bluuebunny/crossref_metadata_2025 huggingface dataset:
Point‐of‐Care Ultrasound Work Flow Innovation: Impact on Documentation and Billing
Authors: Flannigan Matthew J. , Adhikari Srikar
Published: June 2017

Objectives

To evaluate the impact that an innovative automated ultrasound (US) work flow, which allows for bedside performance of examination documentation and order placement, has on point‐of‐care US billing compared to ordering US examinations through an electronic medical record.

Methods

We conducted a retrospective review of point‐of‐care US billing data (March 2014–February 2016) for adult and pediatric emergency departments with an emergency medicine residency and a US fellowship. An innovative work flow with the ability to automate US billing and selectively transfer the images and reports for patient care examinations to an electronic medical record and picture archiving and communication system using the QPath US work flow solution (Telexy Healthcare, Maple Ridge, British Columbia, Canada) was implemented. The total number of examinations billed and percent increase in technical and professional revenue, excluding examinations performed by US fellows, before and after implementation of the automated work flow innovation were determined.

Results

After implementation of our automated US work flow process, the number of patient care US examinations billed increased significantly due to completing documentation and immediate billing determination at the bedside. The increase in percent billing relative to total examinations was noted in both technical (32% to 61%; P < .0001) and professional (37% to 65%; P < .0001) billing components. In addition, there was a net increase in technical and professional fee revenue to 96% and 78%, respectively.

Conclusions

The implementation of an innovative automated work flow to include bedside point‐of‐care US documentation, order placement, and the automated transfer of images and reports led to a significant increase in US billing revenue, documentation, and compliance.
Comparison of Acoustic Radiation Force Impulse Imaging and Strain Elastography in Differentiating Malignant From Benign Thyroid Nodules
Authors: Zhang Fengjuan , Zhao Xinming , Han Ruoling , Du Min , Li Ping , Ji Xiaohui
Published: June 2017

Objectives

This study aimed to evaluate the diagnostic value of acoustic radiation force impulse (ARFI) imaging and strain elastography in differentiating malignant from benign thyroid nodules.

Methods

This study included 128 patients (104 female and 24 male; mean age ± standard deviation, 48 ± 11 years; range, 23–76 years) with 152 pathologically proven thyroid nodules. Conventional sonography, strain ratio (SR) of strain elastography, virtual touch tissue imaging (VTI) grade, and virtual touch tissue quantification (shear wave velocity [SWV]) from ARFI imaging data were generated for each nodule. The diagnostic performance of the three elastography analysis methods was analyzed and compared by multiple receiver operating characteristic curve analysis. The interobserver agreement for VTI grade was also assessed.

Results

The best cutoff values for VTI grade, mean SWV, and mean SR for predicting malignant thyroid nodules were greater than or equal to grade χ, 2.87 m/s and 2.37, respectively. The area under the receiver operating characteristic curve for VTI grade, mean SWV, and mean SR was 0.854, 0.869 and 0.849, respectively (P > .05), and the accuracy was 83.55, 81.58 and 80.26%, respectively (P > .05). The accuracy of the combined use of conventional sonography and ARFI imaging for VTI grade, mean SWV, and mean SR was 98.03, 95.39 and 96.71%, respectively, which was slightly higher than that of conventional sonography (P > .05). The interobserver agreement produced a κ‐value of 0.98 (95% confidence interval, 0.959–1.000).

Conclusions

Both strain elastography and ARFI imaging have high sensitivity and specificity for differentiating malignant from benign thyroid nodules. Combined with sonography, these techniques can improve the accuracy of thyroid nodule diagnosis.
Perioperative pain management after fibular free flap harvesting for head‐and‐neck reconstruction using mini‐catheters to inject local anesthetic: A pilot study
Authors: Ferri Andrea , Varazzani Andrea , Valente Adriana , Pedrazzi Giuseppe , Bianchi Bernardo , Ferrari Silvano , Sesenna Enrico
Published: June 2017

Background

Fibular donor site pain management in the early postoperative period can help minimize complications, patient discomfort, and agitation. Traditional management of postoperative pain consists of systemic administration of opioids and NSAIDS. The use of local anesthetics in addition to systemic analgesics has the potential to improve pain control. Purpose of the study is to evaluate the efficacy of mini‐catheters used to inject local anesthetic into the fibular donor site after flap harvesting for reconstruction of the head‐and‐neck area.

