bluuebunny/crossref_metadata_2025 huggingface dataset:
Structural, optical, and electrical properties of unintentionally doped NiO layers grown on MgO by plasma-assisted molecular beam epitaxy
Authors: Budde Melanie , Tschammer Carsten , Franz Philipp , Feldl Johannes , Ramsteiner Manfred , Goldhahn Rüdiger , Feneberg Martin , Barsan Nicolae , Oprea Alexandru , Bierwagen Oliver
Published: May 2018

NiO layers were grown on MgO(100), MgO(110), and MgO(111) substrates by plasma-assisted molecular beam epitaxy under Ni-flux limited growth conditions. Single crystalline growth with a cube-on-cube epitaxial relationship was confirmed by X-ray diffraction measurements for all used growth conditions and substrates except MgO(111). A detailed growth series on MgO(100) was prepared using substrate temperatures ranging from 20 °C to 900 °C to investigate the influence on the layer characteristics. Energy-dispersive X-ray spectroscopy indicated close-to-stoichiometric layers with an oxygen content of ≈47 at. % and ≈50 at. % grown under low and high O-flux, respectively. All NiO layers had a root-mean-square surface roughness below 1 nm, measured by atomic force microscopy, except for rougher layers grown at 900 °C or using molecular oxygen. Growth at 900 °C led to a significant diffusion of Mg from the substrate into the film. The relative intensity of the quasi-forbidden one-phonon Raman peak is introduced as a gauge of the crystal quality, indicating the highest layer quality for growth at low oxygen flux and high growth temperature, likely due to the resulting high adatom diffusion length during growth. The optical and electrical properties were investigated by spectroscopic ellipsometry and resistance measurements, respectively. All NiO layers were transparent with an optical bandgap around 3.6 eV and semi-insulating at room temperature. However, changes upon exposure to reducing or oxidizing gases of the resistance of a representative layer at elevated temperature were able to confirm p-type conductivity, highlighting their suitability as a model system for research on oxide-based gas sensing.
Accurate measurement of a 96% input coupling into a cavity using polarization tomography
Authors: Hilaire P. , Antón C. , Kessler C. , Lemaître A. , Sagnes I. , Somaschi N. , Senellart P. , Lanco L.
Published: May 2018

Pillar microcavities are excellent light-matter interfaces, providing an electromagnetic confinement in small mode volumes with high quality factors. They also allow the efficient injection and extraction of photons, into and from the cavity, with potentially near-unity input and output-coupling efficiencies. Optimizing the input and output coupling is essential, in particular, in the development of solid-state quantum networks where artificial atoms are manipulated with single incoming photons. Here, we propose a technique to accurately measure input and output coupling efficiencies using polarization tomography of the light reflected by the cavity. We use the residual birefringence of pillar microcavities to distinguish the light coupled to the cavity from the uncoupled light: the former participates in rotating the polarization of the reflected beam, while the latter decreases the polarization purity. Applying this technique to a micropillar cavity, we measure 53 ± 2% output coupling and 96 ± 1% input coupling with unprecedented precision.
Investigation into the behaviors of ventilated supercavities in unsteady flow
Authors: Shao Siyao , Wu Yue , Haynes Joseph , Arndt Roger E. A. , Hong Jiarong
Published: May 2018

A systematic investigation of ventilated supercavitation behaviors in an unsteady flow is conducted using a high-speed water tunnel at the Saint Anthony Falls Laboratory. The cavity is generated with a forward facing model under varying ventilation rates and cavitator sizes. The unsteady flow is produced by a gust generator consisting of two hydrofoils flapping in unison with a varying angle of attack (AoA) and frequency (fg). The current experiment reveals five distinct cavity states, namely, the stable state, wavy state, pulsating state I, pulsating state II, and collapsing state, based on the variation of cavity geometry and pressure signatures inside the cavity. The distribution of cavity states over a broad range of unsteady conditions is summarized in a cavity state map. It shows that the transition of the supercavity from the stable state to pulsating and collapsing states is primarily induced by increasing AoA while the transition to the wavy state triggers largely by increasing fg. Remarkably, the state map over the non-dimensionalized half wavelength and wave amplitude of the perturbation indicates that the supercavity loses its stability and transitions to pulsating or collapsing states when the level of its distortion induced by the flow unsteadiness exceeds the cavity dimension under a steady condition. The state maps under different ventilation rates and cavitator sizes yield similar distribution but show that the occurrence of the cavity collapse can be suppressed with increasing ventilation coefficient or cavitator size. Such knowledge can be integrated into designing control strategies for the supercavitating devices operating under different unsteady conditions.
Amplitude stabilization and active control of a terahertz quantum cascade laser with a graphene loaded split-ring-resonator array
Authors: Wei B. , Kindness S. J. , Almond N. W. , Wallis R. , Wu Y. , Ren Y. , Shi S. C. , Braeuninger-Weimer P. , Hofmann S. , Beere H. E. , Ritchie D. A. , Degl'lnnocenti R.
Published: May 2018

