bluuebunny/crossref_metadata_2025_split huggingface dataset:
Point‐of‐Care Ultrasound Work Flow Innovation: Impact on Documentation and Billing
Authors: Flannigan Matthew J. , Adhikari Srikar 
Published: June 2017

ObjectivesTo evaluate the impact that an innovative automated ultrasound (US) work flow, which allows for bedside performance of examination documentation and order placement, has on point‐of‐care US billing compared to ordering US examinations through an electronic medical record.MethodsWe conducted a retrospective review of point‐of‐care US billing data (March 2014–February 2016) for adult and pediatric emergency departments with an emergency medicine residency and a US fellowship. An innovative work flow with the ability to automate US billing and selectively transfer the images and reports for patient care examinations to an electronic medical record and picture archiving and communication system using the QPath US work flow solution (Telexy Healthcare, Maple Ridge, British Columbia, Canada) was implemented. The total number of examinations billed and percent increase in technical and professional revenue, excluding examinations performed by US fellows, before and after implementation of the automated work flow innovation were determined.ResultsAfter implementation of our automated US work flow process, the number of patient care US examinations billed increased significantly due to completing documentation and immediate billing determination at the bedside. The increase in percent billing relative to total examinations was noted in both technical (32% to 61%; P < .0001) and professional (37% to 65%; P < .0001) billing components. In addition, there was a net increase in technical and professional fee revenue to 96% and 78%, respectively.ConclusionsThe implementation of an innovative automated work flow to include bedside point‐of‐care US documentation, order placement, and the automated transfer of images and reports led to a significant increase in US billing revenue, documentation, and compliance.
Comparison of Acoustic Radiation Force Impulse Imaging and Strain Elastography in Differentiating Malignant From Benign Thyroid Nodules
Authors: Zhang Fengjuan , Zhao Xinming , Han Ruoling , Du Min , Li Ping , Ji Xiaohui 
Published: June 2017

ObjectivesThis study aimed to evaluate the diagnostic value of acoustic radiation force impulse (ARFI) imaging and strain elastography in differentiating malignant from benign thyroid nodules.MethodsThis study included 128 patients (104 female and 24 male; mean age ± standard deviation, 48 ± 11 years; range, 23–76 years) with 152 pathologically proven thyroid nodules. Conventional sonography, strain ratio (SR) of strain elastography, virtual touch tissue imaging (VTI) grade, and virtual touch tissue quantification (shear wave velocity [SWV]) from ARFI imaging data were generated for each nodule. The diagnostic performance of the three elastography analysis methods was analyzed and compared by multiple receiver operating characteristic curve analysis. The interobserver agreement for VTI grade was also assessed.ResultsThe best cutoff values for VTI grade, mean SWV, and mean SR for predicting malignant thyroid nodules were greater than or equal to grade χ, 2.87 m/s and 2.37, respectively. The area under the receiver operating characteristic curve for VTI grade, mean SWV, and mean SR was 0.854, 0.869 and 0.849, respectively (P > .05), and the accuracy was 83.55, 81.58 and 80.26%, respectively (P > .05). The accuracy of the combined use of conventional sonography and ARFI imaging for VTI grade, mean SWV, and mean SR was 98.03, 95.39 and 96.71%, respectively, which was slightly higher than that of conventional sonography (P > .05). The interobserver agreement produced a κ‐value of 0.98 (95% confidence interval, 0.959–1.000).ConclusionsBoth strain elastography and ARFI imaging have high sensitivity and specificity for differentiating malignant from benign thyroid nodules. Combined with sonography, these techniques can improve the accuracy of thyroid nodule diagnosis.
Perioperative pain management after fibular free flap harvesting for head‐and‐neck reconstruction using mini‐catheters to inject local anesthetic: A pilot study
Authors: Ferri Andrea , Varazzani Andrea , Valente Adriana , Pedrazzi Giuseppe , Bianchi Bernardo , Ferrari Silvano , Sesenna Enrico 
Published: June 2017

