bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulation of cell migration by α4 and α9 integrins
Authors: Hight-Warburton Willow , Parsons Maddy
Published: February 2019

Integrins are heterodimeric transmembrane receptors that play an essential role in enabling cells to sense and bind to extracellular ligands. Activation and clustering of integrins leads to the formation of focal adhesions at the plasma membrane that subsequently initiate signalling pathways to control a broad range of functional endpoints including cell migration, proliferation and survival. The α4 and α9 integrins form a small sub-family of receptors that share some specific ligands and binding partners. Although relatively poorly studied compared with other integrin family members, emerging evidence suggests that despite restricted cell and tissue expression profiles, these integrins play a key role in the regulation of signalling pathways controlling cytoskeletal remodelling and migration in both adherent and non-adherent cell types. This review summarises the known shared and specific roles for α4 and α9 integrins and highlights the importance of these receptors in controlling cell migration within both homeostatic and disease settings.
An ion for an iron: streptococcal metal homeostasis under oxidative stress
Authors: Jakubovics Nicholas S.
Published: February 2019

The ability of opportunistic pathogens such as Group A Streptococcus (GAS) to transition between mucosal colonisation and invasive disease requires complex systems for adapting to markedly different host environments. The battle to acquire essential trace metals such as manganese and iron from the host is central to pathogenesis. Using a molecular genetic approach, Turner et al. [Biochem. J. (2019) 476, 595–611] show that it is not just individual metal concentrations that are important, but the ratio of iron to manganese within cells. Increasing this ratio by knocking out pmtA, encoding the Fe(II) exporter PmtA, or by disrupting mtsA, encoding an MtsABC Mn(II)-import system component, led to reductions in superoxide dismutase (SodA) activity and increased sensitivity to oxidative stress. The authors show that SodA is at least 4-fold more active with Mn bound than with Fe and speculate that high intracellular Fe:Mn ratios reduce superoxide dismutase activity through the mismetalation of SodA. Challenging wild-type GAS with 1 mM H2O2 led to a decrease in Fe:Mn ratio and a 3-fold increase in SodA activity, indicating that modulation of the balance between intracellular Fe and Mn may play an important role in adaptation to oxidative stress. This work unravels some of the key mechanisms for maintaining appropriate Mn and Fe concentrations within bacterial cells and underscores the need for future studies that take an holistic view to metal ion homeostasis in bacteria. Strategies aimed at interfering with the balance of intracellular metal ions represent a promising approach for the control of invasive microbial infections.
Genetic obesity increases pancreatic expression of mitochondrial proteins which regulate cholesterol efflux in BRIN-BD11 insulinoma cells
Authors: Caridis Anna-Maria , Lightbody Richard J. , Tarlton Jamie M.R. , Dolan Sharron , Graham Annette
Published: February 2019

Pancreatic β-cells are sensitive to fluctuations in cholesterol content, which can damage the insulin secretion pathway, contributing to the aetiology of type 2 diabetes mellitus. Cholesterol efflux to (apo)lipoproteins, via ATP-binding cassette (ABC) transporter A1 (ABCA1), can prevent intracellular cholesterol accumulation; in some peripheral cells, ABCA1-dependent efflux is enhanced by promotion of cholesterol trafficking to, and generation of Liver X receptor (LXR) ligands by, mitochondrial sterol 27-hydroxylase (Cyp27A1 (cytochrome P450 27 A1/sterol 27-hydroxylase)) and its redox partners, adrenodoxin (ADX) and ADX reductase (ADXR). Despite this, the roles of mitochondrial cholesterol trafficking (steroidogenic acute regulatory protein [StAR] and 18-kDa translocator protein [TSPO]) and metabolising proteins in insulin-secreting cells remain wholly uncharacterised. Here, we demonstrate an increase in pancreatic expression of Cyp27A1, ADXR, TSPO and LXRα, but not ADX or StAR, in obese (fa/fa) rodents compared with lean (Fa/?) controls. Overexpression of Cyp27A1 alone in BRIN-BD11 cells increased INS2 expression, without affecting lipid metabolism; however, after exposure to low-density lipoprotein (LDL), cholesterol efflux to (apo)lipoprotein acceptors was enhanced in Cyp27A1-overexpressing cells. Co-transfection of Cyp27A1, ADX and ADXR, at a ratio approximating that in pancreatic tissue, stimulated cholesterol efflux to apolipoprotein A-I (apoA-I) in both basal and cholesterol-loaded cells; insulin release was stimulated equally by all acceptors in cholesterol-loaded cells. Thus, genetic obesity increases pancreatic expression of Cyp27A1, ADXR, TSPO and LXRα, while modulation of Cyp27A1 and its redox partners promotes cholesterol efflux from insulin-secreting cells to acceptor (apo)lipoproteins; this response may help guard against loss of insulin secretion caused by accumulation of excess intracellular cholesterol.
Comparison of Tinnitus Loudness Measures: Matching, Rating, and Scaling
Authors: Manning Candice , Grush Leslie , Thielman Emily , Roberts Larry , Henry James A.
Published: February 2019

Purpose

Chronic tinnitus (“ringing in the ears”) is a phantom auditory perception with no cure. A goal of treatment is often to reduce the loudness of tinnitus. However, tinnitus loudness cannot be measured objectively. It is most commonly assessed by obtaining a loudness match (LM) with a pure tone and by using a numeric rating scale (NRS). Constrained loudness scaling (CLS) is a more recent measure of tinnitus loudness that utilizes auditory training of a fixed loudness scale to guide tinnitus loudness judgments. The purpose of this study was to compare results using these 3 measures of tinnitus loudness.