We demonstrate the amplitude stabilization of a 2.85 THz quantum cascade laser with a graphene loaded split-ring-resonator array acting as an external amplitude modulator. The transmittance of the modulator can be actively changed by modifying the graphene conductivity via electrostatic back-gating. The modulator operates at room temperature and is capable of actively modulating the quantum cascade laser power level and thus stabilizing the power output via a proportional-integral-derivative feedback control loop. The stability was enhanced by more than 10 times through actively tuning the modulation. Furthermore, this approach can be used to externally control the laser power with a high level of stability.
Plasma-assisted As implants for effective work function modulation of TiN/HfO2 gate stacks on germanium
Authors: Kothari Shraddha , Vaidya Dhirendra , Nejad Hasan , Variam Naushad , Ganguly Swaroop , Lodha Saurabh
Published: May 2018

The plasma assisted As doping (PLAD) technique is used to demonstrate multiple flatband voltages (multi-Vfb) on TiN/HfO2 Ge gate stacks for n-FinFET applications. Through detailed studies with varying doses, implant energies, and TiN cap thicknesses, we show that the PLAD As technique can be used to obtain effective work function (EWF) modulation from the near midgap to the conduction band edge (up to 280 meV) of Ge, a key technological requirement for multi-threshold voltage (VT) Ge n-FinFETs. Furthermore, there is no deterioration of key gate stack parameters such as gate leakage, effective oxide thickness, and gate/channel interface trap densities. From secondary ion mass spectroscopy data, we attribute the tuning of EWF to As accumulation and interfacial dipole formation at the TiN/HfO2 interface. The experimental observations are reinforced by ab initio simulations of near-interface As substitutions at the TiN/HfO2 interface. As substitution at N sites near the interface reduces the EWF, making it more suitable for n-MOS applications.
Waterproof and stretchable triboelectric nanogenerator for biomechanical energy harvesting and self-powered sensing
Authors: Chen Xuexian , Miao Liming , Guo Hang , Chen Haotian , Song Yu , Su Zongming , Zhang Haixia
Published: May 2018

We introduce a waterproof and stretchable triboelectric nanogenerator (TENG) that can be attached on the human body, such as fingers and the wrist, to harvest mechanical energy from body movement. The whole device is composed of stretchable material, making it able to endure diverse mechanical deformations and scavenge energy from them. Under gentle mechanical motions of pressing, stretching and bending, the device with an effective area of 1 × 2 cm2 can generate the peak-to-peak output current of 257.5 nA, 50.2 nA, and 33.5 nA, respectively. Besides, the TENG is tightly encapsulated, enabling it to avoid the influence of the external environment like humidity changes and harvest energy under water. Particularly, owing to the thin and soft properties of the encapsulation film, the device can respond to weak vibrations like the wrist pulse and act as a self-powered pulse sensor, which broadens its application prospects in the field of wearable energy harvesting devices and self-powered sensing systems.
Optimal control of networks in the presence of attackers and defenders
Authors: Kafle Ishan , Bartaula Sudarshan , Shirin Afroza , Klickstein Isaac , Das Pankaz , Sorrentino Francesco
Published: May 2018

We consider the problem of a dynamical network whose dynamics is subject to external perturbations (“attacks”) locally applied at a subset of the network nodes. We assume that the network has an ability to defend itself against attacks with appropriate countermeasures, which we model as actuators located at (another) subset of the network nodes. We derive the optimal defense strategy as an optimal control problem. We see that the network topology as well as the distribution of attackers and defenders over the network affect the optimal control solution and the minimum control energy. We study the optimal control defense strategy for several network topologies, including chain networks, star networks, ring networks, and scale free networks.
Non-linear variation of domain period under electric field in demagnetized CoFeB/MgO stacks with perpendicular easy axis
Authors: Ichikawa N. , Dohi T. , Okada A. , Sato H. , Fukami S. , Ohno H.
Published: May 2018

We investigate a variation of magnetic domain pattern in demagnetized perpendicular-easy-axis CoFeB/MgO stacks with a wide-range electric field and discuss the electric-field effect on the exchange stiffness constant AS. We observe a non-linear variation of domain period DP with the applied electric field, in contrast to the effective perpendicular anisotropy field HKeff that is evaluated from a ferromagnetic resonance and shows a linear response. An analysis based on a model describing the relation of DP to AS and HKeff suggests that AS varies non-linearly with the electric field, implying an involved characteristic mechanism of the exchange stiffness in the studied systems. A possible scenario for explaining the non-linear behavior of AS is discussed.
Responses to phosphorus among barley genotypes
Authors: McDonald G. K. , Taylor J. D. , Gong X. , Bovill W.
Published: May 2018

