bluuebunny/crossref_metadata_2025 huggingface dataset:
Unidirectional ultraviolet whispering gallery mode lasing from floating asymmetric circle GaN microdisk
Authors: Zhu G. Y. , Qin F. F. , Guo J. Y. , Xu C. X. , Wang Y. J.
Published: November 2017

Floating asymmetric circle and circle GaN microdisks are fabricated by using standard semiconductor techniques. Unidirectional ultraviolet whispering gallery mode lasing results from floating asymmetric circle GaN microdisks under optical pumping conditions at room temperature. The characteristics of the unidirectional whispering gallery mode lasing, including the lasing emission direction, threshold, emission intensity, and lasing mode number, are studied. A 2D finite difference time domain simulation on optical field distribution confirmed the resonance mechanism of whispering gallery mode lasing. This work is crucial for enhancing collection efficiency and facilitating the coupling of the electronic and photonic devices.
Omnidirectional ventilated acoustic barrier
Authors: Zhang Hai-long , Zhu Yi-fan , Liang Bin , Yang Jing , Yang Jun , Cheng Jian-chun
Published: November 2017

As an important problem in acoustics, sound insulation finds applications in a great variety of situations. In the existing schemes, however, there has always been a trade-off between the thinness of sound-insulating devices and their ventilating capabilities, limiting their potentials in the control of low-frequency sound in high ventilation environments. Here, we design and experimentally implement an omnidirectional acoustic barrier with a planar profile, subwavelength thickness (0.18 λ), yet high ventilation. The proposed mechanism is based on the interference between the resonant scattering of discrete states and the background scattering of continuous states which induces a Fano-like asymmetric transmission profile. Benefitting from the binary-structured design of the coiled unit and hollow pipe, it maximally simplifies the design and fabrication while ensuring the ventilation for all the non-resonant units with open tubes. The simulated and measured results agree well, showing the effectiveness of our proposed mechanism to block low frequency sound coming from various directions while allowing 63% of the air flow to pass. We anticipate our design to open routes to design sound insulators and to enable applications in traditionally unattainable cases such as those calling for noise reduction and cooling simultaneously.
Low resistivity of graphene nanoribbons with zigzag-dominated edge fabricated by hydrogen plasma etching combined with Zn/HCl pretreatment
Authors: Liu Fengkui , Li Qi , Wang Rubing , Xu Jianbao , Hu Junxiong , Li Weiwei , Guo Yufen , Qian Yuting , Deng Wei , Ullah Zaka , Zeng Zhongming , Sun Mengtao , Liu Liwei
Published: November 2017

Graphene nanoribbons (GNRs) have attracted intensive research interest owing to their potential applications in high performance graphene-based electronics. However, the deterioration of electrical performance caused by edge disorder is still an important obstacle to the applications. Here, we report the fabrication of low resistivity GNRs with a zigzag-dominated edge through hydrogen plasma etching combined with the Zn/HCl pretreatment method. This method is based on the anisotropic etching properties of hydrogen plasma in the vicinity of defects created by sputtering zinc (Zn) onto planar graphene. The polarized Raman spectra measurement of GNRs exhibits highly polarization dependence, which reveals the appearance of the zigzag-dominated edge. The as-prepared GNRs exhibit high carrier mobility (∼1332.4 cm2 v−1 s−1) and low resistivity (∼0.7 kΩ) at room temperature. Particularly, the GNRs can carry large current density (5.02 × 108 A cm−2) at high voltage (20.0 V) in the air atmosphere. Our study develops a controllable method to fabricate zigzag edge dominated GNRs for promising applications in transistors, sensors, nanoelectronics, and interconnects.
Polarization-dependent bi-functional metasurface for directive radiation and diffusion-like scattering
Authors: Cui Li , Wang Wenjun , Ding Guowen , Chen Ke , Zhao Junming , Jiang Tian , Zhu Bo , Feng Yijun
Published: November 2017

In this paper, we design a bi-functional metasurface with different spatial distribution of reflection phase responses depending on the incident polarization. The metasurface with a thickness of only 0.067 λ0 (λ0 is the working wavelength) is constructed by unit cells composing two orthogonal I-shaped metallic structures, and the reflection phase for x- and y-linearly polarized incidence can be independently controlled by the geometric parameters. The metasurface can work as a flat parabolic reflector antenna with a maximum gain reaching about 22 dBi around 9.5 GHz, when it is illuminated by the x-polarized feed source of an offset open-ended waveguide antenna. Meanwhile, designed with randomly distributed reflection phases, the proposed metasurface can behave as an electromagnetic (EM) diffusion-like surface, which is capable of suppressing the backward scattering in a broadband from 8.5 GHz to 14 GHz for y-polarized incidence. By this strategy of EM functionality integration, a metasurface reflector antenna equipped with stealth technique to achieve simultaneously high gain and low backward scattering is obtained. Finally, experiments have been carried out to demonstrate this design principle, which agree with the simulation results. The proposed metasurface could offer a promising route for designing EM devices with polarization-dependent multi-functionalities.
Selective wave-transmitting electromagnetic absorber through composite metasurface
Authors: Sun Zhiwei , Zhao Junming , Zhu Bo , Jiang Tian , Feng Yijun
Published: November 2017

