bluuebunny/crossref_metadata_2025 huggingface dataset:
An adsorption and thermodynamic study of ofloxacin on marine sediments
Authors: Cao Wen-Qing , Song Jun , Yang Gui-Peng
Published: November 2017

Environmental contextOfloxacin, a widely used fluorinated antibiotic, is resistant to biodegradation and hence can accumulate in the environment. A systematic investigation of ofloxacin on marine sediments showed that sediment organic carbon and heterogeneous sites on sediments play important roles in adsorption processes. The results help our understanding of the environmental behaviour and fate of ofloxacin in marine systems. AbstractThe adsorption behaviour of ofloxacin (OFL) on marine sediments treated by different methods was investigated using batch experiments. Three factors (sediment organic carbon content, salinity and temperature) that may affect the adsorption behaviour of OFL were analysed. The equilibrium time for OFL adsorption on marine sediment in natural seawater was ~4–5h. The adsorption of OFL on all sediments with different treatments fitted the Freundlich model well. The adsorption parameter Kf value was in the order of Kf (H2O2 treatment)<Kf (H2O treatment)<Kf (HCl treatment) over the studied concentration range. The adsorption of OFL was influenced not only by the sediment organic carbon content but also by external factors such as salinity of media and temperature. The adsorption was favourably influenced by decreased salinity and temperature of seawater. The adsorption capacity of OFL on marine sediments decreased with an increase of temperature and salinity. The Kf values decreased from 33.73±1.66 to 22.54±1.12(Lkg−1)1/n when the temperature increased from 283 to 313K. The changes in standard Gibbs free energy (ΔG0) and enthalpy (ΔH0) were −6.62±0.34kJmol−1 and −7.58±0.38kJmol−1 respectively, indicating that the adsorption process of OFL was spontaneous and exothermic. The positive value of the entropy change ΔS0 (i.e. 3.38±0.17JK−1mol−1) suggests that the degree of freedom increased during the adsorption process.
Gold nanoparticle-dotted, ionic liquid-functionalised, carbon hybrid material for ultra-sensitive detection of bisphenol A
Authors: Tian Yu , Li Jianbo , Wang Yanhui , Ding Chaofan , Sun Yuanling , Sun Weiyan , Lin Yanna , Luo Chuannan
Published: November 2017

Environmental contextBisphenol A, an important industrial material widely used as a plasticiser, fire retardant and resin polymer material, can cause endocrine disorders and precocious puberty. We developed a portable and efficient method for determining bisphenol A, and apply it to the detection of bisphenol A in bottles for infants and young children.
AbstractA highly effective electrochemical sensor was developed for the highly sensitive detection of bisphenol A (BPA). The sensor is based on a glassy carbon electrode modified with a composite comprising 1-butyl-3-methyl imidazole hydrobromide (an ionic liquid, IL)-functionalised grapheme oxide (GO) to which gold nanoparticles (AuNPs) and carboxylic acid-functionalised carbon nanotubes (CNT) were absorbed. The negatively charged carboxylic acid-functionalised CNTs and AuNPs are adsorbed on the positively charged GO-IL composite film by electrostatic adsorption. The as-prepared GO-IL-CNT-AuNP hybrid nanocomposites exhibit excellent water solubility owing to the high hydrophilicity of the GO-IL components. Moreover, the excellent conductivity is attributed to the good conductivity of the IL, CNT and AuNP components. The hydrid materials enhance the preconcentration efficiency of BPA and accelerate the electron transfer rate at the electrode–electrolyte interface, as such the resultant fabricated electrochemical sensor displays a fast, stable and sensitive detection performance for trace amounts of BPA. Differential pulse voltammetry was used as a sensitive analytical method for the determination of BPA, and a much wider linear dynamic range of BPA determination was found between 5 and 100nM. The limit of detection for BPA was found down to 1.5nM based on a signal to nose ratio of 3. The modified electrode was successfully employed to detect BPA extracted from a plastic water bottle and milk carton.
Where Fossils Dare and Males Matter: combined morphological and molecular analysis untangles the evolutionary history of the spider ant genus Leptomyrmex Mayr (Hymenoptera : Dolichoderinae)
Authors: Barden Phillip , Boudinot Brendon , Lucky Andrea
Published: November 2017

The distinctive ant genus Leptomyrmex Mayr, 1862 had been thought to be endemic to Australasia for over 150 years, but enigmatic Neotropical fossils have challenged this view for decades. The present study responds to a recent and surprising discovery of extant Leptomyrmex species in Brazil with a thorough evaluation of the Dominican Republic fossil material, which dates to the Miocene. In the first case study of direct fossil inclusion within Formicidae Latreille, 1809, we incorporated both living and the extinct Leptomyrmex species. Through simultaneous analysis of molecular and morphological characters in both Bayesian and parsimony frameworks, we recovered the fossil taxon as sister-group to extant Leptomyrmex in Brazil while considering the influence of taxonomic and character sampling on inferred hypotheses relating to tree topology, biogeography and morphological evolution. We also identified potential loss of signal in the binning of morphological characters and tested the impact of parameterisation on divergence date estimation. Our results highlight the importance of securing sufficient taxon sampling for extant lineages when incorporating fossils and underscore the utility of diverse character sources in accurate placement of fossil terminals. Specifically, we find that fossil placement in this group is influenced by the inclusion of male-based characters and the newly discovered Neotropical ‘Lazarus taxon’.
De novo transcription of thyroid hormone receptors is essential for early bovine embryo development in vitro
Authors: Rho N.-Y. , Ashkar F. A. , Revay T. , Madan P. , Rho G.-J. , King W. A. , Favetta L. A.
Published: November 2017

