bluuebunny/crossref_metadata_2025 huggingface dataset:
Photophysics of phenol and pentafluorophenol: The role of nonadiabaticity in the optical transition to the lowest bright 1ππ* state
Authors: Rajak Karunamoy , Ghosh Arpita , Mahapatra S.
Published: February 2018

We report multimode vibronic coupling of the energetically low-lying electronic states of phenol and pentafluorophenol in this article. First principles nuclear dynamics calculations are carried out to elucidate the optical absorption spectrum of both of the molecules. This is motivated by the recent experimental measurements [S. Karmakar et al., J. Chem. Phys. 142, 184303 (2015)] on these systems. Diabatic vibronic coupling models are developed with the aid of adiabatic electronic energies calculated ab initio by the equation of motion coupled cluster quantum chemistry method. A nuclear dynamics study on the constructed electronic states is carried out by both the time-independent and time-dependent quantum mechanical methods. It is found that the nature of low-energy πσ* transition changes, and in pentafluorophenol the energy of the first two 1πσ* states, is lowered by about half an eV (vertically, relative to those in phenol), and they become energetically close to the optically bright first excited 1ππ* (S1) state. This results in strong vibronic coupling and multiple multi-state conical intersections among the ππ* and πσ* electronic states of pentafluorophenol. The impact of associated nonadiabatic effects on the vibronic structure and dynamics of the 1ππ* state is examined at length. The structured vibronic band of phenol becomes structureless in pentafluorophenol. The theoretical results are found to be in good accord with the experimental finding at both high energy resolution and low energy resolution.
Multiscale weighted colored graphs for protein flexibility and rigidity analysis
Authors: Bramer David , Wei Guo-Wei
Published: February 2018

Protein structural fluctuation, measured by Debye-Waller factors or B-factors, is known to correlate to protein flexibility and function. A variety of methods has been developed for protein Debye-Waller factor prediction and related applications to domain separation, docking pose ranking, entropy calculation, hinge detection, stability analysis, etc. Nevertheless, none of the current methodologies are able to deliver an accuracy of 0.7 in terms of the Pearson correlation coefficients averaged over a large set of proteins. In this work, we introduce a paradigm-shifting geometric graph model, multiscale weighted colored graph (MWCG), to provide a new generation of computational algorithms to significantly change the current status of protein structural fluctuation analysis. Our MWCG model divides a protein graph into multiple subgraphs based on interaction types between graph nodes and represents the protein rigidity by generalized centralities of subgraphs. MWCGs not only predict the B-factors of protein residues but also accurately analyze the flexibility of all atoms in a protein. The MWCG model is validated over a number of protein test sets and compared with many standard methods. An extensive numerical study indicates that the proposed MWCG offers an accuracy of over 0.8 and thus provides perhaps the first reliable method for estimating protein flexibility and B-factors. It also simultaneously predicts all-atom flexibility in a molecule.
An efficient laser vaporization source for chemically modified metal clusters characterized by thermodynamics and kinetics
Authors: Masubuchi Tsugunosuke , Eckhard Jan F. , Lange Kathrin , Visser Bradley , Tschurl Martin , Heiz Ulrich
Published: February 2018

A laser vaporization cluster source that has a room for cluster aggregation and a reactor volume, each equipped with a pulsed valve, is presented for the efficient gas-phase production of chemically modified metal clusters. The performance of the cluster source is evaluated through the production of Ta and Ta oxide cluster cations, TaxOy+ (y ≥ 0). It is demonstrated that the cluster source produces TaxOy+ over a wide mass range, the metal-to-oxygen ratio of which can easily be controlled by changing the pulse duration that influences the amount of reactant O2 introduced into the cluster source. Reaction kinetic modeling shows that the generation of the oxides takes place under thermalized conditions at less than 300 K, whereas metal cluster cores are presumably created with excess heat. These characteristics are also advantageous to yield “reaction intermediates” of interest via reactions between clusters and reactive molecules in the cluster source, which may subsequently be mass selected for their reactivity measurements.
Enhancement in the interfacial perpendicular magnetic anisotropy and the voltage-controlled magnetic anisotropy by heavy metal doping at the Fe/MgO interface
Authors: Nozaki Takayuki , Yamamoto Tatsuya , Tamaru Shingo , Kubota Hitoshi , Fukushima Akio , Suzuki Yoshishige , Yuasa Shinji
Published: February 2018

