3 hours) molecular diagnostics for respiratory viruses as compared to conventional molecular tests. Quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies criteria for diagnostic test accuracy (DTA) studies, and the Cochrane Risk of Bias Assessment and Risk of Bias in Nonrandomized Studies of Interventions criteria for randomized and observational impact studies, respectively. Sixty-three DTA reports (56 studies) were meta-analyzed with a pooled sensitivity of 90.9% (95% confidence interval [CI], 88.7%–93.1%) and specificity of 96.1% (95% CI, 94.2%–97.9%) for the detection of either influenza virus (n = 29), respiratory syncytial virus (RSV) (n = 1), influenza virus and RSV (n = 19), or a viral panel including influenza virus and RSV (n = 14). The 15 included impact studies (5 randomized) were very heterogeneous and results were therefore inconclusive. However, we suggest that implementation of rapid diagnostics in hospital care settings should be considered.
All-But-Many Lossy Trapdoor Functions under Decisional RSA Subgroup Assumption and Application
Authors: Cao Nanyuan , Cao Zhenfu , Liu Zhen , Dong Xiaolei , Zhao Xiaopeng
Published: January 2019

Lossy trapdoor functions (LTDFs) were introduced by Peikert and Waters (STOC 2008) and have a number of applications in cryptography. All-but-many lossy trapdoor functions (ABM-LTDFs) are generalizations of LTDFs studied by Hofheinz (Eurocrypt 2012). Specially, using ABM-LTDFs to construct public key encryption (PKE) scheme with selective opening security has been proven feasible. Existing ABM-LTDFs were built on pairings, lattices and decisional composite residuosity (DCR) assumption. However, pairing-based ABM-LTDFs and DCR-based ABM-LTDFs rely on non-standard assumptions. In this paper, we construct an ABM-LTDF under the decisional RSA subgroup (DRSA) assumption, and we employ it to construct PKE scheme with selective opening security. We also propose a construction of DCR-based ABM-LTDF relying on standard assumption in Appendix.
Early- and long-term results of thoracic endovascular aortic repair for blunt traumatic thoracic aortic injury: a single-centre experience†
Authors: Kaneyuki Daisuke , Asakura Toshihisa , Iguchi Atsushi , Yoshitake Akihiro , Tokunaga Chiho , Tochii Masato , Nakajima Hiroyuki
Published: January 2019

OBJECTIVES

Endovascular repair has been proposed as an alternative to classical surgical repair for the management of blunt traumatic thoracic aortic injury. However, the long-term outcomes of endovascular repair and the risks of left subclavian coverage remain unclear.

METHODS

From April 2001 to August 2018, 33 patients with blunt traumatic thoracic aortic injury underwent endovascular repair in our institution. A follow-up computed tomography and a clinical examination were performed before discharge and at 1 month, and yearly or every 2 years thereafter.

RESULTS

The mean age was 45 ± 19 years. The technical success rate was 100%. Complete coverage of the left subclavian artery (LSCA) was performed in 20 patients (60.6%). Among 20 patients with coverage of the LSCA, revascularization was performed in 1 patient. No in-hospital deaths occurred. The clinical follow-up rate was 97%, with a mean period of 7 years and a maximum of 18 years. The survival rates were 100% at 1 year, 95% at 5 years and 88.7% at 10 years after the event. Among the 5 patients (20%) who developed neurological complications, 1 who had undergone implantation of a 200-mm long stent graft and LSCA coverage without revascularization developed paraplegia during the long-term follow-up.

CONCLUSIONS

This study demonstrates that the endovascular treatment of blunt traumatic thoracic aortic injury is a safe and effective therapeutic method over a long-term follow-up period. LSCA coverage and long stent graft placement might be indications for revascularization to prevent spinal cord injury.
Mandibular alignment changes after full-fixed orthodontic treatment: a systematic review and meta-analysis
Authors: Swidi Ahmad J , Griffin Andreea E , Buschang Peter H
Published: January 2019

Background

Although post-treatment mandibular alignment has been extensively investigated, the findings remain controversial.