Method

This study obtained tinnitus loudness measures of LM, NRS, and CLS with 170 participants. These participants are part of a larger study obtaining repeated measures over 6 months. Only baseline data are presented.

Results

Correlations between all measures were weak to moderate: LM versus CLS (
r
= .46), CLS versus NRS (
r
= .49), and LM versus NRS (
r
= .38).

Conclusion

Further systematic research is needed to more fully understand the relationships between these different measures and to establish a valid measure of tinnitus loudness.
Effects of Adaptive Hearing Aid Directionality and Noise Reduction on Masked Speech Recognition for Children Who Are Hard of Hearing
Authors: Browning Jenna M. , Buss Emily , Flaherty Mary , Vallier Tim , Leibold Lori J.
Published: February 2019

Purpose

The purpose of this study was to evaluate speech-in-noise and speech-in-speech recognition associated with activation of a fully adaptive directional hearing aid algorithm in children with mild to severe bilateral sensory/neural hearing loss.

Method

Fourteen children (5–14 years old) who are hard of hearing participated in this study. Participants wore laboratory hearing aids. Open-set word recognition thresholds were measured adaptively for 2 hearing aid settings: (a) omnidirectional (OMNI) and (b) fully adaptive directionality. Each hearing aid setting was evaluated in 3 listening conditions. Fourteen children with normal hearing served as age-matched controls.

Results

Children who are hard of hearing required a more advantageous signal-to-noise ratio than children with normal hearing to achieve comparable performance in all 3 conditions. For children who are hard of hearing, the average improvement in signal-to-noise ratio when comparing fully adaptive directionality to OMNI was 4.0 dB in noise, regardless of target location. Children performed similarly with fully adaptive directionality and OMNI settings in the presence of the speech maskers.

Conclusions

Compared to OMNI, fully adaptive directionality improved speech recognition in steady noise for children who are hard of hearing, even when they were not facing the target source. This algorithm did not affect speech recognition when the background noise was speech. Although the use of hearing aids with fully adaptive directionality is not proposed as a substitute for remote microphone systems, it appears to offer several advantages over fixed directionality, because it does not depend on children facing the target talker and provides access to multiple talkers within the environment. Additional experiments are required to further evaluate children's performance under a variety of spatial configurations in the presence of both noise and speech maskers.
Data‐driven method for the quantitative fault diagnosability analysis of dynamic systems
Authors: Fu Fangzhou , Wang Dayi , Li Linlin , Li Wenbo , Wu Zhigang
Published: February 2019

The main objective of this work is to propose a method for the data‐driven evaluation of fault diagnosability in dynamic systems. This technique promises to be an efficient way to analyse the structural properties of unknown systems and can be used to optimise a system configuration, including sensor placement. The basic idea behind this method, which suitably integrates direct identification methods into the fault diagnosability evaluation, lies in the invariability of the characteristics of the dynamic behaviour corresponding to different fault cases. Data‐driven realisations of distinguishability based on both fault‐free data and fault data are proposed. Furthermore, a novel efficient method for computing distinguishability via the pseudoinverse is proposed. Finally, the effectiveness of the proposed method is illustrated via numerical and practical examples.
Direct voltage control of stand‐alone DFIG under asymmetric loads based on non‐singular terminal sliding mode control and improved extended state observer
Authors: Guo Lei , Wang Dan , Diao Liang , Peng Zhouhua
Published: February 2019

This study investigates direct voltage control of stand‐alone doubly‐fed induction generator (DFIG) system subject to asymmetric loads. An improved voltage regulator is designed based on non‐singular terminal sliding mode control and an improved extended state observer (ESO). Due to the salient features of the improved ESO, the rotor current transducer is not required and the sinusoidal fluctuation in the sliding surface caused by asymmetric loads is eliminated. As a result, satisfactory balanced stator voltage can be generated under asymmetric loads. The proposed method is characterised by the rapid dynamic response and the elimination of sequence decomposition operations. Finally, the proposed method is applied to a 6 kW DFIG‐based hardware system under various loads and varying speed conditions. Both simulation and experiment results are given to validate the effectiveness and robustness of the proposed method for stand‐alone DFIG system.
Graph clustering and variational image segmentation for automated firearm detection in X‐ray images
Authors: Mallia‐Parfitt Noeleene , Giasemidis Georgios
Published: February 2019

Millions of parcels and pieces of luggage are scanned daily for threat detection at border control or high‐security buildings. Currently, the process is manually operated by security agents and it is slow and time‐consuming. The automation of this process will lift the burden from the security agents and will allow larger volumes of items to be scanned. The authors consider the problem of automatic threat detection, in particular firearms, in X‐rays. To achieve this goal, they propose a hybrid algorithm that combines two well‐established image segmentation algorithms into a two‐step clustering method. The first step is a semi‐supervised spectral clustering algorithm at the image level, which classifies whole images into benign or containing a threat. The images classified as threatening from the first step proceed to the second stage, where a variational image segmentation algorithm performs clustering at the pixel level to locate the threat if it exists. The hybrid algorithm is designed to scale‐up the processing of hundreds of images, in comparison to the academic literature where only a handful images are used for demonstration. Numerical experiments establish that the combination of two different algorithms produces better results than using individual algorithms.
Design, optimisation and implementation of low‐voltage synchronous reluctance motor for solar‐powered systems
Authors: Boztas Gullu , Aydogmus Omur , Caner Murat , Guldemir Hanifi
Published: February 2019

