bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergence of coherent vortices from Leslie’s perturbation method in a rotating turbulent ﬂuid
Authors: Dutta Kishore 
Published: April 2018

Abstract

Publisher's Note: This article was withdrawn in July 2018 due to a dispute over the authorship of the work.
The Coriolis force that plays a fundamental role in determining the anisotropic structure of rotating turbulent fluid, has evaded most analytical attempts in understanding the emergence of coherent columnar structures. Here we treated the Coriolis term appearing in the rotating turbulence dynamics as a perturbation acting on the isotropic Kolmogorov state and show that it generates anisotropic (angle-dependent) contribution to the spectral energy density. We find that, with increasing length scales, the turbulent energy density resides more and more predominantly in the wavevectors perpendicular to the rotation axis. This signifies the generation of coherent columnar vortices at sufficiently large scales which is consistent with experimental observations and numerical predictions in rotating turbulence.
Closing the Capacity-Ability Gap: Using Technology to Support Aging With Disability
Authors: Mitzner Tracy L , Sanford Jon A , Rogers Wendy A 
Published: April 2018

Abstract
There is a critical need to develop supports for older adults who have a wide range of abilities, including those aging with long-term impairments. Without appropriate support, many individuals will be functioning below optimal levels and will face participation barriers. Technology holds great promise to provide individualized support for a wide range of abilities and for a variety of domains. To ensure technology interventions are designed well and meet research-documented user requirements, we need more specific, actionable models to provide guidance for those developing and designing interventions. In this paper, we present the TechSAge Aging and Disability Model to bridge models from the aging and disability literatures and to disambiguate the population of individuals aging into disability from those aging with disability (i.e., pre-existing impairments). We also present the TechSAge Technology Intervention Model to support aging with pre-existing impairments, which provides direction and touch points for technology interventions. These models reflect the complex and dynamic interaction between age-related changes and an individual’s prior capabilities and limitations. We describe the need for these models with respect to filling a gap in the disability and aging literature by highlighting the importance of differentiating between age-related changes and long-term impairments when designing interventions. We also show the need for quantitative and qualitative data to refine the models given complexities of the current state of the literature and survey data. The TechSAge Technology Intervention Model can be used to drive and inform technology redesign and development.
Schur complement preconditioners for multiple saddle point problems of block tridiagonal form with application to optimization problems
Authors: Sogn Jarle , Zulehner Walter 
Published: April 2018

Abstract
The importance of Schur-complement-based preconditioners is well established for classical saddle point problems in $\mathbb{R}^N \times \mathbb{R}^M$. In this paper we extend these results to multiple saddle point problems in Hilbert spaces $X_1\times X_2 \times \cdots \times X_n$. For such problems with a block tridiagonal Hessian and a well-defined sequence of associated Schur complements, sharp bounds for the condition number of the problem are derived, which do not depend on the involved operators. These bounds can be expressed in terms of the roots of the difference of two Chebyshev polynomials of the second kind. If applied to specific classes of optimal control problems the abstract analysis leads to new existence results as well as to the construction of efficient preconditioners for the associated discretized optimality systems.
Membership determination of open clusters based on a spectral clustering method
Authors: Gao Xin-Hua 
Published: April 2018

Abstract
We present a spectral clustering (SC) method aimed at segregating reliable members of open clusters in multi-dimensional space. The SC method is a non-parametric clustering technique that performs cluster division using eigenvectors of the similarity matrix; no prior knowledge of the clusters is required. This method is more flexible in dealing with multi-dimensional data compared to other methods of membership determination. We use this method to segregate the cluster members of five open clusters (Hyades, Coma Ber, Pleiades, Praesepe, and NGC 188) in five-dimensional space; fairly clean cluster members are obtained. We find that the SC method can capture a small number of cluster members (weak signal) from a large number of field stars (heavy noise). Based on these cluster members, we compute the mean proper motions and distances for the Hyades, Coma Ber, Pleiades, and Praesepe clusters, and our results are in general quite consistent with the results derived by other authors. The test results indicate that the SC method is highly suitable for segregating cluster members of open clusters based on high-precision multi-dimensional astrometric data such as Gaia data.
Fanconi Anemia Type C: Results of Population Carrier Testing [2A]
Authors: Bardos Jonah D. , Terhaar Catherine , Echeverri Natalia , Longman Ryan 
Published: April 2018