Methods

Prospective study on 31 patients (mean age 52 years) treated for head and neck reconstruction with fibula free flap using minicatheter for local anesthetic injection in the early postoperative time. A bolus of chirochaine (0.125% w/v; 20 mL) was injected through the catheter before the patient regained consciousness. Postoperatively, three consecutive injections (20 mL each) were administered 8, 16, and 24 h after surgery. Pain evaluation before and after local anesthetic injection is used to assess efficacy and overall pain control.

Results

No major or minor complication occurred. Mean pain value was 1.69. At 8 h, the pain scores before injection ranged from 0 to 10 (mean 4.13 ± 3.06). After injection, the pain scores ranged from 0 to 5 (mean 1 ± 1.34). Similarly, at 16 h, the pain scores ranged from 0 to 8 (mean 2.77 ± 2.42) before injection and from 0 to 6 (mean 0.42 ± 1.2) thereafter. At 24 h, the initial pain score ranged from 0 to 6 (mean 1.71 ± 1.74) and from 0 to 1 (mean 0.1 ± 0.3) after drug administration. Pre and postinjection pain scores differences were statistically significant after all three injections (P < .001).

Conclusions

Minicatheter seems to be easy, safe, and efficient when used to control pain after fibular free‐flap harvesting.
Long‐term outcomes of Group D retinoblastoma eyes during the intravitreal melphalan era
Authors: Berry Jesse L. , Shah Sona , Bechtold Mercy , Zolfaghari Emily , Jubran Rima , Kim Jonathan W.
Published: June 2017

Background

To evaluate outcomes of Group D retinoblastoma (Rb) eyes during the intravitreal melphalan era.

Procedure

Retrospective chart review of patients diagnosed with Group D Rb from 2011 to 2016 was done. Overall, 76 Group D eyes of 68 patients were included; salvage therapy included systemic chemoreduction with vincristine, etoposide, and carboplatin with local consolidation, followed by intravitreal injection of melphalan for recurrent or persistent seeding. External beam radiation was not used as a treatment modality. Primary outcome measurement was globe salvage.

Results

Of 76 Group D eyes, 24 were enucleated primarily and 52 were treated with intent to salvage the globe. Systemic chemoreduction salvaged 25 of 52 eyes (48%). Tumor recurrences were diagnosed in 27 eyes (52%); five with massive retinal recurrences underwent enucleation and 22 were treated with intravitreal melphalan injection. Of the 22 injected eyes, 14 (64%) were salvaged and eight required enucleation primarily for retinal recurrences. Success in eradicating vitreous seeds was 100%. The Kaplan–Meier 3‐year survival estimate for treated eyes is 76.5% (95% CI: 61.4–86.3). Median follow‐up for the group of 76 Group D eyes was 29.5 months (SD 17.9 months).

Conclusion

During a 6‐year period that included the initiation of intravitreal melphalan at our institution, the salvage rate of treated Group D eyes was 75% (39/52 eyes). Intravitreal melphalan was utilized for ocular salvage in 42% (22/52 eyes). Systemic chemoreduction combined with intravitreal melphalan for seeding demonstrated a high overall salvage rate for Group D eyes in this cohort.
Photoresponsive biodegradable poly(carbonate)s with pendento‐nitrobenzyl ester
Authors: Shen Huihui , Xia Yingchun , Qin Zhouliang , Wu Juan , Zhang Li , Lu Yanbing , Xia Xinnian , Xu Weijian
Published: June 2017