Synchronous reluctance motors (SynRMs) are an alternative solution in low‐cost applications due to some advantages in terms of manufacturing simplicity. This study deals with a new design and implementation of a SynRM so as to operate at low‐voltage level produced by solar panels without using any boost‐converter. A 4‐inch of standard frame size is chosen for as a submersible pump motor. Preparing for the optimisation step, the commercial design software, Infolytica is used to create the first base structure of the SynRM. As the first step the dc‐link voltage, rated current, rated speed, winding layout, slots number, number of the rotor barriers and the outer/inner diameters of the stator are determined. In the next step, the base structure is optimised by using a genetic algorithm (GA) developed in Matlab environment. The developed GA script and finite element analysis software are operated together for optimisation of the rotor geometry. A direct torque control algorithm is used to analyse the performance of the designed motor. The designed motor is also manufactured and tested experimentally.
Analysis, design, and experimentation of the active hybrid‐series‐parallel PWM dimming scheme for high‐efficient off‐line LED drivers
Authors: Abdelmessih Guirguis Z. , Alonso José Marcos , Dalla Costa Marco A.
Published: February 2019

This study presents a high power factor (PF) light‐emitting diode (LED) driver featuring a pulse width modulation (PWM) dimming technique. The integrated buck‐flyback‐buck converter (IBFBC) is built by connecting a buck converter to the integrated buck‐flyback converter's output. The IBFBC ensures a constant output current regulation as well as high PF at all dimming ratios. The purpose of the output buck converter is to clear up the discontinuous power operation created by the PWM dimming. This occurs when the buck converter absorbs the output power, at LED switched‐off, and sends it back to the input. Thus, the IBFBC maintains the operational enhancement shown by the hybrid‐series‐parallel (HSP)‐PWM technique, ensuring greater efficiency. This study explains the operating principles of the IBFBC using circuit diagrams as well as an average model for the entire converter. Moreover, the study presents a mathematical analysis of the IBFBC power flow. It provides guidance on how to select the optimum value for the output buck inductance. A 230V, 50Hz input, 160V output, 100W AC–DC converter operating at 100 kHz has been implemented. The prototype is fully tested to demonstrate the active HSP‐PWM technique. An efficiency ranging 50–86% corresponding to the dimming ratio of 5–100% is reached, where 5% dimming refers to an output power of 4W.
Synthesis and photocatalytic activity of YVO4 nanocrystals through ethylenediaminetetraacetate‐assisted hydrothermal process
Authors: Li Li , Xu Mai , Xu Airong , Wang Yue , Pan Lu , Sun Zhimei , Wang Fengwu
Published: February 2019

Tetragonal YVO4 nanoparticles of different sizes were successfully prepared through an ethylenediaminetetraacetate ‐mediated hydrothermal method. The crystalline structure and optical property were characterised by transmission electron microscopy (TEM), high resolution TEM, X‐ray diffraction, photoluminescence spectra, and ultraviolet–visible diffuse reflection spectra, respectively. The as‐prepared YVO4 displayed excellent photocatalytic performance. Among them, sample S2 has the highest photocatalytic activity with a photodegradation efficiency of 85% within 180 min illumination, which is due to its smaller size and larger specific surface area. The investigation on the photocatalytic mechanism reveals that hydroxyl radical (•OH) is the main active species in the photocatalytic oxidation process.
Anode modified by BiFeO3 and application in resourceful treatment of salty organic wastewater
Authors: Zhang Xiang , Song Xiaoli , Lu Zeqiang , Chen Aiping , Li Chunzhong
Published: February 2019

The Ni foil or fluorine‐doped SnO2 transparent conductive glass substrates modified by BiFeO3 film with a different atomic ratio of Bi to Fe were prepared by the method of spin coating‐calcination at a different temperature. Coupling photo‐catalysis with electro‐catalysis, resourceful treatment of salty organic wastewater containing methyl orange and cadmium ion was proposed and experimentally achieved. Under visible light irradiation, the highest H2‐production rate (5.46 ml/h cm2), degradation efficiency of methyl orange (51.6%), and the recovery precipitation weight of cadmium hydroxide (0.1846 g) were obtained with Ni foil modified by BiFeO3 (Bi:Fe = 1.10:1.00) film at 550°C of calcination. X‐ray diffraction, ultraviolet–visible diffuse reflectance spectroscopy, scanning electron microscopy, and the resourceful treatment test of salty organic wastewater were used to characterise the catalyst film.
A method to deconvolve stellar rotational velocities
Authors: Orellana R. , Escárate P. , Curé M. , Christen A. , Carvajal R. , Agüero J. C.
Published: February 2019

Aims. The study of accurate methods to estimate the distribution of stellar rotational velocities is important for understanding many aspects of stellar evolution. From such observations we obtain the projected rotational speed (vsini) in order to recover the true distribution of the rotational velocity. To that end, we need to solve a difficult inverse problem that can be posed as a Fredholm integral of the first kind.