Selective wave-transmitting absorbers which have one or more narrow transmission bands inside a wide absorption band are often demanded in wireless communication and radome applications for reducing the coupling between different systems, improving anti-jamming capability, and reducing antennas’ radar cross section. Here we propose a feasible method that utilizing composite of two metasurfaces with different polarization dependent characteristics, one works as electromagnetic polarization rotator and the other as a wideband polarization dependent electromagnetic wave absorber. The polarization rotator produces a cross polarization output in the wave-transmitting band, while preserves the polarization of the incidence outside the band. The metasurface absorber works for certain linear polarization with a much wider absorption band covering the wave-transmitting frequency. When combining these two metasurfaces properly, the whole structure behaves as a wideband absorber with a certain frequency transmission window. The proposal may be applied in radome designs to reduce the radar cross section of antenna or improving the electromagnetic compatibility in communication devices.
Large electrocaloric efficiency over a broad temperature span in lead-free BaTiO3-based ceramics near room temperature
Authors: Li Tangyuan , Liu Xinyu , Shi Sheng , Yin Yihao , Li Hongfa , Wang Qiongyan , Zhang Yunlu , Bian Jihong , Rajput S. S. , Long Changbai , Peng Biaolin , Bai Yang , Wang Yunzhi , Lou Xiaojie
Published: November 2017

We report a large electrocaloric efficiency of 0.029 K cm kV−1 at 303 K and in a wide operating temperature range of 293 K to 313 K in a lead-free Ba0.9Sr0.1(Ti0.9Zr0.1)0.95Sn0.05O3 ceramic by using direct electrocaloric effect (ECE) measurements. Sn4+ doping in Ba0.9Sr0.1Ti0.9Zr0.1O3 not only tunes the rhombohedral-to-paraelectric phase transition temperature to room temperature but also slightly widens the phase transition region, by slightly strengthening the diffuse character and maintaining its good ferroelectricity. Also, polar nanoregions embedded in the matrix facilitate polarization rotation because of a flat energy landscape associated with the relaxor-to-ferroelectric phase transition, inducing enhanced entropy changes and consequently excellent ECE performance.
Analysis of the cool down related cavity performance of the European X-Ray Free Electron Laser vertical acceptance tests
Authors: Wenskat M. , Schaffran J.
Published: November 2017

For the European X-Ray Free Electron Laser (XFEL) cavity production, the cold radio-frequency (RF) test of the cavities at 2K after delivery from the two vendors was the mandatory acceptance test. It has been previously reported, that the cool down dynamics of a cavity across Tc has a significant influence on the observed intrinsic quality factor Q0, which is a measure of the losses on the inner cavity surface. A total number of 367 cool downs is used to analyze this correlation and we show that such a correlation is not observed during the European XFEL cavity production.
PIC-MCC analysis of electron multiplication in a cold-cathode Penning ion generator and its application to identify ignition voltage
Authors: Noori H. , Ranjbar A. H. , Mahjour-Shafiei M.
Published: November 2017

A cold-cathode Penning ion generator (PIG) has been developed in our laboratory to study the interaction of charged particles with matter. The ignition voltage was measured in the presence of the axial magnetic field in the range of 460-580 G. The performed measurements with stainless steel cathodes were in argon gas at pressure of 4 × 10−2 mbar. A PIC-MCC (particle-in-cell, Monte Carlo collision) technique has been used to calculate the electron multiplication coefficient M for various strength of axial magnetic field and applied voltage. An approach based on the coefficient M and the experimental values of the secondary electron emission coefficient γ, was proposed to determine the ignition voltages, theoretically. Applying the values of secondary coefficient γ leads to the average value of γM(V, B) to be = 1.05 ± 0.03 at the ignition of the PIG which satisfies the proposed ignition criterion. Thus, the ion-induced secondary electrons emitted from the cathode have dominant contribution to self-sustaining of the discharge process in a PIG.
Topological valley transport of plate-mode waves in a homogenous thin plate with periodic stubbed surface
Authors: Chen Jiu-Jiu , Huo Shao-Yong , Geng Zhi-Guo , Huang Hong-Bo , Zhu Xue-Feng
Published: November 2017

The study for exotic topological effects of sound has attracted uprising interests in fundamental physics and practical applications. Based on the concept of valley pseudospin, we demonstrate the topological valley transport of plate-mode waves in a homogenous thin plate with periodic stubbed surface, where a deterministic two-fold Dirac degeneracy is form by two plate modes. We show that the topological property can be controlled by the height of stubs deposited on the plate. By adjusting the relative heights of adjacent stubs, the valley vortex chirality and band inversion are induced, giving rise to a phononic analog of valley Hall phase transition. We further numerically demonstrate the valley states of plate-mode waves with robust topological protection. Our results provide a new route to design unconventional elastic topological insulators and will significantly broaden its practical application in the engineering field.
Identification of quantitative trait loci underlying fatty acid content of soybean (Glycine max), including main, epistatic and QTL×environment effects across multiple environments
Authors: Xia Ning , Wu Depeng , Li Xia , Teng Weili , Zhao Xue , Li Haiyan , Han Yingpeng
Published: November 2017