INTRODUCTION:
Fanconi Anemia Type C (FAC) is an autosomal recessive disorder characterized by skeletal malformations, bone marrow failure, increased risk of malignancy, and severe aplastic anemia. Currently, carrier testing for FAC is recommended for the Ashkenazi Jewish (AJ) population. A joint ACOG/ACMG statement highlighted the increasingly multi-ethnic society as consideration for pan-ethnic carrier testing, and recent ACOG committee opinion states that pan-ethnic testing is a reasonable strategy. Our current study assesses how many non-AJ individuals screened positive for FAC when pan-ethnic carrier testing was implemented.

METHODS:
Retrospective database analysis of individuals that received expanded carrier testing utilizing a genotyping panel for three pathologic variants of FAC (c.322delG, IVS4 c.456(+4)A>T, p.R548X) was performed. Expected number of positive carriers in AJ and non-AJ groups were calculated and compared to observed rates. Chi-square analysis was performed to assess for statistical significance (p < 0.01).

RESULTS:
A total of 71,235 individuals were tested for FAC. A higher than expected number of non-AJ individuals tested positive for FAC (56 observed vs 8.89 expected, p<0.001). The number of AJ individuals that screened positive was consistent with expected values (10 observed vs 11.11 expected, p<0.73).

CONCLUSION:
Non-AJ carriers of FAC were more common than expected in this cohort. Pan-ethnic expanded carrier testing will increase the detection of carriers for FAC compared with current ethnicity based screening recommendations. Importantly, carriers of FAC who would be missed by ethnicity based testing convention, will be identified allowing for more complete genetic counseling and family planning options for those who choose testing.
Removal of Bakri Intrauterine Balloon by Rapid or Stepwise Deflation: Which Technique is Better? [5A]
Authors: Wong Melissa , Greene Naomi , Gregory Kimberly D. 
Published: April 2018

INTRODUCTION:
Intrauterine balloon tamponade (IBT) is an effective method for reducing the morbidity associated with postpartum hemorrhage but the best method for removal is unknown. The objective of this study is to determine whether stepwise deflation of the IBT is associated with a reduced likelihood of secondary hemorrhage and blood loss after removal.

METHODS:
This is a retrospective cohort study of patients who received an IBT from 2012-2016. Patients were included if the IBT remained in place at least 2 hours and were excluded in cases of failed IBT placement. Patients were assigned to 1 of 2 groups: the (1) RAPID group underwent deflation all at once and the (2) STEPWISE group underwent deflation in 2 or more serial visits.

RESULTS:
124 subjects met our inclusion criteria: 24 underwent Rapid deflation and 100 underwent Stepwise deflation. There were no significant differences in baseline characteristics between the two groups. Less blood loss after deflation was noted in the patients who underwent Rapid deflation compared to the Stepwise Group (2.1 vs 31 mL, p = 0.005). There were no instances of significant post-deflation hemorrhage in either group. There were no differences in other secondary outcomes including need for additional interventions.

CONCLUSION:
Rapid deflation was associated with less blood loss, though this may reflect a reduced likelihood of accurate measurement in this group given that the catheter is no longer in situ. Rapid deflation rather than stepwise deflation should be considered (and may be preferred) for IBT removal.
Changing the Definition of Postpartum Hemorrhage [10A]
Authors: Coviello Elizabeth , Chornock Rebecca , Cheney Megan , Iqbal Sara , Fries Melissa 
Published: April 2018

INTRODUCTION:
To determine the amount of blood that predicts postpartum hemorrhage, as defined by standard definition compared to Maryland's Hospital Association's definition.