Methods. In this work we have used a novel approach based on maximum likelihood (ML) estimation to obtain an approximation of the true rotational velocity probability density function (PDF) expressed as a sum of known distribution families. In our proposal, the measurements have been treated as random variables drawn from the projected rotational velocity PDF. We analyzed the case of Maxwellian sum approximation, where we estimated the parameters that define the sum of distributions.

Results. The performance of the proposed method is analyzed using Monte Carlo simulations considering two theoretical cases for the PDF of the true rotational stellar velocities: (i) an unimodal Maxwellian probability density distribution and (ii) a bimodal Maxwellian probability density distribution. The results show that the proposed method yielded more accurate estimates in comparison with the Tikhonov regularization method, especially for small sample length (N = 50). Our proposal was evaluated using real data from three sets of measurements, and our findings were validated using three statistical tests.

Conclusions. The ML approach with Maxwellian sum approximation is a accurate method to deconvolve the rotational velocity PDF, even when the sample length is small (N = 50).
Solar flares observed by Rosetta at comet 67P/Churyumov-Gerasimenko
Authors: Edberg N. J. T. , Johansson F. L. , Eriksson A. I. , Andrews D. J. , Hajra R. , Henri P. , Wedlund C. S. , Alho M. , Thiemann E.
Published: February 2019

Context.The Rosetta spacecraft made continuous measurements of the coma of comet 67P/Churyumov-Gerasimenko (67P) for more than two years. The plasma in the coma appeared very dynamic, and many factors control its variability.

Aims.We wish to identify the effects of solar flares on the comet plasma and also their effect on the measurements by the Langmuir Probe Instrument (LAP).

Methods.To identify the effects of flares, we proceeded from an existing flare catalog of Earth-directed solar flares, from which a new list was created that only included Rosetta-directed flares. We also used measurements of flares at Mars when at similar longitudes as Rosetta. The flare irradiance spectral model (FISM v.1) and its Mars equivalent (FISM-M) produce an extreme-ultraviolet (EUV) irradiance (10–120 nm) of the flares at 1 min resolution. LAP data and density measurements obtained with the Mutual Impedence Probe (MIP) from the time of arrival of the flares at Rosetta were examined to determine the flare effects.

Results.From the vantage point of Earth, 1504 flares directed toward Rosetta occurred during the mission. In only 24 of these, that is, 1.6%, was the increase in EUV irradiance large enough to cause an observable effect in LAP data. Twenty-four Mars-directed flares were also observed in Rosetta data. The effect of the flares was to increase the photoelectron current by typically 1–5 nA. We find little evidence that the solar flares increase the plasma density, at least not above the background variability.

Conclusions.Solar flares have a small effect on the photoelectron current of the LAP instrument, and they are not significant in comparison to other factors that control the plasma density in the coma. The photoelectron current can only be used for flare detection during periods of calm plasma conditions.
Mg II λ2797, λ2803 emission in a large sample of low-metallicity star-forming galaxies from SDSS DR14
Authors: Guseva N. G. , Izotov Y. I. , Fricke K. J. , Henkel C.
Published: February 2019

A large sample of Mg II emitting star-forming galaxies with low metallicity [O/H] = log(O/H) – log(O/H)⊙ between –0.2 and –1.2 dex is constructed from Data Release 14 of the Sloan Digital Sky Survey. We selected 4189 galaxies with Mg II λ2797, λ2803 emission lines in the redshift range z ∼ 0.3–1.0 or 35% of the total Sloan Digital Sky Survey star-forming sample with redshift z ≥ 0.3. We study the dependence of the magnesium-to-oxygen and magnesium-to-neon abundance ratios on metallicity. Extrapolating this dependence to [Mg/Ne] = 0 and to solar metallicity we derive a magnesium depletion of [Mg/Ne] ≃ –0.4 (at solar metallicity). We prefer neon instead of oxygen to evaluate the magnesium depletion in the interstellar medium because neon is a noble gas and is not incorporated into dust, contrary to oxygen. Thus, we find that more massive and more metal abundant galaxies have higher magnesium depletion. The global parameters of our sample, such as the mass of the stellar population and star formation rate, are compared with previously obtained results from the literature. These results confirm that Mg II emission has a nebular origin. Our data for interstellar magnesium-to-oxygen abundance ratios relative to the solar value are in good agreement with similar measurements made for Galactic stars, for giant stars in the Milky Way satellite dwarf galaxies, and with low-metallicity damped Lyman-alpha systems.
Traitement à l’iode 131 pour cancer de la thyroïde : estimation des doses de radiation reçues par les proches et des temps de restriction de contact
Authors: Hjiyej A. L. , Aschawa H. , Mellouki I. , Anwar W.
Published: February 2019

Les patients atteints de cancer de la thyroïde et qui sont traités à l’iode radioactif sont une source potentielle d’exposition aux rayonnements chez leur entourage. Cette étude a porté sur 82 cas de cancers différenciés de la thyroïde traités par chirurgie complète, qui ont reçu, chacun 3,7 GBq d’iode 131 et ont été hospitalisés pendant en moyenne 72 h. Nous avons estimé par le calcul, les doses délivrées par ces patients selon différentes situations imaginées de la vie quotidienne, au cas où ils ne respecteraient pas les périodes de restriction recommandées par la CIPR. Le calcul se basait sur la mesure des débits de dose des patients, 15 min après la prise du radionucléide et au moment de quitter l’hôpital. Les doses cumulées par les proches étaient en moyenne de 802,42 μSv pour des durées de contact entre 3 et 5 jours sans restriction. Par ailleurs, nos résultats ont montré que les périodes de restriction de contact avec les proches, telles qu’elles sont préconisées par la CIPR pour les débits à la sortie, supérieures à 10 μSv / h, semblent trop longues et gagneraient à être réduites pour le confort des patients et celui de leurs proches.
Beeinflussung der Sterblichkeit bei älteren Menschen durch
Selen und Q10
Authors: Schmiedel Volker , Alehagen Urban
Published: February 2019