The uses and nutritional value of soybean (Glycine max (L.) Merrill) oil are largely influenced by the levels and relative proportions in the seed of the five major fatty acids: oleic (OA), palmitic (PA), stearic (SA), linoleic (LLA), linolenic (LNA). The present study was undertaken to identify quantitative trait loci (QTLs) that are associated with fatty acid content (particularly OA) and to determine the effects of epistasis and the environment. The mapping population included 134 recombinant inbred lines (RILs) derived from soybean varieties Suinong10 and L-9. Phenotypic data of the two parents and their RILs were obtained at Harbin in 2013, 2014 and 2015. Nineteen QTLs associated with individual fatty acid content (six for OA, four for LNA, three for PA, two for SA, four for LLA) were identified. Twelve of these QTLs (four for OA, three for LNA, two for PA, one for SA, two for LLA) were detected with an additive main effect and/or additive × environment interaction effect in certain environments. Epistatic QTLs were identified for contents of OA (two QTLs), LNA (one QTL) and LLA (one QTL) in different environments, and which exhibited significant epistatic effects. Our observation of these additive and epistatic QTLs suggested that soybean possesses a complex network for fatty acid accumulation, which is valuable for marker-assisted selection.
Corrigendum to: Peter Gavin Hall 1951–2016
Authors: Robinson John , Welsh Alan H.
Published: November 2017

Peter Hall, in the forty years of his research career, produced work in both probability and statistics, whose breadth and depth must be regarded as phenomenal. He displayed extraordinary technical skills together with remarkable intuition in developing and applying multifaceted mathematical approaches in the whole of his work. The impact of this wide-ranging use of powerful mathematical methods has had a profound effect on much of modern mathematical statistics. After completing his DPhil at Oxford, he remained in Australia for almost all his career although he was renowned as one of the major international figures in probability and statistics. Peter was a mentor to a large group of post-graduate students and post-doctoral colleagues giving encouragement and guidance and he attracted many research visitors contributing greatly to the whole of Australian statistical research. Remarkably, given his immense research output, he took a significant role in both editorial duties in major international journals and in advocacy for mathematics and statistics in Australia. Peter was a man of great charm whose modest demeanour belied his staggering abilities. His loss to mathematics and statistics is great, but is matched by the personal loss to us and to his many friends.
Explicit formulas for 𝐶^{1,1} Glaeser-Whitney extensions of 1-Taylor fields in Hilbert spaces
Authors: Daniilidis Aris , Haddou Mounir , Le Gruyer Erwan , Ley Olivier
Published: November 2017

We give a simple alternative proof for the

C

1
,
1

C^{1,1}

–convex extension problem which has been introduced and studied by D. Azagra and C. Mudarra (2017). As an application, we obtain an easy constructive proof for the Glaeser-Whitney problem of

C

1
,
1

C^{1,1}

extensions on a Hilbert space. In both cases we provide explicit formulae for the extensions. For the Glaeser-Whitney problem the obtained extension is almost minimal, that is, minimal up to a multiplicative factor in the sense of Le Gruyer (2009).
Presenting affine Schur algebras
Authors: Fu Qiang , Liu Mingqiang
Published: November 2017

The universal enveloping algebra

U

(

g
l

^

n

)

\mathcal {U}(\widehat {\frak {gl}}_n)

of

g
l

^

n

\widehat {\frak {gl}}_n

was realized in [A double Hall algebra approach to affine quantum Schur–Weyl theory, Cambridge University Press, Cambridge, 2012, Ch. 6] using affine Schur algebras. In particular some explicit multiplication formulas in affine Schur algebras were derived. We use these formulas to study the structure of affine Schur algebras. In particular, we give a presentation of the affine Schur algebra

S

△

(
n
,
r

)

Q

{\mathcal S}_{{\!\vartriangle }}(n,r)_{\mathbb Q}

over 

Q

\mathbb {Q}

.
Spatial cues and not spindle pole maturation drive the asymmetry of astral microtubules between new and preexisting spindle poles
Authors: Lengefeld Jette , Yen Eric , Chen Xiuzhen , Leary Allen , Vogel Jackie , Barral Yves
Published: November 2017

In many asymmetrically dividing cells, the microtubule-organizing centers (MTOCs; mammalian centrosome and yeast spindle pole body [SPB]) nucleate more astral microtubules on one of the two spindle poles than the other. This differential activity generally correlates with the age of MTOCs and contributes to orienting the mitotic spindle within the cell. The asymmetry might result from the two MTOCs being in distinctive maturation states. We investigated this model in budding yeast. Using fluorophores with different maturation kinetics to label the outer plaque components of the SPB, we found that the Cnm67 protein is mobile, whereas Spc72 is not. However, these two proteins were rapidly as abundant on both SPBs, indicating that SPBs mature more rapidly than anticipated. Superresolution microscopy confirmed this finding for Spc72 and for the γ-tubulin complex. Moreover, astral microtubule number and length correlated with the subcellular localization of SPBs rather than their age. Kar9-dependent orientation of the spindle drove the differential activity of the SPBs in astral microtubule organization rather than intrinsic differences between the spindle poles. Together, our data establish that Kar9 and spatial cues, rather than the kinetics of SPB maturation, control the asymmetry of astral microtubule organization between the preexisting and new SPBs.
The Effect of Land Access on Youth Employment and Migration Decisions: Evidence from Rural Ethiopia
Authors: Kosec Katrina , Ghebru Hosaena , Holtemeyer Brian , Mueller Valerie , Schmidt Emily
Published: November 2017

