bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corneal Biomechanical Properties in Obstructive Sleep Apnea Syndrome
Authors: Dikkaya Funda , Yildirim Rengin , Erdur Sevil Karaman , Benbir Gülçin , Aydin Rukiye , Karadeniz Derya 
Published: February 2018

Objectives:
To investigate the corneal biomechanical properties and anterior segment parameters in patients with obstructive sleep apnea syndrome (OSAS).

Methods:
Fifty-four eyes of 54 patients with OSAS and 20 eyes of 20 healthy subjects were included. Patients with mild and moderate OSAS (Respiratory Disturbance Index [RDI] <30) enrolled in group 1, those with severe OSAS (RDI≥30) in group 2 and controls in group 3. Corneal biomechanical properties including corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc) were measured with ocular response analyzer. Maximum (Kmax), minimum (Kmin), and mean simulated (SimKm) keratometry values, corneal astigmatism (CA), and central corneal thickness (CCT) were evaluated with Pentacam Scheimpflug imaging.

Results:
The mean CH and CRF were significantly lower in group 2. The mean CH was 10.9±1.4 mm Hg in group 1, 10.1±1.1 mm Hg in group 2, and 12.1±1.2 mm Hg in group 3 (P<0.001). The mean CRF was 11.1±1.8 mm Hg in group 1, 9.9±1.1 mm Hg in group 2, and 12.2±1.2 mm Hg in group 3 (P<0.001). The CH and CRF values were similar between the groups 1 and 3 (P=0.867 and P=0.743). Corneal-compensated intraocular pressure, IOPg, Kmax, Kmin, SimKm, CA, and CCT values were not statistically different among the three groups.

Conclusions:
Patients with severe OSAS had lower CH and CRF values. The lower CH and CRF values in the severe group were possibly related to changes of the structural properties in the cornea.
Nurse Practitioner Student Knowledge and Attitudes Toward Skin Cancer Assessments
Authors: Woodmansee Ryan , Turnage Dawn , Loerzel Victoria 
Published: February 2018

ABSTRACT
Early detection and treatment of skin cancer is directly related to patient outcomes. However, little is known about how prepared nurse practitioner students are to assess and manage skin lesions. Therefore, the purpose of this study was to assess nurse practitioner student knowledge to determine how well they are being prepared to perform skin cancer assessments. This exploratory, descriptive study surveyed 20 nurse practitioner students about their knowledge, attitudes, and confidence in identifying different skin lesions. Most participants had average knowledge scores related to general skin cancer knowledge (6.4/13 correct) and photo lesion identification (9.65/20 correct). Most students felt they lacked enough dermatology training to prepare them for practice. Most students did not feel confident performing skin cancer assessments, had a hard time differentiating between benign and malignant lesions, and would rather refer patients to a specialist for diagnosis. Nurse practitioner curricula should consider allotting more time for dermatology topics, especially learning to recognize whether a lesion is benign or malignant.
Examining the Relationship of an All-Cause Harm Patient Safety Measure and Critical Performance Measures at the Frontline of Care
Authors: Sammer Christine , Hauck Loran D. , Jones Cason , Zaiback-Aldinger Julie , Li Michael , Classen David 
Published: February 2018

Background
In 2015, the Institute of Medicine Vital Signs report called for a new patient safety composite measure to lessen the reporting burden of patient harm. Before this report, two patient safety organizations had developed an electronic all-cause harm measurement system leveraging data from the electronic health record, which identified and grouped harms into five broad categories and consolidated them into one all-cause harm outcome measure.

Objectives
The objective of this study was to examine the relationship between this all-cause harm patient safety measure and the following three performance measures important to overall hospital safety performance: safety culture, employee engagement, and patient experience.

Methods
We studied the relationship between all-cause harm and three performance measures on eight inpatient care units at one hospital for 7 months.