Objectives

The objective was to assess mandibular alignment changes, as measured by the irregularity index, of patients who underwent full-fixed orthodontic treatment and were followed up at least 1 year after retention.

Search methods

MEDLINE, EMBASE, and Cochrane library, in addition, the reference lists of included studies, were screened. The search was conducted up to April 2018.

Selection criteria

The study designs included both interventional and observational studies of orthodontic patients who received either extraction or non-extraction treatment.

Data collection and analysis

The interventional studies were assessed using the Cochrane Collaboration’s risk of bias assessment tool. The quality of the observational studies was evaluated using National Institution of Health quality assessment tools. The first two authors independently applied the eligibility criteria, extracted the data, and assessed the risk of bias. Any conflicts were resolved with consensus discussion with the third author.

Results

The search retrieved 11 326 articles, 170 of which were assessed for eligibility. There were 44 studies included in the qualitative assessments and 30 in the meta-analyses. The studies included 1 randomized control trial (RCT) and 43 observational studies. The RCT was judged to have a high risk of bias and all of the observational studies had either fair or poor quality. The meta-analysis was based on studies judged to be of fair quality, including a total of 1859 patients. All meta-analyses were performed using random-effect models. The standardized mean difference between post-treatment and post-retention irregularity was 1.22 (95% CI, 1.04–1.40) and 0.85 (95% CI, 0.63–1.07) after extraction and non-extraction treatments, respectively. There was a substantial heterogeneity for the extraction (I2 = 75.2%) and non-extraction (I2 = 70.1%) studies. The follow-up duration (1–10 versus 10–20 years) explained 33% of the heterogeneity, with longer follow-up studies showing more irregularity.

Limitations

The quality of evidence provided by the studies was low. There was a risk of publication bias, and the search was limited to English language.

Conclusions and implications

Post-treatment mandibular irregularity increases are limited. Irregularity increases are slightly greater in patients treated with mandibular premolars extractions, and in patients followed up over longer periods of time.

Registration

The study protocol was not registered.
Enlarging habitable zones around binary stars in hostile environments
Authors: Wootton Bethany A , Parker Richard J
Published: January 2019

Habitable zones are regions around stars where large bodies of liquid water can be sustained on a planet or satellite. As many stars form in binary systems with non-zero eccentricity, the habitable zones around the component stars of the binary can overlap and be enlarged when the two stars are at periastron (and less often when the stars are at apastron). We perform N-body simulations of the evolution of dense star-forming regions and show that binary systems where the component stars originally have distinct habitable zones can undergo interactions that push the stars closer together, causing the habitable zones to merge and become enlarged. Occasionally, overlapping habitable zones can occur if the component stars move further apart, but the binary becomes more eccentric. Enlargement of habitable zones happens to one to two binaries from an average initial total of 352 in each simulated star-forming region, and demonstrates that dense star-forming regions are not always hostile environments for planet formation and evolution.
New Phylogenomic Analysis of the Enigmatic Phylum Telonemia Further Resolves the Eukaryote Tree of Life
Authors: Strassert Jürgen F H , Jamy Mahwash , Mylnikov Alexander P , Tikhonenkov Denis V , Burki Fabien
Published: January 2019

