bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population Genomic Evidence Reveals Subtle Patterns of Differentiation in the Trophically Polymorphic Cuatro Ciénegas Cichlid, Herichthys minckleyi
Authors: Bell Katherine L , Nice Chris C , Hulsey Darrin 
Published: January 2019

AbstractIn recent decades, an increased understanding of molecular ecology has led to a reinterpretation of the role of gene flow during the evolution of reproductive isolation and biological novelty. For example, even in the face of ongoing gene flow strong selection may maintain divergent polymorphisms, or gene flow may introduce novel biological diversity via hybridization and introgression from a divergent species. Herein, we elucidate the evolutionary history and genomic basis of a trophically polymorphic trait in a species of cichlid fish, Herichthys minckleyi. We explored genetic variation at 3 hierarchical levels; between H. minckleyi (n = 69) and a closely related species Herichthys cyanoguttatus (n = 10), between H. minckleyi individuals from 2 geographic locations, and finally between individuals with alternate morphotypes at both a genome-wide and locus-specific scale. We found limited support for the hypothesis that the H. minckleyi polymorphism is the result of ongoing hybridization between the 2 species. Within H. minckleyi we found evidence of geographic genetic structure, and using traditional population genetic analyses found that individuals of alternate morphotypes within a pool appear to be panmictic. However, when we used a locus-specific approach to examine the relationship between multi-locus genotype, tooth size, and geographic sampling, we found the first evidence for molecular genetic differences between the H. minckleyi morphotypes.
“We Just Can’t Afford to Be Democratic”: Liberals, Integrationists, and the Postwar Suburb of Park Forest
Authors: Cooley Will 
Published: January 2019

Abstract
Park Forest, Illinois, emerged as a prototype suburb in the post–World War II era. Scholars have devoted considerable attention to Park Forest but have not thoroughly explored the efforts of the American Friends Service Committee to integrate this village outside of Chicago in the 1950s. Philip Klutznick, the lead developer of Park Forest, advertised the suburb as a melting pot for a new America, drawing the interest of open housing advocates wanting to include African Americans in this mix. Klutznick and most villagers resisted racial integration, but activists persisted, and by the mid-1960s, the suburb became an interracial community. The exhausting and intricate efforts to realize and sustain integration, however, demonstrated the struggles of the open housing campaign.
Development of the Mitochondrial Intermembrane Space Disulfide Relay Represents a Critical Step in Eukaryotic Evolution
Authors: Backes Sandra , Garg Sriram G , Becker Laura , Peleh Valentina , Glockshuber Rudi , Gould Sven B , Herrmann Johannes M 
Published: January 2019

AbstractThe mitochondrial intermembrane space evolved from the bacterial periplasm. Presumably as a consequence of their common origin, most proteins of these compartments are stabilized by structural disulfide bonds. The molecular machineries that mediate oxidative protein folding in bacteria and mitochondria, however, appear to share no common ancestry. Here we tested whether the enzymes Erv1 and Mia40 of the yeast mitochondrial disulfide relay could be functionally replaced by corresponding components of other compartments. We found that the sulfhydryl oxidase Erv1 could be replaced by the Ero1 oxidase or the protein disulfide isomerase from the endoplasmic reticulum, however at the cost of respiration deficiency. In contrast to Erv1, the mitochondrial oxidoreductase Mia40 proved to be indispensable and could not be replaced by thioredoxin-like enzymes, including the cytoplasmic reductase thioredoxin, the periplasmic dithiol oxidase DsbA, and Pdi1. From our studies we conclude that the profound inertness against glutathione, its slow oxidation kinetics and its high affinity to substrates renders Mia40 a unique and essential component of mitochondrial biogenesis. Evidently, the development of a specific mitochondrial disulfide relay system represented a crucial step in the evolution of the eukaryotic cell.
Providing Compassionate Off-Ramps for Medical Students Is a Moral Imperative
Authors: Bellini Lisa M. , Kalet Adina , Englander Robert 
Published: January 2019