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

One new and one established functional cyclooctene were prepared and (co)polymerized using ring‐opening metathesis polymerization. The resulting polymers were hydrogenated to yield the corresponding functional polyolefins that were structurally equivalent to copolymers of ethylene and either methyl methacrylate, t‐butyl acrylate, or acrylic acid after deprotection. The copolymers that incorporate methyl methacrylate into the backbone were used as compatibilizers for poly(methyl methacrylate)/polyethylene blends. The copolymers that incorporate t‐butyl acrylate into the backbone yielded elastomers that could be thermally crosslinked. © 2017 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2017, 55, 3117–3126
Spectral gap characteristics in a daytime valley boundary layer
Authors: Babić Nevio , Večenaj Željko , De Wekker Stephan F. J.
Published: June 2017

A correct estimation of turbulent variances and covariances in the atmospheric boundary layer relies on the determination of turbulent perturbations of wind speed components and scalar quantities, which requires the presence of a so‐called spectral gap. The goal of this work is to determine the range of gap scales necessary to define turbulent perturbations in a daytime valley boundary layer. To accomplish this, we analyze data from a large number of propeller‐vane and sonic anemometers using the fast Fourier transformation and the multiresolution flux decomposition. Daytime gap scales are found to range from 17 to 29 min and show large spatial variability across the valley floor and the adjacent slopes. Synoptically driven conditions that favour the occurrence of mesoscale phenomena, such as rotors and mountain waves, shift daytime gap scales toward longer periods. The low‐frequency end of the gap is also affected by the presence of slope winds that are characterized by a periodicity ranging from 80 to 200 min. Finally, we present a conceptual model of the daytime valley spectral gap which summarizes the findings of this study.
Dynamic Meso-Scale Anchorage of GPI-Anchored Receptors in the Plasma Membrane: Prion Protein vs. Thy1
Authors: Nemoto Yuri L. , Morris Roger J. , Hijikata Hiroko , Tsunoyama Taka A. , Shibata Akihiro C. E. , Kasai Rinshi S. , Kusumi Akihiro , Fujiwara Takahiro K.
Published: June 2017

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

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

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

An analysis of tide gauge records and physical models shows acceleration of sea level rise on the East Coast due to melting of the Greenland Ice Sheet is especially pronounced south of 40°N latitude.
Biophysical stimulation for in vitro engineering of functional cardiac tissues
Authors: Korolj Anastasia , Wang Erika Yan , Civitarese Robert A. , Radisic Milica
Published: June 2017

Engineering functional cardiac tissues remains an ongoing significant challenge due to the complexity of the native environment. However, our growing understanding of key parameters of the in vivo cardiac microenvironment and our ability to replicate those parameters in vitro are resulting in the development of increasingly sophisticated models of engineered cardiac tissues (ECT). This review examines some of the most relevant parameters that may be applied in culture leading to higher fidelity cardiac tissue models. These include the biochemical composition of culture media and cardiac lineage specification, co-culture conditions, electrical and mechanical stimulation, and the application of hydrogels, various biomaterials, and scaffolds. The review will also summarize some of the recent functional human tissue models that have been developed for in vivo and in vitro applications. Ultimately, the creation of sophisticated ECT that replicate native structure and function will be instrumental in advancing cell-based therapeutics and in providing advanced models for drug discovery and testing.
Comments on ‘State feedback control design of continuous‐time switched affine systems’
Authors: Scharlau César C. , Dezuo Tiago J.M. , Trofino Alexandre
Published: June 2017

This note presents important aspects that should be taken into account in the comparative study on stability conditions of switched affine systems with performance presented in the aforementioned paper. Using a numerical example, it is demonstrated that stability conditions for switched affine systems obtained from a max‐type composition to define both the Lyapunov function and switching rule are not necessarily more conservative than the ones obtained from a quadratic Lyapunov function and a min‐type composition to define the switching rule.
Dynamic output‐feedback stabilisation for Markovian jump systems with incomplete transition description and input quantisation: linear matrix inequality approach
Authors: Kwon Nam Kyu , Park Chan‐eun , Park PooGyeon
Published: June 2017