METHODS:
This is a retrospective chart review that identified all women in the electronic medical record with PPH (standard definition >500 ml for vaginal delivery [VD] and >1000 ml for cesarean delivery [CD] and Maryland definition [MD] >=1000 ml for VD and >=1500 ml for CD) as estimated by eBL (n=49) and qBL (n=209)) between September 2014 and September 2015, as estimated by EBL (n=166), and October 2015 and October 2016, as estimated by qBL (n=733). The primary outcome was the area under the receiver-operating-characteristic (ROC) curve (AUC) for blood transfusion in women with PPH. The ROC was generated by calculating the amount of blood loss by each technique and PPH definition, that best predicted blood product transfusion.

RESULTS:
The rate of PPH using the standard definition with eBL and qBL was 5% and 21.23%, respectively (p<0.01). The rate of PPH using MD with eBL and qBL was 1.5% and 6%, respectively (p<0.01). PPH defined by standard definition, postpartum transfusion was predicted by eBL of 1377 ml with 89.2% sensitivity and AUC 0.921 and qBL of 1400 ml with 82.5% sensitivity and AUC 0.866. PPH defined by MD's, postpartum transfusion was predicted by eBL of 1525 ml with 80.6% sensitivity and AUC 0.825 and qbl 1688 ml with 65% sensitivity and AUC 0.759.

CONCLUSION:
PPH by standard definitions predicted blood transfusions at lower blood loss with greater AUC than MD's definition.
Evaluating Hospital Hemorrhage Protocol Components and Maternal Morbidity [15A]
Authors: Srinivas Sindhu 
Published: April 2018

INTRODUCTION:
The Council for Patient Safety in Women's Health suggested implementation of a hemorrhage bundle to reduce obstetrical hemorrhage and improve related morbidity. We previously reported that approximately 20% of the variation in hospital postpartum hemorrhage (PPH) frequency was related to provider/hospital factors. We aim to assess whether the number of recommended components included in a hospital’s obstetrical hemorrhage protocol reduces maternal morbidity.

METHODS:
A total of 14,283 women who delivered at 4 hospitals with hemorrhage protocols between March 2008 and February 2011 were analyzed. Two hospitals updated their protocol during the study period resulting in evaluation of 6 protocols, with analyses being performed based on the protocol in place at the time of delivery. Each protocol was evaluated by two independent reviewers to assess for the presence of 14 components, as recommended by the Council for Patient Safety in Women's Health. Disagreements were adjudicated by a third reviewer, masked to prior determinations. The primary outcome was a composite hemorrhage outcome including transfusion, blood loss>1000 cc, or hysterectomy. Hierarchical models were adjusted for multiple confounders.

RESULTS:
The number of elements present ranged from 1 to 7 per protocol. Nearly all protocols (83%) included a hemorrhage risk assessment and checklist for hemorrhage management. None of the protocols reported existence of a hemorrhage cart or specified the structure of reporting or debriefing. There was no association between the number of protocol elements present and the composite hemorrhage outcome (aOR 1.09; 95%CI 0.80-1.48).

CONCLUSION:
Among the hemorrhage protocols evaluated, only 1 had at least half of the suggested elements. Further evaluation is needed to determine the association of adverse outcomes with these protocols, and which elements are truly key factors in reducing maternal morbidity.
The Relationship Between Treatments and Recurrence in Borderline Ovarian Tumors [30A]
Authors: Lou Tong , Yuan Fang , Bai Huimin , Zhang Zhenyu 
Published: April 2018

INTRODUCTION:
To evaluate the relationship between treatments and recurrence in borderline ovarian tumors.

METHODS:
In a retrospective study, 281 patients, from 2 institutions, with borderline ovarian tumors were investigated. The demographic, clinical and surgical characteristics of the cases were evaluated. The effects of type of surgery, surgical staging; complete or incomplete staging, lymph node removal, appendicectomy and chemotherapy on recurrence rates were calculated by using Kaplan-Meier method and multivariate Cox proportional hazards model analysis.