It is highly unusual for learners to leave medical training in the United States even though some individuals’ goals may change and others may not achieve expected competence. There are a number of possible reasons for this: (1) Students may feel that they have progressed too far into their careers and amassed too much debt to leave medical training; (2) students may be allowed to graduate despite marginal performance; and (3) students may have entered medical training with risk factors for poor performance that were not addressed. As stewards of the educational process, medical educators have an ethical obligation to students and the public to create off-ramps, or points along the educational continuum at which learners can reassess their goals and educators can assess competence, that allow students to leave medicine.
Given the nationwide focus on physician health and wellness, the authors believe the creation of options to leave medical training without compromising one’s self-esteem or incurring unmanageable debt (i.e., compassionate off-ramps) is a moral imperative. The practice of medicine should not be an exercise in survival; it should allow people to develop and thrive over the course of their careers. Offering students options to make use of the medical competencies they have accumulated in other attractive careers would enable medical educators to behave compassionately toward individual students and fulfill their societal obligation to graduate competent and committed physicians. To this end, the authors present six recommendations for consideration.
Does Performance on Evidence-Based Medicine and Urgent Clinical Scenarios Assessments Deteriorate During the Fourth Year of Medical School? Findings From One Institution
Authors: Heidemann Lauren A. , Keilin Charles A. , Santen Sally A. , Fitzgerald James T. , Zaidi Nikki L. , Whitman Laurie , Jones Elizabeth K. , Lypson Monica L. , Morgan Helen K. 
Published: January 2019

Purpose
The fourth year of medical school (M4) should prepare students for residency yet remains generally unstructured, with ill-defined goals. The primary aim of this study was to determine whether there were performance changes in evidence-based medicine (EBM) and urgent clinical scenarios (UCS) assessments before and after M4 year.

Method
University of Michigan Medical School graduates who matched into internship at Michigan Medicine completed identical assessments on EBM and UCS at the beginning of M4 year and 13 months later during postgraduate year 1 (PGY1) orientation. Individual scores on these assessments were compared using paired t test analysis. The associations of academic performance, residency specialty classification, and initial performance on knowledge changes were analyzed.

Results
During academic years 2014 and 2015, 76 students matched into a Michigan Medicine internship; 52 completed identical EBM stations and 53 completed UCS stations. Learners’ performance on the EBM assessment decreased from M4 to PGY1 (mean 93% [SD = 7%] vs. mean 80% [SD = 13%], P < .01), while performance on UCS remained stable (mean 80% [SD = 9%] vs. mean 82% [SD = 8%], P = .22). High M4 performers experienced a greater rate of decline in knowledge level compared with low M4 performers for EBM (−20% vs. −4%, P = .01). Residency specialty and academic performance did not affect performance.

Conclusions
This study demonstrated degradation of performance in EBM during the fourth year and adds to the growing literature that highlights the need for curricular reform during this year.
Effect of Eyelid Crease Formation on Aesthetic Outcomes post Frontalis Suspension for Unilateral Ptosis
Authors: Shome Debraj , Mittal Shilpa Taneja , Kapoor Rinky 
Published: January 2019

Background:
The eyelid crease plays a very important role in determining eyelid symmetry. This study was performed to compare the cosmetic results post silicone rod frontalis suspension surgery, performed with and without eyelid crease formation, for correction of unilateral, congenital ptosis.

Methods:
Prospective, interventional study. One hundred patients with unilateral, congenital ptosis, with poor levator muscle action, operated on by a single facial plastic surgeon, over 5-year duration (2011–2016). Group I had 50 patients, who underwent silicone sling (Bvi Visitec) frontalis suspension surgery. Group II had 50 patients, who underwent frontalis suspension silicone sling (Bvi Visitec) surgery, in combination with eyelid crease formation and levator muscle excision (when required). The cosmetic outcomes were evaluated by the patients themselves and by 3 blinded physician observers and recorded objectively via a 5-point questionnaire, after a 1-year follow-up.

Results:
Patients in group II were much more satisfied than the patients in group I, as confirmed by the subjective and objective evaluations.