How does the amount of land that youth expect to inherit affect their migration and employment decisions? We explore this question in the context of rural Ethiopia using a 2014 cross‐sectional dataset indicating whether or not youth household members from a previous 2010 survey had migrated by 2014, and in which sector they worked in 2014. We estimate a household fixed effects model and exploit exogenous variation in the timing of land redistributions to overcome endogenous household decisions about how much land to bequeath to descendants. We find that larger expected land inheritances significantly lower the likelihood of long‐distance permanent migration and of permanent migration to urban areas. Inheriting more land also leads to a significantly higher likelihood of employment in agriculture and a lower likelihood of employment in the non‐agricultural sector. Conversely, the decision to attend school is unaffected. These results appear to be most heavily‐driven by males and by the older half of our youth sample. We also find suggestive evidence that several mediating factors matter. Land inheritance is a much stronger predictor of rural‐to‐urban permanent migration and non‐agricultural‐sector employment in areas with less vibrant land markets, in relatively remote areas (those far from major urban centers), and in areas with lower soil quality. Overall, these results affirm the importance of push factors in dictating occupation and migration decisions in Ethiopia.
Modeling Heterogeneous Farm Responses to European Union Biofuel Support with a Random Parameter Multicrop Model
Authors: Koutchadé Obafèmi Philippe , Carpentier Alain , Femenia Fabienne
Published: November 2017

Although there is now widespread evidence of substantial variability in economic agents' responses to economic drivers in many applied economics fields, this variability has been largely overlooked by econometric agricultural production models. This article sets out to fill this gap by providing methodological contributions and empirical results. First, we consider panel data multicrop models featuring random intercept and slope parameters to account for the heterogeneous responses of crop producers to economic drivers. Second, we show that Monte Carlo expectation‐maximization algorithms are particularly well‐suited to estimating this type of model. Third, based on an application of our empirical modeling framework with a sample of French grain crop producers, we demonstrate substantial variability in farmers' responses to economic incentives. Fourth, we use the estimated model and a simple “statistical calibration” procedure to build farm‐specific simulation models, which are then used to evaluate the effects of the rapeseed price increase induced by European Union (EU) biofuel support. Our simulation results demonstrate that ignoring the variability in the considered farmers' responses to the economic incentives results in significant overestimation of the increases in rapeseed yield levels and variable input use levels induced by EU biofuel support, as well as significant underestimation of the variability in the congruent increases in rapeseed acreages.
Patient perceptions of receiving test results via online portals: a mixed-methods study
Authors: Giardina Traber D , Baldwin Jessica , Nystrom Daniel T , Sittig Dean F , Singh Hardeep
Published: November 2017

Objective

Online portals provide patients with access to their test results, but it is unknown how patients use these tools to manage results and what information is available to promote understanding. We conducted a mixed-methods study to explore patients’ experiences and preferences when accessing their test results via portals.

Materials and Methods

We conducted 95 interviews (13 semistructured and 82 structured) with adults who viewed a test result in their portal between April 2015 and September 2016 at 4 large outpatient clinics in Houston, Texas. Semistructured interviews were coded using content analysis and transformed into quantitative data and integrated with the structured interview data. Descriptive statistics were used to summarize the structured data.

Results

Nearly two-thirds (63%) did not receive any explanatory information or test result interpretation at the time they received the result, and 46% conducted online searches for further information about their result. Patients who received an abnormal result were more likely to experience negative emotions (56% vs 21%; P = .003) and more likely to call their physician (44% vs 15%; P = .002) compared with those who received normal results.

Discussion

Study findings suggest that online portals are not currently designed to present test results to patients in a meaningful way. Patients experienced negative emotions often with abnormal results, but sometimes even with normal results. Simply providing access via portals is insufficient; additional strategies are needed to help patients interpret and manage their online test results.

Conclusion

Given the absence of national guidance, our findings could help strengthen policy and practice in this area and inform innovations that promote patient understanding of test results.
What Does the Sleeping Brain Say? Syntax and Semantics of Sleep Talking in Healthy Subjects and in Parasomnia Patients
Authors: Arnulf Isabelle , Uguccioni Ginevra , Gay Frederick , Baldayrou Etienne , Golmard Jean-Louis , Gayraud Frederique , Devevey Alain
Published: November 2017

Objectives

Speech is a complex function in humans, but the linguistic characteristics of sleep talking are unknown. We analyzed sleep-associated speech in adults, mostly (92%) during parasomnias.

Methods

The utterances recorded during night-time video-polysomnography were analyzed for number of words, propositions and speech episodes, frequency, gaps and pauses (denoting turn-taking in the conversation), lemmatization, verbosity, negative/imperative/interrogative tone, first/second person, politeness, and abuse.

Results

Two hundred thirty-two subjects (aged 49.5 ± 20 years old; 41% women; 129 with rapid eye movement [REM] sleep behavior disorder and 87 with sleepwalking/sleep terrors, 15 healthy subjects, and 1 patient with sleep apnea speaking in non-REM sleep) uttered 883 speech episodes, containing 59% nonverbal utterance (mumbles, shouts, whispers, and laughs) and 3349 understandable words. The most frequent word was “No”: negations represented 21.4% of clauses (more in non-REM sleep). Interrogations were found in 26% of speech episodes (more in non-REM sleep), and subordinate clauses were found in 12.9% of speech episodes. As many as 9.7% of clauses contained profanities (more in non-REM sleep). Verbal abuse lasted longer in REM sleep and was mostly directed toward insulting or condemning someone, whereas swearing predominated in non-REM sleep. Men sleep-talked more than women and used a higher proportion of profanities. Apparent turn-taking in the conversation respected the usual language gaps.

