bluuebunny/crossref_metadata_2025 huggingface dataset:
Subjektive Arbeitsbelastung, Arbeitszufriedenheit, Work-Life-Balance von Ärzten und Pflegekräften eines Kommunalklinikums im ländlichen Raum im Vergleich zu einem großstädtischen Universitätsklinikum
Authors: Körber Michael , Schmid Klaus , Drexler Hans , Kiesel Johannes
Published: February 2017

Der Ärzte- und Pflegekräftemangel im ländlichen Raum stellt ein aktuelles und ernst zu nehmendes gesundheitspolitisches Problem dar. Die medizinische Versorgung der Landbevölkerung ist als gefährdet einzustufen. Diese Untersuchung vergleicht die empfundene Arbeitsbelastung, die Arbeitszufriedenheit, die Work-Life-Balance sowohl von Ärzten als auch von Pflegekräften an einer Klinik im ländlichen Raum mit 2 Kliniken eines Universitätsklinikums.

Die Ärzte sowie die Pflegekräfte wurden schriftlich und anonym mit einem standardisierten Fragebogeninstrument u. a. zur Arbeitsbelastung, Arbeitszufriedenheit und Work-Life-Balance befragt.

Die Rücklaufquote betrug im Universitätsklinikum wie auch im Kommunalklinikum knapp 50%. Im Universitätsklinikum nahmen 32 Ärzte und 54 Pflegekräfte teil, im kommunalen Haus 18 Ärzte und 137 Pflegekräfte. Die Pflegekräfte des Universitätsklinikums beurteilen die Organisation des Tagesablaufes mit 94.1% besser als die Pflegekräfte des kommunalen Hauses (82,4%, p=0,03). Die Ärzte des Universitätsklinikums können Erlerntes an einer Universitätsklinik mit 87,5% besser in die Praxis umzusetzen als ihre Kollegen an der Kommunalklinik (55,5%, p=0,02). Die Ärzte an der Universitätsklinik schätzen im Gegensatz zu ihren Kollegen an der Kommunalklinik die subjektive Arbeitsbelastung nur zu 50% als gerade richtig ein (kommunal 83,3%, p=0,02) und geben zu 96,9% an „täglich“ oder „mehrmals pro Woche“ unter Zeitdruck zu stehen (kommunal 50%, p<0,01). Die Pflegekräfte beider Häuser geben überwiegend an, ausreichend Möglichkeit zu haben, Familie und Beruf vereinbaren zu können(Uniklinik 62,9%, Kommunalklinik 72,8%). Hingegen sehen die Ärzte des Universitätsklinikums nur zu 20% ausreichend Möglichkeiten, Beruf und Familie zu vereinbaren, bei den Ärzten des kommunalen Klinikums sind es zumindest 42,9% (p=0,13).

Die Rücklaufquote mit knapp 50% ist als gut zu bezeichnen. Aufgrund der kleinen Fallzahlen bei den Ärzten, vor allem im kommunalen Haus, kann vermutet werden, dass interessante Unterschiede teilweise nicht erkannt werden konnten. Bei den Pflegekräften zeigen sich in beiden Kliniken nur geringe Unterschiede. Im Gegensatz dazu sind bei den Ärzten die subjektive Arbeitsbelastung sowie die Werte bei den Beanspruchungsfaktoren am Uniklinikum deutlich höher als bei den Kollegen an der Kommunalklinik. Wie in der Einleitung vermutet, kann trotz der besseren work-life-balance im Kommunalklinikum eine freie Arztstelle nicht besetzt werden.

Die Attraktivität einer Arztstelle hängt derzeit von den guten Karrierechancen und der Arbeit auf wissenschaftlich höchstem Niveau ab.
Die räumliche Verbreitung des Typ 2 Diabetes Mellitus in Berlin – Die Anwendung einer geografisch gewichteten Regressionsanalyse zur Identifikation ortsspezifischer Risikogruppen
Authors: Kauhl Boris , Pieper Jonas , Schweikart Jürgen , Keste Andrea , Moskwyn Marita
Published: February 2017

Das Hintergrundwissen, welche Bevölkerungsgruppen an welchem Ort einem erhöhten Risiko an Typ 2 Diabetes Mellitus (T2DM) zu erkranken ausgesetzt ist, erlaubt effiziente und kostensparende Interventionen, die sich genau an die lokalen Risikogruppen richten. Das Ziel dieser Studie ist die Analyse der räumlichen Verteilung des T2DM und die Identifikation lokaler, bevölkerungsbasierter Risikofaktoren mithilfe globaler und lokaler Regressionsmodelle.

Zur kartografischen Darstellung der T2DM Prävalenz wurde eine bivariate Kernel Density Estimation verwendet. Ein Ordinary Least Squares Regressionsmodell (OLS) wurde zur Identifikation bevölkerungsbasierter Risikofaktoren verwendet. Mithilfe eines geografisch gewichteten Regressionsmodells (GWR) wurde analysiert, wie der Zusammenhang zwischen den ermittelten Risikofaktoren und T2DM innerhalb Berlins variiert.

T2DM ist vor allem im Osten und in den Randgebieten Berlins konzentriert. Das OLS Modell identifiziert Anteile an Personen über 80, Personen ohne Migrationshintergrund, Langzeitarbeitslosigkeit, Haushalte mit Kindern und einen abnehmenden Anteil alleinerziehender Haushalte als soziodemografische Risikofaktoren. Die Ergebnisse des GWR Modells deuten zusätzlich auf starke räumliche Schwankungen des Zusammenhangs zwischen den ermittelten Risikofaktoren und T2DM innerhalb Berlins hin.

