bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extending the unified transform: curvilinear polygons and variable coefficient PDEs
Authors: Colbrook Matthew J 
Published: November 2018

Abstract
We provide the first significant extension of the unified transform (also known as the Fokas method) applied to elliptic boundary value problems, namely, we extend the method to curvilinear polygons and partial differential equations (PDEs) with variable coefficients. This is used to solve the generalized Dirichlet-to-Neumann map. The central component of the unified transform is the coupling of certain integral transforms of the given boundary data and of the unknown boundary values. This has become known as the global relation and, in the case of constant coefficient PDEs, simply links the Fourier transforms of the Dirichlet and Neumann boundary values. We extend the global relation to PDEs with variable coefficients and to domains with curved boundaries. Furthermore, we provide a natural choice of global relations for separable PDEs. These generalizations are numerically implemented using a method based on Chebyshev interpolation for efficient and accurate computation of the integral transforms that appear in the global relation. Extensive numerical examples are provided, demonstrating that the method presented in this paper is both accurate and fast, yielding exponential convergence for sufficiently smooth solutions. Furthermore, the method is straightforward to use, involving just the construction of a simple linear system from the integral transforms, and does not require knowledge of Green’s functions of the PDE. Details on the implementation are discussed at length.
Managers’ perceptions of the effects of a national mandatory accreditation program in Danish hospitals. A cross-sectional survey
Authors: Nicolaisen A , Bogh S B , Churruca K , Ellis L A , Braithwaite J , von Plessen C 
Published: November 2018

Abstract

Objective
This study aimed to examine and compare middle and senior hospital managers’ perceptions of the effects of a mandatory accreditation program in Denmark, the Danish Healthcare Quality Program (Den Danske Kvalitetsmodel [DDKM]) after it was terminated in 2015.

Design
A cross-sectional online questionnaire survey.

Setting
All 26 somatic and psychiatric public hospitals in Denmark.

Participants
All senior and middle managers.

Methods
A questionnaire with open and closed response (five-point Likert scale) questions. Quantitative data were analyzed descriptively and through ordered logistic regression by management level. Qualitative data were subjected to a software-assisted content analysis.

Results
The response rate was 49% (533/1059). In both the qualitative and quantitative data sets, participants perceived the DDKM as having: led to an increased focus on registration, documentation and additional and unnecessary procedures. While the DDKM was perceived as increasing a focus on quality, the time required for accreditation was at the expense of patient care. There were significant differences by management level, with middle managers having more negative perceptions of the DDKM related to time spent on documentation and registration.

Conclusion
While the DDKM had some perceived benefits for quality improvement, it was ultimately considered time-consuming and outdated or having served its purpose. Including managers, particularly middle managers, in refinements to the new quality improvement model could capitalize on the benefits while redressing the problems with the terminated accreditation program.
The phrenological collection of Gama Machado in the Science Museum, University of Coimbra
Authors: Pereira Helena 
Published: November 2018

Abstract
José Joaquim da Gama Machado was a devotee of the doctrine of phrenology. The theory, formulated by the physician Franz Gall c.1792–93, postulated a biological basis for human behaviour, locating the different mental faculties within the cerebral cortex. Machado was among the founders of the Phrenological Society of Paris. In order to conduct his investigations, he gathered an extensive collection of plaster casts moulded from heads, which he bequeathed to the University of Coimbra in 1861. After more than a century and a half, we investigate what is known about its founder, the man and the collector; the historical and scientific context in which the collection originated; and the paths it travelled within the university. In tracing the life of the collection, we identify also the fortuitous and idiosyncratic nature of its long journey from its formation to the present day.
Diagnostic accuracy of the 1,3-β-D-glucan test for pneumocystis pneumonia in a tertiary university hospital in Denmark: A retrospective study
Authors: Engsbro Anne Line , Najat Sara , Jørgensen Karin Meinike , Kurtzhals Jørgen A L , Arendrup Maiken Cavling 
Published: November 2018

