bluuebunny/crossref_metadata_2025 huggingface dataset:
3D Numerical study on the effect of shaft eccentricity on the tribological performance of lubricated sliding contact
Authors: Tauviqirrahman Mohammad , Kurniawan Bayu , Jamari
Published: March 2018

Recently, a growing interest is given to the wall slip and the artificial texturing for improving the performance of lubricated sliding contact. The use of wall slip, artificial texturing, and the combination of slip and texturing can be the effective approach to enhance the performance of the bearing. The present study examines the effect of shaft eccentricity ratio on the hydrodynamic journal bearing performance. 3D numerical modelling based on modified Reynolds equation is used to analyse the effect of texturing and the wall slip on the characteristics of a hydrodynamically lubricated sliding contact. The analysis results point out that with respect to the load support and the power loss of the bearing, the use of wall slip on smooth surface is the most excellent configuration compared to other patterns (i.e. slip-texturing, pure texturing and conventional patterns). It is also confirmed that the wedge effect due to the shaft eccentricity has a significant role in altering the lubricant behaviour. Thus, a particular care must be taken in choosing the pattern of lubricated sliding contact as well as the shaft eccentricity.
Fabrication Dye Sensitized Solar Cells (DSSCs) Using β-Carotene Pigment Based Natural Dye.
Authors: Nirwana Sari Halidun Wa Ode , Cahya Prima Eka , Yuliarto Brian , Suyatman
Published: March 2018

The adsorption characteristic of natural dye has been studied on harvesting light using purification process. The purification process used for separation pigment photosynthesis of syngonium leafs was called fractionation. The first fractionation of the dye contains pigment of β- carotene . The absorpton spectrum of β-carotene has been investigated by using Uv-Vis spectroscopy. The Fourier Transform Infrared revealed that the binding of the dye was on the surface of TiO2. Analysis absorbance and energy gap of the dye has been investigated by using Uv-Vis spectroscopy and Tauc relation. The cells were illuminated under 100 mW/cm2 AM 1.5 condition. The performance of the cells with sensitized the fractionation dye has a short circut current density (Jsc) of 0.27 mA/cm2, an open circuit photovoltage (Voc) of 0.4V, and Fill Factor (FF) of 68.89%. Furthermore, the overall efficiency of DSSC is 0.074%. The low efficiency for the fractionation cell based dye sensitized solar cells due to the weakness of interaction between dye molecule and the surface of TiO2.
Investigation on the performance of the traditional Indonesian fishing vessel
Authors: Bahatmaka Aldias , Kim Dong-Joon , Samuel  , Rio Prabowo Aditya , Zaw May-Thu
Published: March 2018

In this study, numerical investigation of ship resistance and ship motions at the traditional Indonesian fishing vessel is presented. The Computational Fluid Dynamic (CFD) code is used to calculate three dimensional, incompressible, and RANS equations. Different types of the fishing vessel hull form were performed. In this research, the data were collected chosen in north and south coast of Java island. The models were drawing in three dimensional, required for performing the analysis, were developed using Rhinoceros. The present study, the open-source computational fluid dynamics library, OpenFOAM was used to predict the resistance with the interFOAM solver. For the motion analysis, using strip theory in the Maxsurf motions. The probability of deck wetness analysis and ship motion were performed for comparing the models. Both analyses of ship Response Amplitude Operators (RAOs) are performed at three types of sea state (slight, moderate, and rough water). The comparisons of the hull form design will be evaluated to get the best performance based on the sea state condition of the java island.
Bulbous bow applications on a catamaran fishing vessel for improving performance
Authors: Samuel  , Kim Dong-Joon , Iqbal Muhammad , Bahatmaka Aldias , Rio Prabowo Aditya
Published: March 2018

This study aims to prove the usefulness of a bulbous bow traditional catamaran fishing vessel. Bulbous bow applications are widely used to reduce wave resistance. The fishing vessel resistance was calculated using CFD (Computational Fluid Dynamic) approach and combined with classical slender body theory. In this research, the application of bulbous bow was being adopted on traditional catamaran fishing vessel to reduce the total resistance. The bulbous bow has adopted based on Kracht method. Modeling procedure was developed by using linear form coefficients. The ship resistance was simulated using Tdyn software which basically Finite Element Method. The results show that adding bulbous bow can decrease or increase the ship’s total resistance.
Design of Key Performance Indicators (KPI) for Sustainable Supply Chain Management (SSCM) Palm Oil Industry in Indonesia
Authors: Kusrini Elisa , Primadasa Rangga
Published: March 2018

This paper aims to design key performance indicators (KPIs) for evaluating sustainable supply chain management (SSCM) for palm oil processing industry in Indonesia. Supply chain sustainability is the management of environmental, social and economic impacts, and the encouragement of good governance practices, throughout the lifecycle of goods and services. The method in designing KPIs using a triangulation method, ie combining of theory (literature study) with field surveys and validate with the opinion of the expert (expert judgment) as well as compatibility with existing regulations (Indonesian sustainable palm oil / roundtable on sustainable palm oil). There are 29 proposed KPIs for measuring SCM’s sustainable palm oil in Indonesia based on literature and expert judgment. In order to obtain a more precise performance, then the importance level of KPI will be measured using Analytic Hierarchy Analysis (AHP) method. According to the preferences of some managers of palm oil using AHP method showed that the economic factor is the most dominant indicator (62,92%), followed by environmental (18,93%) and social factors (18,15%). In subsequent studies, the results of the KPIs will be used to measure the index of sustainability in the palm oil’s supply chain industry in Indonesia.
Improving performance measurement efficiency in public service using lean six sigma methodology
Authors: Adi Wicaksono Purnawan , Prastawa Heru , Pitaloka Ghabyanza , Putri Nurana
Published: March 2018