Conclusions

Sleep talking parallels awake talking for syntax, semantics, and turn-taking in conversation, suggesting that the sleeping brain can function at a high level. Language during sleep is mostly a familiar, tensed conversation with inaudible others, suggestive of conflicts.
Delirium monitoring and management in the acute care setting
Authors: Cullen Elizabeth , Balas Michele C.
Published: November 2017

Associated with substantial morbidity and mortality, delirium is a syndrome commonly experienced by hospitalized adults. This article presents a case study highlighting how delirium may go unrecognized by the healthcare team and provides 10 suggestions for improving delirium assessment, prevention, and management in the acute care setting.
Chromosomal Microarray Testing For Children With Unexplained Neurodevelopmental Disorders
Authors: Martin Christa Lese , Ledbetter David H.
Published: November 2017

(Abstracted from JAMA 2017;317(24):2545–2546)

Chromosomal microarray analysis (CMA) has emerged as a robust means to detect chromosomal abnormalities including unbalanced chromosomal rearrangements, as well as smaller chromosomal abnormalities than those detectable by karyotype. Chromosomal microarray analysis has replaced conventional G-banded karyotyping due to its greater sensitivity and resolution; G-banding effectively identifies imbalances of DNA greater than 5 to 10 megabases (millions of base pairs), whereas CMA can detect genome-wide imbalances of more than 400 kilobases (thousands of base pairs).
A Retrospective Cohort Study of Hospital Versus Home Care for Pregnant Women With Preterm Prelabor Rupture of Membranes
Authors: Palmer Lynne , Grabowska Kirsten , Burrows Jason , Rowe Hilary , Billing Erin , Metcalfe Amy
Published: November 2017

(Abstracted from Int J Gynecol Obstet 2017;137:180–184)

Pregnancies with preterm prelabor rupture of membranes (PPROM) are at risk of preterm labor, and further risks of infection or adverse cord or placental events increase perinatal morbidity and mortality. Monitoring pregnancies with PPROM in the hospital setting until at least 34 weeks is the standard practice to prevent prematurity-related complications.
Rotational Forceps Versus Manual Rotation and Direct Forceps: A Retrospective Cohort Study
Authors: O’Brien Stephen , Day Fiona , Lenguerrand Erik , Cornthwaite Katie , Edwards Sian , Siassakos Dimitrios
Published: November 2017

(Abstracted from Eur J Obstet Gynecol Reprod Biol 2017;212:119–125)

In case of malposition, both rotational forceps (RF) and manual rotation (MR) followed by direct forceps are used to perform rotational operative vaginal birth (OVB), but evidence regarding the safest and most effective method to assist birth in such cases is still unclear. Although higher rates of complications were reported with the use of RF in the past, in recent times it has been associated with high rates of successful vaginal birth and lower rates of adverse outcomes than alternative modes of birth.
Pediatric CIDP: Clinical Features and Response to Treatment
Authors: Harada Yohei , Herrmann David N. , Logigian Eric L.
Published: November 2017

Objectives:

Childhood chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) responds favorably to immunomodulatory treatment. However, the optimal sequencing and selection of immunotherapy is uncertain.

Methods:

Using accepted diagnostic criteria, pediatric patients with CIDP seen at our center from 1999 to 2015 were identified retrospectively through medical record review. Clinical details and treatment responses were tabulated.

Results:

Ten patients (age 4–16, 6 women) with definite (N = 8) or possible (N = 2) CIDP met criteria. All were initially treated with IVIg; 6 responded but 4 did not. All 4 IVIG nonresponders improved with twice-weekly high-dose oral prednisone, as did 1 IVIg responder who was also treated with twice-weekly oral prednisone when IVIg was discontinued. Pulse steroids were well tolerated.

Conclusions:

Pulse oral corticosteroid therapy holds promise as an alternative treatment to IVIG in pediatric CIDP. Future multicenter studies are warranted to determine the comparative efficacy and safety of weekly pulse oral corticosteroids versus IVIg in pediatric CIDP.
Cancer immunotherapy in patients with new or recurrent malignancies after liver transplantation
Authors: Liu Mengqi , Guo Wenzhi , Zhang Shuijun
Published: November 2017

Cancer immunotherapy, as a new treatment modality, has been shown to be effective, especially in metastatic melanoma and lung cancer. Organ transplantation can be a life-saving procedure for patients with end-stage diseases of lung, heart, kidney and liver. While ironically, as improvements in organ transplantation have extended patients’ lives, new or recurrent postsurgical malignancies have become an increasing threat to their long-term survival, especially in patients after liver transplantation due to hepatocellular carcinoma. The feasibility of immunotherapy treatment for such patients is still to be investigated.
Establishing musculoskeletal oncology service in resource constrained country: challenges and solutions
Authors: Hasan Obada , Zubairi Akbar , Nawaz Zohaib , Umer Masood
Published: November 2017

