bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhanced thermoelectric properties of n-type NbCoSn half-Heusler by improving phase purity
Authors: He Ran , Huang Lihong , Wang Yumei , Samsonidze Georgy , Kozinsky Boris , Zhang Qinyong , Ren Zhifeng
Published: June 2016

Here we report the thermoelectric properties of NbCoSn-based n-type half-Heuslers (HHs) that were obtained through arc melting, ball milling, and hot pressing process. With 10% Sb substitution at the Sn site, we obtained enhanced n-type properties with a maximum power factor reaching ∼35 μW cm−1 K−2 and figure of merit (ZT) value ∼0.6 in NbCoSn0.9Sb0.1. The ZT is doubled compared to the previous report. In addition, the specific power cost ($ W−1) is decreased by ∼68% comparing to HfNiSn-based n-type HH because of the elimination of Hf.
Solar hydrogen production via erbium oxide based thermochemical water splitting cycle
Authors: Bhosale Rahul R. , Sutar Parag , Kumar Anand , AlMomani Fares , Ali Moustafa Hussein , Ghosh Ujjal , AlMuhtaseb Shaheen , Khraisheh Majeda
Published: June 2016

The erbium oxide based water splitting (Eb-WS) cycle was thermodynamically studied by using the HSC Chemistry software and databases. The first step of the Eb-WS cycle involves thermal reduction of Er2O3, whereas the second step corresponds to the production of H2 via water splitting reaction. Equilibrium compositions associated with the thermal reduction and water splitting steps were determined by performing HSC simulations. Influence of partial pressure of oxygen (PO2) in the inert purge gas on thermal reduction temperature (TH) and equilibrium compositions associated with the solar thermal dissociation of Er2O3 was identified. Furthermore, energy and exergy analysis of the Eb-WS cycle was carried out to estimate the cycle (ηcycle) and solar-to-fuel conversion efficiency (ηsolar−to−fuel). Simulation results indicate that the ηcycle and ηsolar−to−fuel of Eb-WS cycle increase with the decrease in TH. Also, the ηcycle and ηsolar−to−fuel can be increased further via the recuperation of the heat released by the water splitting reactor and the quench unit. The ηsolar−to−fuel of Eb-WS cycle was observed to be equivalent to that of ceria cycle.
Corrigendum to: Approaches to management of complaints and notifications about health practitioners in Australia
Authors: Satchell Claudette S. , Walton Merrilyn , Kelly Patrick J. , Chiarella Elizabeth M. , Pierce Suzanne M. , Nagy Marie T. , Bennett Belinda , Carney Terry
Published: June 2016

In 2005, the Australian Productivity Commission made a recommendation that a national health registration regimen and a consolidated national accreditation regimen be established. On 1 July 2010, the National Registration and Accreditation Scheme (NRAS) for health practitioners came into effect and the Australian Health Practitioner Regulation Agency (AHPRA) became the single national oversight agency for health professional regulation. It is governed by the Health Practitioner Regulation National Law Act (the National Law). While all states and territories joined NRAS for registration and accreditation, NSW did not join the scheme for the handling of complaints, but retained its existing co-regulatory complaint-handling system. All other states and territories joined the national notification (complaints) scheme prescribed in the National Law. Because the introduction of NRAS brings with it new processes and governance around the management of complaints that apply to all regulated health professionals in all states and territories except NSW, where complaints management remains largely unchanged, there is a need for comparative analysis of these differing national and NSW approaches to the management of complaints/notifications about health professionals, not only to allow transparency for consumers, but also to assess consistency of decision making around complaints/notifications across jurisdictions. This paper describes the similarities and differences for complaints/notifications handling between the NRAS and NSW schemes and briefly discusses subsequent and potential changes in other jurisdictions.
Effects of plant growth stage and leaf aging on the response of transpiration and photosynthesis to water deficit in sunflower
Authors: Andrianasolo Fety Nambinina , Casadebaig Pierre , Langlade Nicolas , Debaeke Philippe , Maury Pierre
Published: June 2016

Water deficit influences leaf transpiration rate and photosynthetic activity. The genotype-dependent response of the latter has not been assessed in sunflower (Helianthus annuus L.), particularly during the reproductive period when grain filling and lipogenesis depend greatly on photosynthate availability. To evaluate genotypic responses to water deficit before and after flowering, two greenhouse experiments were performed. Four genotypes − two inbred lines (PSC8, XRQ) and two cultivars (Inedi, Melody) − were subjected to progressive water deficit. Non-linear regression was used to calculate the soil water deficit threshold (FTSWt) at which processes (transpiration and photosynthetic activity) were affected by water deficit. In the vegetative growth stage, photosynthetic activity was affected at a lower mean value of FTSWt (0.39) than transpiration (0.55). However, in the reproductive stage, photosynthetic activity was more sensitive to soil water deficit (FTSWt = 0.45). We found a significant (P = 0.02) effect of plant growth stage on the difference between photosynthesis and transpiration rate thresholds and, a significant (P = 0.03) effect of leaf age on transpiration. Such results will improve phenotyping methods and provide paths for integrating genotypic variability into crop models.
How well are health information websites displayed on mobile phones? Implications for the readability of health information
Authors: Cheng Christina , Dunn Matthew
Published: June 2016

Issue addressed

More than 87% of Australians own a mobile phone with Internet access and 82% of phone owners use their smartphones to search for health information, indicating that mobile phones may be a powerful tool for building health literacy. Yet, online health information has been found to be above the reading ability of the general population. As reading on a smaller screen may further complicate the readability of information, this study aimed to examine how health information is displayed on mobile phones and its implications for readability.