This research aims to conduct performance measurement efficiency in government and recommends an improvement to reduce the delay of submitting Functional Worksheet (FW) through Lean Six Sigma methodology. At recent system, the causes of delay in submitting FW are human factors i.e. the employee’s negligence and technical factor i.e. duplication work in inputing data. The employee’s performance measurement takes many times so that the leader can evaluate the employee’s FW after 35 days and 195 minutes. In this research, Web-Based Functional Worksheet Information System was designed as the result of the improvement stage of Lean Six Sigma. The Web-Based Functional Worksheet Information System improved the recent system in submitting FW and reduced the time of finishing the submitting FW. Moreover, the leader could evaluate the employee’s FW in a day.
Performance of current transformer operate under harmonic condition and their effects on transformer differential protection
Authors: Nisja Indra
Published: March 2018

This paper focused to determine the performance of Current Transformer (CT) operates under harmonics condition and their effects on transformer differential protection. A laboratory test has been implemented to determine the error produced by both CT and power transformer when operating under harmonic condition. The test was performing with the actual condition, where the power transformer is connected to an adjusted nonlinear load, so that the test can be conducted with several levels of total harmonic distortion current (THDi). The results shows, for THDi ranging from 16.70% to 40.88% the maximum errors occurred on CT at secondary power transformers is 27.21% and CT at primary power transformers is 8.12%. This error resulted in differential current flow 0.17A and relay trip without any fault. In this study it was found that the relays started to operate incorrectly on THDi 31.5%.
Vital Opportunity
Authors: Twohig Julia
Published: March 2018

The concept of a vital or life force is integral to homeopathic practice and one of the many departure points from mainstream medicine. Dual-processing theory is presented by researchers as an explanation for why some people can and others cannot think vitalistically.
‘MAP’(ing) the Milestones in My Life
Authors: Joshi Bhawisha
Published: March 2018

This article talks about Joshi's method of mapping personalities and mapping Materia Medica. Joshi believes that all three kingdoms and their remedies can be compared and put on the same grid of easy remedy selection. This article takes you through Dr. Bhawisha's personal experiences with patients as well as some learning curves of her life that have helped in this development. To conclude she shares some useful insights that she has gathered through her interactions which became ‘Life-lessons’ as well as practical tips. She hopes that they will help the reader as well.
Kopfschmerz bei Medikamentenübergebrauch
Authors: Katsarava Z. , Nägel S.
Published: March 2018

Es ist ein durch die Internationale Kopfschmerzgesellschaft akzeptierter Konsens,dass die häufige Einnahme von Akutmedikation zur Zunahme oder Chronifizierung von episodischen Kopfschmerzen führen kann.Dieser Kopfschmerz wird als Medikamentenübergebrauchskopfschmerz(MÜKS) bezeichnet.Definiert ist der MÜKS als ein Kopfschmerz,der an mindestens 15 Tagen pro Monat bei Patienten, die seit über 3 Monaten Akuttherapeutika im Übermaß einnehmen,auftritt. Die kritische Einnahmegrenze liegt für Triptane, Opioide und Kombinationsanalgetikabei 10 Tagen, für einfache Analgetikabei 15 Tagen pro Monat. Das Konzept fußt auf der Annahme, dass Menschen mit Migräne oder einem Kopfschmerz vom Spannungstyp ein besonders vulnerables trigeminalesSchmerzsystem haben, welches auf Schmerzmittelübergebrauchmit Sensitisierung der Schmerzverarbeitung und Chronifizierung des Kopfschmerzes reagiert. Der MÜKS wirddeswegen als sekundärer Kopfschmerz betrachtet.Das Mittel der Wahl zur Behandlungist nach aktueller Lehrmeinung eine Entzugsbehandlung.Diesem Konzept wird aber widersprochen.Die Gegner argumentieren,dass die häufige Schmerzmitteleinnahme lediglichbei einem Teil der Kopfschmerzpatientenzur Chronifizierung führt und man sich beidiesen nicht sicher sein kann, dass die Zunahme der Kopfschmerzfrequenz tatsächlich dieFolge des Schmerzmittelgebrauches ist, sondern,dass der übermäßige Schmerzmittelgebrauchdie Folge der häufigeren/chronifizierten Kopfschmerzen ist. Weiter wird argumentiert,die Verläufe würden sich nicht infolge derEntzugsbehandlung, sondern als Konsequenz einer multimodalen Therapie inklusive medikamentöser Prophylaxe und psychologischerund edukativer Betreuung bessern. Deswegensei der MÜKS keine eigene Entität. Durch dieDiagnose eines MÜKS stigmatisiere man dieBetroffenen, enthalte ihnen die nötigenSchmerzmedikamente vor und lasse sie unnötigleiden. In dieser Übersichtsarbeit beleuchtendie Autoren den aktuellen Stand der Literaturund stellen die Argumente für und gegenden MÜKS dar.
A wave-bending structure at Ka-band using 3D-printed metamaterial
Authors: Wu Junqiang , Liang Min , Xin Hao
Published: March 2018