Die orthomolekulare Medizin wird von der konventionellen Medizin immer noch
belächelt, teilweise sogar als unwirksam oder schädlich bekämpft. Besonders das
Fehlen von überzeugenden Studien wird kritisiert. Vor einigen Jahren wurden aber
die Ergebnisse einer randomisierten, doppelblinden Interventionsstudie
publiziert, die eine Halbierung der Sterblichkeit in der Verumgruppe aufzeigte.
Wegen der großen Bedeutung für die orthomolekulare Medizin im Allgemeinen und
die Lebenserwartung und die Lebensqualität bei älteren Menschen im Besonderen
sollen die Ergebnisse dieser Studie hier im Einzelnen vorgestellt werden.
Mit kaltem Wasser gegen Alterungsprozesse – „Anti-Aging“
mit Hydrotherapie nach Kneipp
Authors: Gündling Peter W.
Published: February 2019

Hydrotherapeutische Verfahren erscheinen vielen umständlich, aufwendig und
altmodisch. Doch sie sind alles andere als das. Gerade in der heutigen, chemie-
und chirurgiegläubigen Zeit, stellen sie ein wertvolles Instrument im
naturheilkundlichen Repertoire dar. Als typische Regulationsverfahren wirken sie
ausgleichend auf die Aktivität des vegetativen Nervensystems und tragen so zur
Verbesserung des Stoffwechsels und der Durchblutung bei. Zudem aktivieren sie
das Immunsystem und die zellulären Reparaturmechanismen und regen die Regulation
des Hormonhaushaltes an. Gleichzeitig unterstützen sie – mit relativ geringem
Aufwand – die Eigenverantwortung und Selbsthilfefähigkeit der Betroffenen.
Contemporary Opportunity for Prehabilitation as Part of an Enhanced Recovery after Surgery Pathway in Colorectal Surgery
Authors: Ven Fong Zhi , Chang David , Lillemoe Keith , Nipp Ryan , Tanabe Kenneth , Qadan Motaz
Published: February 2019

The implementation of upfront, preoperative habilitation (“prehabilitation”), as opposed to postoperative habilitation (rehabilitation), provides a unique opportunity to optimize surgical outcomes, while ensuring that patients receive necessary conditioning that may otherwise be significantly delayed by postoperative complications. In this review, opportunities to design, implement, monitor, and evaluate a surgical prehabilitation program in colorectal surgery are discussed, and broken down to include emotional, physical, and nutritional aspects of care in the preoperative setting.
Does Implementation of Enhanced Recovery after Surgery (ERAS) Protocols in Colorectal Surgery Improve Patient Outcomes?
Authors: Berian Julia , Ko Clifford , Ban Kristen
Published: February 2019

Enhanced Recovery after Surgery (ERAS) protocols are multimodal perioperative care pathways designed to accelerate recovery by minimizing the physiologic stress of a surgical procedure. Benefits of ERAS implementation in colorectal surgery include reduced length of stay and decreased complications without an increase in readmissions. Though there is evidence associating individual ERAS protocol elements (e.g., preoperative carbohydrate loading, judicious perioperative fluid administration, and early initiation of postoperative nutrition) with improved outcomes, ensuring high compliance with all elements of an ERAS protocol will maximize benefits to the patient. After ERAS implementation, data collection on protocol process measures can help providers target education and interventions to improve protocol compliance and patient outcomes.
Pain Management in Enhanced Recovery after Surgery (ERAS) Protocols
Authors: Simpson J. , Bao Xiaodong , Agarwala Aalok
Published: February 2019

Pain control is an integral part of Enhanced Recovery after Surgery (ERAS) protocols for colorectal surgery. While opioid therapy remains the mainstay of therapy for postsurgical pain, opioids have undesired side effects including delayed recovery of bowel function, respiratory depression, and postoperative nausea and vomiting. A variety of nonopioid systemic medical therapies as well as regional and neuraxial techniques have been described as improving pain control while reducing opioid use. Multimodal and preemptive analgesia as part of an ERAS protocol facilitates early mobility and early return of bowel function and decreases postoperative morbidity. In this review, we examine several multimodal therapies and their impact on postoperative analgesia, opioid use, and recovery for patients undergoing colorectal surgery.
Applying Enhanced Recovery Pathways to Unique Patient Populations
Authors: Lee Grace , Hodin Richard
Published: February 2019