Methods

Using a cross‐sectional design with convenience sampling, a sample of 270 mobile webpages with information on 12 common health conditions was generated for analysis, they were categorised based on design and position of information display.

Results

The results showed that 71.48% of webpages were mobile‐friendly but only 15.93% were mobile‐friendly webpages designed in a way to optimise readability, with a paging format and queried information displayed for immediate viewing.

Conclusion

With inadequate evidence and lack of consensus on how webpage design can best promote reading and comprehension, it is difficult to draw a conclusion on the effect of current mobile health information presentation on readability.

So what?

Building mobile‐responsive websites should be a priority for health information providers and policy‐makers. Research efforts are urgently required to identify how best to enhance readability of mobile health information and fully capture the capabilities of mobile phones as a useful device to increase health literacy.
Prevalence and risk factors of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and other sexually transmissible infections among women attending antenatal clinics in three provinces in Papua New Guinea: a cross-sectional survey
Authors: Vallely Lisa M. , Toliman Pamela , Ryan Claire , Rai Glennis , Wapling Johanna , Tomado Carolyn , Huliafi Savarina , Munnull Gloria , Rarau Patricia , Phuanukoonnon Suparat , Wand Handan , Siba Peter , Mola Glen D. L. , Kaldor John M. , Vallely Andrew J.
Published: June 2016

Background
Papua New Guinea (PNG) is estimated to have among the highest prevalences of HIV and sexually transmissible infections (STIs) of any Asia-Pacific country, and one of the highest burdens of maternal syphilis globally. The prevalence of curable STIs, such as Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV), among pregnant women in PNG is relatively unknown. Methods: A cross-sectional bio-behavioural survey to investigate the epidemiology of CT, NG, TV and other STIs among pregnant women in three provinces of PNG was undertaken. Women aged 18–35 years attending their first antenatal clinic visit were invited to participate. Participants completed a short interview and provided self-collected vaginal specimens for CT, NG and TV laboratory-based nucleic acid amplification tests and a venepuncture specimen for laboratory testing for syphilis and Herpes simplex virus type-2 (HSV-2) serology. Routine antenatal assessment was conducted according to national guidelines, including HIV counselling and testing and point-of-care syphilis screening. Results: A total of 765 women were enrolled. Overall, 43% (95% confidence interval (CI): 39.2–46.4) had one or more of CT, NG or TV infection. CT was the most prevalent STI (22.9%, 175/765; 95% CI: 19.9–25.9), followed by TV (22.4%, 171/765; 95% CI: 19.4–25.4), and NG (14.2%, 109/765; 95% CI: 11.7–16.7). The prevalence of active syphilis was 2.2% (17/765; 95% CI: 1.2–3.3), HSV-2 was 28.0% (214/765; 95% CI: 24.8–31.2) and HIV, 0.8% (6/765; 95% CI: 0.2–1.4). Prevalences were highest among primigravid women, women aged <25 years, and among those in Central Province. Conclusion: High prevalences of curable genital STIs were observed among women attending routine antenatal clinic services in PNG. These infections have been associated with adverse pregnancy outcomes and could be important contributors to poor maternal and neonatal health in this setting.
The Definition and Diagnosis of Developmental Prosopagnosia
Authors: Bate Sarah , Tree Jeremy J.
Published: June 2016

Over the last 20 years much attention in the field of face recognition has been directed towards the study of developmental prosopagnosia (DP), with some authors investigating the behavioural characteristics of the condition, and many others using these individuals to further our theoretical understanding of the typical face-processing system. It is broadly agreed that the term “DP” refers to people who have failed to develop the ability to recognize faces in the absence of neurological illness or injury, yet more precise terminology in relation to potential subtypes of the population are yet to be confirmed. Furthermore, specific diagnostic techniques and inclusion and exclusion criteria have yet to be uniformly accepted across the field, making cross-paper comparisons and meta-analyses very difficult. This paper presents an overview of the current challenges that face research into DP and introduces a series of papers that attempt to further our understanding of the condition's characteristics. It is hoped that this special issue will provide a springboard for further research addressing these issues, improving the current state of the art by ensuring the quality of theoretical investigations into DP, and by posing advances that will assist those who have the condition.
Interaction in planning vocalizations and grasping
Authors: Tiainen Mikko , Tiippana Kaisa , Vainio Martti , Komeilipoor Naeem , Vainio Lari
Published: June 2016