Conclusion:
The silicone sling frontalis suspension surgery, when combined with eyelid crease creation and levator excision procedure (when required), provides better symmetry, superior cosmesis, and excellent patient satisfaction.
Association between Stenosing Tenosynovitis and Dupuytren’s Contracture in the Hand
Authors: Yang Kai , Gehring Michael , Bou Zein Eddine Savo , Hettinger Patrick 
Published: January 2019

Background:
Both stenosing tenosynovitis and Dupuytren’s contracture are common conditions encountered in hand surgery. Connections between 2 diseases have been suggested in literature. The purpose of this study was to examine whether there’s an association between the 2 processes.

Methods:
A retrospective chart review was performed to include all patients seen by a single surgeon between 2014 and 2017 with the diagnosis of either trigger finger or Dupuytren’s contracture in the same hand. Patients’ demographics, medical history, social and surgical histories are recorded. Univariate and multivariate analysis were conducted.

Results:
A cohort of 238 patients was identified. One hundred ninety-two patients were diagnosed with trigger finger. Eighty-nine patients were diagnosed with Dupuytren’s contracture. Forty-three patients carried both diagnoses. Median age was 61.6 (56–72). Half were male (50.4%) and 66.8% reported current alcohol intake. Other factors include history of former or current tobacco use (52.9%), diabetes (23.9%), and manual labor (31.1%). In the univariate model, trigger finger, sex, and age were significantly associated with the diagnosis of Dupuytren’s contracture, and Dupuytren’s contracture and sex were significantly associated with the trigger finger diagnosis. Diabetes, manual labor, use of alcohol and tobacco were not significant. In the multivariate model, age and trigger finger were significantly associated with Dupuytren’s contracture.

Conclusions:
Significant association between stenosing tenosynovitis and Dupuytren’s contracture was identified in our patient cohort. Patients with stenosing tenosynovitis may be at an increased risk of developing Dupuytren’s contracture or vice versa.
ELONGATED PHOTORECEPTOR OUTER SEGMENT LENGTH AND PROGNOSIS OF CHRONIC CENTRAL SEROUS CHORIORETINOPATHY
Authors: Asano Kimiko Shimizu , Asaoka Ryo , Asano Shotaro , Azuma Keiko , Inoue Tatsuya , Obata Ryo 
Published: January 2019

Purpose:
To evaluate the effect of elongated photoreceptor outer segment length on the visual prognosis of patients with chronic central serous chorioretinopathy after treatment using half-dose and half-fluence photodynamic therapy (reduced PDT).

Methods:
The study included 36 eyes of 36 patients with chronic central serous chorioretinopathy who underwent reduced PDT and were followed up for at least 1 year. Spectral domain optical coherence tomography measurement was conducted at baseline and 12 months after reduced PDT. Thereafter, the association between the best-corrected visual acuity (BCVA) at 12 months after reduced PDT and 7 baseline variables (age, symptom duration, BCVA, outer nuclear layer thickness, elongated photoreceptor outer segment length, height of subretinal detachment, and subfoveal choroidal thickness) was evaluated. Multivariate analyses using the model selection with the corrected Akaike Information Criterion index were performed.

Results:
The optimal model for BCVA at 12 months only included baseline BCVA (coefficient = 0.90, P < 0.0001) and baseline elongated photoreceptor outer segment length (coefficient = −0.0016, P = 0.034), but not outer nuclear layer thickness.

Conclusion:
Elongated photoreceptor outer segment length was significantly associated with BCVA prognosis in patients with chronic central serous chorioretinopathy after reduced PDT and can be useful for predicting residual photoreceptor function during the active phase of chronic central serous chorioretinopathy.
SWEPT-SOURCE AND SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY VERSUS DYE ANGIOGRAPHY IN THE MEASUREMENT OF TYPE 1 NEOVASCULARIZATION
Authors: Cicinelli Maria Vittoria , Cavalleri Michele , Consorte Andrea Celestino , Rabiolo Alessandro , Sacconi Riccardo , Bandello Francesco , Querques Giuseppe 
Published: January 2019

Purpose:
To compare the area of Type 1 neovascularization in patients with age-related macular degeneration calculated on spectral domain optical coherence tomography angiography (SD-OCTA), swept-source OCTA, and indocyanine green angiography (ICGA).