We investigated the influence of heavy metal doping at the Fe/MgO interface on the interfacial perpendicular magnetic anisotropy (PMA) and the voltage-controlled magnetic anisotropy (VCMA) in magnetic tunnel junctions prepared by sputtering-based deposition. The interfacial PMA was increased by tungsten doping and a maximum intrinsic interfacial PMA energy, Ki,0 of 2.0 mJ/m2 was obtained. Ir doping led to a large increase in the VCMA coefficient by a factor of 4.7 compared with that for the standard Fe/MgO interface. The developed technique provides an effective approach to enhancing the interfacial PMA and VCMA properties in the development of voltage-controlled spintronic devices.
Effect of polarization forces on carbon deposition on a non-spherical nanoparticle. Monte Carlo simulations
Authors: Nemchinsky V. , Khrabry A.
Published: February 2018

Trajectories of a polarizable species (atoms or molecules) in the vicinity of a negatively charged nanoparticle (at a floating potential) are considered. The atoms are pulled into regions of strong electric field by polarization forces. The polarization increases the deposition rate of the atoms and molecules at the nanoparticle. The effect of the non-spherical shape of the nanoparticle is investigated by the Monte Carlo method. The shape of the non-spherical nanoparticle is approximated by an ellipsoid. The total deposition rate and its flux density distribution along the nanoparticle surface are calculated. It is shown that the flux density is not uniform along the surface. It is maximal at the nanoparticle tips.
Layer thickness scaling and wake-up effect of pyroelectric response in Si-doped HfO2
Authors: Mart C. , Kämpfe T. , Zybell S. , Weinreich W.
Published: February 2018

The pyroelectric response of polycrystalline, Si-doped HfO2 layers in a thickness range of 10 nm to 50 nm is investigated employing the temperature oscillation method. The largest value of the pyroelectric coefficient is obtained for the 20 nm layer with p = 84 μC m−2 K−1, which is similar to that of lithium niobate. Furthermore, the pyroelectric coefficient is analyzed with respect to field cycling and is found to increase proportionally with the remanent polarization during wake-up, providing further evidence that the hysteresis of the material is truly ferroelectric. However, for different material thicknesses, the switchable polarization and pyroelectric coefficient are not proportional, indicating that only part of the domains is pyroelectrically active, which suggests potential for further improvement of the pyroelectric response. Due to its CMOS compatibility and conformal deposition using atomic layer deposition (ALD), Si-doped HfO2 is a promising candidate for future energy harvesting and sensor applications.
Helix-coil fluctuations show glasslike behavior in gelatin gel networks
Authors: Wolverton Mark
Published: February 2018

Agreement between modeling and experiment that study dynamic responses of gelatin networks reveal a surprising source of glasslike behavior.
Laser cooling delivers a Bose–Einstein condensate
Authors: Smart Ashley G.
Published: February 2018

The new, faster path to condensation could vastly speed up some quantum experiments.
Crystal growth in ice and snow
Authors: Shultz Mary Jane
Published: February 2018

Surface molecular structure is the arbiter in the contest between energy and entropy that largely determines how ice and snow crystals develop.
Sociophysics
Authors: Schweitzer Frank
Published: February 2018

To the extent that individuals interact with each other in prescribed ways, their collective social behavior can be modeled and analyzed.
Quantum interference in chemical reactions
Authors: Aoiz F. Javier , Zare Richard N.
Published: February 2018

Interference much like that observed in two-slit experiments can be seen in the outcomes of chemical processes in which multiple reaction mechanisms lead to the same final state.
Sodium silicate and calcium silicate differentially affect silicon and aluminium uptake, antioxidant performance and phenolics metabolism of ryegrass in an acid Andisol
Authors: Ribera-Fonseca Alejandra , Rumpel Cornelia , Mora María de la Luz , Nikolic Miroslav , Cartes Paula
Published: February 2018

Evidence indicates that silicon (Si) alleviates diverse stresses by improving the antioxidant capacity and phenolics metabolism of plants. We assessed the effect of sodium silicate (Na2SiO3) and calcium silicate (CaSiO3) on Si and aluminium (Al) uptake, antioxidant performance and phenolics (with antioxidant or structural function) of ryegrass cultivated on an acid Andisol under greenhouse conditions. Ryegrass was treated with either sodium silicate or calcium silicate at gradually increasing doses (250, 500 and 1000 mg Si kg–1 soil). Yield and concentrations of Si and Al were measured in roots and two shoot cuts. At the first cut, phenols, antioxidant enzymes, antioxidant capacity, lipid peroxidation and lignin production and composition were also determined. Ryegrass supplied with sodium silicate exhibited the highest Si content. Root Si was closely correlated with Al or Si : Al ratio. Shoot Si uptake increased total phenols and activities of antioxidant enzymes (CAT, APX and POD), but reduced lipid peroxidation. Silicon also changed the lignin production and composition in shoots at the highest sodium silicate dose. Silicon uptake reduced the deleterious effect of soil acidity in ryegrass. Sodium silicate had the greatest influence on the antioxidant system through enhancement of phenols production and antioxidant enzyme activation. Peroxidase activity appears to be associated with increased lignin biosynthesis in plants supplied with sodium silicate.
Temporal–prefrontal cortical network for discrimination of valuable objects in long-term memory
Authors: Ghazizadeh Ali , Griggs Whitney , Leopold David A. , Hikosaka Okihide
Published: February 2018