Previous studies have shown a congruency effect between manual grasping and syllable articulation. For instance, a power grip is associated with syllables whose articulation involves the tongue body and/or large mouth aperture ([kɑ]) whereas a precision grip is associated with articulations that involve the tongue tip and/or small mouth aperture ([ti]). Previously, this effect has been observed in manual reaction times. The primary aim of the current study was to investigate whether this congruency effect also takes place in vocal responses and to investigate involvement of action selection processes in the effect. The congruency effect was found in vocal and manual responses regardless of whether or not the syllable or grip was known a priori, suggesting that the effect operates with minimal or absent action selection processes. In addition, the effect was observed in vocal responses even when the grip was only prepared but not performed, suggesting that merely planning a grip response primes the corresponding articulatory response. These results support the view that articulation and grasping are processed in a partially overlapping network.
Event-related potentials reveal the development of stable face representations from natural variability
Authors: Andrews Sally , Burton A. Mike , Schweinberger Stefan R. , Wiese Holger
Published: June 2016

Natural variability between instances of unfamiliar faces can make it difficult to reconcile two images as the same person. Yet for familiar faces, effortless recognition occurs even with considerable variability between images. To explore how stable face representations develop, we employed incidental learning in the form of a face sorting task. In each trial, multiple images of two facial identities were sorted into two corresponding piles. Following the sort, participants showed evidence of having learnt the faces performing more accurately on a matching task with seen than with unseen identities. Furthermore, ventral temporal event-related potentials were more negative in the N250 time range for previously seen than for previously unseen identities. These effects appear to demonstrate some degree of abstraction, rather than simple picture learning, as the neurophysiological and behavioural effects were observed with novel images of the previously seen identities. The results provide evidence of the development of facial representations, allowing a window onto natural mechanisms of face learning.
Deformation of tropical Hirzebruch surfaces and enumerative geometry
Authors: Brugallé Erwan , Markwig Hannah
Published: June 2016

We illustrate the use of tropical methods by generalizing a formula due to Abramovich and Bertram, extended later by Vakil. Namely, we exhibit relations between enumerative invariants of the Hirzebruch surfaces

Σ
n

\Sigma _n

and

Σ

n
+
2

\Sigma _{n+2}

, obtained by deforming the first surface to the latter.

Our strategy involves a tropical counterpart of deformations of Hirzebruch surfaces and tropical enumerative geometry on a tropical surface in three-space.
Grainyhead-like 2 inhibits the coactivator p300, suppressing tubulogenesis and the epithelial–mesenchymal transition
Authors: Pifer Phillip M. , Farris Joshua C. , Thomas Alyssa L. , Stoilov Peter , Denvir James , Smith David M. , Frisch Steven M.
Published: June 2016

Developmental morphogenesis and tumor progression require a transient or stable breakdown of epithelial junctional complexes to permit programmed migration, invasion, and anoikis resistance, characteristics endowed by the epithelial–mesenchymal transition (EMT). The epithelial master-regulatory transcription factor Grainyhead-like 2 (GRHL2) suppresses and reverses EMT, causing a mesenchymal–epithelial transition to the default epithelial phenotype. Here we investigated the role of GRHL2 in tubulogenesis of Madin–Darby canine kidney cells, a process requiring transient, partial EMT. GRHL2 was required for cystogenesis, but it suppressed tubulogenesis in response to hepatocyte growth factor. Surprisingly, GRHL2 suppressed this process by inhibiting the histone acetyltransferase coactivator p300, preventing the induction of matrix metalloproteases and other p300-dependent genes required for tubulogenesis. A 13–amino acid region of GRHL2 was necessary for inhibition of p300, suppression of tubulogenesis, and interference with EMT. The results demonstrate that p300 is required for partial or complete EMT occurring in tubulogenesis or tumor progression and that GRHL2 suppresses EMT in both contexts through inhibition of p300.
The relationship between variable and polarized optical spectral components of luminous type 1 non-blazar quasars
Authors: Kokubo Mitsuru
Published: June 2016

Optical spectropolarimetry by Kishimoto et al. (2004, MNRAS, 354, 1065) has shown that several luminous type 1 quasars show a strong decrease of the polarized continuum flux in the rest-frame near-ultraviolet (UV) wavelengths of λ < 4000 Å. In the literature, this spectral feature is interpreted as evidence of the broadened hydrogen Balmer absorption edge imprinted on the accretion disk thermal emission due to the disk atmospheric opacity effect. On the other hand, quasar flux variability studies have shown that the variable continuum component in UV–optical spectra of quasars, which is considered to be a good indicator of the intrinsic spectral shape of the accretion disk emission, generally has a significantly flat spectral shape throughout the near-UV to optical spectral range. To examine whether the disk continuum spectral shapes revealed as the polarized flux and as the variable component spectra are consistent with each other, we carry out multi-band photometric monitoring observations for a sample of four polarization-decreasing quasars of Kishimoto et al.'s (4C 09.72, 3C 323.1, Ton 202, and B2 1208+32) to derive the variable component spectra and compare the spectral shape of them with that of the polarized flux spectra. Contrary to expectation, we confirm that the two spectral components of these quasars have totally different spectral shapes, in that the variable component spectra are significantly bluer compared to the polarized flux spectra. This discrepancy between two spectral shapes may imply either (1) the decrease of polarization degree in the rest-frame UV wavelengths is not indicating the Balmer absorption edge feature but is induced by some unknown (de)polarization mechanisms, or (2) the UV–optical flux variability is occurring preferentially at the hot inner radii of the accretion disk and thus the variable component spectra do not reflect the whole accretion disk emission.
Professional Identity Formation and the Clinician–Scientist: A Paradigm for a Clinical Career Combining Two Distinct Disciplines
Authors: Rosenblum Norman D. , Kluijtmans Manon , ten Cate Olle
Published: June 2016