The burden of orthopedic tumor surgery in Pakistan is not known. Similarly the number of procedures being performed for bone and soft tissue surgery are not known. This is even becoming more challenging where the existence of rules and regulations in health care are next to minimal. Furthermore data recording in our country and case registries hardly exist. Despite the lack of information and resources, with high disease burden on community, various providers provide surgical interventions every day in our settings. A lot of tumor surgery is still being done by general surgeons and general orthopedic surgeons who have little knowledge and update about musculoskeletal oncology principles. Lack of subspecialized centers and the high cost of such centers force the patients to visit these surgeons for a highly sophisticated problem like a bone tumor which is the disease of young bones. In this article we will emphasize on the difficulty in establishing an orthopedic tumor service in our part of the world and the consequences including delay in diagnosis, faulty course of management and later decline in functionality, disease progression and increased mortality. We will highlight the principles and stepwise approach of orthopedic tumor surgery and explain the difficulty encountered if these principles are not followed.
Characteristics of Treatment-experienced HIV-infected African Children and Adolescents Initiating Darunavir and/or Etravirine-based Antiretroviral Treatment
Authors: Corrigan Bethany , Mukui Irene , Mulenga Lloyd , Mthethwa Nobuhle , Letsie Mosilinyane , Bruno Stephanie , Rakhmanina Natella
Published: November 2017

Background:

Data are limited on the selection and sequencing of second-line and third-line pediatric antiretroviral treatment (ART) in resource-limited settings. This study aimed to evaluate characteristics of African pediatric patients initiated on darunavir (DRV) and/or etravirine (ETR) through a specific drug donation program.

Methods:

This was a cross-sectional study of baseline immunologic, virologic and demographic characteristics of children and adolescents initiating DRV-based and/or ETR-based ART. Descriptive statistics were used.

Results:

Study enrolled 48 patients (45.8% women; median age = 15 years [interquartile range 17.7–10.3]) at 9 clinical sites in Zambia, Swaziland, Kenya and Lesotho. The majority (87.5%; n = 42) had received ≥2 prior ART regimens; most (81.2%) had received lopinavir/ritonavir-based ART before switch. All patients had detectable HIV RNA (median = 56,653 copies/mL). Forty seven patients (98.9%) had HIV genotype results: 41 (87.2%) had ≥1 nucleos(t)ide reverse transcriptase inhibitor (NRTI)-resistance mutation (RM), predominantly M184V (76.6%; n = 36); 31 (65.9%) had ≥1 non-NRTI-RM, including 27 (57.4%) with ≥1 ETR-RM; 30 (63.8%) had ≥3 protease inhibitor RM, including 20 (42.6%) with ≥1 DRV-RM. For new ART regimens, DRV and raltegravir were most frequently prescribed (83.3%; n = 40 on DRV and raltegravir, each). Eighteen patients (37.5%) were initiated on the NRTI-sparing ART.

Conclusions:

In our study, a significant proportion of treatment-experienced African children and adolescents had one or more DRV-RM and ETR-RM. For the new regimen, more than a third of pediatric patients failing second-line ART were prescribed NRTI-sparing regimens. Better understanding of the current approaches to pediatric ART sequencing in resource-limited settings is needed.
Lessons Learned From iCare: A Postexamination Text-Messaging-Based Program With Sexual Assault Patients
Authors: Hicks Danielle L. , Patterson Debra , Resko Stella
Published: November 2017

Background:

Although beneficial, few sexual assault patients seek follow-up healthcare or counseling after a medical forensic examination. Mobile technology interventions may help patients engage in postcare, but there is a dearth of research on patients’ utilization of these interventions. The current study examines patients’ engagement with a 4-week postassault text message program (iCare), which assessed patients’ safety and well-being, if they needed assistance with accessing nonoccupational postexposure prophylaxis, or scheduling appointments for follow-up pregnancy and sexually transmitted infection testing, and their experience with the criminal justice system.

Methods:

This pilot study collected data from 40 adult patient records and texting communications between the nurse and patients. We utilized descriptive statistics to examine patient utilization of the program.

Results:

Sixty-five percent of the patients responded at least once during the program, but only two responded to every text. Nearly a quarter of the patients (22.5%) requested the texts to stop before the end of the program. A larger portion of the patients (42.5%) did not opt out but stopped replying by the third message. The program appeared to be helpful for increasing the amount of communication between the nurse and the patient, but patients rarely utilized the nurse’s offers of assistance (e.g., counseling, advocacy).

Discussion:

Text interventions appear to be effective for relaying information but may be limited for increasing postexamination service utilization for sexual assault patients. Future research should examine areas of patient needs in the weeks and months postexamination that can be addressed in text interventions.
Screening for Posttraumatic Stress Disorder in Civilians With Mangled Hand Injury
Authors: Cook Ruth A. , Brown Marie-Annette , Allan Christopher , Schepp Karen , Voss Joachim G.
Published: November 2017