Results
The findings demonstrated strong correlations between an all-cause harm measure and patient safety culture, employee engagement, and patient experience at the hospital unit level. Four safety culture domains showed significant negative correlations with all-cause harm at a P value of 0.05 or less. Six employee engagement domains were significantly negatively correlated with all-cause harm at a P value of 0.01 or less, and six of the ten patient experience measures were significantly correlated with all-cause harm at a P value of 0.05 or less.

Conclusions
The results show that there is a strong relationship between all-cause harm and these performance measures indicating that when there is a positive patient safety culture, a more engaged employee, and a more satisfying patient experience, there may be less all-cause harm.
Modified Lengthening Temporalis Myoplasty Involving an Extended Lazy-S Incision to Avoid Facial Scar Formation
Authors: Oji Tomito , Hayashi Akiteru , Ogino Akihiro , Onishi Kiyoshi 
Published: February 2018

Background:
Lengthening temporalis myoplasty is a faster and less invasive alternative to free muscle transfer for smile reconstruction. However, it requires a nasolabial fold incision, which leaves a midfacial scar. Based on esthetic considerations, a modified approach, involving an extended lazy-S (parotidectomy) incision instead of a nasolabial fold incision, was developed.

Methods:
A cadaveric study involving 10 hemifaces was conducted. From February 2013 to March 2016, the modified lengthening temporalis myoplasty procedure was employed in 10 patients. The results were graded from 1 (poor) to 5 (excellent) according to the Terzis grading system. The excursion of the oral commissure was also measured.

Results:
The extended lazy-S incision provides easy and safe access to the coronoid process and good visibility. The patients’ mean age was 56.5 years, and the mean duration of the postoperative follow-up period was 22.2 months. The patients’ underlying conditions included acoustic neuroma (n = 2), Bell palsy (n = 3), congenital conditions (n = 2), brain infarction (n = 1), Ramsay Hunt syndrome (n = 1), and malignant parotid lymphoma (n = 1). One patient suffered a surgical site infection, which was successfully treated with irrigation. All the patients achieved improvements in smile symmetry: 2, 5, and 3 patients obtained excellent, good, and moderate results, respectively. The excursion of the oral commissure ranged from 5 to 10 mm.

Conclusion:
The modified lengthening temporalis myoplasty procedure provides satisfactory functional outcomes without causing significant complications. It does not leave a facial scar and is a preferable option, especially for young and female patients, and patients who have undergone ablative surgery involving the parotid region.
Clinical Outcomes of Digital Three-Dimensional Hydroxyapatite in Repairing Calvarial Defects
Authors: Chen Hongbo , Sun Jiaming , Wang Jie-cong 
Published: February 2018

Purpose:
The objective of this article is to present the long-term outcomes of digital three-dimensional (3D) hydroxyapatite (HA) implants used for calvarial defects. Porous HA provide good results and have many characteristics, making it suitable for calvarial defect reconstruction. However, using HA may be associated with potentially serious complications, including infection and exposure. The authors used digital 3D HA for cranioplasty for many years and accumulated considerable experience from using it. The authors found that digital 3D HA is an effective method for cranioplasty, showing low complication rate.

Methods:
A total of 57 patients underwent calvarial defect reconstruction with 3D HA from June 2009 to August 2016. The follow-up period was 1 to 5 years.

Results:
Most patients (91.2%) were greatly satisfied with the esthetic outcomes of the surgery. The highest rate of complication was seroma (8.8%). Two patients developed postoperative infections (3.5%). One patient with infections was successfully treated with antibiotic therapy. Another patient was required to undergo an extensive surgical debridement followed by delayed autogenous bone reconstruction. One patient suffered from implant exposure. No hematoma, unexpected fractures, asymmetry, and contour or implant abnormalities occurred.