The clinician–scientist role is critical to the future of health care, and in 2010, the Carnegie Report on Educating Physicians focused attention on the professional identity of practicing clinicians. Although limited in number, published studies on the topic suggest that professional identity is likely a critical factor that determines career sustainability. In contrast to clinicians with a singular focus on clinical practice, clinician–scientists combine two major disciplines, clinical medicine and scientific research, to bridge discovery and clinical care. Despite its importance to advancing medical practice, the clinician–scientist career faced a variety of threats, which have been identified recently by the 2014 National Institutes of Health Physician Scientist Workforce. Yet, professional identity development in this career pathway is poorly understood. This Perspective focuses on the challenges to the clinician–scientist’s professional identity and its development. First, the authors identify the particular challenges that arise from the different cultures of clinical care and science and the implications for clinician–scientist professional identity formation. Next, the authors synthesize insights about professional identity development within a dual-discipline career and apply their analysis to a discussion about the implications for clinician–scientist identity formation. Although not purposely developed to address identity formation, the authors highlight those elements within clinician–scientist training and career development programs that may implicitly support identity development. Finally, the authors highlight a need to identify empirically the elements that compose and determine clinician–scientist professional identity and the processes that shape its formation and sustainability.
Do 25-Hydroxyvitamin D Levels Correlate With Fracture Complications?
Authors: Bodendorfer Blake M. , Cook James L. , Robertson Daniel S. , Della Rocca Gregory J. , Volgas David A. , Stannard James P. , Crist Brett D.
Published: June 2016

Objectives:

To determine the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and the likelihood of postoperative complications and fracture reoperation rate in orthopaedic trauma patients receiving vitamin D and calcium supplementation.

Design:

Retrospective case series.

Setting:

Level I trauma center, Midwestern United States.

Patients:

All orthopaedic trauma patients—18 years or older—over a 20-month period were included with available initial and repeat 25(OH)D serum levels. In total, 201 patients met inclusion criteria.

Intervention:

All patients received 1000 IU of vitamin D3 and 1500 mg of calcium daily. Vitamin D deficient and insufficient patients also received 50,000 IU of ergocalciferol (vitamin D2) weekly until 25(OH)D levels normalized or fractures healed.

Main Outcome Measurements:

fracture complications and 25(OH)D levels.

Results:

Fifteen patients experienced postoperative healing complications. There was no significant difference between initial (P = 0.92) or repeat (P = 0.91) 25(OH)D levels between patients with and without fracture healing complications. Twenty-eight patients required repeat orthopaedic surgery. There was no significant difference between initial (P = 0.62) or repeat (P = 0.18) 25(OH)D levels between patients who did or did not require repeat orthopaedic surgery. There was no significant difference between initial (P = 0.66) or repeat (P = 0.89) 25(OH)D levels between patients who did or did not require nonorthopaedic surgery.

Conclusions:

Serum 25(OH)D levels did not significantly affect the likelihood of fracture healing complications requiring surgery or any nonorthopaedic injury-related surgery.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Internally Randomized Control Trial of Radiation Exposure Using Ultra-low Radiation Imaging Versus Traditional C-arm Fluoroscopy for Patients Undergoing Single-level Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Wang Timothy Y. , Farber S. Harrison , Perkins Scott S. , Back Adam G. , Byrd Sarah A. , Chi Debbie , Vincent David , Karikari Isaac O.
Published: June 2016

Study Design.

Randomized controlled trial.

Objective.

To compare radiation exposure between ultra-low radiation imaging (ULRI) with image enhancement and standard-dose fluoroscopy for patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Summary of Background Data.

Although the benefits of MIS are lauded by many, there is a significant amount of radiation exposure to surgeon and operating room personnel. Our goal with this work was to see if by using ultra-low dose radiation settings coupled with image enhancement, this exposure could be minimized.

Methods.

An institutional review board approved, prospective, internally randomized controlled trial was performed comparing ultra-low dose settings coupled with image enhancement software to conventional fluoroscopic imaging. In this study, each patient served as their own control, randomly assigning one side of MIS-TLIF for cannulation and K-wire placement using each imaging modality. Further, the case was also randomly divided into screw placement and cage placement/final images to allow further comparisons amongst patients. Radiation production from the C-arm fluoroscope and radiation exposure to all operating room personnel were recorded.

Results.