The resolution of the broad-scale tree of eukaryotes is constantly improving, but the evolutionary origin of several major groups remains unknown. Resolving the phylogenetic position of these “orphan” groups is important, especially those that originated early in evolution, because they represent missing evolutionary links between established groups. Telonemia is one such orphan taxon for which little is known. The group is composed of molecularly diverse biflagellated protists, often prevalent although not abundant in aquatic environments. Telonemia has been hypothesized to represent a deeply diverging eukaryotic phylum but no consensus exists as to where it is placed in the tree. Here, we established cultures and report the phylogenomic analyses of three new transcriptome data sets for divergent telonemid lineages. All our phylogenetic reconstructions, based on 248 genes and using site-heterogeneous mixture models, robustly resolve the evolutionary origin of Telonemia as sister to the Sar supergroup. This grouping remains well supported when as few as 60% of the genes are randomly subsampled, thus is not sensitive to the sets of genes used but requires a minimal alignment length to recover enough phylogenetic signal. Telonemia occupies a crucial position in the tree to examine the origin of Sar, one of the most lineage-rich eukaryote supergroups. We propose the moniker “TSAR” to accommodate this new mega-assemblage in the phylogeny of eukaryotes.
Efficiency of Tissue Penetration by Currents Induced by 3 Electrotherapeutic Techniques: A Comparative Study Using a Novel Deep-Tissue Measuring Technique
Authors: Ariel Efrat , Ratmansky Motti , Levkovitz Yechiel , Goor-Aryeh Itay
Published: January 2019

Background

Electrotherapy provides a wide range of treatment alternatives for musculoskeletal pathologies. However, for the electrical stimulation to exert a significant therapeutic effect, the induced current must often penetrate deep inside the target tissue.

Objective

The objective was to systematically compare the penetration efficiency of 3 electrotherapeutic stimulation modalities: transcutaneous electrical nerve stimulation (TENS), interferential (IF) stimulation, and combined therapy with pulsed ultrasound and IF current (CTPI).

Design

This was a comparative, experimental laboratory study.

Methods

The penetration efficiency was evaluated as a voltage difference between 2 of an 8-contact spinal cord stimulation array. Each of 20 participants with a preimplanted spinal cord stimulation array was stimulated with TENS (3 different electrode configurations), IF current (3 configurations), and CTPI (1 configuration).

Results

Significant differences in penetration efficiency were found between the various stimulation conditions and electrode configurations. CTPI showed the highest penetration efficiency, followed by IF, and finally TENS. Penetration efficiency was inversely and significantly correlated with skinfold thickness in all conditions, but this correlation was lowest for the CTPI stimulation.

Limitations

Our study design did not include a condition of combined therapy with pulsed ultrasound and TENS, and it did not directly control for current or voltage density under the stimulating electrodes. In addition, further research is required to determine whether a higher stimulation intensity of the target tissue is advantageous clinically.

Conclusions

Pending further testing, CTPI stimulation could prove more effective than IF and TENS in reaching deeper tissues, especially considering the variability in adipose tissue thickness in the population, for example, in cases of patients with obesity.
Immigrants and the Making of America
Authors: Sequeira Sandra , Nunn Nathan , Qian Nancy
Published: January 2019

We study the effects of European immigration to the U.S. during the Age of Mass Migration (1850–1920) on economic prosperity. Exploiting cross-county variation in immigration that arises from the interaction of fluctuations in aggregate immigrant flows and of the gradual expansion of the railway network, we find that counties with more historical immigration have higher income, less poverty, less unemployment, higher rates of urbanization, and greater educational attainment today. The long-run effects seem to capture the persistence of short-run benefits, including greater industrialization, increased agricultural productivity, and more innovation.
‘These Are the Medicines That “Make” Monsters’: Thalidomide in Southern Africa, 1958–1962
Authors: Parle Julie , Wimmelbücker Ludger
Published: January 2019

Thalidomide is amongst the most notorious drugs of all time. The majority of accounts of its distribution to the early 1960s focus on those countries where thalidomide caused the most extensive damage, most notably in economically developed countries. This article raises, however, questions about intended, explored, initiated or sometimes thwarted markets for thalidomide-containing preparations outside ‘the West’. It does so by focusing on Southern African markets for thalidomide, particularly those in Angola, Mozambique, (now) Zimbabwe, Namibia and South Africa. We place differences in the drug’s distribution channels in the context of the political economies of pharmaceuticals markets in the region in the decades after World War 2 and argue that colonial legacies and circuits of commerce can contribute to an understanding of why some regions ‘escaped a thalidomide disaster’. Finally, from late 1961 through 1962, we chart Southern African attempts to establish, or deny, the local presence of the teratogen.
Dickkopf-1 Expression in Androgenetic Alopecia and Alopecia Areata in Male Patients
Authors: Mahmoud Enas Abulkheir , Elgarhy Lamia H. , Hasby Eiman A. , Mohammad Laila
Published: January 2019