AbstractBackgroundFibular donor site pain management in the early postoperative period can help minimize complications, patient discomfort, and agitation. Traditional management of postoperative pain consists of systemic administration of opioids and NSAIDS. The use of local anesthetics in addition to systemic analgesics has the potential to improve pain control. Purpose of the study is to evaluate the efficacy of mini‐catheters used to inject local anesthetic into the fibular donor site after flap harvesting for reconstruction of the head‐and‐neck area.MethodsProspective study on 31 patients (mean age 52 years) treated for head and neck reconstruction with fibula free flap using minicatheter for local anesthetic injection in the early postoperative time. A bolus of chirochaine (0.125% w/v; 20 mL) was injected through the catheter before the patient regained consciousness. Postoperatively, three consecutive injections (20 mL each) were administered 8, 16, and 24 h after surgery. Pain evaluation before and after local anesthetic injection is used to assess efficacy and overall pain control.ResultsNo major or minor complication occurred. Mean pain value was 1.69. At 8 h, the pain scores before injection ranged from 0 to 10 (mean 4.13 ± 3.06). After injection, the pain scores ranged from 0 to 5 (mean 1 ± 1.34). Similarly, at 16 h, the pain scores ranged from 0 to 8 (mean 2.77 ± 2.42) before injection and from 0 to 6 (mean 0.42 ± 1.2) thereafter. At 24 h, the initial pain score ranged from 0 to 6 (mean 1.71 ± 1.74) and from 0 to 1 (mean 0.1 ± 0.3) after drug administration. Pre and postinjection pain scores differences were statistically significant after all three injections (P < .001).ConclusionsMinicatheter seems to be easy, safe, and efficient when used to control pain after fibular free‐flap harvesting.
Long‐term outcomes of Group D retinoblastoma eyes during the intravitreal melphalan era
Authors: Berry Jesse L. , Shah Sona , Bechtold Mercy , Zolfaghari Emily , Jubran Rima , Kim Jonathan W. 
Published: June 2017

AbstractBackgroundTo evaluate outcomes of Group D retinoblastoma (Rb) eyes during the intravitreal melphalan era.ProcedureRetrospective chart review of patients diagnosed with Group D Rb from 2011 to 2016 was done. Overall, 76 Group D eyes of 68 patients were included; salvage therapy included systemic chemoreduction with vincristine, etoposide, and carboplatin with local consolidation, followed by intravitreal injection of melphalan for recurrent or persistent seeding. External beam radiation was not used as a treatment modality. Primary outcome measurement was globe salvage.ResultsOf 76 Group D eyes, 24 were enucleated primarily and 52 were treated with intent to salvage the globe. Systemic chemoreduction salvaged 25 of 52 eyes (48%). Tumor recurrences were diagnosed in 27 eyes (52%); five with massive retinal recurrences underwent enucleation and 22 were treated with intravitreal melphalan injection. Of the 22 injected eyes, 14 (64%) were salvaged and eight required enucleation primarily for retinal recurrences. Success in eradicating vitreous seeds was 100%. The Kaplan–Meier 3‐year survival estimate for treated eyes is 76.5% (95% CI: 61.4–86.3). Median follow‐up for the group of 76 Group D eyes was 29.5 months (SD 17.9 months).ConclusionDuring a 6‐year period that included the initiation of intravitreal melphalan at our institution, the salvage rate of treated Group D eyes was 75% (39/52 eyes). Intravitreal melphalan was utilized for ocular salvage in 42% (22/52 eyes). Systemic chemoreduction combined with intravitreal melphalan for seeding demonstrated a high overall salvage rate for Group D eyes in this cohort.
Photoresponsive biodegradable poly(carbonate)s with pendento‐nitrobenzyl ester
Authors: Shen Huihui , Xia Yingchun , Qin Zhouliang , Wu Juan , Zhang Li , Lu Yanbing , Xia Xinnian , Xu Weijian 
Published: June 2017

ABSTRACTPhotoresponsive amphiphilic diblock poly(carbonate)s mPEG113‐b‐PMNCnwith pendento‐nitrobenzyl ester group were synthesized through ring‐opening polymerization (ROP) using 1,8‐diazabi‐cyclo[5.4.0]undec‐7‐ene (DBU) as catalyst and monomethoxy poly(ethylene glycol) (mPEG) as macroinitiator. In aqueous solution, the copolymers can self‐assemble to spherical micelles with a PC core and a PEG shell. The critical micelle concentration (CMC), size, and morphology of the micelles were demonstrated by means of fluorescence spectroscopy, transmission electron microscopes (TEM), and dynamic light scattering (DLS). Under UV light irradiation, the amphiphilic copolymer micelles disassembled because of the photocleavage ofo‐NB ester, and the light‐controlled release behaviors of payload Nile red were further proved. This study provides a convenient way to construct smart poly(carbonate)s nanocarriers for controlled drug release. © 2017 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem.2017,55, 2770–2780
Synthesis and utility of ethylene (meth)acrylate copolymers prepared by a tandem ring‐opening polymerization hydrogenation strategy
Authors: Onbulak Sebla , Wang Yanzhao , Brutman Jacob P. , Hillmyer Marc A. 
Published: June 2017