Twenty-four patients were randomly assigned to undergo a single level MIS-TLIF. In no case was low radiation imaging abandoned, and no patient had a neurologic decline or required hardware repositioning. Everyone in the operating room—the physician, scrub nurse, circulator, and anesthesiologist—all benefited with 61.6% to 83.5% reduction in radiation exposure during cannulation and K-wire placement to screw insertion aided by ULRI. In every case but the anesthesiologist dose, this was statistically significant (P < 0.05). This benefit required no additional time (P = 0.78 for K-wire placement).

Conclusion.

ULRI, when aided by image enhancement software, affords the ability for all parties in the operating room to substantially decrease their radiation exposure compared with standard-dose C-arm fluoroscopy without adding additional time or an increased complication rate.

Level of Evidence: 2
Cardiac Transplant Postoperative Management and Care
Authors: Freeman Regi , Koerner Erika , Clark Courtney , Halabicky Kathy
Published: June 2016

Heart failure impacts a multitude of individuals each year. Treatment is based on the progression of the disease and severity of symptoms. Cardiac transplant is the gold standard treatment of advanced heart failure, although the availability of organs limits the number of transplants received each year. Postoperative care and monitoring for cardiac transplant is complex and requires specialized nurses and providers at transplant centers for successful outcomes. This article outlines cardiac transplant from preoperative care through transplant, as well as posttransplant monitoring and care including discharge. Special attention is focused on management in the intensive care unit setting and potential complications that can occur in the immediate postoperative period. Interventions for potential complications are also highlighted.
Looking Outside
Authors: Bilhartz Jacob L. , Drayton Amy K. , Shieck Victoria L.
Published: June 2016

A high-quality critical care team is an essential component of any successful organ transplant program. From pretransplant care to the crucial postoperative period, its importance cannot be discounted. However, because of the focused nature of work in an intensive care unit (ICU), all too often members of the ICU team are not able to see and appreciate the ultimate fruits of their labor. These are factors that can contribute to the high rates of burnout and turnover among ICU teams. This article presents the concept of a summer camp for children who have received a solid-organ transplant. We discuss a vehicle by which ICU staff as well as other members of a patient's care team can gain a better appreciation of the full nature of both medical and, perhaps more importantly in this situation, nonmedical goals and outcomes in pediatric transplantation. We review our institutional experience running a summer camp for these children, discuss some of the important points in making such a camp successful, and discuss potential benefits to the campers as well as those taking care of them.
Infectious Angiogenesis—Different Pathways, the Same Goal
Authors: Urbanowicz Maria , Kutzner Heinz , Riveiro-Falkenbach Erica , Rodriguez-Peralto Jose L.
Published: June 2016

Infectious angiogenesis is the biological response of neoangiogenesis induced by infectious organisms. The authors present 3 exemplary entities which show paradigmatic clinico-pathological settings of infectious angiogenesis: Bacillary angiomatosis, Orf (ecthyma contagiosum), and Kaposi sarcoma. The authors review the literature and elucidate etiopathogenetic pathways leading to the phenomenon of neovascularization stimulated by infectious organisms. The authors describe the clinical and histological pictures, interactions between microorganisms and host cells, and changes that occur within cellular structures, as well as angiogenic factors that underpin infectious angiogenesis. The importance of chronic inflammation and tumor angiogenesis is emphasized.
Endocrine prevention of chemotherapy-induced ovarian failure
Authors: Blumenfeld Zeev , Evron Ayelet
Published: June 2016

Purpose of review

Fertility preservation has recently gained a worldwide interest among fertility specialists, oncologists, and all healthcare providers. Thus, the protection against iatrogenic infertility caused by chemotherapy assumes a high priority. Specifically, the issue of endocrine prevention of gonadotoxicity is still a controversial subject.

Recent findings

During the last year, many publications on this subject appeared, swinging the pendulum toward the beneficial role of gonadotropin-releasing hormone agonist (GnRHa) cotreatment for fertility preservation despite gonadotoxic chemotherapy. Here, we summarize the recent publications on fertility preservation and minimizing chemotherapy-induced gonadotoxicity.

More than 10 recent meta-analyses have concluded that GnRHa is beneficial and may decrease the risk of premature ovarian failure and increase the pregnancy rate in survivors. Furthermore, two recent international meetings of experts have concluded that GnRHa is effective and should be offered to every young woman facing gonadotoxic chemotherapy.
Endometrial ablation: considerations and complications
Authors: Moulder Janelle K. , Yunker Amanda
Published: June 2016

Purpose of review

The purpose of the review is to update the reader on endometrial ablation as a treatment for abnormal uterine bleeding, including modifications to initial treatment guidelines and current data on long-term outcomes.

Recent findings

Endometrial ablation continues to be a successful treatment for abnormal uterine bleeding, with new indications potentially forthcoming. Patient selection is key, as certain patient groups are at increased risk for ablation failure and complications.