Methods:
Cross-sectional study enrolling patients with neovascular age-related macular degeneration with Type 1 neovascularization. During the same visit, ICGA (Spectralis HRA, Heidelberg, Germany), 3 × 3-mm or 6 × 6-mm SD-OCTA (CIRRUS AngioPlex model 5000; Carl Zeiss Meditec, Inc, Dublin, OH), and 3 × 3-mm or 6 × 6-mm swept-source OCTA (Plex Elite 9000; Carl Zeiss Meditec, Inc) were performed. Neovascularization areas were compared among the three instruments. The degree of consistency between measurements was investigated through the two-way mixed intraclass correlation, whereas the intermethod agreement was expressed by the Bland–Altman analysis. Mean difference and 95% confidence intervals are provided.

Results:
Eighteen eyes of 14 white patients (10 females, 83.3%) were included in the study. The neovascularization area measured on ICGA was higher compared to that measured on both SD-OCTA (P = 0.008) and swept-source OCTA (P = 0.008), whereas no differences were found between the two OCTA. Similar results were achieved analyzing 3 × 3-mm and 6 × 6-mm scan separately. Lowest reliability resulted from the ICGA versus SD-OCTA pair (intraclass correlation = 0.786, confidence interval = 0.500–0.915). Spectral domain OCTA and swept-source OCTA exhibited an excellent agreement (mean difference = 0.2). Swept-source OCTA offered qualitatively better images of the neovascularization, compared with SD-OCTA.

Conclusion:
Better visualization of the extent of neovascularization is obtained using SS-OCT or SD-OCT compared with ICGA, which may be influenced by choroidal permeability and dye leakage. Neovascularization area on OCTA may become an objective parameter in the follow-up of age-related macular degeneration patients, along with traditional imaging techniques.
The Role of Soft Contact Lens Wear on Meibomian Gland Morphology and Function
Authors: Uçakhan Ömür , Arslanturk-Eren Mehtap 
Published: January 2019

Purpose:
To evaluate the impact of soft contact lens (CL) wear on the morphology and function of the meibomian glands (MG).

Methods:
One hundred seventy-three eyes of 87 soft CL wearers and 103 eyes of 55 age-matched healthy volunteers were included into this study. The patients were divided into 3 groups according to the total duration of lens wear: less than 3 years, 3 to 7 years, and more than 7 years. Ocular Surface Disease Index (OSDI) scores, slitlamp biomicroscopy findings, fluorescein staining of the ocular surface, tear film break-up time (BUT), Schirmer I test, and meibography findings were recorded in all patient eyes and were compared with controls.

Results:
The mean meiboscores of the upper and lower eyelids were significantly higher in CL wearers compared with controls (P<0.05). The mean BUT and the mean MG expressibility were significantly lower, whereas the mean OSDI score, corneal staining scores, percentage of partial/complete gland loss, and percentage of thickened and curled MG in upper/lower lids were statistically significantly higher in CL wearers (P<0.05). Meiboscores were significantly higher in patients with a total lens wear duration of more than 3 years compared to those with less than 3 years of lens wear for both upper/lower lids (P<0.05). The earliest morphological change in the MG of CL wearers was MG thickening, and this parameter was the only meibography finding that had the highest diagnostic ability for MG dysfunction.

Conclusion:
Soft CL wear causes significant morphological and functional changes in MG with thickening of MG presenting an early diagnostic finding of MG dysfunction on meibography.
Improving Nonvocal Critical Care Patients' Ease of Communication Using a Modified SPEACS-2 Program
Authors: Trotta Rebecca L. , Hermann Robin M. , Polomano Rosemary C. , Happ Mary Beth 
Published: January 2019

ABSTRACT

Objective:
To evaluate the feasibility and impact of implementing the “study of patient–nurse effectiveness with assisted communication strategies-2” (SPEACS-2); a program to facilitate communication with nonvocal patients.

Study Design:
The plan-do-study-act quality improvement methodology guided the implementation of a modified SPEACS-2 program within a pre and posttest design. The Ease of Communication Scale (ECS) measured patients' communication difficulty, and care processes measured the program's success.