Die Risikofaktoren für T2DM hängen sehr stark von der lokalen soziodemografischen Zusammensetzung der Berliner Kieze ab und verdeutlichen, dass ein one-size-fits-all Ansatz für die Prävention des T2DM nicht geeignet ist. Präventionsmaßnahmen für T2DM sollten in Zukunft noch stärker auf lokal unterschiedliche Risikogruppen zugeschnitten werden.
On the topology of wall turbulence in physical space
Authors: Tardu Sedat
Published: February 2017

The topological features dominating the different sublayers of the near wall turbulence are revisited through direct numerical simulations performed in large computational domains up to the Karman number of 1100. The averages of the invariants of the velocity gradient tensor, conditioned by fixed magnitudes of the velocity components, are adequately performed. In the physical space, the dominating topology in the viscous sublayer is the stable focus stretching cohabiting with the unstable node/saddle/saddle points. The stable and unstable focuses mostly populate the inner layer with equal importance, while the former become predominant in the meso and outer layers. Eddies within the low speed streaks with intense streamwise negative velocity of very high shear stress are located near the zero-discriminant facets. The enstrophy and straining prevails the stable focus stretching and the unstable compressing, respectively. The Eulerian velocity field conditioned by a given topology seen by an observer moving with the local velocity is also considered. It is found that the wall normal velocity marks the stretching line of the unstable saddles and the compressing line of the stable nodes/saddles/saddles. The conditional velocity fields linked to the unstable focuses compressing and stable focuses stretching are closely similar.
Magnet pole shape design for reduction of thrust ripple of slotless permanent magnet linear synchronous motor with arc-shaped magnets considering end-effect based on analytical method
Authors: Shin Kyung-Hun , Park Hyung-Il , Kim Kwan-Ho , Jang Seok-Myeong , Choi Jang-Young
Published: February 2017

The shape of the magnet is essential to the performance of a slotless permanent magnet linear synchronous machine (PMLSM) because it is directly related to desirable machine performance. This paper presents a reduction in the thrust ripple of a PMLSM through the use of arc-shaped magnets based on electromagnetic field theory. The magnetic field solutions were obtained by considering end effect using a magnetic vector potential and two-dimensional Cartesian coordinate system. The analytical solution of each subdomain (PM, air-gap, coil, and end region) is derived, and the field solution is obtained by applying the boundary and interface conditions between the subdomains. In particular, an analytical method was derived for the instantaneous thrust and thrust ripple reduction of a PMLSM with arc-shaped magnets. In order to demonstrate the validity of the analytical results, the back electromotive force results of a finite element analysis and experiment on the manufactured prototype model were compared. The optimal point for thrust ripple minimization is suggested.
Geometry modulated upconversion photoluminescence of individual NaYF4: Yb3+, Er3+ microcrystals
Authors: Wang Bing , Wang Jiao , Mei Yongfeng
Published: February 2017

Upconversion (UC) photoluminescence (PL) properties of individual β-NaYF4: Yb3+, Er3+ microcrystals are investigated on their crystal orientation and size by a confocal micro-photoluminescence (μ-PL) system. The UC PL intensities including red and green bands of individual microcrystals change nearly lineally with their diameter but in different slopes. The ratio of integrated PL intensities between red and green bands (R/G) of individual microcrystals can be modulated by the crystal geometry, which is attributed to the optical propagation path and optical loss coefficient α. PL emission mapping along the crystal surface reveals a typical characteristic of optical waveguide in our UC microcrystals. Importantly, the variation of anisotropy in (100) and (001) crystal plane influences the UC PL spectra in the single microcrystals. Our finding could help the basic understanding of UC luminescence in micro/nanocrystals and hint their optimized fabrication for enhanced light emission.
Distinct
C-
mannosylation of netrin receptor thrombospondin type 1 repeats by mammalian DPY19L1 and DPY19L3
Authors: Shcherbakova Aleksandra , Tiemann Birgit , Buettner Falk F. R. , Bakker Hans
Published: February 2017

Significance

Protein
C
-mannosylation is restricted to animals and some related species. The
C
-mannosyltransferases probably evolved from enzymes responsible for
N
-glycosylation in the endoplasmic reticulum and are therefore expected to provide similar functions. Here we show that mammals have, in contrast to most lower animals, at least two
C
-mannosyltransferases with different recognition sequences, allowing glycosylation of all three tryptophans in the WxxWxxW motif of thrombospondin repeats, which are small modules found in many different proteins. We demonstrate that one of the
C
-mannosyltransferases, able to modify two tryptophans, is required and sufficient for the netrin receptor to reach the cell surface.
Interacting TCP and NLP transcription factors control plant responses to nitrate availability
Authors: Guan Peizhu , Ripoll Juan-José , Wang Renhou , Vuong Lam , Bailey-Steinitz Lindsay J. , Ye Dening , Crawford Nigel M.
Published: February 2017

Significance

Nitrate is an essential nutrient and a critical signal for plant growth, development, and stress responses. Nitrate signaling underlies a myriad of physiological, morphological, and developmental processes. Here we report that interacting teosinte branched1/cycloidea/proliferating cell factor and NIN-like protein transcription factors constitute a molecular link between nitrate signaling and the control of the cell-cycle progression gene
CYCB1;1
and root meristem growth. Our findings shed light on the regulatory mechanisms underlying an important plant adaptive process for coping with and surviving environmental challenges.
Two tonoplast MATE proteins function as turgor-regulating chloride channels in
Arabidopsis
Authors: Zhang Haiwen , Zhao Fu-Geng , Tang Ren-Jie , Yu Yuexuan , Song Jiali , Wang Yuan , Li Legong , Luan Sheng
Published: February 2017