Enhanced Recovery after Surgery (ERAS) pathways have become popular in colorectal surgery due to their associated decrease in length of stay (LOS), complications, and readmission rate. However, it is unclear if these pathways are safe, feasible, or effective in unique patient populations such as elderly patients, urgent/emergent surgeries, patients with specific comorbidities, inflammatory bowel disease, or pediatric patients. Enhanced recovery pathways appear safe in elderly patients, associated with decreased complications, though with slightly lower rates of adherence and increased LOS and readmission rates. Modified ERAS pathways have been applied to urgent and emergent surgeries, resulting in decreased morbidity and LOS. There have been no studies that performed subgroup analyses of ERAS pathways in patients with specific comorbidities. Studies investigating patients with inflammatory bowel disease on enhanced recovery pathways are extremely limited, but suggest that they are safe and feasible. Data on ERAS pathways in pediatric patients are still emerging. Therefore, though data are sparse, enhanced recovery pathways appear to be safe in unique patient populations, with similar efficacy in decreasing LOS and complications. There is an urgent need for more studies investigating these specific patient groups to aid perioperative decision making by colorectal surgeons.
Pethidine in Low Doses versus Dipyrone for Pain Relief in Labor: A Randomized Controlled Trial
Authors: Nunes Rogevando Rodrigues , Primo André Montenegro
Published: February 2019

Objective To compare low doses of pethidine with dipyrone in labor analgesia.

Methods In a randomized prospective study conducted by Universidade de Fortaleza, in the state of Ceará, Brazil, between May and December 2016, 200 full-term parturients, with very painful uterine contractions and exhibiting uterine cervix dilatation ≥ 5 cm, were selected to receive a single intravenous dose of either 0.25 mg/kg of pethidine (n = 100) or of 25 mg/kg of dipyrone (n = 100). Pain was assessed using the visual analogue scale. The data were analyzed using the Student t-test, the chi-square test and the likelihood ratio.

Results There was a significant improvement in pain in 35% of the parturients. Both drugs presented a similar analgesic effect 1 hour after the intervention (p = 0.692). There was no analgesic effect during the evaluation of the second hour after the intervention with pethidine or dipyrone. There were no adverse effects, such as maternal drowsiness, nausea or vomiting, related to the drugs used.

Conclusion Pethidine in low doses and dipyrone presented equivalent analgesia during labor.

Public Registry of Clinical Trials RBR-4hsyy4.
Effectiveness of Insulin Analogs Compared with Human Insulins in Pregnant Women with Diabetes Mellitus: Systematic Review and Meta-analysis
Authors: Santos Leyna Leite , Santos Jamilly Leite , Barbosa Luciano Timbó , Silva Ivan do Nascimento da , de Sousa-Rodrigues Célio Fernando , Barbosa Fabiano Timbó
Published: February 2019

Diabetes during pregnancy has been linked to unfavorable maternal-fetal outcomes. Human insulins are the first drug of choice because of the proven safety in their use. However, there are still questions about the use of insulin analogs during pregnancy. The objective of the present study was to determine the effectiveness of insulin analogs compared with human insulin in the treatment of pregnant women with diabetes through a systematic review with meta-analysis. The search comprised the period since the inception of each database until July 2017, and the following databases were used: MEDLINE, CINAHL, EMBASE, ISI Web of Science, LILACS, Scopus, SIGLE and Google Scholar. We have selected 29 original articles: 11 were randomized clinical trials and 18 were observational studies. We have explored data from 6,382 participants. All of the articles were classified as having an intermediate to high risk of bias. The variable that showed favorable results for the use of insulin analogs was gestational age, with a mean difference of - 0.26 (95 % confidence interval [CI]: 0.03–0.49; p = 0.02), but with significant heterogeneity (Higgins test [I2] = 38%; chi-squared test [χ2] = 16.24; degree of freedom [DF] = 10; p = 0.09). This result, in the clinical practice, does not compromise the fetal well-being, since all babies were born at term. There was publication bias in the gestational age and neonatal weight variables. To date, the evidence analyzed has a moderate-to-high risk of bias and does not allow the conclusion that insulin analogs are more effective when compared with human insulin to treat diabetic pregnant women.
Hearing Preservation Surgery via Retrosigmoid Approach with Retrolabyrinthine Meatotomy in Small Vestibular Schwannoma
Authors: Cazzador Diego , Borsetto Daniele , Alexandre Enrico , Pavone Chiara , d'Avella Domenico , Mazzoni Antonio , Zanoletti Elisabetta
Published: February 2019

Objectives Vestibular schwannomas (VS) extending into the internal auditory canal (IAC) are currently considered as an unfavorable condition for hearing preservation surgery (HPS) via retrosigmoid (RS) approach due to the poor direct visualization of the facial and cochlear nerves course through the IAC and the fundus during microsurgery.

Design The operative steps are described in a surgical instructional video.

Setting The surgery took place at a tertiary-care center.

Participants Patient is a 45-year-old man who was incidentally diagnosed with an extrameatal VS extending for 9 mm into the left cerebellopontine angle (CPA). Hearing function at diagnoses was excellent, with pure tone average (PTA) = 15 dB and speech discrimination score (SDS) = 100% (class A according to the Tokyo classification) and minimal impairments on auditory brainstem response (ABR). Given these preoperative features in small VS, hearing was the main function to look into in the treatment planning. Initial observation or HPS were proposed.

Results The patient underwent surgical excision for HPS via RS approach combined with retrolabyrinthine meatotomy (RLM). RLM enables the complete exposure of the IAC to the fundus, after drilling the bony surface of the posterior IAC wall, under guidance of the anatomical landmarks, namely, the endolymphatic duct, the blue lines of the posterior, and superior semicircular canals, and common crus. Nor intra-, neither postoperative complications occurred. Histologic examination confirmed the diagnosis of VS. A 3-month short-term follow-up revealed a class B hearing function with PTA = 30 dB, SDS = 100%, and normal facial nerve status.