Three-dimensional printing technologies enable metamaterials of complex structures with arbitrary inhomogeneity. In this work, a 90° wave-bending structure at the Ka-band (26.5–40 GHz) based on 3D-printed metamaterials is designed, fabricated, and measured. The wave-bending effect is realized through a spatial distribution of varied effective dielectric constants. Based on the effective medium theory, different effective dielectric constants are accomplished by special, 3D-printable unit cells, which allow different ratios of dielectric to air at the unit cell level. In contrast to traditional, metallic-structure-included metamaterial designs, the reported wave-bending structure here is all dielectric and implemented by the polymer-jetting technique, which features rapid, low-cost, and convenient prototyping. Both simulation and experiment results demonstrate the effectiveness of the wave-bending structure.
Potential energy surface of triplet O4
Authors: Paukku Yuliya , Varga Zoltan , Truhlar Donald G.
Published: March 2018

We present a global ground-state potential energy surface (PES) for the triplet spin state of O4 that is suitable for treating high-energy vibrational–rotational energy transfer and collision-induced dissociation in electronically adiabatic spin-conserving O2–O2 collisions. The surface is based on MS-CASPT2/maug-cc-pVTZ electronic structure calculations with scaled external correlation; the active space has 16 electrons in 12 orbitals. The global ground-state potential energy surface was fitted by a many-body approach with an accurate O–O pairwise interaction and a fit of the many-body interaction potential to 10 180 electronic structure data points. The many-body fit is based on permutationally invariant polynomials in terms of bond-order functions of the six interatomic distances; the bond-order functions are mixed exponential–Gaussian functions. The geometries calculated and used for the fit include geometry scans corresponding to dissociative and vibrationally excited diatom–diatom collisions of O2, scans corresponding to O3 interacting with O, additional geometries identified by running trajectories, and geometries along linear synchronous transit paths connecting randomly selected points. The global O4 PES includes subsurfaces describing the interaction of diatomic molecules with other diatomic molecules or interactions of triatomic molecules and an atom. The interaction of ozone with a ground-state oxygen atom occurs on the triplet O4 surface, and our surface includes high-energy points with O3–O geometries as well as O2–O2 geometries and O2–O–O geometries.
A study of the asymmetrical distribution of solar activity features on solar and plasma parameters (1967–2016)
Authors: El-Borie M. A. , El-Taher A. M. , Aly N. E. , Bishara A. A.
Published: March 2018

The impact of asymmetrical distribution of hemispheric sunspot areas (SSAs) on the interplanetary magnetic field, plasma, and solar parameters from 1967 to 2016 has been studied. The N-S asymmetry of solar-plasma activities based on SSAs has a northern dominance during solar cycles 20 and 24. However, it has a tendency to shift to the southern hemisphere in cycles 21, 22, and 23. The solar cycle 23 showed that the sorted southern SSAs days predominated over the northern days by ∼17%. Through the solar cycles 21–24, the SSAs of the southern hemisphere were more active. In contrast, the northern SSAs predominate over the southern one by 9% throughout solar cycle 20. On the other hand, the average differences of field magnitude for the sorted northern and southern groups during solar cycles 20–24 are statistically insignificant. Clearly, twenty years showed that the solar plasma ion density from the sorted northern group was denser than that of southern group and a highest northern dominant peak occurred in 1971. In contrast, seventeen out of fifty years showed the reverse. In addition, there are fifteen clear asymmetries of solar wind speed (SWS), with SWS (N) > SWS (S), and during the years 1972, 2002, and 2008, the SWS from the sorted northern group was faster than that of southern activity group by 6.16 ± 0.65 km/s, 5.70 ± 0.86 km/s, and 5.76 ± 1.35 km/s, respectively. For the solar cycles 20–24, the grand-averages of P from the sorted solar northern and southern have nearly the same parameter values. The solar plasma was hotter for the sorted northern activity group than the southern ones for 17 years out of 50. Most significant northern prevalent asymmetries were found in 1972 (5.76 ± 0.66 × 103 K) and 1996 (4.7 ± 0.8 × 103 K), while two significant equivalent dominant southern asymmetries (∼3.8 ± 0.3 × 103 K) occurred in 1978 and 1993. The grand averages of sunspot numbers have symmetric activity for the two sorted northern and southern hemispheres through the solar cycles 20 and 21. The sunspots tend to be the southern dominance during the solar cycles 22 and 23, and it shifted during solar cycle 24 to symmetric distribution on both solar hemispheres.
Sparse learning of stochastic dynamical equations
Authors: Boninsegna Lorenzo , Nüske Feliks , Clementi Cecilia
Published: March 2018

With the rapid increase of available data for complex systems, there is great interest in the extraction of physically relevant information from massive datasets. Recently, a framework called Sparse Identification of Nonlinear Dynamics (SINDy) has been introduced to identify the governing equations of dynamical systems from simulation data. In this study, we extend SINDy to stochastic dynamical systems which are frequently used to model biophysical processes. We prove the asymptotic correctness of stochastic SINDy in the infinite data limit, both in the original and projected variables. We discuss algorithms to solve the sparse regression problem arising from the practical implementation of SINDy and show that cross validation is an essential tool to determine the right level of sparsity. We demonstrate the proposed methodology on two test systems, namely, the diffusion in a one-dimensional potential and the projected dynamics of a two-dimensional diffusion process.
Origin of negative resistance in anion migration controlled resistive memory
Authors: Banerjee Writam , Wu Facai , Hu Yuan , Wu Quantan , Wu Zuheng , Liu Qi , Liu Ming
Published: March 2018