Genetic improvement in phosphorus (P) use efficiency (i.e. the ratio of biomass or yield at nil P to that at a given rate of application) is an important goal to improve P recovery and P efficiency of farming systems. Experiments were conducted at three sites in South Australia between 2009 and 2011 to characterise genetic variation in yield with no applied P and in the response to P fertiliser among a diverse range of barley (Hordeum vulgare L.) genotypes. In each experiment, 39–54 genotypes were grown at 0 or 30 kg P/ha. Responses to P were measured near the beginning of stem elongation by using normalised difference vegetation index (NDVI) and by harvesting the grain. Rhizosheath size was also measured on seedlings. Consistent differences in growth and yield at 0 kg P/ha were measured among the genotypes. By contrast, there were large environmental effects on responses to P, but some genotypes showed consistent responses. Measurements of growth, yield and P uptake on a subset of genotypes showed that most of the variation in biomass and yield could be attributed to variation in P-uptake efficiency (net total P uptake per unit available P) rather than to P-utilisation efficiency (biomass or yield per unit total P uptake). The size of the rhizosheath made a small contribution to variation in NDVI but not grain yield, suggesting that rhizosheath size may be of some benefit to early growth but that this does not persist through to yield. Genetic correlations between NDVI and yield were often weak but were generally positive at 0 kg P/ha. Correlations between responses in NDVI and responses in grain yield were low and often negative. The study identified several barley genotypes that showed consistent differences in yield at low P and responses to P; however, selection for P efficiency based solely on responses in vegetative growth may not be appropriate. Variation in P uptake appeared to be more important than P-utilisation efficiency for P efficiency in barley.
Targetable BET proteins- and E2F1-dependent transcriptional program maintains the malignancy of glioblastoma
Authors: Xu Liang , Chen Ye , Mayakonda Anand , Koh Lynnette , Chong Yuk Kien , Buckley Dennis L. , Sandanaraj Edwin , Lim See Wee , Lin Ruby Yu-Tong , Ke Xin-Yu , Huang Mo-Li , Chen Jianxiang , Sun Wendi , Wang Ling-Zhi , Goh Boon Cher , Dinh Huy Q. , Kappei Dennis , Winter Georg E. , Ding Ling-Wen , Ang Beng Ti , Berman Benjamin P. , Bradner James E. , Tang Carol , Koeffler H. Phillip
Published: May 2018

Significance

Glioblastoma (GBM) cells develop intrinsic or acquired insensitiveness to BET bromodomain inhibitors (BBIs) yet develop persistent BET protein dependency. Selective degradation of BET proteins by a next-generation chemical compound undermines the BET protein dependency and exerts superior antineoplastic effects over inhibition of BET bromodomain. Given the significant difference between bromodomain dependency and BET protein dependency in GBM cells, chemically induced degradation of BET proteins serves as a promising strategy to overcome anticipated clinical BBIs resistance.
Harnessing bistability for directional propulsion of soft, untethered robots
Authors: Chen Tian , Bilal Osama R. , Shea Kristina , Daraio Chiara
Published: May 2018

Significance

A major challenge in soft robotics is the integration of sensing, actuation, control, and propulsion. Here, we propose a material-based approach for designing soft robots. We show an untethered, soft swimming robot, which can complete preprogrammed tasks without the need for electronics, controllers, or power sources on board. To achieve propulsion, we use bistable shape memory polymer muscles connected to paddles that amplify actuation forces. As a proof of principle, we show that these robots can be preprogrammed to follow specific routes or deliver a cargo and navigate back to their deployment point. The proposed design principle can have a broad impact in soft robotics based on programed materials.
The acid test for pH-dependent gating in cloned HV1 channels
Authors: Islas León D.
Published: May 2018

Islas evaluates two papers that provide mechanistic insight into pH-dependent gating in HV1 proton channels.
CCR2 V64I polymorphism in rifampicin resistant tuberculosis patients in Moewardi General Hospital Surakarta, Indonesia
Authors: Marwoto  , Prasetyo Afiono Agung , Reviono  , Suradi
Published: May 2018

CC chemokine receptor-2 (CCR2) play important roles in inflammation. The CCR2 V64I polymorphism already reported associated with many diseases; however, the association of CCR2 V64I polymorphism with tuberculosis is still unknown. Also, there is no report about the presentation of CCR2 V64I polymorphisms in Indonesian tuberculosis patients with rifampicin-mono resistant status has ever been published, to the best of our knowledge. This study evaluated the presence of CCR2 V64I polymorphisms in Javanese rifampicin-mono resistant tuberculosis patients. In an ongoing molecular epidemiology study of human genomic polymorphisms and infection, 51 Javanese rifampicin-mono resistant tuberculosis patients in Dr. Moewardi General Hospital in Surakarta were enrolled in the study. The blood samples were aliquoted and fractionated. The nucleic acids were extracted from all blood samples and subjected to the CCR2 V64I polymorphisms detection by a polymerase chain reaction-sequence-specific primer (PCR-SSP) technique. PCR products were analyzed in 3% agarose. CCR2 64V and 64I homozygote were found in 23.5% (12/51) and 23.5% (12/51) blood samples, respectively. The CCR2 VI genotype was found in 52.9% (27/51) blood samples. The CCR2 VI genotype was found predominant in Javanese rifampicin-mono resistant tuberculosis patients and may have anassociation with the clinical progression.
Latitudinal phenotypic variation in the southernmost trichomycterid, the catfish Hatcheria macraei: an amalgam of population divergence and environmental factors
Authors: Chiarello-Sosa Juan Mauro , Battini Miguel Ángel , Barriga Juan Pablo
Published: May 2018

Body shape and meristic characters are highly variable phenotypic aspects in fish, and in most cases are related to phylogeography, environmental factors and life history patterns. Our main goals here were to evaluate morphological and meristic characters in five populations of the catfish Hatcheria macraei living at different latitudes across Patagonia, and to assess the importance of environmental and phylogenetic variables in determining body shape. The present study reveals great morphological variation among populations distributed along the latitudinal gradient. We found that the highest levels of variation in external morphological features were in peduncle height, dorsal fin length and anus position. This variation in body shape, quantified by geometric morphometrics, was mostly explained by the phylogenetic relationship between populations, stream gradient and spawning temperature. In contrast, the meristic characters, such as vertebral and fin ray numbers, except for dorsal fin ray number, were negatively related to latitude and positively to spawning temperature.
Clinical Implications of Asymptomatic Plasmodium falciparum Infections in Malawi
Authors: Buchwald Andrea G , Sixpence Alick , Chimenya Mabvuto , Damson Milius , Sorkin John D , Wilson Mark L , Seydel Karl , Hochman Sarah , Mathanga Don P , Taylor Terrie E , Laufer Miriam K
Published: May 2018

Background

Asymptomatic Plasmodium falciparum infections are common in Malawi; however, the implications of these infections for the burden of malaria illness are unknown. Whether asymptomatic infections eventually progress to malaria illness, persist without causing symptoms, or clear spontaneously remains undetermined. We identified asymptomatic infections and evaluated the associations between persistent asymptomatic infections and malaria illness.