ABSTRACTOne new and one established functional cyclooctene were prepared and (co)polymerized using ring‐opening metathesis polymerization. The resulting polymers were hydrogenated to yield the corresponding functional polyolefins that were structurally equivalent to copolymers of ethylene and either methyl methacrylate, t‐butyl acrylate, or acrylic acid after deprotection. The copolymers that incorporate methyl methacrylate into the backbone were used as compatibilizers for poly(methyl methacrylate)/polyethylene blends. The copolymers that incorporate t‐butyl acrylate into the backbone yielded elastomers that could be thermally crosslinked. © 2017 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2017, 55, 3117–3126
Dynamic Meso-Scale Anchorage of GPI-Anchored Receptors in the Plasma Membrane: Prion Protein vs. Thy1
Authors: Nemoto Yuri L. , Morris Roger J. , Hijikata Hiroko , Tsunoyama Taka A. , Shibata Akihiro C. E. , Kasai Rinshi S. , Kusumi Akihiro , Fujiwara Takahiro K. 
Published: June 2017

Abstract
The central mechanism for the transmission of the prion protein misfolding is the structural conversion of the normal cellular prion protein to the pathogenic misfolded prion protein, by the interaction with misfolded prion protein. This process might be enhanced due to the homo-dimerization/oligomerization of normal prion protein. However, the behaviors of normal prion protein in the plasma membrane have remained largely unknown. Here, using single fluorescent-molecule imaging, we found that both prion protein and Thy1, a control glycosylphosphatidylinositol-anchored protein, exhibited very similar intermittent transient immobilizations lasting for a few seconds within an area of 24.2 and 3.5 nm in diameter in CHO-K1 and hippocampal neurons cultured for 1- and 2-weeks, respectively. Prion protein molecules were immobile during 72% of the time, approximately 1.4× more than Thy1, due to prion protein’s higher immobilization frequency. When mobile, prion protein diffused 1.7× slower than Thy1. Prion protein’s slower diffusion might be caused by its transient interaction with other prion protein molecules, whereas its brief immobilization might be due to temporary association with prion protein clusters. Prion protein molecules might be newly recruited to prion protein clusters all the time, and simultaneously, prion protein molecules in the cluster might be departing continuously. Such dynamic interactions of normal prion protein molecules would strongly enhance the spreading of misfolded prion protein.
Differential effects of perinatal exposure to antidepressants on learning and memory, acoustic startle, anxiety, and open‐field activity in Sprague‐Dawley rats
Authors: Sprowles Jenna L.N. , Hufgard Jillian R. , Gutierrez Arnold , Bailey Rebecca A. , Jablonski Sarah A. , Williams Michael T. , Vorhees Charles V. 
Published: June 2017

AbstractMost antidepressants inhibit monoamine reuptake. Selective serotonin (5‐HT) reuptake inhibitors (SSRIs) act on the 5‐HT transporter (SERT) whereas norepinephrine‐dopamine reuptake inhibitors (NDRIs) act on the norepinephrine and dopamine transporters. Epidemiological reports link SSRI use during pregnancy to an increased prevalence of autism spectrum disorder (ASD). We previously showed that perinatal exposure to the SSRI citalopram (CIT) results in rodent offspring that exhibit a number of behaviors consistent with an ASD‐like phenotype. The present study examined the effect of perinatal exposure to CIT (at a lower dose), another SSRI, fluoxetine (FLX), and an NDRI, bupropion (BUP). Gravid Sprague‐Dawley rats were subcutaneously injected twice per day (6 h apart) with 5 mg/kg CIT, 5 mg/kg FLX, 15 mg/kg BUP, or saline (SAL) from embryonic day (E) 6–21, and directly to the pups from postnatal day (P) 1–20. As adults, one male/female from each litter was given one of a series of tests. Both SSRI‐exposed groups showed spatial learning deficits in Morris and radial water mazes, increased marble burying, increased acoustic startle, hypoactivity, and attenuated activity to the stimulating effect of the NMDA‐R antagonist MK‐801. The BUP‐exposed group showed a reduction in elevated zero‐maze quadrant entries and increased stimulated open‐field activity following (+)‐amphetamine challenge. These results reinforce concern about the use of antidepressants during pregnancy and highlight how the two classes of drugs produce different constellations of effects with more effects associated with the SSRIs. Further investigation into how antidepressants alter brain development leading to enduring adverse neurobehavioral effects is warranted.
Down‐regulation of miRNAs in the brain and development of diet‐induced obesity
Authors: Maldonado‐Avilés Jaime G. , Guarnieri Douglas J. , Zhu Xianglong , DiLeone Ralph J. 
Published: June 2017