Resistive random access memory (RRAM) is one of the most promising emerging nonvolatile technologies for the futuristic memory devices. Resistive switching behavior often shows negative resistance (NR), either voltage controlled or current controlled. In this work, the origin of a current compliance dependent voltage controlled NR effect during the resetting of anion migration based RRAM devices is discussed. The N-type voltage controlled NR is a high field driven phenomena. The current conduction within the range of a certain negative voltage is mostly dominated by space charge limited current. But with the higher negative voltage, a field induced tunneling effect is generated in the NR region. The voltage controlled NR is strongly dependent on the compliance current. The area independent behavior indicates the filamentary switching. The peak to valley ratio (PVR) is > 5. The variation of PVR as a function of the conduction band offset is achieved. Compared to other reported works, based on the PVR, it is possible to distinguish the RRAM types. Generally, due to the higher electric field effect on the metallic bridge during RESET, the electrochemical metallization type RRAM shows much higher PVR than the valance change type RRAM.
Resolution enhancement in deep-tissue nanoparticle imaging based on plasmonic saturated excitation microscopy
Authors: Deka Gitanjal , Nishida Kentaro , Mochizuki Kentaro , Ding Hou-Xian , Fujita Katsumasa , Chu Shi-Wei
Published: March 2018

Recently, many resolution enhancing techniques are demonstrated, but most of them are severely limited for deep tissue applications. For example, wide-field based localization techniques lack the ability of optical sectioning, and structured light based techniques are susceptible to beam distortion due to scattering/aberration. Saturated excitation (SAX) microscopy, which relies on temporal modulation that is less affected when penetrating into tissues, should be the best candidate for deep-tissue resolution enhancement. Nevertheless, although fluorescence saturation has been successfully adopted in SAX, it is limited by photobleaching, and its practical resolution enhancement is less than two-fold. Recently, we demonstrated plasmonic SAX which provides bleaching-free imaging with three-fold resolution enhancement. Here we show that the three-fold resolution enhancement is sustained throughout the whole working distance of an objective, i.e., 200 μm, which is the deepest super-resolution record to our knowledge, and is expected to extend into deeper tissues. In addition, SAX offers the advantage of background-free imaging by rejecting unwanted scattering background from biological tissues. This study provides an inspirational direction toward deep-tissue super-resolution imaging and has the potential in tumor monitoring and beyond.
Electron scattering in graphene by defects in underlying h-BN layer: First-principles transport calculations
Authors: Kaneko Tomoaki , Ohno Takahisa
Published: March 2018

We investigate the electronic structure and the transport properties of graphene adsorbed onto h-BN with carbon impurities or atomic vacancies using density functional theory and the non-equilibrium Green's function method. We find that the transport properties are degraded due to carrier doping and scattering off of localized defect states in h-BN. When graphene is doped by introducing defects in h-BN, the transmission spectra become asymmetric owing to the reduction of the electronic density of states, which contributes significantly to the degradation of graphene transport properties as compared with the effect of defect levels.
Monte Carlo simulation of III-nitride photocathodes
Authors: Marini Jonathan , Bell L. D. , Shahedipour-Sandvik F.
Published: March 2018

We report on the development and verification of a Monte Carlo simulator for III-nitride photocathode structures. Due to the complexity of the process, attributing experimental photoemission results to physical origins can be difficult. We discuss the distribution of emitted electrons, including physical contributions for the shape and implications for device design. Although the Monte Carlo technique has shown promise in GaAs photocathodes, uncertainty in III-nitride band parameters makes simulation difficult. Here, a range of satellite valley band parameters were studied in the context of photoemission and compared to experimental results. We find that contrary to most published studies for Monte Carlo of III-nitrides, a lower effective mass in the satellite valley gives a closer match to experimental results.
Contact angle measurement with a smartphone
Authors: Chen H. , Muros-Cobos Jesus L. , Amirfazli A.
Published: March 2018

In this study, a smartphone-based contact angle measurement instrument was developed. Compared with the traditional measurement instruments, this instrument has the advantage of simplicity, compact size, and portability. An automatic contact point detection algorithm was developed to allow the instrument to correctly detect the drop contact points. Two different contact angle calculation methods, Young-Laplace and polynomial fitting methods, were implemented in this instrument. The performance of this instrument was tested first with ideal synthetic drop profiles. It was shown that the accuracy of the new system with ideal synthetic drop profiles can reach 0.01% with both Young-Laplace and polynomial fitting methods. Conducting experiments to measure both static and dynamic (advancing and receding) contact angles with the developed instrument, we found that the smartphone-based instrument can provide accurate and practical measurement results as the traditional commercial instruments. The successful demonstration of use of a smartphone (mobile phone) to conduct contact angle measurement is a significant advancement in the field as it breaks the dominate mold of use of a computer and a bench bound setup for such systems since their appearance in 1980s.
Comparison of single-ion molecular dynamics in common solvents
Authors: Muralidharan A. , Pratt L. R. , Chaudhari M. I. , Rempe S. B.
Published: March 2018