Thyroid hormone receptor (THR) α and THRβ mediate the genomic action of thyroid hormones (THs) that affect bovine embryo development. However, little is known about THRs in the preimplantation embryo. The aim of the present study was to investigate the importance of THRs in in vitro preimplantation bovine embryos. THR transcripts and protein levels were detected in developing preimplantation embryos up to the blastocyst stage. Embryonic transcription of THRs was inhibited by α-amanitin supplementation, and both maternal and embryonic transcription were knocked down by short interference (si) RNA microinjection. In the control group, mRNA and protein levels of THRs increased after fertilisation. In contrast, in both the transcription inhibition and knockdown groups there were significant (P < 0.05) decreases in mRNA expression of THRs from the 2-cell stage onwards. However, protein levels of THRs were not altered at 2-cell stage, although they did exhibit a significant (P < 0.05) decrease from the 4-cell stage. Moreover, inhibition of de novo transcripts of THRs using siRNA led to a significant (P < 0.01) decrease in the developmental rate and cell number, as well as inducing a change in embryo morphology. In conclusion, THRs are transcribed soon after fertilisation, before major activation of the embryonic genome, and they are essential for bovine embryo development in vitro.
Osmosensing by the bacterial PhoQ/PhoP two-component system
Authors: Yuan Jing , Jin Fan , Glatter Timo , Sourjik Victor
Published: November 2017

Significance

Whether residing in or invading the host, enterobacteria have to deal with host-related stress conditions. These stress factors also serve as sensory cues, informing bacteria that they are present inside the host. Here, we report that the PhoQ/PhoP two-component system, which was known to sense several host-related environmental changes, responds to osmotic upshift, another key stimulus associated with the host. This sensing is proposed to rely on a mechanism that detects changes in the physical properties of the membrane. Thus, a single enterobacterial kinase, PhoQ, senses a major part of host-associated stimuli. The PhoQ-mediated osmosensing increases bacterial fitness under hyperosmotic conditions found inside the host, and it is likely to play an important role in the regulation of virulence.
A comparison of diminutive expressions in English and Slovene
as exemplified by Roald Dahl’s Matilda
Authors: Sicherl Eva
Published: November 2017

The article presents and compares ways of expressing diminution in English and
Slovene nouns, verbs and adjectives with the aim of testing a hypothesis
suggesting that Slovene uses diminutive forms more frequently than English.
Depending on language typology, diminutiveness can be realized predominantly
word-formationally or predominantly analytically. The hypothesis is tested
against an analysis of diminutive forms used in Dahl’s Matilda
and its Slovene translation, showing that Slovene indeed prefers to use
diminutives more frequently than English. A tendency can be established for
Slovene to form diminutives by word-formational means in the categories of noun
and verb. In verbs, English tends towards neutrality of expression. Frequent use
of multiple diminutiveness and the ability of analytic and synthetic diminutive
forms to be freely interchangeable in Slovene testify to the strong presence of
diminutive forms in the language system.
Shallow features as indicators of English–German contrasts in lexical cohesion
Authors: Kunz Kerstin , Lapshinova-Koltunski Ekaterina , Martínez Martínez José Manuel , Menzel Katrin , Steiner Erich
Published: November 2017

This paper contrasts lexical cohesion between English and German spoken and
written registers, reporting findings from a quantitative lexical analysis.
After an overview of research aims and motivations we formulate hypotheses on
distributions of shallow features as indicators of lexical cohesion across
languages and modes and with respect to register ranking and variation. The
shallow features analysed are: highly frequent words in texts, lexical density,
standardized type-token-ratio, top-frequent content words of the language within
individual registers and texts, and several types of Latinate words. Descriptive
analyses of the corpus are then presented and statistically validated with the
help of univariate and multivariate analyses. The results are interpreted
relative to our hypotheses and related to the following properties of texts in
terms of lexical cohesion: semantic variability, cohesive strength, number and
length of nominal chains, degree of specification of lexis, and degree of
variation along all of these properties.
Blood Cockle Shells Waste as Renewable Source for the Production of Biogenic CaCO3 and Its Characterisation
Authors: Asmi D , Zulfia A
Published: November 2017

The prowess to reuse and recycle of blood cockle shells for raw material in bio-ceramics applications is an attractive component of integrated waste management program. In this paper an attempt is made to introduce a simple process to manufacture biogenic CaCO3 powder from blood cockle shells waste. The biogenic CaCO3 powder was produced from rinsing of blood cockle shells waste using deionised water and oxalic acid for cleaning the dirt and stain on the shells, then drying and grinding followed by heat treatment at 500 and 800 °C for 5 h. The powder obtained was characterised by XRF, DTA/TG, SEM, FTIR, and XRD analysis. The amount of 97.1 % CaO was obtained from XRF result. The thermal decomposition of CaCO3 become CaO due to mass loss was observed in the TG curve. The SEM result shows the needle-like aragonite morphology of blood cockle shells powder transformed to cubic-like calcite after heat treated at 500 °C. These results were consistent with FTIR and XRD results.
Complete Integrability of the Parahoric Hitchin System
Authors: Baraglia David , Kamgarpour Masoud , Varma Rohith
Published: November 2017