Gynecologists should continue to offer this treatment to appropriate patients with abnormal uterine bleeding, with adequate counseling regarding anticipated success rates, factors associated with failure, alternative treatments, and long-term consequences related to ablation.
Management of Senile Ptosis with Levator Muscle Resection Using the Putterman Clamp
Authors: Yang Ju-Wen
Published: June 2016

Putterman clamp, a muscle clamp, is commonly used in conjunctival müllerectomies. We report 3 cases of senile ptosis repaired with levator muscle resection using the Putterman clamp. The redundant levator aponeurosis was removed with electrocautery after clamping with the Putterman clamp. The levator muscle was refixed to the tarsus with three 4-0 Vicryl stitches after adjusting the height of the eyelid fissure. No intraoperative difficulties were encountered. Ecchymosis and edema were limited in the immediate postoperative period. No complications were noted during the follow-up. The benefits of using the Putterman clamp in levator muscle resection are illustrated in these cases.
Large Ganglion Cyst with Unusual Location on the Back—A Case Report
Authors: Schoellhammer Liv , Nielsen Thomas Wagner , Berg Jais Oliver
Published: June 2016

A ganglion cyst is a soft tissue tumor-like lesion filled with colloid material commonly located on the hand and wrist. We report a case of a large ganglion cyst with an unusual location on the back. The patient presented with a mass growing over 2 months measuring 11.2 × 4.7 × 7.2 cm on magnetic resonance imaging. Ultrasound and puncture was attempted twice without achieving drainage. After surgical removal, histologic examination diagnosed the tumor as a ganglion cyst. We conclude that when evaluating a subcutaneous soft tissue mass, regardless of localization, a ganglion cyst may be a differential diagnosis.
Predictive Factors for Drainage Volume after Expander-based Breast Reconstruction
Authors: Suga Hirotaka , Shiraishi Tomohiro , Shibasaki Yuka , Takushima Akihiko , Harii Kiyonori
Published: June 2016

Background:

Closed suction drains are widely used in breast reconstruction, and the drains are removed based on a volume criterion. However, to the best of our knowledge, there has been no study analyzing predictive factors for drainage volume after breast reconstruction.

Methods:

Data of daily drainage in cases with expander-based breast reconstruction between February 2013 and March 2015 (131 patients and 134 expanders) were retrospectively analyzed. Patient factors and operative factors were examined for their influences on total drainage using univariate and multivariate analyses.

Results:

The total drainage was 557.3 ± 359.7 mL. A strong correlation was observed between total drainage and duration of drains (correlation coefficient, 0.908). Operative factors, such as mastectomy type, expander type, operative time, and blood loss, did not affect the total drainage. Patients with axillary lymph node dissection showed a higher total volume of drainage (P < 0.001). The weight of the resected specimen, body weight, and breast volume calculated preoperatively showed a strong correlation with total drainage (correlation coefficients, 0.454, 0.388, and 0.345, respectively). In multiple regression analysis with preoperative data, age (P = 0.008), body weight (P = 0.018), and scheduled axillary dissection (P < 0.001) were significant predictive factors for total drainage. Among postoperative data, age (P = 0.003), axillary dissection (P = 0.032), and weight of resected specimen (P = 0.013) were significant predictors.

Conclusions:

Based on preoperative and/or postoperative information, plastic surgeons can predict the total drainage and duration of drains after expander-based breast reconstruction. Age, breast mass, and axillary lymph node dissection are important factors for this prediction.
CANDIDA ENDOPHTHALMITIS FROM THE REACTIVATION OF A DORMANT LENTICULAR FUNGAL ABSCESS IN A PREMATURE INFANT
Authors: Yanoga Fatoumata , Garcia-Gonzalez Jose M. , Greenwald Mark , Shapiro Michael J. , Blair Michael P.
Published: June 2016

Background/Purpose:

To report a case of fungal endophthalmitis from reactivation of a dormant lenticular fungal abscess in a severely premature infant.

Methods:

Single retrospective case report.

Results:

A female born at 23 and 6/7 weeks and weighing 620 g was diagnosed at age 29 weeks post menstrual age with persistent tunica vasculosa lentis, lenticular opacity, and aggressive posterior retinopathy of prematurity, and received bilateral intravitreal injection of bevacizumab. At the time of injection she was receiving systemic antibiotics for sepsis and fungemia. The retinopathy of prematurity regressed, as did the tunica vasculosa lentis, but a small plaque remained on the lens. At 5.5 months of age, patient presented with hypopyon and elevated intraocular pressure. Culture of intraocular fluid demonstrated Candida albicans.

Conclusion:

Candida lenticular abscess is a rare complication of systemic fungemia in premature infants. Bevacizumab-induced regression of tunica vasculosa lentis may have decreased the ability of systemically administered antifungal medications to reach the colonized lens.
SPONTANEOUS CLOSURE OF MACULAR HOLE AFTER DRAINAGE OF SUBFOVEAL PERFLUOROCARBON LIQUID
Authors: Casswell Edward J. , Banerjee Philip J. , Charteris David G. , Sullivan Paul M.
Published: June 2016

Purpose:

To report a rare case of macular hole formation after drainage of subretinal perfluorocarbon liquid (PFCL), which closed spontaneously.

Methods:

Retrospective case report. A 60-year-old was noted to have subfoveal PFCL after a macula-involving retinal detachment repair with silicone oil tamponade. Spectral domain optical coherence tomography (Spectralis; Heidelberg Engineering, Heidelberg, Germany) was used for postoperative imaging.