Abstract
1,3-β-D-glucan (BG), a cell-wall component of most fungi including Pneumocystis (PC), is recommended by international guidelines for screening for pneumocystis pneumonia (PCP) in hematologic patients. We retrospectively validated the BG test in our tertiary university hospital. Forty-five patients (median age 53 years, 33% female) tested for PC by polymerase chain reaction (PCR) and/or immunoflourescence (IF)-microscopy with a stored blood sample within ±5 days of the PC test were tested by the Fungitell (cutoff <60 and >80 pg/ml). Cases had symptoms and radiology compatible with PCP and positive IF-microscopy (proven PCP, n = 8) or positive PCR (probable PCP, n = 10). Controls had no compatible symptoms/radiology and negative tests for PC on conventional testing (no PCP, n = 24), or positive PCR/IF-microscopy (colonized, n = 3). Median BG-levels were 1108 pg/ml (proven PCP), 612 pg/ml (probable PCP), 29 pg/ml (colonized), and 48 pg/ml (controls, P < 0.001). Compared to the PCP case/control classification, the BG test showed sensitivities of 83–89% and specificities of 64–74%, positive likelihood ratio (LR) of 3.2 and negative LR of 0.23 at recommended cutoff and moderate agreement between tests. Optimal cutoff was ≥73 pg/ml. In PCR-positive cases, the agreement between the BG test and IF-microscopy was 78–89% with fair/moderate agreement. Elevated BG levels were seen in controls with probable invasive fungal infections (n = 4), hemodialysis, bacterial infections and/or betalactams. To conclude, 11% of patients with PCP would be missed if the BG test had been used for diagnosing PCP. Specificity was moderate. Among PCR-positive patients, the BG test identified more cases than IF-microscopy. BG testing is potentially helpful but sensitivity is insufficient to exclude PCP.
The magnetic propeller accretion regime of LkCa 15
Authors: Donati J-F , Bouvier J , Alencar S H , Hill C , Carmona A , Folsom C P , Ménard F , Gregory S G , Hussain G A , Grankin K , Moutou C , Malo L , Takami M , Herczeg G J ,   MaTYSSE Collaboration
Published: November 2018

ABSTRACT
We present a spectropolarimetric study of the classical T Tauri star (cTTS) LkCa 15 investigating the large-scale magnetic topology of the central star and the way the field connects to the inner regions of the accretion disc. We find that the star hosts a strong poloidal field with a mainly axisymmetric dipole component of 1.35 kG, whereas the mass accretion rate at the surface of the star is 10−9.2 M⊙  yr−1. It implies that the magnetic field of LkCa 15 is able to evacuate the central regions of the disc up to a distance of 0.07 au at which the Keplerian orbital period equals the stellar rotation period. Our results suggest that LkCa 15, like the lower mass cTTS AA Tau, interacts with its disc in a propeller mode, a regime supposedly very efficient at slowing down the rotation of cTTSs hosting strong dipolar fields.
On the possibility of detecting ultrashort period exoplanets with LISA
Authors: Wong Kaze W K , Berti Emanuele , Gabella William E , Holley-Bockelmann Kelly 
Published: November 2018

ABSTRACT
Cunha, Silva & Lima recently reexamined the possibility of detecting gravitational waves from exoplanets, claiming that three ultrashort period systems would be observable by LISA. We revisit their analysis and conclude that the currently known exoplanetary systems are unlikely to be detectable, even assuming a LISA observation time Tobs = 4 yr. Conclusive statements on the detectability of one of these systems, GP Com b, will require better knowledge of the system’s properties, as well as more careful modelling of both LISA’s response and theG alactic confusion noise. Still, the possibility of exoplanet detection with LISA is interesting enough to warrant further study, as gravitational waves could yield dynamical properties that are difficult to constrain with electromagnetic observations.
Functional Comparison of a Pediatric Patient With Osteosarcoma and Limb-Sparing Distal Femoral Endoprosthesis With an Identical Twin
Authors: Ambler Steven B. , Highsmith M. Jason , Alvero Christine , Binitie Odion T. 
Published: November 2018

Background/Objective:
In children, limb salvage techniques have been more slowly adopted because of concerns of complications from multiple surgical procedures, the sacrificing of the physis, and the leg-length discrepancy that can ensue. The purpose of this study was to compare gait and function between a pediatric patient with a distal femur replacement and his identical, healthy twin brother.

Methods:

Design: A single, case-control design was used.