Significance

Animals, including humans, are surrounded by many objects, only some of which are valuable. To survive, it is critical to efficiently discriminate valuable objects, particularly those that are only occasionally or seasonally available. Here, we use fMRI to show that, in macaques, a network consisting of areas in the temporal and prefrontal cortex and their associated subcortical structures maintained value memories for a large number of objects. This memory representation lasted for many months after the objects were last seen and accordingly the monkeys were able to find valuable objects efficiently. We postulate that this temporal–prefrontal circuit is critical for drawing on learned value memory to guide goal-oriented behavior toward certain objects.
A multitude of “lishes”
Authors: Lambert James
Published: February 2018

The present paper deals with portmanteau terms based on the wordEnglish, the bulk of which form a varied and extensive nomenclature used to describe hybrids of the English language with other languages. A citation database of over 3,500 entries was created containing 510 separate terms dating from the early 20th century to mid-2016. These figures indicate a widespread interest in the ways in which English hybridises with other languages and becomes localised in various parts of the globe. The results also show a trend of continuing increase in the coining of such terms to be expected in an increasingly globalised world. However, to date there has been no exhaustive examination of names for English-language hybrids. The present paper examines these portmanteau terms with regard to semantics, etymology, history, frequency, and pronunciation, and presents an alphabetical table of the complete set of terms in the Appendix.
Advanced Dublin English as audience and referee design in Irish radio advertising
Authors: O’Sullivan Joan
Published: February 2018

This paper examines change in the sociolinguistic landscape of Irish English based on a diachronic corpus of radio advertisements from 1997 and 2007, with a focus on the relatively new accent variety, Advanced Dublin English (AdvD) (Hickey 2013). The quantitative and qualitative analyses are based onSussex’s (1989)“Action and Comment” framework (which differentiates the advertisement components based on discourse genre) and onBell’s (1984)audience and referee design framework. AdvD is viewed in the 1997 subcorpus as outgroup referee design where it has an “initiative” role in constructing listener identity. In the 2007 subcorpus, the increased frequency of AdvD suggests that it is evolving to an audience designed style. Stylised representations of this accent can be understood as ingroup referee design, a strategy which facilitates the evolution of this form as audience design. These findings illustrate the initiative role of the media in constructing contemporary cultural identities (Piller 2001).
Pronoun omission in high-contact varieties of English
Authors: Tamaredo Iván
Published: February 2018

This paper considers pronoun omission in different varieties of English. It argues that omitted pronouns simplify structures if their referents are accessible in discourse, which explains the greater frequency of this grammatical feature in high-contact varieties of English, spoken in speech communities with a history of high numbers of second-language users. A corpus study of two high-contact varieties, Indian English and Singapore English, and a low-contact one, British English, is conducted in order to examine the distribution of omitted and overt pronouns. As expected, pronoun omission is more frequent in the high-contact varieties than in British English. Moreover, pronouns are omitted almost exclusively when they have highly accessible referents as antecedents, which is not a conventionalized feature of the grammars of Indian or Singapore English, where overt pronouns are the default choice when referring to antecedents.
Depicting and describing meanings with iconic signs in Norwegian Sign Language
Authors: Ferrara Lindsay , Halvorsen Rolf Piene
Published: February 2018

There is growing momentum towards a theory of languaging that acknowledges the diverse semiotic repertoires people use with each other. This paper contributes to this goal by providing further evidence from signed language discourse. In particular, we examine iconic signs from Norwegian Sign Language, which can be interpreted as both “regular” lexical signs and token depictions. This dual potential is manipulated by signers in context. We analyze these signs asdescriptionsanddepictions, two different modes of representation. Then we compare these signs to some of the description and depiction that occurs in spoken language discourse. In this way we aim to present some of the advantages of using description and depiction in analyses of communication and interaction. By doing this, we also forge links between the languaging of speakers and the languaging of signers.
Mismatch negativity (MMN)
Authors: Gabr Takwa A.
Published: February 2018

Background:

Cochlear implants (CIs) can be used effectively in the profoundly impaired children. However, they show great variability in their outcomes and performance in the rehabilitation program. This variability could be related to the underlying temporal processing variability in those children.

Objectives:

To assess fine auditory discrimination in children fitted with CIs.