Conclusions RLM via RS approach proved to be effective for HPS, enabling the full course of the facial and cochlear nerves through the IAC to be directly exposed.

The link to the video can be found at: https://youtu.be/KC1S4pxpLCk.
Transverse Cervical Artery Flap Repair of Benign Acquired Tracheoesophageal Fistula
Authors: Artz Jourdain , Yoo Daniel , Gilbert-Fernández Juan , Walvekar Rohan , Risher William , Dupin Charles
Published: February 2019

Acquired tracheoesophageal fistulas are rare but associated with significant morbidity and mortality. The majority of cases are due to prolonged or complicated endotracheal intubation, tracheostomy, or esophageal malignancy, or subsequent to radiation or chemotherapy for treatment of the latter. Other etiologies include esophageal stenting and complications secondary to endoscopic procedures. The pathophysiology involves chronic inflammation of the esophagus or posterior wall of the trachea, ultimately promoting fistulization between these two structures. Risk factors primarily depend on the etiology; however, excessive balloon pressures and prolonged intubation are among the strongest predictors of acquired tracheoesophageal fistula. In two reported cases, intubation with persistent air leaks resulted in fistulization. Patients present with refractory pneumonia, aspiration, hypoxemia, acute respiratory distress, enteral feed in endotracheal aspirate, or gastric distention following extubation. It can be difficult to distinguish normal functional deterioration from deterioration secondary to intubation. Up to 51% of patients intubated for at least 48 hours may experience dysphagia following extubation. Ultimately, the diagnostic algorithm includes an esophagogram, followed by imaging with computed tomography (CT) scan, and, more recently, CT scan with three-dimensional reconstructions, a bronchoscopy, and an esophagoscopy. Spontaneous closure rarely occurs, and the primary treatment modalities include interventional therapy with stenting via bronchoscopy, esophagoscopy, or surgical correction. Surgical intervention is associated with higher risks due to surrounding vital anatomy and, often, technical challenges requiring multispecialty care. Our case study presents a novel and effective method of repairing a benign acquired tracheoesophageal fistula utilizing the transverse cervical artery flap.
Evaluation of Secure Messaging Applications for a Health Care System: A Case Study
Authors: Liu Xinran , Sutton Paul , McKenna Rory , Sinanan Mika , Fellner B. , Leu Michael , Ewell Cris
Published: February 2019

Objective The use of text messaging in clinical care has become ubiquitous. Due to security and privacy concerns, many hospital systems are evaluating secure text messaging applications. This paper highlights our evaluation process, and offers an overview of secure messaging functionalities, as well as a framework for how to evaluate such applications.

Methods Application functionalities were gathered through literature review, Web sites, speaking with representatives, demonstrations, and use cases. Based on similar levels of functionalities, vendors were grouped into three tiers. Essential and secondary functionalities for our health system were defined to help narrow our vendor choices.

Results We stratified 19 secure messaging vendors into three tiers: basic secure communication, secure communication within an existing clinical application, and dedicated communication and collaboration systems. Our essential requirements revolved around functionalities to enhance security and communication, while advanced functionalities were mostly considered secondary. We then narrowed our list of 19 vendors to four, then created clinical use cases to rank the final vendors.

Discussion When evaluating a secure messaging application, numerous factors must be considered in parallel. These include: what clinical processes to improve, archiving text messages, mobile device management, bring your own device policy, and Wi-Fi architecture.

Conclusion Secure messaging applications provide a Health Insurance Portability and Accountability Act (HIPAA) compliant communication platform, and also include functionality to improve clinical collaboration and workflow. We hope that our evaluation framework can be used by other health systems to find a secure messaging application that meets their needs.
Real-Time Continuous Glucose Monitoring in Gestational Diabetes: A Randomized Controlled Trial
Authors: Lane Andrew S. , Mlynarczyk Malgorzata A. , de Veciana Margarita , Green Lauren M. , Baraki Dana I. , Abuhamad Alfred Z.
Published: February 2019

Objective To evaluate whether real-time continuous glucose monitoring improves glycemic control over intermittent self-monitoring of blood glucose in gestational diabetes.

Study Design We performed a single-institution randomized controlled trial. Patients with gestational diabetes were randomized to use either real-time or blinded continuous glucose monitoring. The primary outcome was mean sensor glucose level during the fourth week of continuous glucose monitoring use. Secondary outcomes included glycemic control and a composite of obstetric and neonatal outcomes.

Results Of the 40 enrolled patients, 12 (60%) patients in the blinded continuous glucose monitoring group and 11 (55%) in the real-time continuous glucose monitoring group completed 4 weeks of monitoring and were included in the final analysis. There was no significant difference in mean sensor glucose level between the blinded continuous glucose monitoring group (98.9 ± 8.9 mg/dL) and the real-time continuous glucose monitoring group (107.5 ± 11.4 mg/dL). There were also no significant differences in the time spent in glycemic target, maternal, or neonatal outcomes.