Significance

Turgor pressure is the driving force for cell growth in plants, and the large central vacuole provides the major space for turgor regulation. However, the molecular identity and function of many transporters that control water and solute fluxes in and out of vacuoles remain unknown. We report here that two Multidrug and Toxic Compound Extrusion (MATE)-type transporters show previously unrecognized function as chloride channels essential for turgor regulation in
Arabidopsis
. The MATE transporters are highly conserved from bacteria, fungi, plants, to animals, and widely accepted as transporters of organic compounds. This study, showing some MATE transporters as chloride channels, thus breaks the old dogma on the functional definition of this large family of transporters.
Effects of rare earths on nanocrystalline for nitrocarburised layer of stainless steel
Authors: Liu R. L. , Yan M. F.
Published: February 2017

Solution-treated stainless steel was plasma-nitrocarburised at the precipitation-sensitive temperature with and without rare earth (RE) addition. The nitrocarburised layers were characterised by means of X-ray diffraction, transmission electron microscope, nanoindentation and anodic polarisation test. Experimental results show that the depth of plasma-nitrocarburised layer can be apparently increased from 60 to 75 μm after RE addition. More importantly, microstructure of stainless steel surface is refined into nano-sized grains after plasma nitrocarburising. At the depth of 20 μm, the hardness and the modulus of the nanocrystallised layer are as high as 13.6 and 218 GPa. After RE addition, the hardness and the modulus of the nanocrystallised layer increase to 17.5 and 255 GPa, respectively.
Investigations on microstructure and mechanical properties of containing-Si coatings
Authors: Chen Wanglin , Zhang Daoda , Yao Dengcan , Zhang Shihong , Wu Weiwei
Published: February 2017

Advanced AlCrSiN and AlTiSiN coatings were deposited on high-speed steel by cathodic vacuum arc. The microstructures, mechanical and tribological properties were studied, as well as cutting performance. The results show that multilayered AlCrSiN coating mainly consists of nanocrystalline fcc-AlCrN and a few amorphous Si3N4 phases, with an average module period of about 6.0 nm. While the AlTiSiN coating reveals nano-composite structure consisted of nanocrystalline fcc-AlTiN and hcp-AlN embedded into Si3N4 amorphous matrix. The AlCrSiN-coated tool reveals a more excellent cutting performance when compared with the AlTiSiN-coated tool due to its higher hardness, adhesion strength, H3/ E*2 ratio and wear resistance when compared with the AlTiSiN coating.
Television and anti-immigrant sentiments: the mediating role of fear of crime and perceived ethnic diversity
Authors: Jacobs Laura , Hooghe Marc , de Vroome Thomas
Published: February 2017

Previous research has established a correlation between fear of crime and anti-immigrant sentiments. In this paper, we explore the role of television in explaining individual differences in fear of crime, perceived ethnic diversity and anti-immigrant sentiments. We use the ‘Social Cohesion Indicators in Flanders’ data, a representative survey in the Flemish region of Belgium, combined with real-life indicators of ethnic diversity and crime at the community level. Results of a multilevel structural equation model suggest that watching television is positively associated with fear of crime and perceived ethnic diversity, which in turn is associated with anti-immigrant sentiments. Preference for public television is, however, associated with lower anti-immigrant sentiments, perceived ethnic diversity and fear of crime levels. Real crime and ethnic diversity levels are only weakly related to anti-immigrant sentiments. We conclude that especially perceptions are important in influencing anti-immigrant sentiments and that television use is associated with these perceptions.
Building State Capability
Authors: Andrews Matt , Pritchett Lant , Woolcock Michael
Published: February 2017

Governments play a major role in the development process, and constantly introduce reforms and policies to achieve developmental objectives. Many of these interventions have limited impact, however; schools get built but kids don’t learn, IT systems are introduced but not used, plans are written but not implemented. These achievement deficiencies reveal gaps in capabilities, and weaknesses in the process of building state capability. This book addresses these weaknesses and gaps. It starts by providing evidence of the capability shortfalls that currently exist in many countries, showing that many governments lack basic capacities even after decades of reforms and capacity-building efforts. The book then analyzes this evidence, identifying capability traps that hold many governments back—particularly related to isomorphic mimicry (where governments copy best practice solutions from other countries that make them look more capable even if they are not more capable) and premature load bearing (where governments adopt new mechanisms that they cannot actually make work, given weak extant capacities). The book then describes a process that governments can use to escape these capability traps. Called PDIA (problem-driven iterative adaptation), this process empowers people working in governments to find and fit solutions to the problems they face. The discussion about this process is structured in a practical manner so that readers can actually apply tools and ideas to the capability challenges they face in their own contexts. These applications will help readers devise policies and reforms that have more impact than those of the past.
The Searchframe
Authors: Andrews Matt , Pritchett Lant , Woolcock Michael
Published: February 2017

This chapter focuses on taking action in PDIA, performing real-time experimental iterations aimed at achieving quick wins to facilitate learning about the context and the effectiveness of potential solutions to the focal problem. It begins with “crawling the design space,” where one recognizes that there are always multiple ideas from which to draw solutions. These ideas facilitate experimentation, which occurs in rapid iterations where teams take action, reflect on experience, and then act again. Each iteration allows teams to learn by doing, and adapt their actions in response to the learnings. We offer various tools to use, including a Searchframe. This is an adaptation of the Logframe currently used in many development organizations. The Searchframe gives structure to the adaptive process, giving policymakers a tool to communicate end goals, learn, adapt, and progress. Readers can use such tools to structure their own iterative strategy to address stubborn challenges.
Fast admixture analysis and population tree estimation for SNP and NGS
data
Authors: Cheng Jade Yu , Mailund Thomas , Nielsen Rasmus
Published: February 2017

Motivation

Structure methods are highly used population genetic methods for classifying individuals in a sample fractionally into discrete ancestry components.