In this study, a dynamic output‐feedback stabilisation problem for Markovian jump systems (MJSs) with incomplete transition description and input quantisation is investigated. While the previous researches about output‐feedback stabilisation for MJSs assumed that the transition rates are completely known, a more general situation where the transition rates are partly unknown is considered. Moreover, the proposed controller includes non‐linear control part to eliminate the effect of input quantisation. Two numerical examples are provided to demonstrate the feasibility of the proposed dynamic output‐feedback controller.
Thermal analysis of high‐voltage cables with several types of insulation for different configurations in the presence of harmonics
Authors: Shazly Jehan H. , Mostafa Mohamed A. , Ibrahim Doaa K. , Abo El Zahab Essam E.
Published: June 2017

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

This article presents automatic generation control of an interconnected combined cycle gas turbine (CCGT) incorporated unequal area thermal system under restructured environment. Investigations have been carried out with two generating companies and two distribution companies in each area. Area 1 includes CCGT‐thermal system and area 2 includes thermal–thermal system. Both areas are employed with appropriate generation rate constraint (GRC) and governor dead band in thermal systems. Integral minus proportional derivative with first‐order filter effect (I‐PDF) controller is used as secondary controller whose promising performance is compared with proportional, proportional integral and proportional integral derivative controller. The controller gains and other parameters are optimised using stochastic fractal search (SFS) algorithm. Sensitivity analysis is performed with change in system loading, system parameters such as inertia constant, governor and turbine time constant and random load disturbances to evaluate the robustness of proposed SFS optimised I‐PDF controller. The simulation results with different set of contractual agreement postulated by DISCO participation matrix and its violation illustrates the effectiveness of SFS optimised I‐PDF controller. Additionally, the system under restructured regime is investigated with combinatorial increment in GRC and delayed controller action for appropriate use and maintenance of the proposed controller.
Solution techniques for transient stability‐constrained optimal power flow – Part I
Authors: Abhyankar Shrirang , Geng Guangchao , Anitescu Mihai , Wang Xiaoyu , Dinavahi Venkata
Published: June 2017

This series of studies present the state‐of‐the‐art for the solution of the transient stability constrained optimal power flow problem (TSC‐OPF). Three different classes of solution techniques: dynamic optimisation‐based, SIME method, and computational intelligence, are discussed in detail. Moreover, discussed are issues to consider while solving such problems, various application areas, and future directions in this research area. A comprehensive resource of the available literature, publicly available test systems, and relevant numerical libraries is also provided. This study presents the TSC‐OPF formulation and discusses various dynamic optimisation‐based approaches. Two optimisation techniques, full‐space and reduced‐space method, are presented for solving the resulting non‐linear optimisation problem.
Switching model analysis and implementation of electric spring for voltage regulation in smart grids
Authors: Areed Emad Fuad , Abido Mohammad A. , Al‐Awami Ali T.
Published: June 2017

This study proposes a new switching model for steady‐state and dynamic analysis of an electric spring (ES). The accuracy of the developed ES model is demonstrated. The developed model is used to design a controller for bus voltage regulation in a distribution network with an intermittent renewable source. The ES controller design problem is formulated as an optimisation problem with a time domain‐based objective function to reduce the time‐weighted voltage deviations. Real coded genetic algorithm is considered for optimal design of the AC and DC PI controllers of the ES. The distribution system with ES is simulated and the developed model is investigated under different types of disturbances and load variations. In addition, the system considered is developed on real time digital simulator and the proposed controllers are implemented on dSPACE DS1103 platform for a hardware‐in‐loop experimental setup. Simulation results have been validated by the experimental results. The results show the effectiveness of the developed model and the proposed controller design approach to enhance greatly the reliability of the distribution network considered.
Bandwidth control of cylindrical ring dielectric resonator antennas using metallic cap and sleeve loading
Authors: Shaik Latheef A. , Saha Chinmoy , Arora Shivam , Das Sanghamitro , Siddiqui Jawad Y. , Iyer Ashwin K.
Published: June 2017