Background:

Androgenetic alopecia (AGA) results from shortening of the anagen phase of the hair cycle and, subsequently, miniaturization of hair follicles. Alopecia areata (AA) is a disease of autoimmunity where T cells attack anagen hair follicles and shows multifactorial etiology. Dickkopf-1 (DKK-1) is a gene that is responsible for transformation of anagen to catagen, which suggests that it is involved in development of both diseases.

Objectives:

To evaluate the tissue levels of dickkopf-1 in male patients with AGA and AA in comparison with controls, in an attempt to know its role in the pathogenesis of both disorders.

Methods:

DKK-1 immunohistochemical expression was evaluated in lesional scalp biopsies taken from 20 male patients with AGA evaluated clinically by the modified Norwood–Hamilton score, 20 male patients with AA evaluated clinically by SALT score, and 20 healthy controls within the same age and sex of the studied patients.

Results:

A highly significant difference in DKK-1 expression between patients with AGA and healthy controls was found (P
2 < 0.001). There were also significant differences in DKK-1 expression between patients with AA and healthy controls (P
3 = 0.013), and between both patient groups (P
1 = 0.002).

Conclusions:

Both AGA and AA showed significant increase in DKK-1 immunohistochemical expression. This may enhance the idea of its possible role in the pathogenesis of AGA and AA, and being a new target for treatment of these hair disorders.
Polycystic ovary syndrome: is the cardiometabolic risk increased after menopause?
Authors: Alur-Gupta Snigdha , Dokras Anuja
Published: January 2019

Although more commonly known for its fertility sequelae, dermatologic, metabolic, and psychological morbidities associated with polycystic ovary syndrome (PCOS) are not well recognized. This Practice Pearl reviews the effect of PCOS on cardiometabolic risk during the reproductive years and the consequence of these findings in middle-aged women. Current screening and management recommendations are reviewed.
Relationships between menopausal symptoms, sense of coherence, coping strategies, and quality of life
Authors: Ngai Fei Wan
Published: January 2019

Objectives:

The aims of this study were to examine the relationships between menopausal symptoms, sense of coherence (SOC), coping strategies, and quality of life, and to test the mediating effects of SOC and coping strategies on the relationships between menopausal symptoms and quality of life among Chinese women during menopausal transition.

Methods:

Two hundred one women aged 40 to 60 years and currently undergoing menopausal transition were recruited at community centers between June and August 2017. Menopausal symptoms, SOC, coping strategies, and quality of life were assessed by the Menopause Rating Scale, the Sense of Coherence Scale, the Brief COPE Inventory, and the Medical Outcomes Study Short-Form-36, respectively. Data were analyzed by path analysis.

Results:

Menopausal symptoms were associated with poorer quality of life, and both SOC and maladaptive coping were found to mediate the effects of menopausal symptoms on quality of life. The results suggest that SOC might alleviate the adverse effects of menopausal symptoms on quality of life, whereas maladaptive coping strategies might aggravate the adverse effects of menopausal symptoms on quality of life.

Conclusions:

The results provide new insights into the importance of considering SOC and coping strategies and their interactions with menopausal symptoms and quality of life in the situation of menopausal transition.
HIGHER-ORDER ABERRATIONS IN EYES WITH SILICONE OIL TAMPONADE
Authors: Shin Joo Youn , Chung In Kwon , Han Ga Hee , Byeon Suk Ho , Kim Jin Hyoung , Lee Doh , Lee Jonghyun
Published: January 2019

Purpose:

To investigate the changes in higher-order aberrations (HOAs) after silicone oil removal and to evaluate their associations with visual acuity.