Conclusion Our study shows that the use of continuous glucose monitoring with real-time feedback did not significantly decrease mean glucose values compared with intermittent self-monitoring of blood glucose after 4 weeks of continuous glucose monitoring use.
Improved electric energy density and conversion efficiency of natural rubber composites as dielectric elastomer generators
Authors: Yang Dan , Xu Yingjie , Ruan Mengnan , Xiao Zhenxing , Guo Wenli , Wang Huaming , Zhang Liqun
Published: February 2019

Dielectric elastomer generators (DEGs), which can harvest energy from environmental sources, have gained considerable research attention over the past few decades. However, the current dielectric elastomers exhibit low electric energy density and conversion efficiency, which limit their practical application. Herein, the electric energy density and conversion efficiency of natural rubber (NR) composites have been enhanced by adding of barium titanate (BT) nanoparticles and dioctyl phthalate (DOP) plasticizer in NR matrix. Due to the synergistic effect of BT and DOP, a high dielectric constant and a low elastic modulus are exhibited by NR composites, which can be attributed to the adjusting of filler network and polymeric intermolecular attractions. The as-prepared BT/DOP/NR composites have exhibited an enhanced harvested electric energy density of 0.71 mJ/cm3 and energy conversion efficiency of 3.8%, which are ∼3.8 and 4.7 times higher than pure NR, respectively. In addition, the as-prepared NR composites exhibit excellent actuation properties, which indicate that these composites have great potential in a wide range of applications, such as energy harvesters and soft sensors.
Dynamical scaling in the Ohmic spin-boson model studied by extended hierarchical equations of motion
Authors: Wang Qianlong , Gong Zhihao , Duan Chenru , Tang Zhoufei , Wu Jianlan
Published: February 2019

Through a decomposition of the bath correlation function, the hierarchical equations of motion are extended to the Ohmic spin-boson model at zero temperature. For two typical cutoff functions of the bath spectral density, the rate kernel of spin dynamics is numerically extracted by a time-convolution equation of the average magnetic moment. A characteristic time is defined accordingly as the inverse of the zeroth-order moment of the rate kernel. For a given Kondo parameter in the incoherent regime, the time evolution of average magnetic moments gradually collapses onto a master curve after rescaling the time variable with the characteristic time. The rescaled spin dynamics is nearly independent of the cutoff frequency and the form of cutoff functions. For a given cutoff frequency, the characteristic time with the change of the Kondo parameter is fitted excellently as a function of the renormalized tunneling amplitude. Despite a significant difference in definition, our result is in good agreement with the characteristic time of the noninteracting blip approximation.
Interaction of the SH+ ion with molecular hydrogen:
Ab initio
potential energy surface and scattering calculations
Authors: Dagdigian Paul J.
Published: February 2019

The potential energy surface describing the interaction of the SH+ ion in its ground X3Σ− electronic state with molecular hydrogen has been computed through restricted coupled cluster calculations including single, double, and (perturbative) triple excitations [RCCSD(T)], with the assumption of fixed bond lengths. The computed points were fit to an analytical form suitable for time-independent quantum scattering calculations of rotationally inelastic cross sections and rate coefficients. Representative sets of energy dependent state-to-state rotationally inelastic cross sections and rate coefficients are presented and discussed. A propensity to conserve the fine-structure label is observed, as expected from a formal analysis of the scattering equations.
Temporospatial variation in ecosystem configuration in a pilot city for the Water Ecological Civilisation Project, China
Authors: Yang S. , Yang Y. , Sun C. , Gai Y. , Zhang Y. , Zhao C. , Dong B. , Feng P. , Zhang Z.
Published: February 2019

Jinan City is the first pilot city for the Water Ecological Civilisation Project in China. The success of its ecological restoration is directly linked to achievements of construction of water ecological civilisation. For this reason, studies were performed of the temporospatial heterogeneity of the aquatic ecosystem in Jinan based on aquatic ecology data collected in field investigations from 2014 to 2015. The results show that the overall species richness in Jinan City aquatic ecosystems was higher in 2014 than in 2015 and that the community structure was more complex. Specifically, the density of Naididae and Chironomidae accounted for a high proportion of organisms in urban rivers. For fish community structure, the Cyprinidae had the largest variety and the highest density and biomass. Analysis of the primary hydrological water quality factors driving aquatic ecosystem structure showed that the overall river velocity was slow, with the exception of the main stem of the Yellow River in Jinan City. In addition, the overall total nitrogen concentration in Jinan City rivers was relatively high, and was higher in plains areas than in mountainous areas. This study can provide a scientific reference for aquatic ecological rehabilitation in Jinan City, as well as for the pilot cities program.
EMI teacher and student identities and linguistic practices
Authors: Ploettner Joan Catherine
Published: February 2019

Although the incorporation of English Medium Instruction (EMI) in multilingual higher education institutions is widely
accepted, it may be a source of tension for university professors for whom English is an additional language, particularly when both teacher
and students share an L1 other than English. A need exists to examine how linguistic attributes of EMI are interpreted and executed by
participants. This study focuses on dialogue between a content specialist and a language specialist during an EMI teacher development
partnership at a multilingual Catalan university. Membership Category Analysis (MCA) explores the categories made relevant in interaction,
category associated features and responsibilities, and their procedural relevance within the interaction. The article focuses on results
relating to the emerging identities of EMI classroom participants and related linguistic attributes. The results shed light on tensions
relating to language use in EMI, and may inform EMI teacher development processes and classroom language policy.