Methods

Children and adults (N = 120) who presented at a health facility with uncomplicated malaria were followed monthly for 2 years. During follow-up visits, participants with malaria symptoms were tested and, if positive, treated. Samples from all visits were tested for parasites using both microscopy and polymerase chain reaction, and all malaria infections underwent genotyping. Cox frailty models were used to estimate the temporal association between asymptomatic infections and malaria illness episodes. Mixed models were used to estimate the odds of clinical symptoms associated with new versus persistent infections.

Results

Participants had a median follow-up time of 720 days. Asymptomatic infections were detected during 23% of visits. Persistent asymptomatic infections were associated with decreased risk of malaria illness in all ages (hazard ratio 0.50, P < .001). When asymptomatic infections preceded malaria illness, newly-acquired infections were detected at 92% of subsequent clinical episodes, independent of presence of persistent infections. Malaria illness among children was more likely due to newly-acquired infections (odds ratio, 1.4; 95% confidence interval, 1.3–1.5) than to persistent infections.

Conclusions

Asymptomatic P. falciparum infections are associated with decreased incidence of malaria illness, but do not protect against disease when new infection occurs.
Low birthweight and preterm birth: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015
Authors: Silveira Mariangela F , Victora Cesar G , Horta Bernardo L , da Silva Bruna G C , Matijasevich Alicia , Barros Fernando C ,   Pelotas Cohorts Study Group, Barros Aluisio J D , Menezes Ana M B , Bertoldi Andrea Dâmaso , Bassani Diego G , Wehrmeister Fernando C , Gonçalves Helen , Santos Iná S , Murray Joseph , Tovo-Rodrigues Luciana , Assunção Maria Cecilia F , Domingues Marlos Rodrigues , Hallal Pedro R C
Published: May 2018

Background

Despite positive changes in most maternal risk factors in Brazil, previous studies did not show reductions in preterm birth and low birthweight. We analysed trends and inequalities in these outcomes over a 33-year period in a Brazilian city.

Methods

Four population-based birth cohort studies were carried out in the city of Pelotas in 1982, 1993, 2004 and 2015, with samples ranging from 4231 to 5914 liveborn children. Low birthweight (LBW) was defined as <2500 g, and preterm birth as less than 37 weeks of gestation. Information was collected on family income, maternal skin colour and other risk factors for low birthweight. Multivariable linear regression was used to estimate the contribution of risk factors to time trends in birthweight.

Results

Preterm births increased from 5.8% (1982) to 13.8% (2015), and LBW prevalence increased from 9.0% to 10.1%, being higher for boys and for children born to mothers with low income and brown or black skin colour. Mean birthweight remained stable, around 3200 g, but increased from 3058 to 3146 g in the poorest quintile and decreased from 3307 to 3227 g in the richest quintile. After adjustment for risk factors for LBW, mean birthweight was estimated to have declined by 160 g over 1982–2015 (reductions of 103 g in the poorest and 213 g in the richest quintiles).

Conclusions

Data from four birth cohorts show that preterm births increased markedly. Mean birthweights remained stable over a 33-year period. Increased prevalence of preterm and early term births, associated with high levels of obstetric interventions, has offset the expected improvements due to reduction in risk factors for low birthweight.
Consumer Deceleration
Authors: Husemann Katharina C , Eckhardt Giana M
Published: May 2018

People increasingly seek out opportunities to escape from a sped-up pace of life by engaging in slow forms of consumption. Drawing from the theory of social acceleration, we explore how consumers can experience and achieve a slowed-down experience of time through consumption. To do so, we ethnographically study the Camino de Santiago pilgrimage in Spain and introduce the concept of consumer deceleration. Consumer deceleration is a perception of a slowed-down temporal experience achieved via a decrease in certain quantities (traveled distance, use of technology, experienced episodes) per unit of time through altering, adopting, or eschewing forms of consumption. Consumers decelerate in three ways: embodied, technological, and episodic. Each is enabled by consumer practices and market characteristics, rules, and norms, and results in time being experienced as passing more slowly and as being an abundant resource. Achieving deceleration is challenging, as it requires resynchronization to a different temporal logic and the ability to manage intrusions from acceleration. Conceptualizing consumer deceleration allows us to enhance our understanding of temporality and consumption, embodied consumption, extraordinary experiences, and the theory of social acceleration. Overall, this study contributes to consumer research by illuminating the role of speed and rhythm in consumer culture.
Comparison of Urinary Biomarkers of Exposure in Humans Using Electronic Cigarettes, Combustible Cigarettes, and Smokeless Tobacco
Authors: Lorkiewicz Pawel , Riggs Daniel W , Keith Rachel J , Conklin Daniel J , Xie Zhengzhi , Sutaria Saurin , Lynch Blake , Srivastava Sanjay , Bhatnagar Aruni
Published: May 2018

Background

Cigarette smoking is associated with an increase in cardiovascular disease risk, attributable in part to reactive volatile organic chemicals (VOCs). However, little is known about the extent of VOC exposure due to the use of other tobacco products.