Methods:

Fifty-nine eyes of 58 patients who underwent SO removal were included. Total, corneal, and internal optic HOAs, and best-corrected visual acuity were measured before and 1 month after SO removal, and changes were compared between phakic and pseudophakic eyes.

Results:

Total ocular and internal optic HOAs decreased significantly after SO removal both in pseudophakic (n = 40, all P < 0.001) and phakic eyes (n = 19, P = 0.017, P = 0.004). Preoperative HOAs (P < 0.001) and changes in HOAs (P = 0.006) were greater in pseudophakic eyes than in phakic eyes. Best-corrected visual acuity was significantly improved after SO removal, from 20/105 to 20/78 (P < 0.001) in pseudophakic eyes, whereas there was no difference in phakic eyes (P = 0.714). Preoperative HOAs and the reduction in HOAs after SO removal were greater in best-corrected visual acuity–improved eyes than best-corrected visual acuity–unchanged eyes (P < 0.001).

Conclusion:

Silicone oil tamponade induced an increase in HOAs, and these increases were greater in pseudophakic eyes than in phakic eyes. Silicone oil may cause additional visual impairments because of HOAs, beyond those caused by retinal diseases, particularly in pseudophakic eyes.
ADVERSE EFFECT OF MACULAR INTRARETINAL HEMORRHAGE ON THE PROGNOSIS OF SUBMACULAR HEMORRHAGE DUE TO RETINAL ARTERIAL MACROANEURYSM RUPTURE
Authors: Doi Shinichiro , Kimura Shuhei , Morizane Yuki , Hosokawa Mio M. , Shiode Yusuke , Hirano Masayuki , Toshima Shinji , Takahashi Kosuke , Hosogi Mika , Fujiwara Atsushi , Okanouchi Toshio , Inoue Yasushi , Shiraga Fumio
Published: January 2019

Purpose:

To investigate the clinical course of submacular hemorrhage associated with ruptured retinal arterial macroaneurysm using swept-source optical coherence tomography.

Methods:

This study included 23 eyes of 23 consecutive patients diagnosed with submacular hemorrhage associated with ruptured retinal arterial macroaneurysm. Cases underwent displacement of submacular hemorrhage (vitrectomy + subretinal injection of tissue plasminogen activator + air tamponade) and were followed up for 6 months after surgery. Localization of the preoperative hemorrhage and its effect on preoperative and postoperative best-corrected visual acuity, central retinal thickness, and continuity of the ellipsoid zone were measured.

Results:

Macular intraretinal hemorrhage (IRH) was observed in 17 eyes (73.9%, IRH [+] group) and was not observed in 6 eyes (26.1%, IRH [−] group). The IRH (+) group showed worse postoperative best-corrected visual acuity values compared with the IRH (−) group (0.89 ± 0.47 in logarithm of the minimal angle of resolution units, Snellen equivalent 20/155 and 0.16 ± 0.23, 20/29, respectively; P < 0.01), smaller central retinal thickness values (97.7 ± 53.5 μm, 173.0 ± 32.3 μm, respectively; P < 0.01), and a higher rate of ellipsoid zone disruption (100%, 33.3%, respectively; P < 0.01).

Conclusion:

Patients with preoperative macular IRH showed lower postoperative visual acuity and worse macular contour after submacular hemorrhage displacement compared with patients without macular IRH.
Extended-release gabapentin for failed back surgery syndrome: results from a randomized double-blind cross-over study
Authors: Gewandter Jennifer S. , Frazer Maria E. , Cai Xueya , Chiodo Valerie F. , Rast Shirley A. , Dugan Michelle , Carter Hudson A. , Rahmani Redi , Stone Jonathan J. , Markman John D.
Published: January 2019