Participants: A 13-year-old adolescent boy underwent a distal femoral resection and endoprosthetic reconstruction with a noninvasive extendible endoprosthesis. The control was the healthy, identical twin brother of the case patient.

Main Outcome Measure(s):
Functional movement testing consisting of 5× Sit-to-Stand Test, 10-m Walk Test, Timed Up and Go (TUG) test, and L-test. Spatiotemporal gait analysis was used to assess degree of asymmetry.

Results:
Comparisons were mixed across the functional movement testing, with the patient performing inferiorly on the 5× Sit-to-Stand Test and the 10-m Walk Test and superiorly on the TUG test and the L-test. Degree of asymmetry for step time, swing time, single support, and initial double support were all significantly different (P ≤ .05), with the patient being less symmetric in all measures.

Limitations:
This study is limited by its small sample size and a comparison with a single time point.

Conclusion:
Although the patient is doing well functionally, asymmetries remain compared with his twin. Future research should focus on more direct comparison of subjects who have undergone different treatment options for sarcoma.
Neonatal Morbidity After Management of Vaginal Noncephalic Second-Twin Delivery by Residents
Authors: Schmitz Thomas , Korb Diane , Azria Elie , Deruelle Philippe , Kayem Gilles , Rozenberg Patrick , Sananès Nicolas , Sénat Marie-Victoire , Sentilhes Loic , Vayssière Christophe , Winer Norbert , Goffinet François ,   for the JUmeaux MODe d’Accouchement (JUMODA) Study Group and the Groupe de Recherche en Obstétrique et Gynécologie (GROG)
Published: November 2018

OBJECTIVE:
To assess neonatal mortality and morbidity according to whether a resident or senior obstetrician initially managed vaginal delivery of noncephalic second twins.

METHODS:
The JUmeaux MODe d'Accouchement study was a national, prospective, population-based, cohort study of twin deliveries in 176 maternity units in France, where active management of second-twin delivery is recommended. The primary outcome of our study was a composite of neonatal mortality and morbidity. Neonatal outcomes of noncephalic second twins born at or after 32 weeks of gestation after vaginal delivery of the first twin were compared according to the initial managing practitioner—supervised resident or senior obstetrician. Deliveries performed by a senior obstetrician after failure by a resident were classified as resident deliveries. Deliveries in maternity units without residents were excluded. We used multilevel multivariable Poisson regression models and propensity score matching to control for indication bias and potential confounders, including the maternity unit status. We performed subgroup analyses according to gestational age at delivery, before or after 37 weeks of gestation, and to the noncephalic second twin presentation, breech or transverse.

RESULTS:
Among 1,376 noncephalic second-twin deliveries, 545 (39.6%) were initially managed by a resident and 831 (60.4%) by a senior obstetrician. Residents failed to deliver the second twin in 125 (22.9%) women. Composite neonatal mortality and morbidity did not differ between the resident and senior groups (13/545 [2.4%] vs 29/831 [3.5%]; adjusted relative risk 0.78, 95% CI 0.35–1.74). Subgroup analyses were consistent with the overall analysis.

CONCLUSION:
Supervised resident and senior staff management of noncephalic second-twin vaginal delivery is associated with similar neonatal morbidity and mortality, which supports continued training of residents in such deliveries.
Cervical Screening by Pap Test and Visual Inspection Enabling Same-Day Biopsy in Low-Resource, High-Risk Communities
Authors: Tao Lin , Amanguli A. , Li Feng , Wang Ying Hong , Yang Lan , Mohemaiti Meiliguli , Zhao Jin , Zou Xiao Guang , Saimaiti Abudukeyoumu , Abudu Mirensha , Maimaiti Mikairemu , Chen Shi Yan , Abudukelimu Ruxianguli , Maimaiti Ayinuer , Li Shu Gang , Zhang Wei , Aizimu Ayinuer , Yang An Qiang , Wang Ju , Pang Li Juan , Cao Yu Guang , Gu Wen Yi , Zhang Wen Jie 
Published: November 2018

OBJECTIVE:
To develop an effective, low-cost, single-visit cervical screening strategy incorporating a modified Pap test and visual inspection with acetic acid and Lugol’s iodine for low-income settings.