This study investigates the effect of loading a monopole‐fed cylindrical ring dielectric resonator antenna using a metallic cap and metallic sleeve on its top and outer surface, respectively. The proposed design exhibits a considerable shift of its upper cut‐off frequency (from 13.8 to 20.5 GHz for top loading and 8.2 to 15.9 GHz for outer‐surface loading) with varying inner radii (height) of the metallic cap (sleeve), thereby providing the bandwidth (BW) controllability. Fabricated prototypes were measured and compared with simulations and good agreement was obtained. The measured return loss exhibits the desired BW control without affecting the peak gain and radiation pattern of the antenna, which is also confirmed by the measured radiation patterns. The proposed concept can be used to reconfigure the BW of the antenna according to the user's requirements and improve signal‐to‐noise ratio by rejecting unwanted frequency bands without employing any additional filter section.
Impact of Al content on InAs/AlSb/Alx Ga1−x Sb tunnelling diode
Authors: Zeng Yuping , Hsu Chingyi , Chang Edward Yi , Hu Chenming
Published: June 2017

A method to engineer the peak‐to‐valley ratio (PVR) by design of the epitaxial layers is presented. The impact of Al content on PVR of InAs/AlSb/Alx Ga1−x Sb tunnelling diode is studied. A simplified analytical model is used to explain the PVRs dependence on Al content. It was found that PVR reaches its maximum when Al content x is zero with a quantised InAs layer. The peak positions appeared in the negative differential region are effectively controlled by the applied gate bias. A PVR ratio as high as 7.1 was achieved, which is beneficial for a wide range of circuit applications. Adjusting Al content provides a new way to engineer the PVR as opposed to the conventional way of being optimised by varying barrier thicknesses or doping levels.
Early Outpatient Physical Therapy May Improve Range-of-Motion in Primary Total Knee Arthroplasty
Authors: McGinn Tanner , Chughtai Morad , Khlopas Anton , Grasmick Paige , Mullaji Arun , Harwin Steven , Bhave Anil , Mont Michael
Published: June 2017

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

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

This paper is part of a thematic issue on Hydrogen in Metallic Alloys
Is There a Preoperative Morphine Equianalgesic Dose that Predicts Ability to Achieve a Clinically Meaningful Improvement Following Spine Surgery?
Authors: Wick Joseph B , Sivaganesan Ahilan , Chotai Silky , Archer Kristin R , Posey Samuel L , Evans Parker T , Campbell Joel R , Devin Clinton J
Published: June 2017

BACKGROUND

Preoperative opioid use is widespread and associated with worse patient-reported outcomes following spine surgery.

OBJECTIVE

To calculate a threshold preoperative morphine equianalgesic (MEA) dose beyond which patients are less likely to achieve the minimum clinically important difference (MCID) following elective surgery for degenerative spine disease.

METHODS

The study included 543 cervical and 1293 lumbar patients. Neck Disability Index and Oswestry Disability Index scores were collected at baseline and 12 mo postoperatively. Preoperative MEA doses were calculated retrospectively. Multivariate logistic regression was then performed to determine the relationship between MEA dose and the odds of achieving MCID. As a part of this regression, Bayesian inference and Markov Chain Monte Carlo methods were used to estimate the values of inflection points (or “thresholds”) in MEA.

RESULTS

Overall, 1020 (55.5%) patients used preoperative opioids. A total of 50.3% of cervical and 61.9% of lumbar patients achieved MCID. The final logistic regression model demonstrated that MCID achievement decreased significantly when mean preoperative MEA dose exceeded 47.8 mg/d, with a 95% credible interval of 29.0 to 60.0 mg/d.