Persistent pain after lumbar surgery (failed back surgery syndrome [FBSS]) remains a leading indication for chronic analgesia. However, no analgesics have proven efficacious for this condition. Although trials have evaluated gabapentinoids for chronic low back pain, none of these trials focused solely on FBSS. This randomized, double-blind cross-over trial evaluated the efficacy of gabapentin (1800 mg/day) for FBSS. Eligible patients had a diagnosis of FBBS, an average daily pain score of at least 4 of 10, a neuropathic pain component (indicated by the PainDetect), and reported at least half of their pain radiating in their lower extremity. Participants were randomized to 2, 7-week study periods separated by a 10-day washout. The primary outcome measure was a 0 to 10 numeric rating scale (NRS) of average pain. Secondary measures included the McGill Pain Questionnaire and Patient Global Impression of Change. The treatment effect was analyzed using a mixed effect analysis of covariance with fixed effects for treatment, period, and baseline 7-day mean NRS pain score and a random effect for the participant. The outcome of the model was the mean 7-day NRS score for the last 7 days of each treatment period. Thirty-two participants were randomized and included in the primary analysis; 25 completed both study periods. No difference was detected between treatments on any outcome measure, including the primary (least square mean difference in NRS: −0.01 confidence interval: [−0.22 to 0.20]). Given the escalating rate of complex lumbar surgery, future research to develop novel therapies for this prevalent syndrome is needed.
Sex differences in central nervous system plasticity and pain in experimental autoimmune encephalomyelitis
Authors: Catuneanu Ana , Paylor John W. , Winship Ian , Colbourne Fred , Kerr Bradley J.
Published: January 2019

Multiple sclerosis (MS) is a neurodegenerative autoimmune disease with many known structural and functional changes in the central nervous system. A well-recognized, but poorly understood, complication of MS is chronic pain. Little is known regarding the influence of sex on the development and maintenance of MS-related pain. This is important to consider, as MS is a predominantly female disease. Using the experimental autoimmune encephalomyelitis (EAE) mouse model of MS, we demonstrate sex differences in measures of spinal cord inflammation and plasticity that accompany tactile hypersensitivity. Although we observed substantial inflammatory activity in both sexes, only male EAE mice exhibit robust staining of axonal injury markers and increased dendritic arborisation in morphology of deep dorsal horn neurons. We propose that tactile hypersensitivity in female EAE mice may be more immune-driven, whereas pain in male mice with EAE may rely more heavily on neurodegenerative and plasticity-related mechanisms. Morphological and inflammatory differences in the spinal cord associated with pain early in EAE progression supports the idea of differentially regulated pain pathways between the sexes. Results from this study may indicate future sex-specific targets that are worth investigating for their functional role in pain circuitry.
The Case for an Amharic Term for Stroke: “Ye-Angol Tikat”
Authors: Aseffa Sosena , Stutzman Sonja , Kamal Abulkadir , Measho Dawit , Gebreyohanns Mehari
Published: January 2019

Background: This study was developed to explore the efficacy of introducing the Amharic phrase “Ye-Angol Tikat,” which translates to “brain attack“ in English, as a mechanism to enhance stroke education among the Amharic-speaking Ethiopian community. Methods: A prospective, nonrandomized, survey was completed by 294 Amharic-speaking persons. The survey explored support and desire for a culturally appropriate terminology for stroke. Results: Most of the participants (93%) support the need for an Amharic term to describe stroke. Conclusion: This pilot project demonstrates a strong support for a descriptive and standardized terminology for stroke within the Amharic-speaking community.
Decision to deploy coronary reperfusion is not affected by the volume of ST-segment elevation myocardial infarction patients managed by prehospital emergency medical teams
Authors: Lapostolle Frédéric , Bataille Sophie , Loyeau Aurélie , Simon Benoît , Laborne François-Xavier , Dupas François , Boche Thévy , Lamhaut Lionel , Pirès Virginie , Lefort Hugues , Mapouata Mireille , Le Bail Gaëlle , Weisslinger Lisa , Juliard Jean-Michel , Lambert Yves
Published: January 2019

Objective

Mortality in patients with ST-segment elevation myocardial infarction (STEMI) has been associated with the volume of activity of percutaneous coronary intervention (PCI) facilities. This observational study investigated whether the coronary reperfusion-decision rate is associated with the volume of activity in a prehospital emergency setting.