Let $\mathcal {G}$ be a parahoric group scheme over a complex projective curve X of genus greater than one. Let $\mathrm {Bun}_{\mathcal {G}}$ denote the moduli stack of $\mathcal {G}$-torsors on X. We prove several results concerning the Hitchin map on $T^{\ast }\!\mathrm {Bun}_{\mathcal {G}}$. We first show that the parahoric analogue of the global nilpotent cone is isotropic and use this to prove that $\mathrm {Bun}_{\mathcal {G}}$ is “very good” in the sense of Beilinson–Drinfeld. We then prove that the parahoric Hitchin map is a Poisson map whose generic fibres are abelian varieties. Together, these results imply that the parahoric Hitchin map is a completely integrable system.
Luminous quasars do not live in the most overdense regions of galaxies at z ∼ 4
Authors: Uchiyama Hisakazu , Toshikawa Jun , Kashikawa Nobunari , Overzier Roderik , Chiang Yi-Kuan , Marinello Murilo , Tanaka Masayuki , Niino Yuu , Ishikawa Shogo , Onoue Masafusa , Ichikawa Kohei , Akiyama Masayuki , Coupon Jean , Harikane Yuichi , Imanishi Masatoshi , Kodama Tadayuki , Komiyama Yutaka , Lee Chien-Hsiu , Lin Yen-Ting , Miyazaki Satoshi , Nagao Tohru , Nishizawa Atsushi J , Ono Yoshiaki , Ouchi Masami , Wang Shiang-Yu
Published: November 2017

We present the cross-correlation between 151 luminous quasars (MUV < −26) and 179 protocluster candidates at z ∼ 3.8, extracted from the Wide imaging survey (∼121 deg2) performed as part of the Hyper Suprime-Cam Subaru Strategic Program (HSC-SSP). We find that only two out of 151 quasars reside in regions that are more overdense compared to the average field at >4 σ. The distributions of the distances between quasars and the nearest protoclusters and the significance of the overdensity at the positions of quasars are statistically identical to those found for g-dropout galaxies, suggesting that quasars tend to reside in almost the same environment as star-forming galaxies at this redshift. Using stacking analysis, we find that the average density of g-dropout galaxies around quasars is slightly higher than that around g-dropout galaxies on 1.0–2.5 pMpc scales, while at <0.5 pMpc that around quasars tends to be lower. We also find that quasars with higher UV luminosity or with more massive black holes tend to avoid the most overdense regions, and that the quasar near-zone sizes are anti-correlated with overdensity. These findings are consistent with a scenario in which luminous quasars at z ∼ 4 reside in structures that are less massive than those expected for the progenitors of today’s rich clusters of galaxies, and possibly that luminous quasars may be suppressing star formation in their close vicinity.
The Survey Checklist (Manifesto)
Authors: Gehlbach Hunter , Artino Anthony R.
Published: November 2017

Checklists can mitigate a multitude of high-cost mistakes in fields ranging from surgery to aviation. As part of a standard protocol, checklists may provide many benefits, including improved equity and communication among team members and more efficient integration of different processes during complex tasks. Mostly, though, checklists serve as easy, efficient means to remind professionals of what they already know but can easily forget. By improving processes, checklists can reduce procedural errors, miscommunications, and even deaths. Although the stakes of writing a survey are rarely as high as they are for performing surgery or piloting a plane, checklists can improve the quality of surveys in medical education. In this Perspective, the authors propose a survey checklist to serve the same core function as surgical checklists—to reduce error. That is, a survey checklist can help medical education practitioners and researchers gather more accurate responses. Designers can use the checklist in the appendix to guide item creation processes or to help evaluate the quality of existing surveys. The checklist focuses on formulating items, crafting response options, and formatting/organizing the whole survey.
Recruitment of Dual-Career Academic Medicine Couples
Authors: Putnam Charles W. , DiMarco Judy , Cairns Charles B.
Published: November 2017

Today it is not uncommon to discover that a candidate for a faculty position has a partner or spouse who is also an academician, adding complexity to the recruitment process. Here, the authors address two practical obstacles to the recruitment of faculty who have an academic partner: dual recruitment and conflict of interest. The authors have found that tandem recruitment works best when suitable positions for both spouses are first identified so that recruitment can proceed synchronously. This approach decreases misperceptions of favoritism toward either’s candidacy. Managing conflict of interest, generated by the appointment of one spouse in a supervisory position over the other, requires a proactive, transparent, well-designed plan. After canvassing human resource policies and conducting interviews with national academic leaders, the authors have developed an administrative structure that places “key” decisions (hiring and retention; promotion and tenure; salary, bonuses, and benefits; performance evaluations; and disciplinary matters) regarding the supervised spouse in the jurisdiction of an alternative administrator or committee. The authors also offer suggestions both for mitigating misperceptions of bias in day-to-day decisions and for the support and mentoring of the supervised partner or spouse.
A Pilot Study of Responses to Suctioning Among Neonates on Bubble Nasal Continuous Positive Airway Pressure
Authors: Sweet Michele , Armbruster Debra , Bainbridge Erin , Reiner Brianna , Tan Alai , Chipps Esther
Published: November 2017

Background:

Maintenance of a patent airway while the neonate is on nasal continuous positive airway pressure (nasal CPAP) requires vigilant monitoring and oral/nasopharyngeal suctioning. Currently, no evidence-based guidelines for safe suctioning in neonates while on bubble nasal CPAP have been published.

Purpose:

(1) To characterize the clinical and behavioral responses of neonates on bubble nasal CPAP in a level III neonatal intensive care unit following routine oral and nasopharyngeal suctioning.