Laying a basis for molecularly specific theory for the mobilities of ions in solutions of practical interest, we report a broad survey of velocity autocorrelation functions (VACFs) of Li+ and PF6− ions in water, ethylene carbonate, propylene carbonate, and acetonitrile solutions. We extract the memory function, γ(t), which characterizes the random forces governing the mobilities of ions. We provide comparisons controlling for the effects of electrolyte concentration and ion-pairing, van der Waals attractive interactions, and solvent molecular characteristics. For the heavier ion (PF6−), velocity relaxations are all similar: negative tail relaxations for the VACF and a clear second relaxation for γt, observed previously also for other molecular ions and with n-pentanol as the solvent. For the light Li+ ion, short time-scale oscillatory behavior masks simple, longer time-scale relaxation of γt. But the corresponding analysis of the solventberg Li+H2O4 does conform to the standard picture set by all the PF6− results.
Electron and positron interaction with pyrimidine: A theoretical investigation
Authors: Sinha Nidhi , Antony Bobby
Published: March 2018

Pyrimidine (C4H4N2) is considered as the building block of nucleobases, viz., cytosine, thymine and uracil. They provide a blueprint for probing the scattering of radiation by DNA and RNA bases. In this article, we report the elastic and total scattering cross-sections for electron and positron scattering from the pyrimidine molecule, employing a spherical complex optical potential (SCOP) formalism for an extensive energy range of 10 eV to 5 keV. In the case of positron scattering, the original SCOP formalism is modified to adequately solve the positron-target dynamics. Moreover, a reasonable agreement is observed between the present results and other available datasets, for both electron and positron scattering. The cross-sections for electron and positron impact scattering by pyrimidine are necessary input data for codes that seek to simulate radiation damage, and hence are useful to model biomolecular systems.
Modified chloride diffusion model for concrete under the coupling effect of mechanical load and chloride salt environment
Authors: Lei Mingfeng , Lin Dayong , Liu Jianwen , Shi Chenghua , Ma Jianjun , Yang Weichao , Yu Xiaoniu
Published: March 2018

For the purpose of investigating lining concrete durability, this study derives a modified chloride diffusion model for concrete based on the odd continuation of boundary conditions and Fourier transform. In order to achieve this, the linear stress distribution on a sectional structure is considered, detailed procedures and methods are presented for model verification and parametric analysis. Simulation results show that the chloride diffusion model can reflect the effects of linear stress distribution of the sectional structure on the chloride diffusivity with reliable accuracy. Along with the natural environmental characteristics of practical engineering structures, reference value ranges of model parameters are provided. Furthermore, a chloride diffusion model is extended for the consideration of multi-factor coupling of linear stress distribution, chloride concentration and diffusion time. Comparison between model simulation and typical current research results shows that the presented model can produce better considerations with a greater universality.
Decay of superconducting correlations for gauged electrons in dimensions D ≤ 4
Authors: Tada Yasuhiro , Koma Tohru
Published: March 2018

We study lattice superconductors coupled to gauge fields, such as an attractive Hubbard model in electromagnetic fields, with a standard gauge fixing. We prove upper bounds for a two-point Cooper pair correlation at finite temperatures in spatial dimensions D ≤ 4. The upper bounds decay exponentially in three dimensions and by power law in four dimensions. These imply the absence of the superconducting long-range order for the Cooper pair amplitude as a consequence of fluctuations of the gauge fields. Since our results hold for the gauge fixing Hamiltonian, they cannot be obtained as a corollary of Elitzur’s theorem.
Oversized galactosides as a probe for conformational dynamics in LacY
Authors: Smirnova Irina , Kasho Vladimir , Jiang Xiaoxu , Chen Hong-Ming , Withers Stephen G. , Kaback H. Ronald
Published: March 2018

Significance

LacY catalyzes stoichiometric symport of lactose and an H
+
across the membrane by an alternating access mechanism and is a paradigm for the major facilitator superfamily, the largest family of membrane transport proteins. The established mechanism is expanded here by kinetic studies involving binding and transport of greatly oversized substrates. Data demonstrate the high-affinity galactoside-specific interaction of LacY with large fluorescent substrates and, importantly, unrestricted accessibility of the sugar-binding site in the periplasmic-open conformation of the transporter. Moreover, oversized aglycones of galactosidic substrates do not preclude active transport; to accommodate a large-size ligand within occluded intermediate, it is likely that in the highly flexible LacY molecule additional movements in helical bends and kinks occur during the formation of extra space.
Bounds on the complexity of Replica Symmetry Breaking for spherical spin glasses
Authors: Jagannath Aukosh , Tobasco Ian
Published: March 2018

In this paper, we study the Crisanti-Sommers variational problem, which is a variational formula for the free energy of spherical mixed

p
p

-spin glasses. We begin by computing the dual of this problem using a min-max argument. We find that the dual is a 1D problem of obstacle type, where the obstacle is related to the covariance structure of the underlying process. This approach yields an alternative way to understand Replica Symmetry Breaking at the level of the variational problem through topological properties of the coincidence set of the optimal dual variable. Using this duality, we give an algorithm to reduce this a priori infinite dimensional variational problem to a finite dimensional one, thereby confining all possible forms of Replica Symmetry Breaking in these models to a finite parameter family. These results complement the authors’ related results for the low temperature

Γ
\Gamma

-limit of this variational problem. We briefly discuss the analysis of the Replica Symmetric phase using this approach.
Torsion des variétés abéliennes CM
Authors: Gaudron Éric , Rémond Gaël
Published: March 2018