Study Population:
Nurses (N = 385) across 5 intensive care units were trained in SPEACS-2. We assessed 354 nonvocal patients (aged 18–95 years) requiring continued mechanical ventilation after withdrawal of heavy sedation. Patients were evaluated over one 2-week preintervention (n = 163) and two 3-week postintervention periods (n = 128; n = 63). A subsample of intervention patients (n = 204) completed the ECS.

Results:
Ease of Communication Scale scores improved significantly (p = .027) from baseline (mean 25.86 ± 12.2, n = 71) to postintervention period 2 (21.22 ± 12.2, n = 63). Nurses' use of communication techniques and compliance with communication plans of care incrementally increased after training.

Conclusions:
Implementing SPEACS-2 demonstrated positive changes in patients' ease of communication and feasibility of incorporating evidence-based communication strategies into practice.
Falls in Hospital Causing Injury
Authors: Trinh Lieu Thi Thuy , Assareh Hassan , Wood Michael , Addison-Wilson Cathleen , Sathiyaseelan Yasoda 
Published: January 2019

ABSTRACT

Aims:
To describe falls causing injury, types of injuries, and the reporting of these falls.

Methods:
Administrative and incident reporting datasets between July 2012 and June 2017 were analyzed.

Results:
Using both datasets, 5,653 falls were identified (3.7 per 1,000 bed-days). Administrative and incident datasets accounted for 40.8% (2,299) and 84.4% (4,752) of falls, respectively. More than half the falls in the administrative data required only observation/examination (1,221 falls; 53.1%, 0.8 per 1,000 bed-days). The remaining 1,078 falls (46.9%; 0.7 per 1,000 bed-days) caused 1,533 injuries (1.0 per 1,000 bed-days). Most injuries happened in patients who were 65 years or older (73.9%), during the first episode of care (79.0%), in the acute care setting (70.4%), or on the same level (60.1%). The most common injuries were to the head (33.3%). Some injuries were serious (169; 11.0%; 0.11 per 1,000 bed-days). Falls resulting in injury in older patients, with a more severe medical condition and at smaller hospitals, were more likely to be recorded in the incident reporting system whereas subsequent falls were less likely to be recorded.

Conclusions:
Fewer than half of the falls recorded in administrative data resulted in injuries. A tenth of all falls caused serious injuries.
Chronic Distal Sensory Polyneuropathy Is a Major Contributor to Balance Disturbances in Persons Living With HIV
Authors: Sakabumi Duaa Z. , Moore Raeanne C. , Tang Bin , Delaney Patrick A. , Keltner John R. , Ellis Ronald J. 
Published: January 2019

Background:
Medical comorbidities accumulate in older persons living with HIV (PLWH), causing disability and reduced quality of life. Sensory neuropathy and polypharmacy may contribute to balance difficulties and falls. The contribution of neuropathy is understudied.

Objective:
To evaluate the contribution of chronic distal sensory polyneuropathy (cDSPN) to balance disturbances among PLWH.

Methods:
Ambulatory PLWH and HIV− adults (N = 3379) were prospectively studied. All participants underwent a neurologic examination to document objective abnormality diagnostic of cDSPN and reported neuropathy symptoms including pain, paresthesias, and numbness. Participants provided detailed information regarding balance disturbance and falls over the previous 10 years. Balance disturbances were coded as minimal or none and mild-to-moderate. Covariates included age, HIV disease, and treatment characteristics and medications (sedatives, opioids, and antihypertensives).

Results:
Eleven percent of participants reported balance disturbances at some time during the last 10 years; the rate in PLWH participants exceeding that for HIV− [odds ratio 2.59, 95% confidence interval: 1.85 to 3.64]. Fifty-two percent met criteria for cDSPN. Balance problems were more common in those with cDSPN [odds ratio = 3.3 (2.6–4.3)]. Adjusting for relevant covariates, balance disturbances attributable to cDSPN were more frequent among HIV+ than HIV− (interaction P = 0.001). Among individuals with cDSPN, older participants were much more likely to report balance disturbances than younger ones.

Conclusions:
cDSPN contributes to balance problems in PLWH. Assessments of cDSPN in older PLWH should be a clinical priority to identify those at risk and to aid in fall prevention and the ensuing consequences, including bone fractures, subdural hematoma, hospital admissions, and fatal injury.