Methods:

This pilot study has a 1-sample within-subject repeated-measures design in which neonates (N = 16) served as their own control. Data on a neonate's physiological and behavior measures (heart rate, respiratory rate, oxygen saturation [Sao
2], and Premature Infant Pain Profile [PIPP] score) were collected before, during, and after the completion of suctioning sequence.

Finding/Results:

A total of 16 neonates with a mean gestational age of 29.76 weeks and an average day of life of 3.4 were enrolled. The infant's heart rates did not differ significantly (P = .51) across the suctioning sequence. There were no statistical significant changes in the average respiratory rate across the suctioning sequences (P = .79). Sao
2 demonstrated a drop between baseline and after each suctioning (P < .001). The PIPP score demonstrated a precipitous increase throughout the procedure (P < .001). On average, it took 9.5 seconds (SD = 4.9) to complete the suctioning sequences.

Implications for Practice:

Our results suggest that the guideline tested is safe and tolerated by infants.

Implications for Research:

This guideline should be tested in a larger sample and with neonates on other nasal CPAP systems.
Environmental Infection Prevention
Authors: Grota Patti G. , Grant Patti S.
Published: November 2017

Although progress has been made in decreasing health care–associated infections (HAI) in intensive care unit (ICU) patients, there has been an increase in HAI caused by drug-resistant pathogens, particularly those that contaminate the environment such as methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, Pseudomonas spp, Acinetobacter spp, and Clostridium difficile. The ICU environment including sinks and medical equipment has been identified as being at risk for contamination and associated with cross-transmission of pathogens between the health care provider, the environment, and the patient. This article addresses the role of the ICU nurse as a team facilitator collaborating with environmental services, infection preventionists, and others to influence ICU design during preconstruction planning and unit environmental hygiene after construction to promote patient safety and prevent HAI associated with contaminated environments and equipment.
Tele-ICU and Patient Safety Considerations
Authors: Hassan Erkan
Published: November 2017

The tele-ICU is designed to leverage, not replace, the need for bedside clinical expertise in the diagnosis, treatment, and assessment of various critical illnesses. Tele-ICUs are primarily decentralized or centralized models with differing advantages and disadvantages. The centralized model has sufficiently powered published data to be associated with improved mortality and ICU length of stay in a cost-effective manner. Factors associated with improved clinical outcomes include improved compliance with best practices; providing off-hours implementation of the bedside physician's care plan; and identification of and rapid response to physiological instability (initial clinical review within 1 hour) and rapid response to alerts, alarms, or direct notification by bedside clinicians. With improved communication and frequent review of patients between the tele-ICU and the bedside clinicians, the bedside clinician can provide the care that only they can provide. Although technology continues to evolve at a rapid pace, technology alone will most likely not improve clinical outcomes. Technology will enable us to process real or near real-time data into complex and powerful predictive algorithms. However, the remote and bedside teams must work collaboratively to develop care processes to better monitor, prioritize, standardize, and expedite care to drive greater efficiencies and improve patient safety.
Informatics for the Modern Intensive Care Unit
Authors: Anderson Diana C. , Jackson Ashley A. , Halpern Neil A.
Published: November 2017

Advanced informatics systems can help improve health care delivery and the environment of care for critically ill patients. However, identifying, testing, and deploying advanced informatics systems can be quite challenging. These processes often require involvement from a collaborative group of health care professionals of varied disciplines with knowledge of the complexities related to designing the modern and “smart” intensive care unit (ICU). In this article, we explore the connectivity environment within the ICU, middleware technologies to address a host of patient care initiatives, and the core informatics concepts necessary for both the design and implementation of advanced informatics systems.
Relationship Between Pityriasis Lichenoides and Mycosis Fungoides: A Clinicopathological, Immunohistochemical, and Molecular Study
Authors: Zaaroura Hiba , Sahar Dvora , Bick Tova , Bergman Reuven
Published: November 2017

Background:

Several cases of pityriasis lichenoides (PL) have been reported to evolve into mycosis fungoides (MF).

Objective:

To elucidate clues to this progression.

Methods:

Fifty-eight patients with PL between 2000 and 2013 (follow-up: 3–16 years, average: 8.3).

Results:

A total of 3 (5.2%) of the 58 patients with PL developed MF after 3–11 years of prolonged clinical course. Papules and small plaques characterized PLs, and patches and larger plaques subsequent MFs. A total of 35 of 41 (85%) followed up non-MF associated patients with PL reported lasting complete remissions. Histopathologically, apoptotic keratinocytes disappeared mostly or completely in subsequent MFs. The presence of epidermotropism, folliculotropism, and epidermal lymphocytic nuclear atypia in PLs was not predictive of MF. CD8+ cells were the dominant intraepidermal lymphocytes in the 3 PLs but remained so in only 1 subsequent MF. CD7+ lymphocytes decreased substantially in 2 MFs, and lymphocytic nuclear atypia increased markedly in 1. T-cell receptor gene rearrangement studies demonstrated clonal populations in 1 of 2 studied PLs and in all 3 subsequent MFs.