Conclusions:
The digital 3D HA implant was highly biocompatible and durable for the reconstruction of calvarial defects. With appropriate treatment, the proposed method was able to achieve a functional and cosmetic reconstruction with lesser complications.
A Rare Cause of Objective Tinnitus: Jugular Diverticulum
Authors: Gözen Emine Deniz , Erdur Zülküf Burak , Karaman Emin , Yener Murat , Kizilkiliç Osman 
Published: February 2018

Abstract
The jugular bulb is a venous structure linking the sigmoid sinus with the internal jugular vein. Jugular diverticulum is a rare condition characterized by extraluminal outpouching from the jugular bulb. As the patients may be totally asymptomatic, but sensorineural symptoms such as sensorineural hearing loss, tinnitus and vertigo can also occur. Diagnosis of these patients can be made by some radiologic methods such as high-resolution computerized tomography, magnetic resonance imaging, or a novel radiologic technique flat panel computed tomography. In this paper we report a 22-year-old female patient with jugular diverticulum presenting with tinnitus complaint.
The Effect of Upper Aging Blepharoplasty on Upper and Lower Eyelid Position
Authors: Park Jinhwan , Choi Boyoon , Baek Sehyun 
Published: February 2018

Purpose:
Change in eyelid position after upper blepharoplasty is an important factor that can affect postoperative patient satisfaction. However, no one has investigated eyelid changes during follow-up for upper eyelid surgery. Thus, the purpose of this study was to investigate position changes in the upper and lower eyelids during the follow-up period after upper blepharoplasty in Korean.

Methods:
The authors retrospectively reviewed the clinical records of patients who underwent upper blepharoplasty for uncomplicated upper eyelid dermatochalasis. Digital photographs were taken preoperatively, immediately after surgery, and at 1 week postoperative, 1 month postoperative, and 3 months postoperative. Our main-effect variables were marginal reflex distance (MRD) 1 and 2 and palpebral fissure height (PFH), which were measured from digital photographs using ImageJ software.

Results:
We enrolled 180 eyes from 90 patients (M: 35 and F: 55) with a mean age of 63.8 ± 10.3 years. The eyelid measurements (MRD1, MRD2, PFH) taken preoperatively, immediately after surgery, and 1 week, 1 month, and 3 months postoperative were, respectively: MRD1 (mm): 2.56 ± 1.08, 1.91 ± 0.86, 2.21 ± 1.02, 2.66 ± 1.01, 2.75 ± 0.99; MRD2 (mm): 4.91 ± 0.93, 4.62 ± 0.87, 4.68 ± 0.90, 4.87 ± 0.86, 4.91 ± 0.83; and PFH (mm): 7.48 ± 1.64, 6.53 ± 1.46, 6.89 ± 1.53, 7.52 ± 1.51, 7.65 ± 1.49. All postoperative measurements for MRD1 and PFH were significantly different from the preoperative measurement, except for measurements taken 1 month postoperative. MRD2 measurements differed significantly from the preoperative measurements immediately after surgery and 1 week postoperative. Among age, preoperative PFH, and amount of skin-muscle resection, only preoperative PFH significantly affected PFH changes immediately after surgery and at 3 months postoperative (OR 0.636, 95% CI 0.478–0.847, OR 0.506, 95% CI 0.386–0.663).

Conclusion:
All eyelid measurements (MRD1, MRD2, and PFH) decreased 1 week postoperatively from values immediately after surgery, but MRD1 and PFH increased slightly 3 months postoperative. We note that postoperative changes in PFH may be large in patients with large PFH before blepharoplasty. It should also be noted that reverse ptosis of the lower eyelid occurs immediately after upper eyelid surgery.
Disparities in Rates of Surgical Intervention Among Racial and Ethnic Minorities in Medicare Accountable Care Organizations
Authors: Schoenfeld Andrew J. , Sturgeon Daniel J. , Dimick Justin B. , Bono Christopher M. , Blucher Justin A. , Barton Lauren B. , Weissman Joel S. , Haider Adil H. 
Published: February 2018

Objective:
To assess the effect of Accountable Care Organizations (ACOs) on the use of surgical services among racial and ethnic minorities.

Background:
Health reform efforts were expected to reduce healthcare disparities. The impact of ACOs on existing disparities in access to surgical care remains unknown.