Methods

We recruited 48 healthy, tobacco users in four groups: cigarette, smokeless tobacco, occasional users of first generation e-cigarette and e-cigarette menthol and 12 healthy nontobacco users. After abstaining for 48 h, tobacco users used an assigned product. Urine was collected at baseline followed by five collections over a 3-h period to measure urinary metabolites of VOCs, nicotine, and tobacco alkaloids.

Results

Urinary levels of nicotine were ≃2-fold lower in occasional e-cigarette and smokeless tobacco users than in the cigarette smokers; cotinine and 3-hydroxycotinine levels were similar in all groups. Compared with nontobacco users, e-cigarette users had higher levels of urinary metabolites of xylene, cyanide, styrene, ethylbenzene, and benzene at baseline and elevated urinary levels of metabolites of xylene, N,N-dimethylformamide, and acrylonitrile after e-cigarette use. Metabolites of acrolein, crotonaldehyde, and 1,3-butadiene were significantly higher in smokers than in users of other products or nontobacco users. VOC metabolite levels in smokeless tobacco group were comparable to those found in nonusers with the exception of xylene metabolite—2-methylhippuric acid (2MHA), which was almost three fold higher than in nontobacco users.

Conclusions

Smoking results in exposure to a range of VOCs at concentrations higher than those observed with other products, and first generation e-cigarette use is associated with elevated levels of N,N-dimethylformamide and xylene metabolites.

Implications

This study shows that occasional users of first generation e-cigarettes have lower levels of nicotine exposure than the users of combustible cigarettes. Compared with combustible cigarettes, e-cigarettes, and smokeless tobacco products deliver lower levels of most VOCs, with the exception of xylene, N,N-dimethylformamide, and acrylonitrile, whose metabolite levels were higher in the urine of e-cigarette users than nontobacco users. Absence of anatabine in the urine of e-cigarette users suggests that measuring urinary levels of this alkaloid may be useful in distinguishing between users of e-cigarettes and combustible cigarettes. However, these results have to be validated in a larger cohortcomprised of users of e-cigarettes of multiple brands.
First Report of Curvularia Leaf Spot of Corn, Caused by Curvularia lunata, in the United States
Authors: Garcia-Aroca T. , Doyle V. , Singh R. , Price T. , Collins Keith
Published: May 2018

During the summer of 2017, corn (Zea mays L.) in production areas throughout Louisiana exhibited symptoms similar to eyespot, caused by Kabatiella zeae (Narita & Y. Hirats). Symptoms included round to oval, light tan to light brown lesions (0.5 to 2.0-mm diameter) with reddish-brown margins often with chlorotic halos in the mid to upper canopy of corn at the brown silk stage. The disease was not severe enough to warrant management; however, it was a concern to corn producers. Symptomatic leaves were obtained from diseased corn, lesion margins were disinfested, and the suspected pathogen was isolated and tentatively identified as Curvularia lunata. Koch’s postulates were completed by inoculating V4 to V5 stage corn plants with a spore suspension and subjecting plants to a 16-h dew period at 25°C, observing symptomology, reisolating the pathogen, and identification via molecular analysis. To our knowledge this is the first report of the disease in Louisiana and the United States.
The reliability of radiostereometric analysis in determining physeal motion in slipped capital femoral epiphysis in standard uniplanar and low-dose EOS biplanar radiography: a phantom model study
Authors: Hurry Jennifer K. , Rehan Saad , Spurway Alan J. , Laende Elise K. , Astephen Wilson Janie L. , Logan Karl J. , Dunbar Michael J. , El-Hawary Ron
Published: May 2018

Physeal closure after slipped capital femoral epiphysis fixation can be difficult to assess on two-dimensional conventional radiographs. Radiostereometric analysis offers improved motion detection over conventional radiography, whereas the EOS biplanar imager provides a means for low radiation weight-bearing images. This phantom study assessed the reliability of measuring motion using radiostereometric analysis in the EOS using a slipped capital femoral epiphysis model. The accuracy and precision were better than 0.09±0.05 mm and 0.20°±0.36° when centered in the imaging space, were within the limits of clinical significance, and were not different from a standard uniplanar radiostereometric system.
Pseudoadjuvant chemotherapy in resectable metastatic colorectal cancer
Authors: Polastro Laura , El Hachem Georges , Hendlisz Alain
Published: May 2018

Purpose of review

In this article, we focus on the potential benefits and risks of chemotherapy administration before (perioperative) or after (pseudoadjuvant) a curative resection of colorectal cancer (CRC) metastases.

Recent findings

In the published evidence, there is a lack of survival benefit from peri or postoperative chemotherapy in the context of resectable metastatic CRC. However, high-risk patients may have a certain benefit when receiving a postoperative cytotoxic treatment. Apart from, according to the published data, the administration of a preoperative chemotherapy has been associated with serious parenchymal liver damage and an increase in the postoperative morbidity-mortality rate.