Contribution

We introduce a new optimization algorithm for the classical STRUCTURE model in a maximum likelihood framework. Using analyses of real data we show that the new method finds solutions with higher likelihoods than the state-of-the-art method in the same computational time. The optimization algorithm is also applicable to models based on genotype likelihoods, that can account for the uncertainty in genotype-calling associated with Next Generation Sequencing (NGS) data. We also present a new method for estimating population trees from ancestry components using a Gaussian approximation. Using coalescence simulations of diverging populations, we explore the adequacy of the STRUCTURE-style models and the Gaussian assumption for identifying ancestry components correctly and for inferring the correct tree. In most cases, ancestry components are inferred correctly, although sample sizes and times since admixture can influence the results. We show that the popular Gaussian approximation tends to perform poorly under extreme divergence scenarios e.g. with very long branch lengths, but the topologies of the population trees are accurately inferred in all scenarios explored. The new methods are implemented together with appropriate visualization tools in the software package Ohana.

Availability and Implementation

Ohana is publicly available at https://github.com/jade-cheng/ohana. In addition to source code and installation instructions, we also provide example work-flows in the project wiki site.

Supplementary information

Supplementary data are available at Bioinformatics online.
Cognitive Constraints on Valuing Annuities
Authors: Brown Jeffrey R , Kapteyn Arie , Luttmer Erzo F P , Mitchell Olivia S
Published: February 2017

This paper documents consumers’ difficulty valuing life annuities. Using a purpose-built experiment in the American Life Panel, we show that the prices at which people are willing to buy annuities are substantially below the prices at which they are willing to sell them. We also find that buy values are negatively correlated with sell values and that the sell–buy valuation spread is negatively correlated with cognition. This spread is larger for those with less education, weaker numerical abilities, and lower levels of financial literacy. Our evidence contributes to the emerging literature on heterogeneity in financial decision-making abilities, particularly regarding retirement payouts. (JEL: D14, D91, G11, H55)
Awake Craniotomy vs Craniotomy Under General Anesthesia for Perirolandic Gliomas: Evaluating Perioperative Complications and Extent of Resection
Authors: Eseonu Chikezie I. , Rincon-Torroella Jordina , ReFaey Karim , Lee Young M. , Nangiana Jasvinder , Vivas-Buitrago Tito , Quiñones-Hinojosa Alfredo
Published: February 2017

BACKGROUND: A craniotomy with direct cortical/subcortical stimulation either awake or under general anesthesia (GA) present 2 approaches for removing eloquent region tumors. With a reported higher prevalence of intraoperative seizures occurring during awake resections of perirolandic lesions, oftentimes, surgery under GA is chosen for these lesions.

OBJECTIVE: To evaluate a single-surgeon's experience with awake craniotomies (AC) vs surgery under GA for resecting perirolandic, eloquent, motor-region gliomas.

METHODS: Between 2005 and 2015, a retrospective analysis of 27 patients with perirolandic, eloquent, motor-area gliomas that underwent an AC were case-control matched with 31 patients who underwent surgery under GA for gliomas in the same location. All patients underwent direct brain stimulation with neuromonitoring and perioperative risk factors, extent of resection, complications, and discharge status were assessed.

RESULTS: The postoperative Karnofsky Performance Score (KPS) was significantly lower for the GA patients at 81.1 compared to the AC patients at 93.3 (P = .040). The extent of resection for GA patients was 79.6% while the AC patients had an 86.3% resection (P = .136). There were significantly more 100% total resections in the AC patients 25.9% compared to the GA group (6.5%; P = .041). Patients in the GA group had a longer mean length of hospitalization of 7.9 days compared to the AC group at 4.2 days (P = .049).

CONCLUSION: We show that AC can be performed with more frequent total resections, better postoperative KPS, shorter hospitalizations, as well as similar perioperative complication rates compared to surgery under GA for perirolandic, eloquent motor-region glioma.
Search for the warm–hot intergalactic medium around A 2744 using Suzaku
Authors: Hattori Shiho , Ota Naomi , Zhang Yu-Ying , Akamatsu Hiroki , Finoguenov Alexis
Published: February 2017

We present the results from Suzaku satellite observations of the surrounding region of a galaxy cluster, A 2744, at z = 0.3. To search for oxygen emission lines from the warm–hot intergalactic medium (WHIM), we analyzed X-ray spectra from two northeastern regions 2.2–3.3 and 3.3–4.4 Mpc from the center of the cluster, which offers the first test on the presence of a WHIM near the typical accretion shock radius (∼2 r200) predicted by hydrodynamical simulations. For the 2.2–3.3 Mpc region, the spectral fit significantly (99.2% significance) improved when we included O vii and O viii lines in the spectral model. A comparable WHIM surface brightness was obtained in the 3.3–4.4 Mpc region and the redshift of the O viii line is consistent with z = 0.3 within errors. The present results support that the observed soft X-ray emission originated from the WHIM. However, considering both statistical and systematic uncertainties, O viii detection in the northeast regions was marginal. The surface brightnesses of the O viii line in 10−7 photons cm−2 s−1 arcmin−2 for the 2.2–3.3 and 3.3–4.4 Mpc regions were measured to be 2.7 ± 1.0 and 2.1 ± 1.2, giving upper limits on the baryon overdensity of δ = 319(< 442) and 284(< 446), respectively. This is comparable with previous observations of cluster outskirts and their theoretical predictions. The future prospect for WHIM detection using the Athena X-IFU micro-calorimeter is briefly discussed here. In addition, we also derived the intracluster medium temperature distribution of A 2744 to detect a clear discontinuity at the location of the radio relic. This suggests that the cluster has undergone strong shock heating by mass accretion along the filament.
Positive-feedback, ratiometric biosensor expression improves high-throughput metabolite-producer screening efficiency in yeast
Authors: Williams Thomas C. , Xu Xin , Ostrowski Martin , Pretorius Isak S. , Paulsen Ian T.
Published: February 2017