Methods:
We used national Medicare data (2009–2014) to compare rates of surgery among white, African American, Hispanic, and Asian Medicare beneficiaries for coronary artery bypass grafting, colectomy, total hip arthroplasty, hip fracture repair, and lumbar spine surgery. We performed a pre-post difference in differences analysis between African American, Hispanic, and Asian patients receiving surgical care in ACO and non-ACO organizations before and after the implementation of ACOs. The time period 2009 to 2011 was considered the pre-ACO period, and 2012 to 2014 the post-ACO period.

Results:
Rates of surgical intervention in the ACO cohort were significantly lower (P < 0.001) as compared to non-ACOs for whites, African Americans, Hispanics, and Asians in both the pre- and post-ACO periods. There was no significant difference in the adjusted change in the rate of surgical interventions among minority patients as compared to whites in ACOs and non-ACOs between 2009 to 2011 and 2012 to 2014. The odds of receiving surgical intervention were lowest for minority patients in ACOs during the post-ACO period (P < 0.001).

Conclusions:
We found persistent differences in the use of surgery among racial and ethnic minorities between the time periods 2009 to 2011 and 2012 to 2014. These disparities were not impacted by the formation of ACOs. Programs that specifically incentivize ACOs to improve surgical access for minorities may be necessary.
Fabrication and electromagnetic performance of talc/NiTiO
3
composite
Authors: Qin Wen-Li , Xia Tian , Ye Ying , Zhang Ping-Ping 
Published: February 2018

In this study, the electromagnetic (EM) performance of talc/NiTiO
3
composite was evaluated. The morphology of talc displayed a lamella structure; there were many nanoparticles of NiTiO
3
coated on the talc lamella
.
Thermal destruction occurred, which increased the surface area from 2.51 m
2
g
−1
to 79.09 m
2
g
−1
at the calcined stage at 650°C. The presence of NiTiO
3
increased dielectric loss and magnetic loss of talc. The calculation of EM wave absorption of talc/NiTiO
3
obtained a maximum reflection loss of −11.94 dB at the thickness of 6.85 mm; the optimum thickness for microwave absorption is 6.3–7.3 mm. This study revealed a new approach for fabricating an EM absorber and broadening applications of both talc and NiTiO
3
in EM absorption.
The ductile/brittle transition provides the critical test for materials failure theory
Authors: Christensen Richard M. 
Published: February 2018

It is reasoned that any materials failure theory that claims generality must give full account of ductile versus brittle failure behaviour. Any such proposed theory especially must admit the capability to generate the ductile/brittle transition. A derivation of the failure surface orientations from a particular isotropic materials failure theory reveals that uniaxial tension has its ductile/brittle transition at
T
/
C
= 1/2, where
T
and
C
are the uniaxial strengths. Between this information and the corresponding ductile/brittle transition in uniaxial compression it becomes possible to derive the functional form for the fully three-dimensional ductile/brittle transition. These same general steps of verification must be fulfilled for any other candidate general failure theory.
Dynamic simulations of many-body electrostatic self-assembly
Authors: Lindgren Eric B. , Stamm Benjamin , Maday Yvon , Besley Elena , Stace A. J. 
Published: February 2018

Two experimental studies relating to electrostatic self-assembly have been the subject of dynamic computer simulations, where the consequences of changing the charge and the dielectric constant of the materials concerned have been explored. One series of calculations relates to experiments on the assembly of polymer particles that have been subjected to tribocharging and the simulations successfully reproduce many of the observed patterns of behaviour. A second study explores events observed following collisions between single particles and small clusters composed of charged particles derived from a metal oxide composite. As before, observations recorded during the course of the experiments are reproduced by the calculations. One study in particular reveals how particle polarizability can influence the assembly process.
This article is part of the theme issue ‘Modern theoretical chemistry’.
Kinetics and dynamics of near-resonant vibrational energy transfer in gas ensembles of atmospheric interest
Authors: McCaffery Anthony J. 
Published: February 2018