Surgery is the only potentially curative treatment for metastatic CRC, but the risk of recurrence remains high. The current guidelines recommend the administration of either a perioperative or a pseudoadjuvant chemotherapy in this setting despite the absence of survival benefit. A better selection of patients who may require and gain an advantage from chemotherapy in the setting of resectable metastasis is highly needed. In this view, a prospective trial enrolling patients at high risk of recurrence is ongoing.
Physical activity modifies genetic susceptibility to obesity in postmenopausal women
Authors: Ochs-Balcom Heather M. , Preus Leah , Nie Jing , Wactawski-Wende Jean , Agyemang Linda , Neuhouser Marian L. , Tinker Lesley , Zheng Cheng , Kazlauskaite Rasa , Qi Lihong , Sucheston-Campbell Lara E.
Published: May 2018

Objective:

We conducted a gene-environment interaction study to evaluate whether the association of body mass index (BMI) associated meta genome-wide association study single-nucleotide polymorphisms (SNPs) (as a genetic risk score) and BMI is modified by physical activity and age.

Methods:

In 8,206 women of European ancestry from the Women's Health Initiative (WHI), we used linear regression to examine main effects of the 95 SNP BMI genetic risk score (GRS) and physical activity on BMI, and evaluated whether genetic associations are modified by physical activity (two-way interaction) and age (three-way interaction).

Results:

We found evidence for modification of the BMI GRS-BMI association according to both physical activity and age. We observed a significant two-way interaction of BMI GRS × physical activity in the crude model (P interaction = 0.05), where a smaller effect of the BMI GRS on BMI with increasing physical activity. The beta coefficient was 0.05 (standard error [SE] = 0.02, P = 0.01) for the high-activity group compared with beta = 0.13 (SE = 0.02, P = 4.8 × 10−9) for the sedentary group. The three-way interaction was statistically significant (adjusted P interaction = 0.01). Notably, in the 70+ age group, the BMI GRS-BMI association was attenuated and no longer significant in the high-activity group; the beta coefficient for the 70+ high-activity group was relatively small and nonsignificant (beta = 0.02, SE = 0.03, P = 0.58) compared with 70+ sedentary group (beta = 0.17, SE = 0.03, P = 2.5 × 10−7).

Conclusion:

Our study suggests that physical activity attenuates the influence of genetic predisposition to obesity, and this effect is more profound in the oldest age group.
Immunogenicity and Safety of Primary and Booster Vaccinations of a Fully Liquid DTaP-IPV-HB-PRP-T Hexavalent Vaccine in Healthy Infants and Toddlers in Germany and the Czech Republic
Authors: Prymula Roman , Kieninger Dorothee , Feroldi Emmanuel , Jordanov Emilia , B’Chir Siham , DaCosta Xavier
Published: May 2018

To support a fully liquid, diphtheria (D)-tetanus (T)-acellular pertussis (aP)-inactivated poliovirus (IPV)-hepatitis B (HB)-Haemophilus influenzae b (PRP-T) vaccine in Europe using a 2, 3, 4 month primary series and a booster at 11–15 months of age. Phase III, randomized, observer-blind studies in Germany and the Czech Republic. Participants who had not received HB vaccine were randomized to a 2, 3, 4 month primary series of DTaP-IPV-HB-PRP-T (group 1; N = 266) or a reconstituted DTaP-HB-IPV//PRP-T comparator (group 2; N = 263) and a booster of the same vaccine. Pneumococcal vaccine (PCV13) and rotavirus vaccine were coadministered at 2, 3, 4 months, and the booster was coadministered with PCV13. Noninferiority (group 1 versus group 2) was tested postprimary series for seroprotection rates (anti-HB and anti-PRP) and vaccine response rates (anti-pertussis toxin and anti-filamentous hemagglutinin). Safety was assessed by parental reports. Noninferiority was demonstrated with the lower bound of the 95% confidence interval for the difference (group 1 to group 2) being > −10% for each comparison. Primary series immune responses were high for all antigens and similar in each group. Prebooster antibody persistence was good, and there was a strong anamnestic response, both being similar for the investigational and control vaccines. Responses to PCV13 and rotavirus vaccine were similar in each group. There were no safety concerns. These data support the use of the DTaP-IPV-HB-PRP-T vaccine in a 2, 3, 4 month schedule without a birth dose of HB vaccine, with a booster dose in the second year of life administered with routine childhood vaccines.
Waxy Papules on the Central Chest
Authors: David Anjali R. , Rundle Chandler W. , Jacob Sharon E.
Published: May 2018

Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. This is a teledermatology case of waxy papules on the central chest.
Brimonidine
Authors: Limone Brittanya , Luke Janiene
Published: May 2018

A drug is a particular substance in physiology that exerts an effect when ingested or otherwise introduced into the body. Drugs may be administered in a variety of constitutions from capsules, injections, creams, and ointments to inhalants, liquids, and dermal patches; via different routes, namely, topical, parenteral, and inhalation; and via injection routes such as subcutaneous, intramuscular, or intravenous. The purpose of this column is to highlight some of the more commonly encountered drugs in dermatology. More specifically, this column will bring further understanding to the mechanism of action, administration, dosage, adverse effects, and viable alternatives to each particular drug being discussed. In this article, the role of the drug brimonidine tartrate, as a dermatologic treatment for erythema associated with rosacea, will be discussed.
The Safety and Utility of Fiberoptic Bronchoscopy in the Very Elderly
Authors: McLaughlin Cameron W. , Skabelund Andrew J. , Easterling Ellis R. , Morris Michael J.
Published: May 2018

Background:

Flexible bronchoscopy (FB) is a common modality for diagnostic sampling within the thorax. It is utilized often in the elderly population, but there is limited data on the safety and utility of the procedure in the very elderly.