Biosensors are valuable and versatile tools in synthetic biology that are used to modulate gene expression in response to a wide range of stimuli. Ligand responsive transcription factors are a class of biosensor that can be used to couple intracellular metabolite concentration with gene expression to enable dynamic regulation and high-throughput metabolite producer screening. We have established the Saccharomyces cerevisiae WAR1 transcriptional regulator and PDR12 promoter as an organic acid biosensor that can be used to detect varying levels of para-hydroxybenzoic acid (PHBA) production from the shikimate pathway and output green fluorescent protein (GFP) expression in response. The dynamic range of GFP expression in response to PHBA was dramatically increased by engineering positive-feedback expression of the WAR1 transcriptional regulator from its target PDR12 promoter. In addition, the noise in GFP expression at the population-level was controlled by normalising GFP fluorescence to constitutively expressed mCherry fluorescence within each cell. These biosensor modifications increased the high-throughput screening efficiency of yeast cells engineered to produce PHBA by 5,000-fold, enabling accurate fluorescence activated cell sorting isolation of producer cells that were mixed at a ratio of 1 in 10,000 with non-producers. Positive-feedback, ratiometric transcriptional regulator expression is likely applicable to many other transcription-factor/promoter pairs used in synthetic biology and metabolic engineering for both dynamic regulation and high-throughput screening applications.
Lack of Association between Preoperative Statin Use and Respiratory and Neurologic Complications after Cardiac Surgery
Authors: Komatsu Ryu , Yilmaz Huseyin Oguz , You Jing , Bashour C. Allen , Rajan Shobana , Soltesz Edward G. , Sessler Daniel I. , Turan Alparslan
Published: February 2017

Background

Statins may reduce the risk of pulmonary and neurologic complications after cardiac surgery.

Methods

The authors acquired data for adults who had coronary artery bypass graft, valve surgery, or combined procedures. The authors matched patients who took statins preoperatively to patients who did not. First, the authors assessed the association between preoperative statin use and the primary outcomes of prolonged ventilation (more than 24 h), pneumonia (positive cultures of sputum, transtracheal fluid, bronchial washings, and/or clinical findings consistent with the diagnosis of pneumonia), and in-hospital all-cause mortality, using logistic regressions. Second, the authors analyzed the collapsed composite of neurologic complications using logistic regression. Intensive care unit and hospital length of stay were evaluated with Cox proportional hazard models.

Results

Among 14,129 eligible patients, 6,642 patients were successfully matched. There was no significant association between preoperative statin use and prolonged ventilation (statin: 408/3,321 [12.3%] vs. nonstatin: 389/3,321 [11.7%]), pneumonia (44/3,321 [1.3%] vs. 54/3,321 [1.6%]), and in-hospital mortality (52/3,321 [1.6%] vs. 43/3,321 [1.3%]). The estimated odds ratio was 1.06 (98.3% CI, 0.88 to 1.27) for prolonged ventilation, 0.81 (0.50 to 1.32) for pneumonia, and 1.21 (0.74 to 1.99) for in-hospital mortality. Neurologic outcomes were not associated with preoperative statin use (53/3,321 [1.6%] vs. 56/3,321 [1.7%]), with an odds ratio of 0.95 (0.60 to 1.50). The length of intensive care unit and hospital stay was also not associated with preoperative statin use, with a hazard ratio of 1.04 (0.98 to 1.10) for length of hospital stay and 1.00 (0.94 to 1.06) for length of intensive care unit stay.

Conclusions

Preoperative statin use did not reduce pulmonary or neurologic complications after cardiac surgery.
Using Community-Based Participatory Research and Human-Centered Design to Address Violence-Related Health Disparities Among Latino/a Youth
Authors: Kia-Keating Maryam , Santacrose Diana E. , Liu Sabrina R. , Adams Jessica
Published: February 2017

High rates of exposure to violence and other adversities among Latino/a youth contribute to health disparities. The current article addresses the ways in which community-based participatory research (CBPR) and human-centered design (HCD) can help engage communities in dialogue and action. We present a project exemplifying how community forums, with researchers, practitioners, and key stakeholders, including youths and parents, integrated HCD strategies with a CBPR approach. Given the potential for power inequities among these groups, CBPR + HCD acted as a catalyst for reciprocal dialogue and generated potential opportunity areas for health promotion and change. Future directions are described.
In Vivo Chondrogenesis in 3D Bioprinted Human Cell-laden Hydrogel Constructs
Authors: Möller Thomas , Amoroso Matteo , Hägg Daniel , Brantsing Camilla , Rotter Nicole , Apelgren Peter , Lindahl Anders , Kölby Lars , Gatenholm Paul
Published: February 2017

Background:

The three-dimensional (3D) bioprinting technology allows creation of 3D constructs in a layer-by-layer fashion utilizing biologically relevant materials such as biopolymers and cells. The aim of this study is to investigate the use of 3D bioprinting in a clinically relevant setting to evaluate the potential of this technique for in vivo chondrogenesis.