This study of near-resonant, vibration–vibration (V–V) gas-phase energy transfer in diatomic molecules uses the theoretical/computational method, of Marsh & McCaffery (Marsh & McCaffery 2002J. Chem. Phys.117, 503 (doi:10.1063/1.1489998)) The method uses the angular momentum (AM) theoretical formalism to compute quantum-state populations within the component molecules of large, non-equilibrium, gas mixtures as the component species proceed to equilibration. Computed quantum-state populations are displayed in a number of formats that reveal the detailed mechanism of the near-resonant V–V process. Further, the evolution of quantum-state populations, for each species present, may be followed as the number of collision cycles increases, displaying the kinetics of evolution for each quantum state of the ensemble's molecules. These features are illustrated for ensembles containing vibrationally excited N2in H2, O2and N2initially in their ground states.This article is part of the theme issue ‘Modern theoretical chemistry’.
Modulation of slow and fast oscillations by direct current stimulation in the cerebral cortex in vitro
Authors: D’Andola Mattia , Weinert Julia F. , Mattia Maurizio , Sanchez-Vives Maria V. 
Published: February 2018

AbstractNon-invasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS), play a growing role in the treatment of neurological disorders. However, the mechanisms by which electric fields modulate cortical network activity are only partially understood. To explore the spatiotemporal modulation of cortical activity by electric fields (DC fields), we exposed neocortical slices to constant fields of varying intensity and direction and we measured their effect on the low (<1 Hz) and high frequencies (beta 15-30 Hz and gamma 30-90 Hz) of spontaneously generated cortical oscillations. Slow oscillations consist of Up (active) and Down (silent) states. We found that DC fields ranging from -6 to +6 V/m induced an exponential increase in the frequency of slow oscillations through the regulation of the excitability and duration of Down states, while hardly affecting Up states duration. A computational model based on the mean-field theory of attractor dynamics provided a mechanistic and quantitative description of the network dynamics underlying such precise modulation of slow oscillatory frequency. The modulation of high frequencies by DC fields was less consistent, the high frequency power varying with the intensity of the fields only in a fraction of slices. Interestingly, negative DC fields of increasing intensities progressively and effectively reversed the increase in high frequency power induced by kainate application. Our findings have implications for the understanding of cortical oscillations and the mechanisms by which they are modulated by DC fields and may contribute to the future development of tools with an accurate spatiotemporal control of cortical activity.Significance statementActing on the brain through electrical stimulation in order to correct dysfunctions or to induce functional recovery is a relatively common technique nowadays used in the clinical realm. In spite of the existence of previous studies on the effect of electric fields on neuronal and network physiology, questions regarding the mechanisms underlying exogenous electrical modulation of cortical dynamics still remain open. We demonstrate that continuous electric fields between -6 and +6 V/m induce a precise modulation of slow and fast cortical rhythms. Based on both experimental evidence and theoretical analysis, we describe some of the mechanistic underpinnings at play and provide useful information for the development of tools with better spatiotemporal control of cortical activity.
A nonlinear updating algorithm captures suboptimal inference in the presence of signal-dependent noise
Authors: Egger Seth W. , Jazayeri Mehrdad 
Published: February 2018

AbstractBayesian models of behavior have advanced the idea that humans combine prior beliefs and sensory observations to minimize uncertainty. How the brain implements Bayes-optimal inference, however, remains poorly understood. Simple behavioral tasks suggest that the brain can flexibly represent and manipulate probability distributions. An alternative view is that brain relies on simple algorithms that can implement Bayes-optimal behavior only when the computational demands are low. To distinguish between these alternatives, we devised a task in which Bayes-optimal performance could not be matched by simple algorithms. We asked subjects to estimate and reproduce a time interval by combining prior information with one or two sequential measurements. In the domain of time, measurement noise increases with duration. This property makes the integration of multiple measurements beyond the reach of simple algorithms. We found that subjects were able to update their estimates using the second measurement but their performance was suboptimal, suggesting that they were unable to update full probability distributions. Instead, subjects’ behavior was consistent with an algorithm that predicts upcoming sensory signals, and applies a nonlinear function to errors in prediction to update estimates. These results indicate that inference strategies humans deploy may deviate from Bayes-optimal integration when the computational demands are high.