RESULTS:
This study investigated 281 patients who were finally diagnosed with borderline epithelial ovarian tumors. The median follow-up for survivors was 43.0 months (range, 5-237). Median time to recurrence was 41.0 months (range, 2-190). Twenty patients (7.1%) experienced relapse and 4 patients (1.4%) died of disease within the observations period. In multivariate analysis, removing ipsilateral ovary (HR: 0.074 [95% CI, 0.023-0.234], p=0.000), FIGO stage II-III (HR: 3.719 [95% CI, 1.418-9.749], p=0.008) and ovary surface involvement (HR: 9.720 [95% CI, 1.006-93.893], p=0.049) were independent prognostic factors on recurrence. The ovary surface involvement (HR: 64.996 [95%CI, 4.054-1041.941], p=0.003) was independent prognostic factor on OS.

CONCLUSION:
Our study reveals the impact of removing ipsilateral ovary, FIGO stage II-III and ovary surface involvement on the recurrence, and ovary surface involvement was co-related with overall survival. Patients presenting these risk factors should undergo closer follow-up.
Association Between Perinatal Outcomes and Mode of Conception in Twin Pregnancies [8B]
Authors: Janssen Ashley , Dahlke Joshua , Hultgren Elizabeth , Satpathy Hemant , Bonebrake Robert , Patel Emily 
Published: April 2018

INTRODUCTION:
Artificial reproductive technology (ART) is associated with increased risks of adverse perinatal outcomes in singleton gestations; however, the association in twin gestations is less clear. Minimal data exists on the impact of oral and injectable fertility medications on maternal and perinatal outcomes in twins. Our objective was to examine the impact of conception method on perinatal outcomes.

METHODS:
We performed a retrospective cohort of all twin pregnancies delivered in a single-tertiary care-center with ultrasound evaluation between 1/1/2013 and 4/1/2016. Women with unknown conception method, missing maternal or neonatal data, and monochorionic-monoamniotic twins were excluded. The primary outcome was maternal and neonatal morbidity in twin pregnancies conceived among three groups.

RESULTS:
Of 424 twin pregnancies during the study period, 417 met inclusion criteria. 199 conceived spontaneously (G1), 86 conceived through oral/injectable medications (G2), and 132 conceived through in-vitro fertilization (IVF) (G3). Compared to G1, G2 and G3 were more likely nulliparous, privately insured, diagnosed with preeclampsia (G2: P=.03; G3: P<.01), experienced greater rates of postpartum hemorrhage (G2: P=.02; G3: P<.01) and less likely to conceive monochorionic-diamniotic twins. No difference was noted in composite maternal or neonatal morbidity between groups.

CONCLUSION:
Twin gestations conceived via IVF or oral/injectable medications are similarly associated with an increased risk of preeclampsia and postpartum hemorrhage compared to spontaneous conception. Women who conceive by infertility treatment, regardless of the type, should be counseled regarding this increased maternal risk.
Premature Ovarian Insufficiency with a Balanced Reciprocal Translocation of Chromosomes 1 and 13 [13B]
Authors: Wiltshire Ashley , Wang Emily , Saint-Louis Hedwige , Phillips Kiwita 
Published: April 2018

INTRODUCTION:
Premature ovarian insufficiency (POI) is defined as hypergonadotropic hypogonadism before the age of 40 years. Though most commonly deemed as idiopathic, specific etiologies include genetic abnormalities, autoimmune conditions, infections, and toxin exposure. Genetic etiologies of POI are usually due to abnormalities involving the X chromosome and are rarely associated with autosomal mutations.

METHODS:
The clinical case was analyzed and followed with a literature review.

RESULTS:
The patient is a 36-year-old G0 female who presented with four months of secondary amenorrhea, a recent abrupt development of kidney failure, and hyperparathyroidism. Laboratory results revealed a negative urine pregnancy test, euprolactinemia, euthyroidism and negative serum 21-hydroxylase antibody. Serum FSH was markedly elevated. Serum Estradiol, Inhibin-B, and Anti-Mullerian Hormone were below normal limits. Pelvic ultrasonography revealed an endometrial lining of 1.1 cm, with inability to identify bilateral ovaries.
A balanced reciprocal translocation between the long arms of chromosomes 1 and 13 was identified: 46,XX,t(1;13)(q25;q14.1).