Posttraumatic stress disorder (PTSD) is a symptom cluster of intrusion, avoidance, negative alteration in cognition, and alteration in arousal and reactivity following trauma. PTSD occurs frequently after a physical trauma such as a severe hand injury. It is often not recognized and consequently untreated. Previous research has shown that 10%–40% of civilian trauma survivors experience PTSD in the first 12 months after injury. There is great urgency to identify patients in the early stage of recovery from trauma, as PTSD becomes more difficult to treat in its chronic form. Mangling hand injuries are particularly disabling because they are an integral part of our social body image. We wanted to investigate the degree of PTSD screening and the follow-up-referral procedures in all mangled hand cases at the hand clinic of a large Northwestern Trauma Center. A retrospective medical record review was conducted from January to December 2012 using an existing PTSD screen with data from the electronic medical records. We found that 40% of the patients with mangled hand injury were classified as “at risk” according to our PTSD screening but only 22% of those cases were referred to rehabilitation psychiatry for further evaluation and treatment. The low rate of referral for PTSD after mangled hand injury was alarming. On the basis of this, we instituted a new screening protocol for all patients with mangled hand injury using the 4-item Primary Care-PTSD screening tool and provided an informational brochure on PTSD. The investigation led to a positive change in the practice environment and workflow of the clinic. We have not conducted any follow-up study as yet, but our goal is to screen all patients with mangled hand injury and refer all patients for psychiatric therapy who have positively answered 3 of the 4 screening questions.
Accuracy of First-Trimester Combined Test in Screening for Trisomies 21, 18 and 13
Authors: Santorum M. , Wright D. , Syngelaki A. , Karagioti N. , Nicolaides K. H.
Published: November 2017

(Abstracted from Ultrasound Obstet Gynecol 2017;49:714–720)

In the last few years, major accomplishments have been made in the screening of trisomies through the development of maternal blood cell-free DNA (cfDNA) analysis. In a previous study, this group published a statistical algorithm used to calculate patient's risks for trisomies 21, 18, and 13 based on patient-specific information obtained from a combined clinical test.
Nontraumatic Convexal Subarachnoid Hemorrhage Accompanied by Sylvian Hematoma
Authors: Ninomiya Kenji , Fukasawa Maki , Kawakami Yuka , Fuke Chiaki , Miyazaki Tetsuji
Published: November 2017

We describe an autopsy case of nontraumatic convexal subarachnoid hemorrhage (cSAH) accompanied by sylvian hematoma. A woman in her 50s was found dead in her house. On autopsy, massive cSAH accompanied by sylvian hematoma was observed. Because of the absence of subarachnoid hemorrhage (SAH) in the basal cistern, initial suspicion was that of a traumatic SAH. After a detailed investigation, a ruptured cerebral aneurysm of the distal middle cerebral artery was found in the hematoma, and the cSAH in this case was confirmed to be endogenous. Convexal subarachnoid hemorrhages typically result from traumatic injury, whereas endogenous cSAHs are exceedingly rare. Autopsy findings of a sylvian hematoma with SAH may result from endogenous hemorrhage from ruptured aneurysm of the distal middle cerebral artery. Detailed investigation of the hematoma may help identify the culprit lesion and help arrive at the correct postmortem diagnosis.
Deaths Associated With Brotizolam Poisoning From a Single Drug Overdose
Authors: Sakai Kentaro , Saito Kazuyuki , Takada Aya , Hikiji Wakako , Kikuchi Yosuke , Fukunaga Tatsushige
Published: November 2017

Brotizolam is a short-acting hypnotic in the benzodiazepine family, and fatal poisonings by an overdose of brotizolam are rare. This report describes 4 cases of deaths associated with brotizolam poisoning from a single drug overdose. The ages ranged from 51 to 90 years, and the postmortem interval between death and tissue sampling was 1.5 to 2.5 days. These deaths were classified as 1 homicide and 3 suicides. The concentration of the brotizolam ranged from 0.05 to 0.21 mg/L in the blood samples. Ethanol, which could cause mild alcohol intoxication, was detected in the blood samples from 2 cases. Postmortem examinations did not find any significant pathologic conditions, except for a case of death by drowning in a bathtub due to brotizolam poisoning. These 4 cases suggest that a brotizolam overdose should not be underestimated in terms of its fatal effects, particularly when situations involve alcohol intoxication, injury subsequent to the poisoning, or underlying medical conditions including aging.
A Rare Case of Isolated Atrial Myocarditis Causing Death With no Post Mortem Computed Tomography Scan Correlation
Authors: Tse Rexson , Garland Jack , Kesha Kilak , Triggs Yvonne , Modahl Lucy , Milne David , Yap Zhi , Stables Simon
Published: November 2017

Acute myocarditis is a potentially fatal cardiac pathology that is thought to cause sudden death through arrhythmia and cardiac failure. Of the different subtypes, lymphocytic myocarditis is the most common form. The pathophysiology of myocarditis can be generally diffuse or focally involve the ventricles, but less frequently affects the atria. Although the clinical literature reports isolated atrial myocarditis as a cause of atrial fibrillation and enlargement, there is scant postmortem literature on the findings of this pathology. We report a fatal case of isolated lymphocytic atrial myocarditis affecting only the left atrium in a 56-year-old man, where microscopy of the left atrium confirmed a florid lymphocytic myocarditis. Retrospective postmortem computed tomography scan review did not show any abnormalities on the left atrial wall.
Inhibition of Skin Wound Contraction by Nanofibrillar Cellulose Hydrogel
Authors: Nuutila Kristo , Laukkanen Antti , Lindford Andrew , Juteau Susanna , Nuopponen Markus , Vuola Jyrki , Kankuri Esko
Published: November 2017

Background:

Although wound contraction is an essential part of healing, excessive contraction can compromise healing through induction of scarring and fibrosis. This in turn leads to development of wound contractures that limit elasticity and function. Major research efforts have focused on development of novel therapeutic approaches to gain inhibitory control over wound contraction. Despite these efforts, the need for cost-effective, clinically feasible, and effective agents to inhibit wound contraction remains.