In this note, we improve on a result of Silverberg giving an upper bound for the order of a rational torsion point on a CM abelian variety over a number field in terms of the degree of the field and the dimension of the variety. The proof uses the main theorem of complex multiplication and class field theory.
Wave Change of Intraoperative Transcranial Motor-Evoked Potentials During Corrective Fusion for Syndromic and Neuromuscular Scoliosis
Authors: Ando Kei , Kobayashi Kazuyoshi , Ito Kenyu , Tsushima Mikito , Morozumi Masayoshi , Tanaka Satoshi , Machino Masaaki , Ota Kyotaro , Nishida Yoshihiro , Ishiguro Naoki , Imagama Shiro
Published: March 2018

BACKGROUND

There is little information on intraoperative neuromonitoring during correction fusion surgery for syndromic scoliosis.

OBJECTIVE

To investigate intraoperative TcMEPs and conditions (body temperature and blood pressure) for syndromic scoliosis.

METHODS

The subjects were 23 patients who underwent 25 surgeries for corrective fusion using TcMEP. Patients were divided into groups based on a decrease (DA+) or no decrease (DA−) of the amplitude of the TcMEP waveform of ≥70%. The groups were compared for age, sex, disease, type of surgery, fusion area, operation time, estimated blood loss, body temperature, blood pressure, Cobb angle, angular curve (Cobb angle/number of vertebra), bending flexibility, correction rate, and recovery.

RESULTS

The mean Cobb angles before and after surgery were 85.2° and 29.1°, giving a correction rate of 68.2%. There were 16 surgeries (64.0%) with intraoperative TcMEP wave changes. The DA+ and DA− groups had similar intraoperative conditions, but the short angular curve differed significantly between these groups. Amplitude deterioration occurred in 4 cases during first rod placement, in 8 during rotation, and in 3 during second rod placement after rotation. Seven patients had complete loss of TcMEP. However, most TcMEP changes recovered after pediclectomy or decreased correction. The preoperative angular curve differed significantly between patients with and without TcMEP changes (P < .05).

CONCLUSION

Intraoperative TcMEP wave changes occurred in 64.0% of surgeries for corrective fusion, and all but one of these changes occurred during the correction procedure. The angular curve was a risk factor for intraoperative motor deficit.
Combined Nasoseptal and Inferior Turbinate Flap for Reconstruction of Large Skull Base Defect After Expanded Endonasal Approach: Operative Technique
Authors: Boetto Julien , Labidi Moujahed , Watanabe Kentaro , Hanakita Shunya , Bouazza Schahrazed , Passeri Thibault , Bernat Anne-Laure , Froelich Sebastien
Published: March 2018

BACKROUND

Increasing indications for endoscopic endonasal approaches have led neurosurgeons to develop new reconstruction techniques for larger skull base defects. Vascularized grafts have been a great adjunction to reduce the rate of cerebrospinal fluid leak and can also be used to cover exposed critical structures such as the internal carotid artery. The nasoseptal flap and the inferior or middle turbinate flap are thus widely used in endoscopic skull base surgery, but may be insufficient for very large defects.

OBJECTIVE

To present a new mucosal flap used to cover large skull base defects in which the mucosa of the inferior turbinate, inferior meatus, nasal floor, and nasal septum is harvested in 1 piece keeping both vascular pedicles intact (inferior turbinate and septal arteries).

METHODS

We describe a surgical technique to harvest a combined inferior turbinate-nasoseptal flap.

RESULTS

Technical pearls and surgical pitfalls are described through 2 clinical cases in which the nasoseptal mucosa was partially damaged during a previous surgery, rendering the nasoseptal flap insufficient by itself. The flap is harvested thanks to 2 mucosal cuts: a first circular cut around the choanal arch and the junction between the hard and the soft palate, and a second one combining classical cuts of the nasoseptal flap and the inferior turbinate flap.

CONCLUSION

The inferior turbinate-nasoseptal flap can be a useful alternative in patients whose septal mucosa was partially damaged and/or with very large postoperative skull base defects.
Short-Term Medical Missions: Toward an Ethical Approach
Authors: Matlick Garrett Logan
Published: March 2018

Projects must have clearly stated intentions and sustainability plans.
Mandatory Parental Counseling Reduces Vaccine Exemptions
Authors: Zolot Joan
Published: March 2018

States take steps to increase vaccination rates for entering kindergartners.
The Value of Simulation in Nursing Education
Authors: Sofer Dalia
Published: March 2018

This clinical activity is transforming nursing training and practice.
New Hypotension Treatment for Septic Shock
Authors: Aschenbrenner Diane S.
Published: March 2018

Giapreza, an exogenous form of angiotensin II, has been approved to treat hypotension in adults with septic or other distributive shock. It should be added to the vasopressors used in the standard treatment of hypotension and shock.

Giapreza use can cause thrombotic and thromboembolic events. Patients receiving the drug require prophylaxis with anticoagulants.
Major Change in Warning for Asthma Drugs
Authors: Aschenbrenner Diane S.
Published: March 2018

The Food and Drug Administration has removed the black box warning from the labeling of combination long-acting β-agonists (LABAs) and corticosteroids used in asthma treatment. The warning stated that these combination drugs may increase the risk of serious asthma-related events such as hospitalization, intubation, or death.