Conclusions:

A few PLs may evolve into MF. Prolonged clinical course, appearance of patches and larger plaques, markedly increased lymphocytic nuclear atypia, marked diminution of apoptotic keratinocytes and CD7+ and CD8+ lymphocytes, and clonal T-cell receptor gene rearrangement may serve as clues.
Identifying the Factors Affecting Comfort and the Comfort Levels of Patients Hospitalized in the Coronary Care Unit
Authors: Nural Nesrin , Alkan Semiha
Published: November 2017

Comfort, a concept associated with the art of nursing, is important for reducing the negative impact of hospitalization in a coronary care unit (CCU). Providing nursing interventions that ensure patient comfort is important for patients to respond positively to treatment. To determine the factors affecting comfort and the comfort levels of patients hospitalized in the CCU. A descriptive study. The study was conducted between December 2015 and February 2016 in the CCU of a state hospital located in Trabzon, Turkey. The sample consisted of 119 patients who complied with the criteria of inclusion for the study. Data were collected using the “Patient Information Form” and a “General Comfort Questionnaire.” The mean patient comfort score was 3.22 ± 0.33, and we found significant relationships between comfort scores and age (r= −0.19;P= .03) and communication by nurses and physicians (P< .05). Regression analysis revealed that sufficient communication by physicians, education level, age, and having a companion were related to the comfort level (P< .05). Communication by nurses and physicians and having a companion could change the comfort levels of patients hospitalized in the CCU.
IMPACT OF ETIOLOGY ON THE OUTCOME OF PEDIATRIC RHEGMATOGENOUS RETINAL DETACHMENT
Authors: Huang Ying-Chen , Chu Yen-Chang , Wang Nan-Kai , Lai Chi-Chun , Chen Kuan-Jen , Hwang Yih-Shiou , Wu Wei-Chi
Published: November 2017

Purpose:

To evaluate the clinical features and surgical outcomes of rhegmatogenous retinal detachment in pediatric patients and to identify the independent effect of each etiology on the outcome.

Methods:

A review of patients younger than 18 years who underwent vitreoretinal surgery was conducted at Chang Gung Memorial Hospital, Taoyuan, between 2008 and 2013. Patients were classified according to etiology. Multivariate logistic regression analysis was performed to evaluate the association between outcomes and each etiologic factor.

Results:

A total of 86 cases (mean age: 12.9 ± 4.8 years; 76.7% male) were included. The mean follow-up was 46.3 ± 23.9 months. In 90.7% of patients, at least one etiology could be identified, including myopia (55.8%), congenital or developmental disease (39.5%), trauma (27.9%), and previous intraocular surgery (17.4%). Among the risk factors examined in this study, congenital or developmental disease had the worst functional outcomes (P = 0.006). Myopia was a good prognostic factor for a better retinal reattachment rate (P = 0.030). Myopic rhegmatogenous retinal detachment had the lowest probability of surgical failure (8.08%), and idiopathic rhegmatogenous retinal detachment had the lowest likelihood of postoperative visual decline (4.65%).

Conclusion:

Myopia and congenital or developmental disease are the leading etiologies of pediatric rhegmatogenous retinal detachment. Different etiologies are associated with distinctive outcomes, and congenital and developmental diseases are independent prognostic factors of a poor response.
AIR/FLUID-DROPPING TECHNIQUE FOR INTRACAPSULAR DISTILLED WATER APPLICATION
Authors: Zhang Qi , Huang Liuhui , Jin Haiying , Li Jing , Zhao Peiquan
Published: November 2017

Purpose:

We describe a simplified technique of intracapsular distilled water application for targeting lens epithelial cells using vitrectomy approach of fluid–air exchange and to evaluate the reliability and safety of this technique.

Methods:

Consecutive patients with cataract were randomly assigned to treatment group and control group. After the nucleus removal and cortical aspiration, the space of anterior chamber and capsular bag were maintained with continuous infusion of sterile air by using fluid–air exchange technique through side-port incision. Distilled water was dropped into the capsular bag using a specially designed syringe. A concave air–fluid surface (a physical phenomenon) insured the contact of distilled water with the inner surface of the capsule without overflowing from the bag. The distilled water remained in place for 3 minutes and was then removed by the syringe.

Results:

No intraoperative surgical complication was observed, and no damage to adjacent intraocular structures was observed during the postoperative follow-up. There was no statistical difference of corneal endothelial cell loss between the treatment group and the control group. Histological study confirmed damage to the lens epithelial cells from anterior capsular specimens treated by the technique.

Conclusion:

The simplified technique using vitrectomy approach is safe and specific for targeting lens epithelial cells without associated complications.
OPTICAL COHERENCE TOMOGRAPHY AND HISTOLOGY OF AGE-RELATED MACULAR DEGENERATION SUPPORT MITOCHONDRIA AS REFLECTIVITY SOURCES
Authors: Litts Katie M. , Zhang Yuhua , Freund K. Bailey , Curcio Christine A.
Published: November 2017

Purpose:

Widespread adoption of optical coherence tomography has revolutionized the diagnosis and management of retinal disease. If the cellular and subcellular sources of reflectivity in optical coherence tomography can be identified, the value of this technology will be advanced even further toward precision medicine, mechanistic thinking, and molecular discovery. Four hyperreflective outer retinal bands are created by the exquisite arrangement of photoreceptors, Müller cells, retinal pigment epithelium, and Bruch membrane. Because of massed effects of these axially compartmentalized and transversely aligned cells, reflectivity can be localized to the subcellular level. This review focuses on the second of the four bands, called ellipsoid zone in a consensus clinical lexicon, with the central thesis that mitochondria in photoreceptor inner segments are a major independent reflectivity source in this band, because of Mie scattering and waveguiding.