Methods

Prospectively collected data for the period 2003–2013 were extracted from a regional registry of all STEMI patients handled by eight dispatch centers (SAMUs) in and around Paris [41 mobile ICU (MICUs)]. A possible association between volume of activity (number of STEMIs) and coronary reperfusion-decision rate, and subsidiarily between volume of activity and choice of technique (fibrinolysis vs. primary PCI), were investigated. Explanatory factors (patient age, sex, delay between pain onset and first medical contact, and access to a PCI facility) were analyzed in a multivariate analysis.

Results

Overall, 18 162 patients; male/female 3.5/1; median age 62 (52–72) years were included in the analysis. The median number of STEMIs per MICU was 339 (IQ 220–508) and that of reperfusion-decisions was 94% (91–95). There was no association between the decision rate and the number of STEMIs (P = 0.1). However, the decision rate was associated with age, sex, delay, and access to a PCI facility (P < 0.0001) in a highly significant way. Fibrinolysis was a more frequent option for low-volume (remoter PCI facilities) than high-volume MICUs (30 vs. 16%).

Conclusion

The decision of coronary reperfusion in a prehospital emergency setting depended on patient characteristics, delay between pain onset and first medical contact, and access to a PCI facility, but not on volume of activity. Promoting fibrinolysis use in underserved areas might help increase the reperfusion-decision rate.
Molecular regulation of plasma lipid levels during systemic inflammation and sepsis
Authors: Trinder Mark , Boyd John H. , Brunham Liam R.
Published: January 2019

Purpose of review

Sepsis is a common syndrome of multiorgan system dysfunction caused by a dysregulated inflammatory response to an infection and is associated with high rates of mortality. Plasma lipid and lipoprotein levels and composition change profoundly during sepsis and have emerged as both biomarkers and potential therapeutic targets for this condition. The purpose of this article is to review recent progress in the understanding of the molecular regulation of lipid metabolism during sepsis.

Recent findings

Patients who experience greater declines in high-density lipoprotein during sepsis are at much greater risk of succumbing to organ failure and death. Although the causality of these findings remains unclear, all lipoprotein classes can sequester and prevent the excessive inflammation caused by pathogen-associated lipids during severe infections such as sepsis. This primordial innate immune function has been best characterized for high-density lipoproteins. Most importantly, results from human genetics and preclinical animal studies have suggested that several lipid treatment strategies, initially designed for atherosclerosis, may hold promise as therapies for sepsis.

Lipid and lipoprotein metabolism undergoes significant changes during sepsis. An improved understanding of the molecular regulation of these changes may lead to new opportunities for the treatment of sepsis.
Face Transplantation for Granulomatosis With Polyangiitis (Wegener Granulomatosis)
Authors: Hashem Ahmed M. , Djohan Risal , Bernard Steven , Hendrickson Mark , Schwarz Graham , Gharb Bahar B. , Rampazzo Antonio , Hoffman Gary S. , Doumit Gaby , Bergfeld Wilma , Zins James E. , Siemionow Maria , Papay Francis , Gastman Brian
Published: January 2019

Background

We report new data for a rare face transplant performed 3 years ago. Granulomatosis with polyangiitis (GPA) (Wegener) is a severe autoimmune necrotizing vasculitis and parenchymal inflammatory disease that can affect any organ including those of the craniofacial region. Skin involvement manifests as malignant pyoderma. This account (1) highlights the technical details of face transplantation for this unique indication, (2) reports the 3-year posttransplant outcome, and (3) describes relevant immunological aspects.

Methods

A Le Fort III near-total face and near-total scalp transplant was performed after extensive trauma and subsequent bone and soft tissue infection in a patient with GPA. Incisions were planned along facial aesthetic subunits. The vascular pedicle comprised the facial and superficial temporal arteries bilaterally. The functioning left eye was preserved and fitted into the donor tissues.