Methods:

Thirty-six nude mice (Balb-C, female) received a 5- × 5- × 1-mm piece of bioprinted cell-laden nanofibrillated cellulose/alginate construct in a subcutaneous pocket. Four groups of printed constructs were used: (1) human (male) nasal chondrocytes (hNCs), (2) human (female) bone marrow–derived mesenchymal stem cells (hBMSCs), (3) coculture of hNCs and hBMSCs in a 20/80 ratio, and (4) Cell-free scaffolds (blank). After 14, 30, and 60 days, the scaffolds were harvested for histological, immunohistochemical, and mechanical analysis.

Results:

The constructs had good mechanical properties and keep their structural integrity after 60 days of implantation. For both the hNC constructs and the cocultured constructs, a gradual increase of glycosaminoglycan production and hNC proliferation was observed. However, the cocultured group showed a more pronounced cell proliferation and enhanced deposition of human collagen II demonstrated by immunohistochemical analysis.

Conclusions:

In vivo chondrogenesis in a 3D bioprinted human cell-laden hydrogel construct has been demonstrated. The trophic role of the hBMSCs in stimulating hNC proliferation and matrix deposition in the coculture group suggests the potential of 3D bioprinting of human cartilage for future application in reconstructive surgery.
Corneal Endothelial Cell Integrity in Precut Human Donor Corneas Enhanced by Autocrine Vasoactive Intestinal Peptide
Authors: Koh Shay-Whey M. , Coll Timothy , Gloria Dante , Sprehe Nicholas
Published: February 2017

Purpose:

To demonstrate that vasoactive intestinal peptide (VIP), a corneal endothelial (CE) cell autocrine factor, maintains the integrity of corneal endothelium in human donor corneoscleral explants precut for endothelial keratoplasty.

Methods:

Twelve paired human donor corneoscleral explants used as control versus VIP-treated explants (10 nM, 30 minutes, 37°C) were shipped (4°C) to the Lions Eye Institute for Transplantation and Research for precutting (Moria CBM-ALTK Keratome), shipped back to the laboratory, and cultured in ciliary neurotrophic factor (CNTF, 0.83 nM, 37°C, 24 hours). Trephined endothelial discs (8–8.5 mm) were analyzed for differentiation markers (N-cadherin, CNTF receptor α subunit [CNTFRα], and connexin 43) by Western blot after a quarter of the discs from 4 paired explants were cut away and stained with alizarin red S for microscopic damage analysis. Two additional paired explants (6 days in culture) were stained for panoramic view of central CE damage.

Results:

VIP treatment increased N-cadherin and CNTFRα levels (mean ± SEM) to 1.38 ± 0.11-fold (P = 0.003) and 1.46 ± 0.22-fold (P = 0.03) of paired controls, respectively, whereas CE cell CNTF responsiveness in upregulation of connexin 43 increased to 2.02 ± 0.5 (mean ± SEM)-fold of the controls (P = 0.04). CE damage decreased from (mean ± SEM) 10.0% ± 1.2% to 1.6% ± 0.3% (P < 0.0001) and 9.1% ± 1.1% to 2.4% ± 1.0% (P = 0.0006). After 6 days in culture, the damage in whole CE discs decreased from 20.0% (control) to 5.5% (VIP treated).

Conclusions:

VIP treatment before precut enhanced the preservation of corneal endothelium.
Evaluation and Quality Assessment of Prestripped, Preloaded Descemet Membrane Endothelial Keratoplasty Grafts
Authors: Tran Khoa D. , Dye Philip K. , Odell Kelly , Galloway Joshua , Stoeger Christopher G. , Straiko Michael D. , Terry Mark A.
Published: February 2017

Purpose:

To determine graft quality and feasibility of Descemet membrane endothelial keratoplasty (DMEK) grafts that are prestripped and preloaded into injectors by eye bank technicians before shipping to surgeons.

Methods:

DMEK grafts (n = 31) were prepared from donor corneas and preloaded into Straiko Modified Jones tubes and set inside viewing chambers filled with 20 mL of Optisol-GS. Preloaded grafts were evaluated using specular microscopy and slit-lamp biomicroscopy. Endothelial cell loss (ECL) was captured by vital dye staining and quantified using FIJI. A subset of preloaded tissues was subjected to a shipping validation and 5-day storage assay. Fourteen additional DMEK grafts (not preloaded) were examined to quantify damage resulting from prestripping alone.

Results:

Specular microscopy was able to be performed for all preloaded tissues. Average ECL for preloaded tissues quantified by vital dye staining and FIJI after overnight storage was 16.8% ± 5.9%, and differed from slit-lamp ECL estimation by an average of 5.3% ± 3.6%. The average damage caused by prestripping alone was 9.3% ± 5.9%, and it was significantly less than that of preloaded tissues (P < 0.01). Average ECL for preloaded tissues subjected to round-trip shipping events was 18.5% ± 12.4%, and ECL for tissues stored at 4°C for 5 days after preloading was 13.1% ± 9.5%.