Methods:

We review the evolution of Band 2 nomenclature in published literature and discuss the origins of imaging signals from photoreceptor mitochondria that could make these organelles visible in vivo.

Results:

Our recent data pertain to outer retinal tubulation, a unique neurodegenerative and gliotic structure with a highly reflective border, prominent in late age-related macular degeneration. High-resolution histology and multimodal imaging of outer retinal tubulation together provide evidence that inner segment mitochondria undergoing fission and translocation toward the nucleus provide the reflectivity signal.

Conclusion:

Our data support adoption of the ellipsoid zone nomenclature. Identifying subcellular signal sources will newly inform clinical.
COMBINING EXTERNAL NEEDLE DRAINAGE AND SCLERAL BUCKLING WITH VITRECTOMY FOR THE REPAIR OF BULLOUS RETINAL DETACHMENTS
Authors: Chen Judy J. , Kalevar Ananda , Jumper James Michael
Published: November 2017

Purpose:

To describe a technique of combined scleral buckle with external needle drainage and vitrectomy in the treatment of bullous exudative retinal detachment, schisis detachment, or bullous retinoschisis threatening the fovea.

Methods:

A retrospective chart review of four eyes of four patients who underwent the procedure described.

Results:

Four eyes of four patients who underwent combined scleral buckling with external needle drainage and vitrectomy by a single surgeon for a bullous exudative retinal detachment, schisis detachment, or bullous retinoschisis threatening the fovea were included in this series. All four patients were attached after a single surgical intervention. No patient developed complications from the external drainage.

Conclusion:

External needle drainage of bullous subretinal or intraschisis fluid in combination with vitrectomy is a successful technique for treating bullous exudative retinal detachments, schisis detachment, or foveal-threatening retinoschisis. The technique avoids many complications associated with conventional drainage procedures. Long-term results seem promising because of extended follow-up demonstrating sustained anatomical success with a single intervention.
CELLULAR IMAGING OF THE TAPETAL-LIKE REFLEX IN CARRIERS OF RPGR-ASSOCIATED RETINOPATHY
Authors: Kalitzeos Angelos , Samra Ranjit , Kasilian Melissa , Tee James J. L. , Strampe Margaret , Langlo Christopher , Webster Andrew R. , Dubra Alfredo , Carroll Joseph , Michaelides Michel
Published: November 2017

Purpose:

To examine the features of the tapetal-like reflex (TLR) in female carriers of RPGR-associated retinopathy by means of adaptive optics scanning light ophthalmoscopy (AOSLO) and spectral domain optical coherence tomography.

Methods:

Nine molecularly confirmed RPGR carriers and three healthy controls underwent ocular examination and the following retinal imaging modalities: color photography, near-infrared reflectance, fundus autofluorescence, spectral domain optical coherence tomography, and AOSLO. After identifying TLR areas across all imaging modalities, normalized local contrast of outer retinal bands on spectral domain optical coherence tomography was calculated and AOSLO-acquired photoreceptor mosaic analysis was performed.

Results:

Seven carriers had TLR areas, which colocalized with increased rod photoreceptor reflectivity on confocal AOSLO and reduced cone photoreceptor densities. Parafoveal TLR areas also exhibited reduced local contrast (i.e., increased reflectivity) of the outer retinal bands on spectral domain optical coherence tomography (inner segment ellipsoid zone and outer segment interdigitation zone). Healthy controls did not show TLR.

Conclusion:

The cellular resolution provided by AOSLO affords the characterization of the photoreceptor mosaic in RPGR carriers with a TLR. Features revealed include reduced cone density, increased cone inner segment diameter, and increased rod outer segment reflectivity.
PERIVASCULAR GRANULOMATA IN THE RETINA DEMONSTRATED BY EN FACE OPTICAL COHERENCE TOMOGRAPHY IN A PATIENT WITH BLAU SYNDROME
Authors: Friesen Erika T. , Phasukkijwatana Nopasak , Tsui Irena , Berkenstock Meghan K. , Holland Gary N. , Sarraf David
Published: November 2017

Purpose:

To describe the multimodal retinal imaging findings of a case of Blau syndrome.

Methods:

Case report. The multimodal retinal imaging findings, including widefield angiography, cross-sectional and en face spectral domain optical coherence tomography, and optical coherence tomography angiography, of a case of Blau syndrome are described.

Results:

A 12-year-old Hispanic girl with polyarticular arthritis, skin rash, and panuveitis was diagnosed with a rare condition referred to as Blau syndrome. Genetic testing identified an NOD2 mutation. Cross-sectional and en face optical coherence tomography illustrated presumed perivascular granulomata in the middle retina. Optical coherence tomography angiography failed to display flow within these lesions.

Conclusion:

This report illustrates the presence of a remarkable distribution of perivascular, presumably granulomatous, retinal lesions in the middle retina. Similar perivascular granulomata have been noted in the histopathological analysis of ocular sarcoidosis.
Assessing Early Intervention Provider Needs
Authors: Spence Christine M. , Connor Susan M. , Burke Ted , Cheema Jehanzeb R. , Ostrosky Michaelene M.
Published: November 2017

A statewide needs assessment was conducted with early interventionists to gather information on perceived professional development (PD) needs. Across 3 years, 4,455 early interventionists responded to an online survey. Data were analyzed for reported needs on PD topics in seven broad areas related to early intervention processes and content. Differences were found on the basis of participants' geographical location, years of experience working in early intervention, and professional discipline. Results revealed that respondents in one geographical location of the state, and respondents with fewer years of early intervention experience, reported statistically significant higher PD needs for six of the seven topical areas. Implications for future needs assessments, PD, and research are discussed.
Antipsychotic Polypharmacy and Its Relation to Metabolic Syndrome in Patients With Schizophrenia
Authors: Aly El-Gabry Dina M. , Abdel Aziz Karim , Okasha Tarek , Azzam Hanan , Okasha Ahmed
Published: November 2017