CONCLUSION

Minimum and maximum MEA doses exist, between which increasing opioid dose is associated with decreased ability to achieve clinically meaningful improvement following spine surgery. Patients with preoperative MEA dose exceeding 29 mg/d, the lower limit of the 95% credible interval for the mean MEA dose above which patients exhibit significantly decreased achievement of MCID, may be considered for preoperative opioid weaning.
Structure of the human pro-myostatin precursor and determinants of growth factor latency
Authors: Cotton Thomas , Fischer Gerhard , Wang Xuelu , McCoy Jason , Czepnik Magdalena , Thompson Thomas B. , Hyvönen Marko
Published: June 2017

Myostatin, a key regulator of muscle mass in vertebrates, is biosynthesised as a latent precursor in muscle and is activated by sequential proteolysis of the pro-domain. To investigate the molecular mechanism by which pro-myostatin remains latent, we have solved the structure of unprocessed promyostatin and analysed the properties of the protein in its different forms. Crystal structures and SAXS analyses show that pro-myostatin adopts an open, V-shaped structure with a domain-swapped arrangement. The pro-mature complex, after cleavage of the furin site, has significantly reduced activity compared with mature growth factor and persists as a stable complex that is resistant to the natural antagonist follistatin. The latency appears to be conferred by a number of distinct features that collectively stabilise the interaction of the pro-domains with the mature growth factor, enabling a regulated step-wise activation process, distinct from the prototypical pro-TGF-β1. These results provide a basis for understanding the effect of missense mutations in pro-myostatin and pave the way for the design of novel myostatin inhibitors.
Whole genome amplification and sequencing of low cell numbers directly from a bacteria spiked blood model
Authors: Anscombe Catherine , Misra Raju.V , Gharbia Saheer
Published: June 2017

Whilst next generation sequencing is frequently used to whole genome sequence bacteria from cultures, it’s rarely applied directly to clinical samples. Therefore, this study addresses the issue of applying NGS microbial diagnostics directly to blood samples. To demonstrate the potential of direct from blood sequencing a bacteria spiked blood model was developed. Horse blood was spiked with clinical samples ofE. coliandS. aureus, and a process developed to isolate bacterial cells whilst removing the majority of host DNA. One sample of each isolate was then amplified using ϕ29 multiple displacement amplification (MDA) and sequenced. The total processing time, from sample to amplified DNA ready for sequencing was 3.5 hours, significantly faster than the 18-hour overnight culture step which is typically required. Both bacteria showed 100% survival through the processing. The direct from sample sequencing resulted in greater than 92% genome coverage of the pathogens whilst limiting the sequencing of host genome (less than 7% of all reads). Analysis ofde novoassembled reads allowed accurate genotypic antibiotic resistance prediction. The sample processing is easily applicable to multiple sequencing platforms. Overall this model demonstrates potential to rapidly generate whole genome bacterial data directly from blood.
Recruitment of CRISPR-Cas systems by Tn7-like transposons
Authors: Peters Joseph E. , Makarova Kira S. , Shmakov Sergey , Koonin Eugene V.
Published: June 2017

A survey of bacterial and archaeal genomes shows that many Tn7-like transposons contain ‘minimal’ type I-F CRISPR-Cas systems that consist of fused cas8f and cas5f, cas7f and cas6f genes, and a short CRISPR array. Additionally, several small groups of Tn7-like transposons encompass similarly truncated type I-B CRISPR-Cas systems. This gene composition of the transposon-associated CRISPR-Cas systems implies that they are competent for pre-crRNA processing yielding mature crRNAs and target binding but not target cleavage that is required for interference. Here we present phylogenetic analysis demonstrating that evolution of the CRISPR-Cas containing transposons included a single, ancestral capture of a type I-F locus and two independent instances of type I-B loci capture. We further show that the transposon-associated CRISPR arrays contain spacers homologous to plasmid and temperate phage sequences, and in some cases, chromosomal sequences adjacent to the transposon. A hypothesis is proposed that the transposon-encoded CRISPR-Cas systems generate displacement (R-loops) in the cognate DNA sites, targeting the transposon to these sites and thus facilitating their spread via plasmids and phages. This scenario fits the “guns for hire” concept whereby mobile genetic elements can capture host defense systems and repurpose them for different stages in the life cycle of the element.