Results:

Two months postdetachment repair, the patient underwent removal of silicone oil and drainage of subfoveal PFCL using a 41-gauge cannula through a extrafoveal retinotomy. A full-thickness macular hole was noted 2 weeks postoperatively. This closed spontaneously 4 months later, with an improvement in vision, although there was evidence of subfoveal atrophy.

Conclusion:

Macular hole formation can occur after drainage of subfoveal PFCL, with a favorable prognosis if managed conservatively. The resultant foveal atrophy highlights the importance of early identification and removal of subretinal PFCL.
Evidence Supporting an Association Between Expression of Major Histocompatibility Complex II by Microglia and Optic Nerve Degeneration During Experimental Glaucoma
Authors: Chidlow Glyn , Ebneter Andreas , Wood John P.M. , Casson Robert J.
Published: June 2016

Aim:

We acquired age-matched and sex-matched Sprague-Dawley rats from 2 independent breeding establishments. Serendipitously, we observed that constitutive, and bacterial toxin–induced, expression of major histocompatibility complex (MHC) class II RT1B chain in the uveal tract was much lower in one of the cohorts. Activated microglia are known to upregulate MHC II RT1B expression during optic nerve (ON) degeneration induced by raised intraocular pressure (IOP). We investigated whether, in a model of experimental glaucoma, microglial upregulation of MHC II RT1B was less efficacious and ON degeneration correspondingly less severe in the cohort of rats with low MHC II RT1B expression.

Methods:

Experimental glaucoma was induced by lasering the trabecular meshwork using a standard protocol. After 2 weeks of elevated IOP, retinal ganglion cells (RGC) survival, ON degeneration, and microglial responses were determined in both cohorts of rats.

Results:

Raised IOP-induced expression of MHC II RT1B by microglia was muted in the “Low” cohort compared with the “High” cohort. Axonal degeneration, RGC loss, and microgliosis were all significantly lower in the cohort of rats with low basal and induced expression of MHC II RT1B, despite both cohorts displaying IOP responses that were indistinguishable in terms of peak IOP and IOP exposure.

Conclusions:

Expression of MHC II RT1B by activated microglia in the ON during experimental glaucoma was associated with more severe RGC degeneration. Further studies are needed to elucidate the role of MHC II during experimental glaucoma.
Tuberculosis Infection Status Post Partial Knee Arthroplasty
Authors: Brown Sheldon , Berger Ryan , Ramgopal Moti , Dahya Vishal
Published: June 2016

A 55-year-old hospitalized woman presented with a right knee wound and associated swelling, hemarthrosis, and persistent pain 2 weeks after undergoing a right knee hemiarthroplasty. The right knee wound was cultured and results revealed Mycobacterium tuberculosis. Right knee hardware was removed; irrigation and debridement were performed. An antibiotic spacer impregnated with isoniazid was then inserted into the wound cavity. The patient successfully completed a 6-month regimen of antituberculosis medication therapy, and subsequent knee cultures were negative. A total knee arthroplasty revision was performed following eradication of tuberculosis and the patient remained symptom free with a fully functional total knee arthroplasty.
Epstein-Barr Virus With Underlying Advanced Human Immunodeficiency Virus Infection Causing Bilateral Peripheral Facial Palsy and Aseptic Meningitis
Authors: Shandal Varun , Lachman Tim
Published: June 2016

Many viral infections causing unilateral peripheral facial palsy (PFP) are well described. They infrequently produce bilateral PFP. Human immunodeficiency virus (HIV) and Epstein-Barr virus (EBV) are known to cause bilateral PFP independently. Bilateral PFP from EBV is reported mainly in children; it rarely occurs in an adult. Advanced HIV infection makes an adult more likely to have EBV-related bilateral PFP. We describe a patient with bilateral peripheral facial weakness from EBV with an underlying HIV infection.
End-Stage Mycobacteria Pneumonia in Older Women
Authors: Patel Neha , Nanjappa Sowmya , Yacoub Abraham Tareq , Greene John N.
Published: June 2016

Mycobacterium abscessus lung disease, although rare, has become increasingly difficult to treat. Currently, there is no standardized treatment regimen regarding when to start antibiotic therapy and how to construct treatment regimens. In general, there has been an increased level of interest in nontuberculous mycobacterium (NTM) infections, most likely secondary to the association of NTM infection with acquired immune deficiency syndrome and recognition that NTM pulmonary infections are encountered with increasing frequency in other immunocompromised populations. With increasing prevalence, there is an increased need for standardized diagnosis and treatment. Here we discuss 3 cases of end-stage mycobacteria pneumonia in elderly women and the various treatment regimens used.
Early Childhood Inclusion in Australia
Authors: Kemp Coral R.
Published: June 2016