Purpose/Background

Few studies have examined the relationship between antipsychotic polypharmacy and metabolic syndrome in schizophrenia. Some studies suggest that antipsychotic polypharmacy may be associated with greater metabolic risk, whereas other studies suggest that this is uncertain. To date, there have been no studies in Egypt or the Arab world that have investigated this relationship. We sought to compare subjects with schizophrenia receiving antipsychotic polypharmacy and monotherapy as regards metabolic outcomes and to investigate medication-related factors associated with metabolic syndrome.

Methods/Procedures

We recruited 118 subjects with schizophrenia and compared between those receiving antipsychotic polypharmacy (86 subjects) and monotherapy (32 subjects) as regards demographic, clinical, metabolic, and antipsychotic medication characteristics. We examined the effect of antipsychotic-related factors an outcome of metabolic syndrome.

Findings/Results

The prevalence of metabolic syndrome in our sample was 38.1%. Except for gender, there was no statistically significant difference as regards demographic and clinical characteristics, rates of metabolic syndrome, or for individual metabolic parameters. We found a statistically significant difference (P < 0.05) between the 2 groups as regards the number, dose, and duration of intake and for the number of subjects receiving typical antipsychotics (oral and depot) and a number of individual antipsychotic medications. Using logistic regression, receiving haloperidol depot was the only antipsychotic-related factor predictive for metabolic syndrome.

Implications/Conclusions

The prevalence of metabolic syndrome does not differ in schizophrenia whether patients are receiving polypharmacy and monotherapy nor do they differ for individual metabolic parameters. Most antipsychotic-related characteristics did not predict for metabolic syndrome.
Health Burden and Socioeconomic Disparities From Hearing Loss: A Global Perspective
Authors: Ramsey Tam , Svider Peter F. , Folbe Adam J.
Published: November 2017

Objectives/Hypothesis:

To characterize the disability-related health burden of hearing loss (HL) at a global level, with a focus on socioeconomic health disparities.

Methods:

The global burden of HL, as calculated by disability-adjusted life years (DALYs) per 100,000 individuals, was evaluated for 184 countries. Data from 5-year intervals encompassing 1990 to 2015 were organized by human development index (HDI) categorizations as specified by the U.N. Development Program (UNDP). Gini coefficients and concentration indices were used to evaluate global inequality in HL burden over this time period.

Results:

There was a global lack of improvement in hearing loss burden over 25 years. National HL burden, as measured by age-standardized DALYs, had an inverse relationship with successive level of development (p < 0.0001). Global inequalities in HL burden as measured by the concentration index decreased from 1990 to 2005, remained stable between 2005 and 2010, and slightly increased from 2010 to 2015. Central Sub-Saharan Africa, followed by Eastern Sub-Saharan Africa and South Asia, had the greatest rates of disease burden in 2015.

Conclusions:

To our knowledge, this analysis is the first to investigate socioeconomic-related inequalities in hearing loss burden using statistical tools such as the Gini coefficient and concentration index. Although inequalities have largely decreased in recent decades, the global burden of hearing loss remains high and there are recent signs of increased inequality. These data suggest that a greater distribution of hearing care resources may need to be directed towards developing countries to combat global hearing loss burden.

Level of Evidence: III
Cochlear Implantation in a Patient With Sickle Cell Disease With Early Cochlear Sclerosis
Authors: Kim Seon Jeong , Taheri Muhammad Reza , Merkison Marquitta , Monfared Ashkan
Published: November 2017

Objective:

We report a case of bilateral sudden sensorineural hearing loss (SNHL) and early cochlear sclerosis in a patient with sickle cell disease.

Methods:

A 19-year-old female presented with sequential bilateral sudden SNHL and early cochlear sclerosis. Cochlear implantation was performed.

Results:

Early cochlear fibrosis in the hook region and basal turn was encountered within a few months of deafness. Implantation required serial dilation using various insertion guides. Postsurgical telemetry readings revealed 19 electrodes (7 paired basal electrodes, 5 single apical electrodes) in a good working order with low impedances in bilateral ears. Activation of the processors successfully provided access to the speech frequency range in both the ears.

Conclusion:

This is the first case of intraoperative documentation of rapid cochlear sclerosis in a patient with SNHL caused by sickle cell disease. Early cochlear implantation should be considered in these patients, and otolaryngologists should be aware of the possibility of rapid cochlear sclerosis without ossification in these patients.
Liberal Right Ventricular Assist Device Extracorporeal Membrane Oxygenation Support for Right Ventricular Failure after Implantable Left Ventricular Assist Device Placement
Authors: Fischer Quentin , Kirsch Matthias
Published: November 2017