Conclusions:

It is possible to prepare, evaluate, and ship DMEK grafts loaded inside a glass carrier and viewing chamber. The ability to evaluate tissues after processing allows for adherence to the Eye Bank Association of America Medical Standards, and for surgeons to receive the most accurate tissue information.
Immunosuppression as a Possible Risk Factor for Interferon Nonresponse in Ocular Surface Squamous Neoplasia
Authors: Ashkenazy Noy , Karp Carol L. , Wang Gaofeng , Acosta Carolina Mercado , Galor Anat
Published: February 2017

Purpose:

The mechanism by which ocular surface squamous neoplasia (OSSN) responds to topical interferon-alpha-2b (IFNα2b) is not known. We report the cases of 3 immunosuppressed patients whose tumors did not respond to topical IFNα2b therapy. The purpose of this series is to shed light on potential mechanisms of IFNα2b in OSSN.

Methods:

Retrospective case series of 3 immunosuppressed patients whose biopsy-proven OSSN did not respond to topical IFNα2b treatment.

Results:

Three white, immunosuppressed males (mean age 70 years, range 66–76) were diagnosed with OSSN. Topical IFNα2b 1 million units/mL was administered 4 times a day and used for a mean of 5 months (range 2–7 mo) without an adequate response. All patients were then switched to 5-fluorouracil. Successful eradication of OSSN was achieved in 2 cases, and improvement of OSSN in another. The latter patient was switched to mitomycin-C with subsequent resolution of OSSN.

Conclusions:

These cases suggest that an intact immune system may be an important link between IFNα2b therapy and tumor resolution. As such, topical IFNα2b may not be an optimal choice for patients with underlying immunosuppression. It may be more effective in this patient population to switch to a non–immune-modulating therapy such as 5-fluorouracil or mitomycin-C.
Screening Children for Abuse and Neglect: A Review of the Literature
Authors: Hoft Mary , Haddad Lisa
Published: February 2017

Child abuse and neglect occur in epidemic numbers in the United States and around the world, resulting in major physical and mental health consequences for abused children in the present and future. A vast amount of information is available on the signs and symptoms and short- and long-term consequences of abuse. A limited number of instruments have been empirically developed to screen for child abuse, with most focused on physical abuse in the context of the emergency department, which have been found to be minimally effective and lacking rigor. This literature review focuses on physical, sexual, and psychological abuse and neglect, occurring in one or multiple forms (polyabuse). A systematic, in-depth analysis of the literature was conducted. This literature review provides information for identifying children who have been abused and neglected but exposes the need for a comprehensive screening instrument or protocol that will capture all forms of child abuse and neglect. Screening needs to be succinct, user-friendly, and amenable for use with children at every point of care in the healthcare system.
Prison Nursing: Formation of a Stable Professional Identity
Authors: Choudhry Khurshid , Armstrong David , Dregan Alexandru
Published: February 2017

Aim:

The aim of this study was to analyze how working within prison environments can influence the self-identity and professional identity of nurses.

Background:

The prison environment can be a difficult environment for nurses to deliver care within, with nurses having to carry out activities that seem to go against their professional role, while at the same time providing care to prisoners who have greater health needs than the general population. There is a lack of theoretical consideration of how prison nurses carry out their role in the face of such challenges.

Method:

This study used a review of literature published over the last 11 years exploring nurses’ beliefs, thoughts, and feelings toward delivering care within prison environment.

Implications for Forensic Nursing:

With time, nurses working within prison environments develop specific skills to be able to deliver appropriate care to their patients. These skills include adapting to both the prison environment and the prison culture. Ultimately, adaptations lead to a change in identity allowing nurses to work effectively within prison.

Conclusion:

Providers of prison healthcare should ensure that induction (orientation) processes for new nurses are designed to address specific challenges that nurses face including the potential for cognitive dissonance. They should ensure that nurses receive training to develop and acquire the skills highlighted in this review. Ensuring that this training is in place may increase nurse retention.
Changes in Residual Limb Anthropometrics and Lift, Carry, and Timed Walking Performance in Men with Transtibial Amputation due to Trauma
Authors: Dionne Carol P. , Crawford Derek A. , Day Jonathan D. , Ertl William J.J.
Published: February 2017

Introduction

Despite advances in prosthetic management and rehabilitation, otherwise healthy men with transtibial amputation (TTA) risk residuum injury during work-related activity (WRA) performance. Little is known about WRAs, perceived exertion, or residuum anthropometric changes over time in this cohort. This information may help direct longer-term considerations for those with TTA within the workforce.

Materials and Methods

In this preliminary study, investigators prospectively examined and compared WRA performance (floor-to-knuckle lift, 25-ft carry, self-paced, and brisk 2-minute walk tests [2MWT]), gait asymmetry (differences in step length, stride length, and cadence), report of perceived exertion (RPE), and residuum anthropometrics (length, girths) in otherwise healthy men with TTA at least 6 months after rehabilitation, during two visits, 12 months apart.

Results

Twenty-one participants showed little difference between visits in residuum anthropometrics or in distances walked (self-paced, brisk 2MWT; p > 0.05). All had received rehabilitation varying from time of surgery and beyond initial receipt of prosthesis (n = 8; 38%) to only upon receipt of the initial prosthesis (n = 13; 62%). However, participants reported greater exertion at visit 2 during the brisk 2MWT (0.9 RPE difference; p = 0.034) but lifted 40.4 lb more at visit 2 than at the initial visit (p = 0.034). There was a progressively larger cadence difference from visit 1 to visit 2 (increased asymmetry) during the timed self-paced walk test (p = 0.026).