Results

The procedure took 21 hours, and transfusion was limited to 4 units of packed red cells. Early medical and surgical complications were successfully treated. At 3 years, acceptable aesthetic outcome was achieved with adequate color match and scalp hair growth. The patient has recovered light touch, temperature, and 2-point discrimination and has evidence of symmetric cheek elevation albeit with limited eyelid and frontalis function. GPA relapse did not occur. Four acute rejections were fully reversed.

Conclusions

This case represents a new underlying disease (trauma + GPA) leading to face transplantation and a unique clinical scenario where allografting was indicated for potentially life-threatening and sight-preserving reasons and not for mere functional and aesthetic concerns. Despite complexity, 3-year clinical outcome is encouraging, and the patient is no longer at risk for dural exposure, meningitis, and related morbidity.
Geographic Variation in Breast Reconstruction Modality Use Among Women Undergoing Mastectomy
Authors: Anderson Spencer R. , Sieffert Michelle R. , Talarczyk Colonel Matthew R. , Johnson R. Michael , Fox Major Justin P.
Published: January 2019

Purpose

Despite changes in legislation and an increase in public awareness, many women may not have access to the various types of breast reconstruction. The purpose of this study was to evaluate variation in reconstructive modality at the health service area (HSA) level and its relationship to the plastic surgeon workforce in the same area.

Methods

Using the Arkansas, California, Florida, Nebraska, and New York state inpatient databases, we conducted a cross-sectional study of adult women undergoing mastectomy for cancer from 2009 to 2012. The primary outcomes were receipt of reconstruction and the reconstructive modality (autologous tissue versus implant) used. All data were aggregated to the HSA level and augmented with plastic surgeon workforce data. Correlation coefficients were calculated for the relationship between the outcomes and workforce.

Results

The final sample included 67,984 women treated across 103 HSAs. The average patient was 58.5 years, had private insurance (53.5%), and underwent unilateral mastectomy for invasive cancer. At the HSA level, the median immediate breast reconstruction rate was 25.0% and varied widely (interquartile range, 43.2%). In areas where reconstruction was performed, the median autologous (10.2%) and free tissue (0.4%) reconstruction rates were low, with more than 30% of HSAs never using autologous tissue. There was a direct correlation between an HSA's plastic surgeon density and autologous reconstruction rate (r = 0.81, P < 0.001).

Conclusions

Despite efforts to remove financial barriers and improve patients' awareness, accessibility to various modalities of reconstruction is inadequate for many women. Efforts are needed to improve the availability of more comprehensive breast reconstruction care.
Health Insurance Portability and Accountability Act Noncompliance in Patient Photograph Management in Plastic Surgery
Authors: Lam Jonathan S. , Simpson Benjamin K. , Lau Frank H.
Published: January 2019

Background

Today, plastic surgeons have largely transitioned to digital photography. This shift has introduced new risks to daily workflows, notably data theft and Health Insurance Portability and Accountability Act (HIPAA) violations.

Methods

We performed a national survey of digital photograph management patterns among members of the American Society of Plastic Surgery and trainees in Accreditation Council for Graduate Medical Education–accredited plastic surgery programs.

Results

Our findings showed that attendings preferred the use of stand-alone digital cameras (91.4%), whereas trainees preferred the use of smartphones (96.1%) for capturing patient photographs. The rate of noncompliance was nearly identical; 82.8% of attendings were HIPAA noncompliant when using stand-alone digital cameras compared with 90.2% of trainees using smartphones. Both groups also breached HIPAA rules when using other photographic management modalities.

Conclusions

This is the first study to quantify the prevalence of noncompliance with regard to an entire digital photograph management workflow. These findings were consistent with previous studies that reported that younger physicians tend to embrace newer technologies, whereas older attendings are more reluctant. The findings also suggest that HIPAA noncompliance in digital photograph security and management is a significant problem within the plastic surgery community.