Refractory right ventricular failure (RVF) after implantation of left ventricular assist device (LVAD) is a dramatic complication. The addition of right ventricular assist device (RVAD) may improve RV recovery and lead to improve outcomes. From February 2012 to September 2014, 44 patients received a HeartMate II. These patients were retrospectively compared in two groups according to early liberal implantation of an extracorporeal membrane oxygenation (ECMO) used as a RVAD established between a femoral vein and the pulmonary artery. Of the 44 patients, 22 required addition of a temporary RVAD (t-RVAD group). Patients are sicker in the t-RVAD group with significantly higher rate of preoperative extracorporeal life support (46% vs. 9%; p = 0.016) or any mechanical circulatory support (55% vs. 14%; p = 0.01), more preoperative hemofiltration (23% vs. 0%; p = 0.048), and more inotrope support by dobutamine (68.2% vs. 27.3%; p = 0.015). Likewise Michigan risk score was significantly higher in t-RVAD group (2.61 ± 2.2 vs. 1.0 ± 1.6 pts; p = 0.013) and INTERMACS clinical profile (2.1 ± 0.6 vs. 3.4 ± 1.3 pts; p = 0.0001). Despite severity of preimplant conditions in t-RVAD group, clinical outcomes did not differ in both groups with similar survival rate at 6 months (60.4 ± 12 vs. 71.4 ± 9.9%; p = 0.585). Early and liberal use of temporary RVAD in patients with risk factors of RVF could improve the prognostic after LVAD implantation.
Celiac Disease by the Age of 13 Years Is Not Associated With Probiotics Administration in Infancy
Authors: Savilahti Emma Merike , Ilonen Jorma , Kukkonen Anna Kaarina , Savilahti Erkki , Kuitunen Mikael
Published: November 2017

Probiotics are theoretically promising in primary prevention of celiac disease (CD), but research evidence on the topic is scarce. We used the data and material of a clinical double‐blind randomized placebo‐controlled trial on primary allergy prevention (n = 1223) to investigate in an exploratory study whether administration of a mix of pro‐ and prebiotics during late pregnancy and first 6 months of life was associated with prevalence of CD during 13‐year follow‐up. Children who fulfilled diagnostic criteria for CD (n = 11) and subjects with a serum sample available for analyzing CD antibodies (n = 867) were included. CD or elevated tissue transglutaminase IgA antibodies were not associated with probiotics or placebo. Nor were there any associations with the mode of delivery, the duration of exclusive or total breast‐feeding, or respiratory infections during the first 2 years of life. Allergic diseases or sensitization by the age of 2 or 5 years were not clearly associated with the development of CD.
An Autopsy Case of Sudden Death in Neurofibromatosis Type 1 With Pheochromocytoma and Myocarditis
Authors: Takamiya Masataka , Niitsu Hisae , Saigusa Kiyoshi
Published: November 2017

An autopsy case of sudden death in a 33-year-old man with neurofibromatosis type 1 (von Recklinghausen disease), pheochromocytoma, and myocarditis is reported. The decedent was found in his bedroom in cardiopulmonary arrest. Polypoid, elastic dermal papules on the neck, chest, abdomen, and back, and flat dark-brown macules on the chest and abdomen were observed. Flat, ovoid, dark-brown freckles were present in both axillae. Examination of the right adrenal gland revealed a tumor measuring 5 cm × 5 cm × 3 cm. Microscopic examination of the myocardium revealed moderate neutrophilic and lymphocytic infiltrates. In the right adrenal gland, tumor cells contained abundant granular eosinophilic cytoplasm and exhibited cell-nesting with an alveolar pattern (Zellballen). Polygonal cells were seen together with rich vascular networks. Immunohistochemical analyses showed cells diffusely positive for chromogranin A and dopamine β-hydroxylase. Furthermore, blood from the right heart and the right common iliac vein contained high concentrations of serum epinephrine, norepinephrine, and dopamine. Death was attributed to adrenal crisis: circulatory failure caused by excessive catecholamines produced by the pheochromocytoma. In addition, myocarditis, which had been induced chronically by catecholamines, would have also contributed adversely to the clinical course. Pheochromocytoma and myocarditis should be considered when sudden death occurs in the setting of neurofibromatosis type 1.
Does Specialty Training and Practice Setting Affect Adherence to the Pediatric Emergency Care Applied Research Network Criteria for Pediatric Head Trauma?
Authors: Tama Maria , Andharia Neel , Bufano Collin , Greenstein Josh , Khodorkovsky Boris
Published: November 2017

Objective

The goal was to determine the effects of specialty training and practice settings on the adherence to the Pediatric Emergency Care Applied Research Network (PECARN) criteria.

Methods

A retrospective study was conducted on a 2-campus hospital. Chart documentation was used to determine adherence to PECARN criteria. Inclusion criteria were any traumatic head injury within 24 hours in patients younger than 18 years over a 1-year period. Specialty training was subdivided into 3 groups: pediatric emergency medicine, emergency medicine (EM), and general pediatrics. The 2 hospital campuses are distinctly different practice settings, one being an academic practice setting, which is also a trauma center that has a dedicated pediatric emergency department, staffed by pediatric emergency medicine, EM, and general pediatrics physicians, and the second campus is a community practice and is staffed solely by EM physicians. Statistical analysis was performed using χ2 and Cochran-Mantel-Haenszel tests. All analyses were 2-sided, and P < 0.05 was considered statistically significant.

Results

A total of 709 pediatric patients with traumatic head injuries were analyzed. Overall adherence to PECARN criteria was 93%. No statistical difference was found between different specialty training on the academic campus. In addition, the rate of adherence among EM physicians at the academic and community settings was 94.8% versus 86.5%, respectively (P = 0.004).

Conclusions

Practice setting had an effect on adherence to PECARN criteria in pediatric patients with acute traumatic head injury. The same determination on adherence was not demonstrated among physicians with different specialty trainings.