CONCLUSION:
Balanced translocations are associated with a relatively high risk for adverse reproductive history. However, they are not commonly associated with POI. Interestingly, chromosome 13q14.1 is a region encompassing the FOXO1 gene, which plays a significant role in granulosa cell function and follicular maturation. This specific gene break point is most likely the etiology of her POI and possibly her other new-onset co-morbidities. There are no other reported POI cases associated with a balanced translocation between chromosomes 1 and 13 in the literature. Further research is needed on this specific gene break point to understand the timing and mechanism of its effects.
Pregnancy and Fertility Concerns: A Survey of United States Obstetrics and Gynecology Residents [16B]
Authors: Schwartz Kaia , Martin Caitlin , Hipp Heather S. , Kawwass Jennifer 
Published: April 2018

INTRODUCTION:
Reproductive life planning is an important aspect of OBGYN resident education. Despite learning about declining fertility and the potential problems associated with delaying pregnancy, OBGYN residents overestimate the age at which fertility declines and the success rates of fertility treatment. We aim to characterize attitudes towards infertility, pregnancy timing, and oocyte cryopreservation among current OBGYN residents.

METHODS:
We present a cross sectional study of female trainees from 27 academic OBGYN resident training programs. A voluntary, anonymous online survey was used to assess resident reproductive experiences and characterize attitudes towards personal family planning and infertility.

RESULTS:
Of 756 trainees who were sent the survey, 487 opened the email, and 309 participated (63.4% response rate per opened email, 40.9% overall). Average respondent age was 29.7 years. The majority of residents expressed the desire to have children, but reported not yet having started childbearing (75.8%, n=210). Almost half described delaying conception for career/education reasons (45.4%, n=196). The majority desired to start childbearing at age <35 (90%, n=210). Of those not complete with childbearing, 78.5% reported worrying about infertility (n=205) and 40.8% reported considering embryo or oocyte cryopreservation (n=111).

CONCLUSION:
Although female OBGYN residents learn to help patients with reproductive health planning, many delay their own pregnancies until after residency past the peak fertile window with the intention of having a first child before age 35. Many also report considering fertility preservation. To help alleviate anxiety and improve reproductive autonomy, residents may benefit from fertility preservation counseling and creation of an environment that allows trainees to begin family building.
A Qualitative Study of Pregnancy and Birth Experience for Women with Opioid Use Disorder and a History of Sexual Trauma [22B]
Authors: Sobel Lauren , O'Rourke-Suchoff Danielle , Remis Kimberly , Sia Michelle , Saia Kelley , Bell Shannon L. 
Published: April 2018

INTRODUCTION:
Opioid use in pregnancy has increased dramatically, paralleling the epidemic observed in the general population. Many of these women have a history of sexual trauma. Our objective was to identify factors that adversely affect the labor and delivery experience for women with opioid use disorder and concomitant sexual trauma history.

METHODS:
This is a subgroup analysis of 13 women with a history of sexual trauma who participated in an opioid replacement therapy program during pregnancy. Participants underwent semi-structured qualitative interviews for a study about women with a history of sexual trauma. Interviews focused on the antenatal, intrapartum, and immediate post-partum experiences.

RESULTS:
Participants felt stigmatized by unfamiliar providers for their opioid use disorder and voiced desire for a childbirth experience unaffected by addiction, except when medically necessary. Most participants were concerned their opioid tolerance would lead to inadequate intrapartum pain management. Many felt they received less breastfeeding encouragement than women without opioid use disorder. Separation from infants for routine care or management of neonatal abstinence syndrome without adequate explanation concerned participants. In this situation, many feared they had lost custody, felt there was little institutional concern for maternal-infant bonding and reported guilt about the impact of addiction on the infant.

CONCLUSION:
Women with opioid use disorder and concomitant sexual trauma history report distrust of the medical system. Emphasizing established therapeutic relationships, ensuring clear communication regarding intrapartum pain control, promoting infant care in the post-partum room, and reinforcing legal determination of custody may improve labor and delivery experiences for this group of women.