METHODS:
We conducted a prospective cohort trial. Two low-income Muslim Uyghur communities in China’s far western Kashi Prefecture served as pilot and validation study sites, respectively, and 4,049 women (aged 30–59 years) were screened. The conventional Pap test was modified using a cotton swab to collect cervical cells without scraping the cervix using an Ayre spatula, allowing visual inspection with acetic acid (and visual inspection with Lugol’s iodine if visual inspection with acetic acid was negative) to be performed in a single visit. Results from both tests were available within 1–2 hours. Women positive for either or both underwent same-day biopsy that was shipped by a courier service to a central pathology laboratory.

RESULTS:
Single-visit screening incorporating both a modified Pap test and visual inspection achieved a sensitivity of 96.0% (95% CI 91.6–100), which was superior to Pap testing (76%, 95% CI 66.3–85.7; P<.001) or visual inspection with acetic acid–visual inspection with Lugol’s iodine (48%, 95% CI 36.7–59.3; P<.001) alone in detecting cervical intraepithelial neoplasia (CIN) 2 or worse lesions. Rapid interpretation of both diagnostic procedures facilitated efficient same-day biopsy that achieved a negative predictive value of 98.2% in detecting CIN 2 or worse lesions. The increased sensitivity and minimized loss of follow-up allowed this approach to identify an extremely high prevalence of CIN 1 (2,741/100,000, 95% CI 2,238–3,245/100,000), CIN 2 or 3 (1,457/100,000, 95% CI 1,088–1,826/100,000), and cervical cancer (395/100,000, 95% CI 202–589/100,000) among these underscreened, at-risk women.

CONCLUSION:
Single-visit cervical screening with both a modified Pap test and visual inspection has greater sensitivity to detect high-grade CINs, reduces loss of follow-up, and could be an efficient low-cost strategy for low-resource settings.
Incident Diabetes in Survivors of Critical Illness and Mechanisms Underlying Persistent Glucose Intolerance: A Prospective Cohort Study
Authors: Kar Palash , Plummer Mark P. , Ali Abdelhamid Yasmine , Giersch Emma J. , Summers Matthew J. , Weinel Luke M. , Finnis Mark E. , Phillips Liza K. , Jones Karen L. , Horowitz Michael , Deane Adam M. 
Published: November 2018

Objectives:
Stress hyperglycemia occurs in critically ill patients and may be a risk factor for subsequent diabetes. The aims of this study were to determine incident diabetes and prevalent prediabetes in survivors of critical illness experiencing stress hyperglycemia and to explore underlying mechanisms.

Design:
This was a prospective, single center, cohort study. At admission to ICU, hemoglobin A1c was measured in eligible patients. Participants returned at 3 and 12 months after ICU admission and underwent hemoglobin A1c testing and an oral glucose tolerance test. Blood was also collected for hormone concentrations, whereas gastric emptying was measured via an isotope breath test. β-cell function was modeled using standard techniques.

Setting:
Tertiary-referral, mixed medical-surgical ICU.

Patients:
Consecutively admitted patients who developed stress hyperglycemia and survived to hospital discharge were eligible.

Measurements and Main Results:
Consent was obtained from 40 patients (mean age, 58 yr [sd, 10], hemoglobin A1c 36.8 mmol/mol [4.9 mmol/mol]) with 35 attending the 3-month and 26 the 12-month visits. At 3 months, 13 (37%) had diabetes and 15 (43%) had prediabetes. At 12 months, seven (27%) participants had diabetes, whereas 11 (42%) had prediabetes. Mean hemoglobin A1c increased from baseline during the study: +0.7 mmol/mol (–1.2 to 2.5 mmol/mol) at 3 months and +3.3 mmol/mol (0.98–5.59 mmol/mol) at 12 months (p = 0.02). Gastric emptying was not significantly different across groups at either 3 or 12 months.