Importance

CRISPR-Cas is an adaptive immunity system that protects bacteria and archaea from mobile genetic elements. We present comparative genomic and phylogenetic analysis of degenerate CRISPR-Cas variants associated with distinct families of transposable elements and develop the hypothesis that such repurposed defense systems contribute to the transposable element propagation by facilitating transposition into specific sites. Such recruitment of defense systems by mobile elements supports the “guns for hire” concept under which the same enzymatic machineries can be alternately employed for transposon proliferation or host defense.
Soil community assembly varies across body sizes in a tropical forest
Authors: Zinger Lucie , Taberlet Pierre , Schimann Heidy , Bonin Aurélie , Boyer Frédéric , Barba Marta De , Gaucher Philippe , Gielly Ludovic , Giguet-Covex Charline , Iribar Amaia , Réjou-Méchain Maxime , Rayé Gilles , Rioux Delphine , Schilling Vincent , Tymen Blaise , Viers Jérôme , Zouiten Cyril , Thuiller Wilfried , Coissac Eric , Chave Jérôme
Published: June 2017

The relative influence of deterministic niche-based (i.e. abiotic conditions, biotic interactions) and stochastic-distance dependent neutral processes (i.e. demography, dispersal) in shaping communities has been extensively studied for various organisms, but is far less explored jointly across the tree of life, in particular in soil environments. Here, using a thorough DNA-based census of the whole soil biota in a large tropical forest plot, we show that soil aluminium, topography, and plant species identity are all important drivers of soil richness and community composition. Body size emerges as an important feature of the comparative ecology of the different taxa at the studied spatial scale, with microorganisms being more importantly controlled by environmental factors, while soil mesofauna rather display random spatial distribution. We infer that niche-based processes contribute differently to community assembly across trophic levels due to spatial scaling. Body size could hence help better quantifying important properties of multitrophic assemblages.
The structural basis for regulation of the nucleo-cytoplasmic distribution of Bag6 by TRC35
Authors: Mock Jee-Young , Xu Yue , Ye Yihong , Clemons William M.
Published: June 2017

The metazoan protein BCL2-associated athanogene cochaperone 6 (Bag6) forms a hetero-trimeric complex with ubiquitin-like 4A (Ubl4A) and transmembrane domain recognition complex 35 (TRC35). This Bag6 complex is involved in tail-anchored protein targeting and various protein quality control pathways in the cytosol as well as regulating transcription and histone methylation in the nucleus. Here we present a crystal structure of Bag6 and its cytoplasmic retention factor TRC35, revealing that TRC35 is remarkably conserved throughout opisthokont lineage except at the C-terminal Bag6-binding groove, which evolved to accommodate a novel metazoan factor Bag6. Remarkably, while TRC35 and its fungal homolog guided entry of tail-anchored protein 4 (Get4) utilize a conserved hydrophobic patch to bind their respective C-terminal binding partners Bag6 and Get5, Bag6 wraps around TRC35 on the opposite face relative to the Get4-5 interface. We further demonstrate that the residues involved in TRC35 binding are not only critical for occluding the Bag6 nuclear localization sequence from karyopherin α binding to retain Bag6 in the cytosol, but also for preventing TRC35 from succumbing to RNF126-mediated ubiquitylation and degradation. The results provide a mechanism for regulation of Bag6 nuclear localization and the functional integrity of the Bag6 complex in the cytosol.
Distinct representations of planned reach trajectories in human premotor and posterior parietal cortex
Authors: Pilacinski Artur , Lindner Axel
Published: June 2017