Methods:

FBs performed outside the intensive care unit in the San Antonio Military Health System on patients 85 years and older were reviewed. Outcomes including indications, complications, diagnostic yield, and final diagnosis were compared with a control group consisting of patients’ ages of 65 to 79 years old.

Results:

Seventy-three bronchoscopies were performed in each group. The mean age of the older group was 87.1±2.6 years, and had a higher American Society of Anesthesiology (ASA) class than the younger group (P=0.03). There were no significant differences in the indications for bronchoscopy (P>0.05), sampling performed (P>0.05), complication rates (P>0.05), diagnostic yield (P>0.05), or final diagnoses (P>0.05). Similar proportions of each group with a malignancy diagnosis received some form of therapy (P>0.05), although fewer of the older group underwent surgery (P=0.03). Analysis of the cohort demonstrated that ASA class 3 to 4 was associated with increased rate of complications and use of anesthesia compared with lower ASA class (P<0.02).

Conclusion:

FB in the elderly demonstrated no differences in procedural complications, diagnostic yield, and utility of the procedure for an underlying diagnosis. This study suggests bronchoscopy is as safe and useful in the very elderly as a population of the age of 65 to 79.
Outcomes of Conservative Management of High Grade Squamous Intraepithelial Lesions in Young Women
Authors: Lee Marette H. , Finlayson Sarah J. , Gukova Ksenia , Hanley Gillian , Miller Dianne , Sadownik Leslie Ann
Published: May 2018

Objective

The aim of the study was to determine regression rates of cervical intraepithelial neoplasia (CIN) 2 and 3 in women younger than 24 years, followed conservatively for up to 24 months.

Materials and Methods

This is a retrospective chart review of colposcopy patients in clinic database based on the following: (1) younger than 24 years at first visit; (2) first visit January 1, 2010, to May 31, 2013, and at least 1 follow-up visit after diagnosis; (3) histologic diagnosis of CIN2+; and (4) optimal conservative management (observation for up to 24 months or to 24 years, whichever occurred first). Patient information and clinical/pathologic data were extracted from charts to examine patient characteristics and treatment outcomes, CIN2+ regression rates, median times to regression for CIN2 versus CIN3 (Kaplan-Meier survival analysis), and predictors of regression (multivariate logistic regression analysis).

Results

A total of 154 women met criteria. The most severe histological diagnoses were CIN2 in 99 (64.3%), CIN3 in 51 (33.1%), and adenocarcinoma in situ in 4 (2.6%). Adenocarcinoma in situ was immediately treated. In follow-up, CIN2 regressed to CIN1 or negative in 74 women (74.7%)-median time to regression, 10.8 months. Cervical intraepithelial neoplasia 3 regressed in 11 women (21.6%)-median time to regression not reached (last follow-up censored at 52.7 months). Cervical intraepithelial neoplasia 2 on biopsy, low grade referral Pap, and younger age predicted regression. Overall, 49 women (31.8%) were treated.

Conclusions

Conservative management should continue to be recommended to young women with CIN2. Rigorous retention mechanisms are required to ensure that these women return for follow-up.
Outcomes After Infections in Adolescents and Young Adults with Continuous-Flow Left Ventricular Assist Devices
Authors: Chen Sharon , Cantor Ryan S. , Auerbach Scott , Schumacher Kurt , Almond Christopher S. , Eghtesady Pirooz , Alejos Juan , Das Bibhuti B. , Hong Borah J. , Jaquiss Robert D. B. , Kirklin James K. , Jeewa Aamir
Published: May 2018

Infections in adult ventricular assist device patients increase subsequent mortality and stroke risk. Less is known about outcomes after infections in younger patients, where diabetes and obesity, risk factors associated with poor outcomes, are less prevalent. The purpose of this study was to examine outcomes after infections in adolescents and young adults with continuous-flow left ventricular assist devices (VAD) bridged to transplant. From Pediatric Interagency Registry for Mechanically Assisted Circulatory Support and Interagency Registry for Mechanical Circulatory Support registries, we identified patients aged 12–29 years with continuous-flow VADs implanted as bridged to transplant from September 2012 to March 2016. The primary predictor variable was first reported infection. The primary outcome was death on VAD support; secondary outcome was clinical stroke. Kaplan–Meier and Cox proportional hazard methods were used to compare outcomes between patients before or without infection and patients after infection. Ninety-two adolescents (12–18 years of age) and 224 young adults (19–29 years of age) with 3,748 patient-months of follow-up were included. Adolescents were smaller (body surface area 1.7 vs. 2.0 m2, p < 0.01) and implanted at higher Interagency Registry for Mechanical Circulatory Support profiles (p = 0.005); there were no differences in diabetes and obesity, and survival on VAD was similar (p = 0.22). Among adolescents but not young adults, mortality increased after infection (hazard ratio 8.2, 95% confidence interval 1.6–42.6, p = 0.01). In contrast, stroke risk increased after infection in young adults (hazard ratio 3.1, 95% confidence interval 1.3–7.6, p = 0.01) but not in adolescents. Despite similar underlying risk factors, adolescents have increased mortality after infections, whereas young adults have increased strokes after infections. Both pre- and postimplant factors likely contribute to the discrepancy in outcomes between the two age cohorts.
Surfactant Administration During Pediatric Cardiac Extracorporeal Membrane Oxygenation
Authors: Chrysostomou Constantinos , Maul Timothy , Istvanic Filip , Wearden Peter
Published: May 2018