Conclusions:
Diabetes and prediabetes occur frequently in survivors of ICU experiencing stress hyperglycemia. Based on the occurrence rate observed in this cohort, structured screening and intervention programs appear warranted.
Cytoimmunofluorescence Diagnosis in Surgically Induced Pemphigus Foliaceus
Authors: Magdaleno-Tapial Jorge , Valenzuela-Oñate Cristian , Giacaman-von der Weth Macarena , García-Legaz Martínez Marta , Hernández-Bel Pablo , Carballeira-Braña Alexo , Sánchez-Carazo José Luis , Alegre-de Miquel Víctor 
Published: November 2018

Abstract:
Pemphigus foliaceus is an autoimmune bullous disease with autoantibodies against desmoglein 1. Case reports of pemphigus after surgery have also been described, which may simulate an infection of the surgical wound, a contact dermatitis, or even a tumor recurrence. Cytoimmunofluorescence can help to establish a rapid diagnosis.
Treatment of Complicated Anal Fistula by an Endofistular Polyurethane-Sponge Vacuum Therapy: A Pilot Study
Authors: Schniewind Bodo , Schafmayer Clemens , von Schönfels Witigo , Heits Nils G. , Kucharzik Torsten , Klein Georg , Hampe Jochen 
Published: November 2018

BACKGROUND:
Treatment of supra- and transsphincteric anal fistulas remains a clinical challenge because current treatment results are variable and potentially endanger sphincter function.

OBJECTIVE:
Based on positive results of endoluminal polyurethane-sponge vacuum therapy in the upper and lower GI tract, a new system for endofistular vacuum therapy was developed for anal fistulas to utilize vacuum therapy to remove the endofistular pseudoepithelium and to induce granulation in the fistula tract.

DESIGN:
This study is based on a prospective case series.

PATIENTS:
Seven patients with complicated anal fistulas (3 associated with Crohn’s disease and 4 of cryptoglandular origin) longer than 4 cm were treated. Initially, the fistula was curettaged and the first endofistular vacuum therapy sponge was positioned in the fistula tract. The inner fistula opening was closed by suture. A 125 mm Hg constant vacuum was applied to the sponge, and the endofistular vacuum therapy sponge was changed a median of 3 (3–5) times after each 48 to 72 hours of constant vacuum therapy. After final removal, the fistulas were reevaluated every other week for 3 months.

MAIN OUTCOME MEASURE:
The main outcome measured was the closure of the fistula.

RESULTS:
All patients tolerated the therapy well and no adverse events were observed. Fistula tract closure was demonstrated within 4 weeks after the termination of vacuum therapy. One patient with cryptoglandular fistula developed a recurrence within the follow-up of 3 months.

LIMITATIONS:
This was an observational study that had no control arm.

CONCLUSION:
In this pilot case series, the results are encouraging. Because endoluminal vacuum therapy would be a new and sphincter-sparing therapy, this concept warrants further investigation in controlled trials.
Immediate and Long-term Complications of Direct-to-implant Breast Reconstruction after Nipple- or Skin-sparing Mastectomy
Authors: Lam Thomas C. , Hsieh Frank , Salinas James , Boyages John 
Published: November 2018

Background:
Traditionally, breast reconstruction options after mastectomy comprise an autologous flap or staged expander/implant reconstruction, or a combination of both. Recent introduction of skin or nipple-sparing mastectomies have led to much interest in direct-to-implant immediate breast reconstructions. We performed a retrospective review of our initial experience.

Methods:
Between June 1998 and December 2010, 31 of 671 patients (4.6%) who received implant-only breast reconstruction underwent direct-to-implant immediate breast reconstruction after mastectomy for primary or recurrent cancers, or risk reduction. Their files were audited, and the primary factor examined was the failure of reconstruction with loss of prosthesis. Other complications, revision surgery, and aesthetic result are also recorded.

Results:
The mean follow-up period for the 31 patients was 49.5 months. A total of 45 mastectomies were performed for 21 primary and 4 recurrent breast cancers after previous conservation surgery and radiotherapy (RT), and 20 for risk reduction. Ten patients received RT (4 before mastectomy and 6 afterward). Average size of implants was 380.0 g (range, 205–620 g). The most common postoperative complications were seromas (20%); only 1 implant was lost (2.22%). Nineteen breasts required revision surgery after 6 months with 1 more implant lost. Despite the high revision rate, 28 (90.3%) had excellent or good aesthetic result.

Conclusions:
Immediate single-stage direct-to-implant breast reconstruction has a high rate of both immediate postoperative complications and revisions after 6 months, especially after RT. However, most complications are manageable and do not necessarily result in implant loss. Most cases can have a successful outcome without implant loss with excellent or good cosmetic results.