Single-ingredient LABAs will continue to receive this black box warning.
New Route for Buprenorphine Administration
Authors: Aschenbrenner Diane S.
Published: March 2018

Buprenorphine, used to treat opioid use disorder, is now available in a once-monthly injectable form and sold under the trade name Sublocade. It can be initiated after the patient has received and tolerated a consistent dose of a transmucosal buprenorphine–naloxone product for at least a week.

Sublocade must be administered by a health care professional. Nurses and NPs who administer the drug must confirm they are injecting it into the subcutaneous tissue, as injection into a vessel could lead to serious harm or death.
Money Spent on Social Services Improves Health Outcomes
Authors: Rosenberg Karen , Mechcatie Elizabeth
Published: March 2018

According to this study:

Increased spending on social services is associated with better population health outcomes.
Applying American Society of Addiction Medicine Performance Measures in Commercial Health Insurance and Services Data
Authors: Thomas Cindy Parks , Ritter Grant A. , Harris Alex H.S. , Garnick Deborah W. , Freedman Kenneth I. , Herbert Barbara
Published: March 2018

Objectives:

ASAM's Standards of Care for the Addiction Specialist established appropriate care for the treatment of substance use disorders. ASAM identified three high priority performance measures for specification and testing for feasibility in various systems using administrative claims: use of pharmacotherapy for alcohol use disorder (AUD); use of pharmacotherapy for opioid use disorder (OUD); and continuity of care after withdrawal management services. This study adds to the initial testing of these measures in the Veteran's Health Administration (VHA) by testing the feasibility of specifications in commercial insurance data (Cigna).

Methods:

Using 2014 and 2015 administrative data, the proportion of individuals with an AUD or OUD diagnosis each year who filled prescriptions or were dispensed appropriate FDA-approved pharmacotherapy. For withdrawal management follow up, the proportion with an outpatient encounter within seven days was calculated. The sensitivity of specifications was also tested.

Results:

Rates of pharmacotherapy for AUD ranged from 6.2% to 7.6% (depending on year and specification details), and rates for OUD pharmacotherapy were 25.0% to 29.7%. Seven-day follow up rate after withdrawal management in an outpatient setting was 20.5%, and an additional 39.7% in an inpatient or residential setting.

Conclusions:

Application of ASAM specifications is feasible in commercial administrative data. Because of varying system needs and payment practices across health systems, measures may require adjustment for different settings. Moving forward, important focus will be on the continued refinement of these measures with the new ICD-10 coding systems, new formulations of current medications, and new payment approaches such as bundled payment.
Surgical Approaches for the Treatment of Thoracic Disk Herniation
Authors: Nayak Nikhil R. , Bauman Joel A. , Stein Sherman C. , Thawani Jayesh P. , Malhotra Neil R.
Published: March 2018

Study Design:

A decision analysis.

Objective:

To perform a decision analysis utilizing postoperative complication data, in conjunction with health-related quality of life (HRQoL) utility scores, to rank order the average health utility associated with various surgical approaches used to treat symptomatic thoracic disk herniation (TDH).

Summary of Background Data:

Symptomatic TDH is an uncommon entity accounting for <1% of all symptomatic herniated disks. A variety of surgical approaches have been developed for its treatment, which may be classified into 4 major categories: open anterolateral transthoracic, minimally invasive anterolateral thoracoscopic, posterior, and lateral. These treatments have varying risk/benefit profiles, but there is still no set algorithm for choosing an approach in cases with multiple surgical options.

Methods:

We searched Medline, EMBASE, and the Cochrane Library for relevant articles on surgical approaches for TDHs published between 1990 and August 2014. Pooled complication data and HRQoL utility scores associated with each complication were evaluated using standard meta-analytic techniques to determine which surgical approach resulted in the highest average HRQoL.

Results:

Posterior surgical approaches resulted in the highest average HRQoL, followed by thoracoscopic, lateral, and finally open anterolateral transthoracic procedures. The higher average HRQoL associated with posterior approaches over all others was highly significant (P<0.001); conversely, the open anterolateral approach resulted in a lower average postoperative utility compared with all other approaches (P<0.001).

Conclusions:

The results of this decision analysis favor posterior over lateral approaches, and thoracoscopic over open anterolateral approaches for the treatment of symptomatic TDHs, which may guide surgeons in cases where multiple surgical options are feasible. Future studies, such as randomized clinical trials, are necessary to ascertain whether novel surgical strategies have risk/benefit profiles that ultimately supersede those of traditional approaches, and whether enough cases are encountered by the average surgeon to justify their adoption.
Medical Management of Osteoporosis for Elective Spine Surgery
Authors: Hassanzadeh Hamid , Puvanesarajah Varun , Dalkin Alan C.
Published: March 2018

Over 50 million Americans have low bone mass. Poor bone quality is known to complicate spinal fusion surgery, which relies on strong bony purchase to be effective. Unfortunately, many spine surgeons do not perform routine workups for either osteoporosis or osteomalacia. Effective screening and risk factor assessment can allow for appropriate medical management of osteoporosis in the perioperative setting, improving outcomes. Medical management can be grouped into several different categories: vitamins and minerals, bisphosphonates, recombinant parathyroid hormone, estrogen replacement or modification, inhibitors of receptor activator of nuclear factor κ-B ligand (RANKL), and calcitonin. Calcium and vitamin D supplements are the least expensive to prescribe, with minimal side effects and promising animal studies, and thus should be provided to most osteoporotic patients. Recombinant parathyroid hormone can also be considered, as clinical studies have demonstrated impressive results in spine fusion patients. Bisphosphonates, estrogen therapy or selective estrogen receptor modulators, and calcitonin should all be avoided in this patient population given unproven benefit and potentially harmful side-effect profiles. Denosumab is potentially an option, but may not be first line given the general lack of supporting data for its use in perioperative management of spine surgery patients.
Adult Spinal Deformity Correction with Multi-level Anterior Column Releases
Authors: Demirkiran Gokhan , Theologis Alexander A. , Pekmezci Murat , Ames Christopher , Deviren Vedat
Published: March 2018

Study Design:

Case series.