We investigated the safety and efficacy of surfactant during extracorporeal membrane oxygenation (ECMO) in children with cardiac disease. ECMO patients administered surfactant (surfactant group) were compared with patients who did not receive (control). Criteria to administer surfactant were based on a decreased lung compliance of <0.5 ml/kg/cm H2O. Efficacy was determined on pulmonary compliance change and the radiography-based respiratory distress severity (RDS) score. For the surfactant group, lung compliance measurements and RDS scores were obtained just before the first surfactant administration (T0), 24 hours after the last dose of surfactant (T1), and 24 hours after ECMO decannulation (T2). For the control group, measurements were obtained at baseline (T0), day of ECMO decannulation (T1), and 24 hours after ECMO decannulation (T2). Eighty were on ECMO, 29 in the surfactant, and 51 in the control group. Surfactant group was younger 20 (6–140) vs. 28 (8–928) days old (p = 0.03), had longer ECMO duration 110 (58–192) vs. 46 (29–84) hours (p = 0.001), and had longer mechanical ventilation 16 (11–26) vs. 7 (5–9) days (p = 0.003). The lung compliance and RDS scores in the surfactant group improved significantly between baseline and 24 hours after decannulation, 0.36 ± 0.13 vs. 0.5 ± 0.12 ml/kg/cm H2O (p = 0.002) and 13 ± 3 vs. 12 ± 2 (p = 0.04), respectively. None developed pneumothorax. Mild pulmonary hemorrhage occurred twice (one in each group). Hospital duration and survival were similar 36 (19–48) vs. 31 (18–48) days and 69% vs. 78% in surfactant and control groups, respectively. Although this is a relatively small study, surfactant appears to be safe in pediatric cardiac ECMO patients.
Link Between Celiac Disease and Inflammatory Bowel Disease
Authors: Shah Ayesha , Walker Marjorie , Burger Daniel , Martin Neal , von Wulffen Moritz , Koloski Natasha , Jones Mike , Talley Nicholas J. , Holtmann Gerald J.
Published: May 2018

Goal:

The aim of this analysis was to assess in patients with inflammatory bowel disease (IBD) the risk of celiac disease and in celiac disease patients the risk of IBD.

Background:

Previous studies report a possible association between IBD and celiac disease; however, this link is controversial.

Study:

Using the search terms “inflammatory bowel disease” and “celiac disease,” we identified initially 1525 publications. In total 27 studies met inclusion criteria. Proportions and 95% confidence intervals (CIs) for the prevalence of IBD in celiac disease and vice versa were compared with published prevalence rates for the respective geographic regions.

Results:

We included 41,482 adult IBD patients (20,357 with Crohn’s disease; 19,791 with ulcerative colitis; and 459 patients with celiac disease). Overall, in IBD patients the prevalence of celiac disease was 1110/100,000 (95% CI, 1010-1210/100,000) as compared with a prevalence of 620/100,000 (95% CI, 610-630/100,000) in the respective populations (odds ratio, 2.23; 95% CI, 1.99-2.50). In contrast, in patients with celiac disease, 2130/100,000 had IBD (95% CI, 1590-2670/100,000) as compared with 260/100,000 (95% CI, 250/100,000-270/100,000) in the respective populations (odds ratio, 11.10; 95% CI, 8.55-14.40). This effect was not different for ulcerative colitis and Crohn’s disease. Although there was no evidence for publication bias for celiac disease in IBD, the funnel plot suggested that the association between IBD in celiac disease might be influenced by publication bias.

Conclusions:

The data are consistent with the notion that celiac disease is a risk factor for IBD and to lesser degree patients with IBD have an increased risk of celiac disease.
History of Acquired Monosaccharide Intolerance in Houston, Texas
Authors: Klish William J.
Published: May 2018

It is appropriate that we begin the clinical part of this conference with a discussion of acquired monosaccharide intolerance. This disease is the most severe form of carbohydrate malabsorption and maldigestion that can afflict an infant. The following article describes the pathophysiology of the disease, as well as its treatment, much of which was based on studies done by the Section of Pediatric Gastroenterology and Nutrition at Baylor College of Medicine. Acquired monosaccharide intolerance has almost disappeared from the United States but remains a problem in the developing world where it is included as part of the diagnosis of environmental enteropathy. Present research on this disease seems to sometimes duplicate what is already known.
Posttranslational Processing and Function of Mucosal Maltases
Authors: Amiri Mahdi , Naim Hassan Y.
Published: May 2018

The final step of carbohydrate digestion in the intestine is performed by 2 major α‐glucosidases of the intestinal mucosa, sucrase‐isomaltase (SI) and maltase‐glucoamylase. Both of these enzymes are type II membrane glycoproteins, which share a significant level of homology in gene and protein structures and yet have differences in the posttranslational processing, substrate specificity and functional capacity. Insufficient activity of these disaccharidases particularly SI as a result of genetic mutations or secondary intestinal pathologies is associated with carbohydrate maldigestion and gastrointestinal intolerances. This review will discuss the maturation profiles of SI and maltase‐glucoamylase relative to their functional capacities and deficiencies.