Conclusions

Regardless of improved lift capacity or residuum anthropometric stability, this healthy male cohort with TTA demonstrated progressively worsened cadence asymmetry during self-paced 2MWT and reported increased exertion during brisk-paced 2MWT. Otherwise healthy working-age men with TTA may require continual intervention to minimize cadence asymmetry and perceived exertion, potentially reducing residuum injury risk.
Orchestration of late events in erythropoiesis by KLF1/EKLF
Authors: Gnanapragasam Merlin Nithya , Bieker James J.
Published: February 2017

Purpose of review

Transcriptional regulators provide the molecular and biochemical basis for the cell specific properties and characteristics that follow from their central role in establishing tissue-restricted expression. Precise and sequential control of terminal cell divisions, nuclear condensation, and enucleation are defining characteristics within erythropoietic differentiation. This review is focused on KLF1, a central global regulator of this process.

Recent findings

Studies in the past year have brought a number of proteins that are targets of KLF1 regulation into focus with respect to their roles in terminal erythroid differentiation. Many of these are involved in fine control of the cell cycle at both early (E2F2, Cyclin A2) and later (p18, p27, p19) stages of differentiation, or are directly involved in enucleation (p18, p27). Dramatic biophysical changes controlled at the nuclear lamin by caspase 3 enable histone release and nuclear condensation, whereas dematin association with structural proteins alters the timing of enucleation. Conditional ablation of mDia2 has established its role in late stage cell cycle and enucleation.

Transcription factors such as KLF1, along with epigenetic modifiers, play crucial roles in establishing the proper onset and progression of terminal differentiation events. Studies from the past year show a remarkable multifaceted convergence on cell cycle control, and establish that the orthochromatic erythroblast stage is a critical nodal point for many of the effects on enucleation. These studies are relevant to understanding the underlying causes of anemia and hematologic disease where defective enucleation predicts a poor clinical outcome.
Molecular Cytogenetic Approach to Characterize Novel and Cryptic Chromosome Abnormalities in Childhood Myeloid Malignances of Fanconi Anemia
Authors: Borges Maria L.R. , Capela de Matos Roberto R. , Amaral Bethânia d.A. Silva , Soares-Ventura Eliane M. , Leite Edinalva P. , Silva Mariluze O. d. , Cornélio Maria T.M. Nogueira , Silva Maria L. M. , Liehr Thomas , Marques-Salles Terezinha d. J.
Published: February 2017

Myeloid malignancies can be either primary or secondary, whether or not a specific cause can be determined. Fanconi anemia (FA), a rare constitutional bone marrow failure, usually presents an increased possibility of clonal evolution, due to the increase in chromosomal instability, TP53 activation, and cell death. The evolution of FA may include aplastic anemia by the progressive failure of the bone marrow and myelod neoplasias, such as acute myeloid leukemia and myelodysplastic syndrome. Chromosome abnormalities, particularly of chromosomes, 1, 3, and 7, during the aplastic phase of the disease are predictive of evolution to acute myeloid leukemia/myelodysplastic syndrome. Cytogenetic studies are indispensable to characterize chromosome abnormalities, and thus an important part of the clinical management, and for planning of therapeutic interventions. Here, clinical data and outcomes of 4 FA, 3 of them with myeloid malignances and 1 asymptomatic, and detailed characterization of their chromosome abnormalities using cytogenetics techniques are described.
Positive Association Between Nightmares and Heart Rate Response to Loud Tones
Authors: Tanev Kaloyan S. , Orr Scott P. , Pace-Schott Edward F. , Griffin Michael , Pitman Roger K. , Resick Patricia A.
Published: February 2017

Seventy-three women with posttraumatic stress disorder (PTSD) resulting from rape or physical assault participated in a loud-tone procedure, while skin conductance (SC), heart rate, and electromyogram responses were recorded. Pearson correlations were examined between each psychophysiological response and Clinician-Administered PTSD Scale (CAPS) symptom scores. Significant correlations were adjusted for each remaining individual PTSD symptom score. Heart rate response (HRR) significantly correlated with CAPS total score and with CAPS nightmares. The relationship between HRR and nightmares remained significant after controlling for each of the other 16 individual PTSD symptoms, for the remaining reexperiencing cluster, and for CAPS total score. The zero-order correlations between SC response and nightmares and between electromyography response and nightmares were both not significant. The association of nightmares with larger HRR in the absence of an association with larger SC response likely reflects reduced parasympathetic tone. Thus, our findings indirectly support a role for reduced parasympathetic tone in PTSD nightmares.
Sex Differences in Psychiatric Hospitalizations of Individuals With Psychotic Disorders
Authors: Shlomi Polachek Inbal , Manor Adi , Baumfeld Yael , Bagadia Ashlesha , Polachek Ari , Strous Rael D. , Dolev Zipora
Published: February 2017

We aimed to evaluate the association between sex and hospitalization characteristics in psychotic disorders. We identified all acute hospitalizations, between 2010 and 2013, for psychotic disorders in patients younger than 45 and older than 55 years (n = 5411) in the hospital's database. In addition, we identified patients who were prescribed with intramuscular risperidone (n = 280) or clozapine (n = 192) at discharge. The results showed that women younger than 45 years had lower proportions of hospitalizations (33.52% vs. 66.47%) and involuntary hospitalizations (33.85% vs. 45.55%) than did men in the same age group. Women older than 55 years had higher proportions of hospitalizations (57.22% vs. 42.77%) and similar proportion of involuntary hospitalizations. Women younger than 45 years were prescribed similar doses of intramuscular risperidone and lower doses of clozapine (345.8 vs. 380.2 mg) and women older than 55 years were prescribed higher doses of intramuscular risperidone (44.8 vs. 34.4 mg/2 weeks) and clozapine (164.32 vs. 154.5 mg) than were men in the same age group. Women in the reproductive years have better hospitalization characteristics than do men on these measures.