Objective:

To evaluate radiographic and clinical outcomes of adults with spinal deformity treated with multilevel anterior column releases (ACR).

Summary of Background Data:

Pedicle subtraction osteotomy can be used effectively to correct spinal deformity; however, it is not without complications. ACR is an attractive alternative minimally invasive technique for spinal deformity correction, although few clinical reports on its clinical effectiveness exist.

Methods:

Adults with spinal deformity who underwent multilevel ACRs (≥2) followed by open posterior instrumentation with a minimum 1-year follow-up were retrospectively reviewed. Deformity radiographic data and clinical outcomes, including the Oswestry Disability Index (ODI) and the EuroQol-5D were analyzed.

Results:

Eight patients [7 female, 1 male; mean age 65 y (49–79 y)] met inclusion criteria. The mean follow-up was 18.4 months (12–28 mo). The average number of levels treated with an ACR per patient was 2.4 (2–3). There were no anterior approach–related complications. The average number of levels instrumented posteriorly was 8.1 (3–15). Six patients underwent Schwab type 1 posterior osteotomies (partial facetectomies). After the first anterior stage, there was a significant increase in the lumbar lordosis and significant decreases in the sagittal vertical axis, pelvic tilt, and lumbopelvic mismatch (P<0.05). After the second stage there was no significant change in the sagittal vertical axis, lumbar lordosis, pelvic tilt, or lumbopelvic mismatch relative to the values obtained after ACR. There was significantly less disability postoperatively [ODI: 15 (0–30)] compared with preoperatively [ODI: 46 (16–80)] (P<0.01). There was significant improvement in general health after operation, as assessed by the EuroQol-5D utility scores [preop: 0.44 (0.21–0.82) vs. postop: 0.71 (0.60–0.80)] (P=0.01). Back and leg visual analog scale pain scores improved significantly postoperatively.

Conclusions:

A staged approach using multilevel ACRs with open posterior instrumentation has an acceptable complication profile and provides excellent restoration of sagittal and coronal balance and pelvic parameters in adults with spinal deformity.
Intraoperative Neuromonitoring in Pediatric and Adult Spine Deformity Surgery
Authors: Strike Sophia A. , Hassanzadeh Hamid , Jain Amit , Kebaish Khaled M. , Njoku Dolores B. , Becker Daniel , Ain Michael C. , Sponseller Paul D.
Published: March 2018

Study Design:

Review of techniques and description of institutional clinical experience.

Objective:

To provide a historical review and description of key neuromonitoring concepts, focusing on neurogenic motor-evoked potentials and descending neurogenic evoked potentials, and to review the authors’ experience with neuromonitoring techniques in children and adults undergoing spinal deformity surgery.

Summary of Background Data:

The original form of neuromonitoring, the Stagnara wake-up test, remains the “gold standard” for detecting true neurological deficits. Multiple newer modalities involving cortical and muscular monitoring, such as somatosensory evoked potentials and motor evoked potentials, have been developed and are widely used. Descending and neurogenic evoked potentials are becoming more common for neuromonitoring in patients undergoing spinal deformity surgery.

Methods:

A PubMed search for literature related to “neuromonitoring” was performed, and recent, as well as historical, articles were reviewed. Clinical experience regarding the use of neuromonitoring in adult and pediatric spinal deformity surgery was obtained from institutional experts.

Results:

Although not regularly used, the Stagnara wake-up test remains the gold standard for detecting neurological injury. Somatosensory evoked potentials measure signals transmitted from the periphery to the cortex and have historically been widely used but are limited by delay, poor localization, and the inability to detect damage to motor tracts. Motor evoked potentials continue to be used widely and measure muscular activity after cortical stimulation, but they are difficult to interpret in patients with underlying motor disorders and cannot be continuously monitored. Newer techniques such as descending neurogenic evoked potentials and neurogenic motor evoked potentials monitoring are used at some high-volume centers.

Conclusions:

Familiarity with the history of neuromonitoring in spinal deformity surgery and an understanding of the physiological systems used for neuromonitoring provide a framework from which spine surgeons can select appropriate monitoring for their patients.
Cervical Spondylotic Myelopathy
Authors: Iyer Aditya , Azad Tej D. , Tharin Suzanne
Published: March 2018

Cervical spondylotic myelopathy (CSM) is a degenerative disease that represents the most common spinal cord disorder in adults. The natural history of the disease can be insidious, and patients often develop debilitating spasticity and weakness. Diagnosis includes a combination of physical examination and various imaging modalities. There are various surgical options for CSM, consisting of anterior and posterior procedures. This article summarizes the literature regarding the pathophysiology, natural history, and diagnosis of CSM, as well as the various treatment options and their associated risks and indications.