AbstractNovel therapeutic interventions for obesity and comorbid conditions require knowledge of the molecular elements playing a role in the development of obesity. Chronic low‐grade inflammation has been consistently reported in obese individuals. In this study, we first determined whether key molecular modulators of inflammation, microRNA‐155 (miR‐155) and microRNA‐146a (miR‐146a), are regulated by an obesogenic diet within brain regions associated with reward, metabolism and energy balance. C57BL/6J mice were chronically exposed to a high‐fat diet (HFD) or a standard chow (CTL). Significant reductions in the levels of miR‐155 (82%) and miR‐146a (41%) levels were observed within the nucleus accumbens of HFD mice compared to CTL. Further analysis of miR‐155 regulation showed no significant changes in levels across peripheral tissue (white adipose, spleen, kidney or liver) between HFD and CTL mice. The effect of lower miR‐155 on the development of obesity was determined by exposing wild‐type (WT) and miR‐155 knockout mice (miR‐155 KO) to HFD. Male miR‐155 KO gained significantly more weight than WT littermates. Metabolic analyses revealed that miR‐155 KO significantly ate more HFD compared to WT, without differing in other metabolic measures including energy expenditure. Together, these data show that miR‐155 is physiologically down‐regulated after intake of an obesogenic diet, and that loss of miR‐155 increases intake of an obesogenic diet. Moreover, these findings shed light on a potential miRNA‐based mechanism contributing to the development of diet‐induced obesity.
Biophysical stimulation for in vitro engineering of functional cardiac tissues
Authors: Korolj Anastasia , Wang Erika Yan , Civitarese Robert A. , Radisic Milica 
Published: June 2017

Engineering functional cardiac tissues remains an ongoing significant challenge due to the complexity of the native environment. However, our growing understanding of key parameters of the in vivo cardiac microenvironment and our ability to replicate those parameters in vitro are resulting in the development of increasingly sophisticated models of engineered cardiac tissues (ECT). This review examines some of the most relevant parameters that may be applied in culture leading to higher fidelity cardiac tissue models. These include the biochemical composition of culture media and cardiac lineage specification, co-culture conditions, electrical and mechanical stimulation, and the application of hydrogels, various biomaterials, and scaffolds. The review will also summarize some of the recent functional human tissue models that have been developed for in vivo and in vitro applications. Ultimately, the creation of sophisticated ECT that replicate native structure and function will be instrumental in advancing cell-based therapeutics and in providing advanced models for drug discovery and testing.
Thermal analysis of high‐voltage cables with several types of insulation for different configurations in the presence of harmonics
Authors: Shazly Jehan H. , Mostafa Mohamed A. , Ibrahim Doaa K. , Abo El Zahab Essam E. 
Published: June 2017

In this contribution, the three‐phase underground cable is modelled using COMSOL Multiphysics software to evaluate the steady state and transient thermal performances. Finite element technique is applied using the heat conduction equation to study the temperature distributions in power cables components and the surrounding environment for both linear and non‐linear loads. A real case study of 220 kV, 340 MVA three‐phase single core copper cables insulated by XLPE is studied. Other types of insulation such as oil, and SF6 gas and their contributions of convection and radiation are investigated at trefoil and flat configurations. The loading capability under different ambient conditions for average moisture soil and dry soil with low‐moisture content are also evaluated taking into account the unfavourable effect of dry zones formation. Moreover, the challenge of predicting the accurate thermal performance and estimating the required derating factor in the presence of odd harmonics is considered. The effect of the change of the frequency spectrum of the non‐linear load current by involving different simultaneous harmonic orders for the same total harmonic distortion is extensively investigated for both flat and trefoil configurations. It is concluded that all harmonics contributions should be considered, to accurately calculate the required cable derating.
Automatic generation control of a multi‐area CCGT‐thermal power system using stochastic search optimised integral minus proportional derivative controller under restructured environment
Authors: Saha Debdeep , Saikia Lalit Chandra 
Published: June 2017