From the introduction of early intervention services in Australian in the mid-1970s, the families of children with intellectual and multiple disabilities have been encouraged to enroll their children in local preschools and childcare centers. Children with disabilities have also accessed a range of alternatives to full inclusion, such as reverse inclusion and partial inclusion; however, the availability of the range of inclusive options has been limited. Although federal and state governments provide funding to support inclusion, the value of the support has been diminished by difficulties associated with the funding application processes and the lack of skills of early childhood staff and supporting specialists. Recent changes to early childhood provision in Australia have increased the potential of early childhood services to better provide for children with a range of disabilities. The barrier of specialist staff inadequately prepared to support early childhood professionals to promote full participation in center activities remains.
Early Childhood Inclusion in Israel
Authors: Al-Yagon Michal , Aram Dorit , Margalit Malka
Published: June 2016

This article describes conceptual aspects, current policies and practices, and research representing the Israeli perspective regarding early childhood inclusion (ECI) at preschool ages (3–6 years). We review legislative, historical, attitudinal, philosophical, practical, empirical, and cultural issues regarding ECI in Israel. Finally, we focus on several major topics and challenges that call for further discussion and intervention, along with suggestions for future directions to enhance ECI in educational settings with regard to policies, research, training, and practices.
Early Childhood Inclusion in Spain
Authors: Giné Climent , Balcells-Balcells Anna , Cañadas Margarita , Paniagua Gema
Published: June 2016

This article describes early childhood inclusion in educational settings in Spain. First, we address the legislative framework of preschool education in Spain and offer a brief analysis of some relevant issues, including the current situation of early childhood education and inclusion at this stage. Second, current policies and practices relating to the inclusion of students with special needs in early childhood education are analyzed. Issues such as staff characteristics and training, the ratio of children with special needs to children without special needs, forms of schooling, curriculum, and available supports are covered. Third, we present a brief summary of the evaluation and research on early childhood inclusion. Despite the limited availability of data, we present some results from a recent study that includes aspects such as the facilitators and barriers to inclusion, development of the student, participation and acceptance, and the ongoing process of inclusion. Finally, the main challenges that we face in our country and the next steps regarding the learning and development of students, participation of families, teacher training, working conditions, and future research are addressed.
Using a graphical risk tool to examine willingness to take migraine prophylactic medications
Authors: Turner Dana P. , Golding Adrienne N. , Houle Timothy T.
Published: June 2016

Many migraine sufferers use daily prophylactic therapy to reduce the frequency of their headache attacks. The Food and Drug Administration has approved several different medications for migraine prophylaxis, but it is not clear whether sufferers perceive these treatments to provide clinically significant benefits given their side effect profiles. Three hundred headache sufferers were recruited from the community and local headache clinics using print and television advertising. Participants reported experiencing problematic headache attacks with a median (IQR) frequency of 7.0 (4-13) headache days per month. These sufferers participated in a cross-sectional, single-site, study that used a specially designed computer assessment task. Participants were instructed on the probability of experiencing the 3 most commonly experienced side effects for several blinded medication profiles: divalproex sodium, venlafaxine, gabapentin, propranolol, and topiramate. After learning the likelihood of experiencing side effect profiles of each medication, participants were asked whether they would be willing to take the medication for a given headache reduction level, which ranged from 0 to 7 days per month. The side effect profile for divalproex sodium was associated with the smallest willingness to take, with gabapentin, propranolol, and topiramate perceived to be much more agreeable. However, <60% of participants reported willingness to take any of these medications even if they provided a 50% reduction in headache frequency. Several general predictors of willingness to take were observed including high headache-related disability, depressive symptoms, and pain medication concerns including fear of tolerance. These findings suggest that if properly informed of the side effect profiles of these medications, many patients might opt for other treatments.
Does association of opioid use with pain and function differ by fibromyalgia or widespread pain status?
Authors: Turner Judith A. , Shortreed Susan M. , Saunders Kathleen W. , LeResche Linda , Thielke Stephen , Von Korff Michael
Published: June 2016

Many consider chronic opioid therapy (COT) to be ineffective for fibromyalgia, but empirical evidence is limited. Among patients identified as initiating COT, we examined whether fibromyalgia was associated with different relationships of opioid use to pain and activity interference outcomes 12 months later. We obtained electronic data on diagnoses and opioid prescriptions. We obtained patient self-report data, including pain and activity interference measures, at baseline, 4 months, and 12 months. Among 1218 patients, 429 (35%) met our definition of fibromyalgia. Patients with and without fibromyalgia who had intermittent/lower-dose or regular/higher-dose opioid use at 12 months had similar 12-month pain intensity scores. However, among patients with minimal/no opioid use at 12 months, 12-month pain intensity was greater for those with fibromyalgia (adjusted mean = 5.15 [95% confidence interval, 4.80–5.51]; 0-10 scale) than for those without (4.44 [4.15–4.72]). Similar patterns were observed for 12-month activity interference. Among patients who discontinued opioids by 12 months, those with fibromyalgia were more likely to report bothersome side effects and less likely to report pain improvement as important reasons for discontinuation (P < 0.05). In sum, at 12 months, among patients who had discontinued opioids or used them minimally, those with fibromyalgia had worse outcomes and were less likely to have discontinued because of pain improvement. Among patients continuing COT, pain and activity interference outcomes were worse than those of patients with minimal/no opioid use and did not differ for those with fibromyalgia vs those with diverse other chronic pain conditions.