Methods:

In this study, the authors investigated the effect of nanofibrillar cellulose hydrogel on wound contraction both in vitro and in vivo. Two different porcine full-thickness wounds (8-mm punch-biopsy wounds and 4 × 4-cm wounds covered with a 1:3-meshed split-thickness skin graft) were treated with or without nanofibrillar cellulose or carboxymethylcellulose (Purilon hydrogel), which was used as a reference treatment. Wound contraction was observed macroscopically, and histologic sections were taken at 14-day follow-up.

Results:

Nanofibrillar cellulose hydrogel inhibited 70 percent of punch-biopsy wound contraction, whereas the carboxymethylcellulose hydrogel was ineffective. Importantly, application of nanofibrillar cellulose on split-thickness skin grafts did not inhibit epithelialization of the interstices or cell migration from the graft.

Conclusion:

The authors’ results, although preliminary, indicate a potential for nanofibrillar cellulose hydrogel as a novel material for controlling excessive wound contraction.
The Ndc80 complex targets Bod1 to human mitotic kinetochores
Authors: Schleicher Katharina , Porter Michael , ten Have Sara , Sundaramoorthy Ramasubramanian , Porter Iain M. , Swedlow Jason R.
Published: November 2017

Regulation of protein phosphatase activity by endogenous protein inhibitors is an important mechanism to control protein phosphorylation in cells. We recently identified Biorientation defective 1 (Bod1) as a small protein inhibitor of protein phosphatase 2A containing the B56 regulatory subunit (PP2A-B56). This phosphatase controls the amount of phosphorylation of several kinetochore proteins and thus the establishment of load-bearing chromosome-spindle attachments in time for accurate separation of sister chromatids in mitosis. Like PP2A-B56, Bod1 directly localizes to mitotic kinetochores and is required for correct segregation of mitotic chromosomes. In this report, we have probed the spatio-temporal regulation of Bod1 during mitotic progression. Kinetochore localization of Bod1 increases from nuclear envelope breakdown until metaphase. Phosphorylation of Bod1 at threonine 95 (T95), which increases Bod1's binding to and inhibition of PP2A-B56, peaks in prometaphase when PP2A-B56 localization to kinetochores is highest. We demonstrate here that kinetochore targeting of Bod1 depends on the outer kinetochore protein Ndc80 and not PP2A-B56. Crucially, Bod1 depletion functionally affects Ndc80 phosphorylation at the N-terminal serine 55 (S55), as well as a number of other phosphorylation sites within the outer kinetochore, including Knl1 at serine 24 and 60 (S24, S60), and threonine T943 and T1155 (T943, T1155). Therefore, Ndc80 recruits a phosphatase inhibitor to kinetochores which directly feeds forward to regulate Ndc80, and Knl1 phosphorylation, including sites that mediate the attachment of microtubules to kinetochores.
Is inflammatory micronucleation the key to a successful anti-mitotic cancer drug?
Authors: Mitchison T. J. , Pineda J. , Shi J. , Florian S.
Published: November 2017

Paclitaxel is a successful anti-cancer drug that kills cancer cells in two-dimensional culture through perturbation of mitosis, but whether it causes tumour regression by anti-mitotic actions is controversial. Drug candidates that specifically target mitosis, including inhibitors of kinesin-5, AurkA, AurkB and Plk1, disappointed in the clinic. Current explanations for this discrepancy include pharmacokinetic differences and hypothetical interphase actions of paclitaxel. Here, we discuss post-mitotic micronucleation as a special activity of taxanes that might explain their higher activity in solid tumours. We review data showing that cells which exit mitosis in paclitaxel are highly micronucleated and suffer post-mitotic DNA damage, and that these effects are much stronger for paclitaxel than kinesin-5 inhibitors. We propose that post-mitotic micronucleation promotes inflammatory signalling via cGAS–STING and other pathways. In tumours, this signalling may recruit cytotoxic leucocytes, damage blood vessels and prime T-cell responses, leading to whole-tumour regression. We discuss experiments that are needed to test the micronucleation hypothesis, and its implications for novel anti-mitotic targets and enhancement of taxane-based therapies.
Growth and size control during development
Authors: Vollmer Jannik , Casares Fernando , Iber Dagmar
Published: November 2017

The size and shape of organs are characteristic for each species. Even when organisms develop to different sizes due to varying environmental conditions, such as nutrition, organ size follows species-specific rules of proportionality to the rest of the body, a phenomenon referred to as allometry. Therefore, for a given environment, organs stop growth at a predictable size set by the species's genotype. How do organs stop growth? How can related species give rise to organs of strikingly different size? No definitive answer has been given to date. One of the major models for the studies of growth termination is the vinegar flyDrosophila melanogaster.Therefore, this review will focus mostly on work carried out inDrosophilato try to tease apart potential mechanisms and identify routes for further investigation.One general rule, found across the animal kingdom, is that the rate of growth declines with developmental time. Therefore, answers to the problem of growth termination should explain this seemingly universal fact. In addition, growth termination is intimately related to the problems of robustness (i.e. precision) and plasticity in organ size, symmetric and asymmetric organ development, and of how the ‘target’ size depends on extrinsic, environmental factors.