Goal-directed movements of the hand are often directed straight at the target, e.g. when swatting a fly; but when drawing or avoiding obstacles, hand trajectories can also become quite complex. Studies on movement planning have largely neglected the latter case and the question of whether the same neural machinery is planning straight, saccade-like vs. complex hand trajectories. Using time-resolved fMRI during delayed response tasks we examined planning activity in human superior parietal lobule (SPL) and dorsal premotor cortex (PMd). We show that the recruitment of both areas in trajectory planning differs significantly: PMd represented both straight and complex hand trajectories while SPL only those that led straight to the target. This implies that complex and computationally demanding reach planning is governed by a frontal pathway while a parietal route could warrant an alternative and faster way to put simple plans into action.
Head-on replication-transcription collisions lead to formation of life threatening R-loops
Authors: Lang Kevin S. , Hall Ashley N. , Merrikh Christopher N. , Ragheb Mark , Merrikh Houra
Published: June 2017

Encounters between transcription and DNA replication machineries lead to conflicts that shape genomes, influence evolution, and lead to genetic diseases in humans. Although unclear why, head-on transcription (lagging strand genes) is especially disruptive to replication, increases DNA breaks, and promotes mutagenesis. Here, we show that head-on replication-transcription conflicts lead to pervasive RNA:DNA hybrid formation inBacillus subtilis. We find that replication beyond head-on conflict regions requires the activity of a RNA:DNA hybrid processing enzyme, RNase HIII. Remarkably, pervasive RNA:DNA hybrid formation at head-on genes completely stops replication and inhibits gene expression in a replication-dependent manner. Accordingly, we find that resolution of head-on conflicts by RNase HIII is crucial for survival upon exposure to various stresses, as many stress response genes are encoded head-on to replication. We conclude that R-loops, RNA:DNA hybrids formed outside of the transcription bubble, exacerbate head-on replication-transcription conflicts, thereby threatening life, especially upon exposure to environmental stresses.
Rhodosporidium toruloides:A new platform organism for conversion of lignocellulose into terpene biofuels and bioproducts
Authors: Yaegashi Junko , Kirby James , Ito Masakazu , Sun Jian , Dutta Tanmoy , Mirsiaghi Mona , Sundstrom Eric R. , Rodriguez Alberto , Baidoo Edward , Tanjore Deepti , Pray Todd , Sale Kenneth , Singh Seema , Keasling Jay D. , Simmons Blake A. , Singer Steven W. , Magnuson Jon K. , Arkin Adam P. , Skerker Jeffrey M. , Gladden John M.
Published: June 2017

Background

Economical conversion of lignocellulosic biomass into biofuels and bioproducts is central to the establishment of a robust bioeconomy. This requires a conversion host that is able to both efficiently assimilate the major lignocellulose-derived carbon sources and divert their metabolites toward specific bioproducts.

Results

In this study, the carotenogenic yeastRhodosporidium toruloideswas examined for its ability to convert lignocellulose into two non-native sesquiterpenes with biofuel (bisabolene) and pharmaceutical (amorphadiene) applications. We found thatR. toruloidescan efficiently convert a mixture of glucose and xylose from hydrolyzed lignocellulose into these bioproducts, and unlike many conventional production hosts, its growth and productivity were enhanced in lignocellulosic hydrolysates relative to purified substrates. This organism was demonstrated to have superior growth in corn stover hydrolysates prepared by two different pretreatment methods, one using a novel biocompatible ionic liquid (IL) choline α-ketoglutarate, which produced 261 mg/L of bisabolene at bench-scale, and the other using an alkaline pretreatment, which produced 680 mg/L of bisabolene in a high gravity fed-batch bioreactor. Interestingly,R. toruloideswas also observed to assimilatep-coumaric acid liberated from acylated grass lignin in the IL hydrolysate, a finding we verified with purified substrates.R. toruloideswas also able to consume several additional compounds with aromatic motifs similar to lignin monomers, suggesting that this organism may have the metabolic potential to convert depolymerized lignin streams alongside lignocellulosic sugars.

Conclusions

This study highlights the natural compatibility ofR. toruloideswith bioprocess conditions relevant to lignocellulosic biorefineries and demonstrates its ability to produce non-native terpenes.