This article presents automatic generation control of an interconnected combined cycle gas turbine (CCGT) incorporated unequal area thermal system under restructured environment. Investigations have been carried out with two generating companies and two distribution companies in each area. Area 1 includes CCGT‐thermal system and area 2 includes thermal–thermal system. Both areas are employed with appropriate generation rate constraint (GRC) and governor dead band in thermal systems. Integral minus proportional derivative with first‐order filter effect (I‐PDF) controller is used as secondary controller whose promising performance is compared with proportional, proportional integral and proportional integral derivative controller. The controller gains and other parameters are optimised using stochastic fractal search (SFS) algorithm. Sensitivity analysis is performed with change in system loading, system parameters such as inertia constant, governor and turbine time constant and random load disturbances to evaluate the robustness of proposed SFS optimised I‐PDF controller. The simulation results with different set of contractual agreement postulated by DISCO participation matrix and its violation illustrates the effectiveness of SFS optimised I‐PDF controller. Additionally, the system under restructured regime is investigated with combinatorial increment in GRC and delayed controller action for appropriate use and maintenance of the proposed controller.
Early Outpatient Physical Therapy May Improve Range-of-Motion in Primary Total Knee Arthroplasty
Authors: McGinn Tanner , Chughtai Morad , Khlopas Anton , Grasmick Paige , Mullaji Arun , Harwin Steven , Bhave Anil , Mont Michael 
Published: June 2017

AbstractKnee stiffness is a relatively common complication following a primary total knee arthroplasty (TKA). Following this procedure, rehabilitation is essential to maintain, improve, and prevent the loss of knee range-of-motion (ROM). Currently, there is a paucity of studies describing whether the timing of physical therapy (PT) post-TKA plays a role in ROM outcomes. Therefore, the purpose of this study was to compare (1) flexion and (2) extension ROM at final follow-up of TKA patients who either began outpatient physical therapy (OPT) within 6 weeks or after 6 weeks of their TKA. Surgical records from all TKAs performed at one institution (three surgeons) between January 2013 and December 2014 (n = 485) were analyzed. Their mean age was 63 years (range, 32–90 years). Patients were stratified into two cohorts: patients who had OPT within 6 weeks (n = 411) and those who started after 6 weeks (n = 74). The t-tests were used to compare mean flexion and extension ROM at final follow-up. The patients who attended OPT within 6 weeks had a significantly higher mean flexion ROM at their final clinical visit ([mean, 114 degrees; range, 60–140 degrees] versus [mean, 111degrees; range, 80–130 degrees]). There was a lower mean extension in the patients who attended PT earlier as compared with those who attended it later (0.7 vs. 1.5 degrees). Patients who attended OPT within 6 weeks of TKA had a better mean flexion and extension ROM as compared with those who started after 6 weeks. Attending PT earlier may allow a patient to have better ROM and decreased stiffness. Because stiffness recalcitrant to PT is usually treated with manipulation under anesthesia (MUA), attending PT earlier and improving ROM may potentially allow post-TKA patients to avoid undergoing manipulation under anesthesia. Further work is needed to validate these findings. Future studies should be prospective with larger cohorts.
Effect of cathodic hydrogen-charging current density on the hydrogen diffusivity in nanostructured bainitic steels
Authors: Kazum Oluwole , Bobby Kannan M. 
Published: June 2017

The effect of cathodic hydrogen-charging current on the effective hydrogen diffusivity in nanostructured bainitic steels produced at transformation temperatures 200°C (BS200) and 350°C (BS350) was investigated and compared to that of mild steel. The effective hydrogen diffusivity at 10 mA cm−2 was the lowest for BS200, followed by BS350 and mild steel, due to the finer microstructure and higher dislocation density in the bainitic ferrite of BS200. Increase in the hydrogen-charging current density, i.e. 20 and 30 mA cm−2, increased the effective hydrogen diffusivity of mild steel by 37 and 135%, and BS350 by 49 and 150%, respectively. For BS200, the increase was not significant (2%) at 20 mA cm−2, but increased by 34% at 30 mA cm−2. This paper is part of a thematic issue on Hydrogen in Metallic Alloys