Methods:

Mismatch negativity (MMN) was recorded in 20 children fitted with unilateral CIs. MMN was recorded in two tones paradigms using 1000 Hz, 4000 Hz and one speech paradigm using speech syllables.

Results:

Children fitted with CI have good MMN that morphologically similar to that recorded in normal hearing peers, however, with delayed latencies. There was also a good correlation between MMN response and duration of CI use.

Conclusion:

MMN can be used as good new diagnostic AEPs for the assessment of fine discrimination in CIs users. So, MMN provides for further efforts for improving CI design and speech strategy and monitor recipients’ results in rehabilitation program.
Superiority of localized surface plasmon resonance technique in characterization of ultra-thin metallic films
Authors: Sudheer  , Tiwari P. , Bhartiya S. , Mukherjee C. , Rai S. K. , Rai V. N. , Srivastava A. K.
Published: February 2018

The comparison and correlation of morphological, optical and crystallographic properties of ultra-thin Au films obtained using field-emission scanning electron microscopy (FESEM), x-ray reflectivity (XRR), UV-visible transmission, and grazing incidence x-ray diffraction (GIXRD) are presented. The Au thin films of different thickness are grown on the glass substrate using the sputtering technique. The particle size, number density and the covered area fraction of Au thin film are obtained from FESEM images. The XRR technique is used to determine the film thickness and surface roughness. The localized surface plasmon resonance (LSPR) response of Au thin films is obtained using UV-Vis transmission spectroscopy. The LSPR peak position and its strength are correlated with film morphology and thickness. Finally, it is shown that LSPR based spectroscopy techniques can provide much better information about morphology and thickness of the Au films up to a resolution of ~1 nm.
Neonatal BCG Vaccination Influences Cytokine Responses to Toll-like Receptor Ligands and Heterologous Antigens
Authors: Freyne Bridget , Donath Susan , Germano Susan , Gardiner Kaya , Casalaz Dan , Robins-Browne Roy M , Amenyogbe Nelly , Messina Nicole L , Netea Mihai G , Flanagan Katie L , Kollmann Tobias , Curtis Nigel
Published: February 2018

Background

BCG vaccination is associated with a reduction in all-cause infant mortality in high-mortality settings. The underlying mechanisms remain uncertain, but long-term modulation of the innate immune response (trained immunity) may be involved.

Methods

Whole-blood specimens, collected 7 days after randomization from 212 neonates enrolled in a randomized trial of neonatal BCG vaccination, were stimulated with killed pathogens and Toll-like receptor (TLR) ligands to interrogate cytokine responses.

Results

BCG-vaccinated infants had increased production of interleukin 6 (IL-6) in unstimulated samples and decreased production of interleukin 1 receptor antagonist, IL-6, and IL-10 and the chemokines macrophage inflammatory protein 1α (MIP-1α), MIP-1β, and monocyte chemoattractant protein 1 (MCP-1) following stimulation with peptidoglycan (TLR2) and R848 (TLR7/8). BCG-vaccinated infants also had decreased MCP-1 responses following stimulation with heterologous pathogens. Sex and maternal BCG vaccination status interacted with neonatal BCG vaccination.

Conclusions

Neonatal BCG vaccination influences cytokine responses to TLR ligands and heterologous pathogens. This effect is characterized by decreased antiinflammatory cytokine and chemokine responses in the context of higher levels of IL-6 in unstimulated samples. This supports the hypothesis that BCG vaccination modulates the innate immune system. Further research is warranted to determine whether there is an association between these findings and the beneficial nonspecific (heterologous) effects of BCG vaccine on all-cause mortality.
Spiral jet
Authors: Istomin Ya N
Published: February 2018

We show that a quasi-cylindrical configuration of a jet in the central region, where direct electric current flows, is confined in a radial equilibrium by a spiral wave at the periphery of a jet. A spiral wave means that in a coordinate system moving with the velocity of the matter along the axis of the jet, all quantities are proportional to exp {ik∥z + imϕ}, z is the longitudinal coordinate, and ϕ is the azimuthal angle. The luminosity of such a jet corresponds to observations. It is also shown that the jet slowly expands with distance z from its base by the power law, R(z) ∝ zk, where the exponent k varies from ≃0.5 to ≃1.
Activation of Nuclear Factor-kappa B in Endothelial Cells of Chronic Subdural Hematoma Outer Membranes
Authors: Osuka Koji , Watanabe Yasuo , Usuda Nobuteru , Aoyama Masahiro , Kawaguchi Reo , Takeuchi Mikinobu , Takayasu Masakazu
Published: February 2018

BACKGROUND: Chronic subdural hematoma (CSDH) is considered an angiogenic and inflammatory disease. Nuclear factor-kappa B (NF-κB) induces the production of inflammatory cytokines and adhesion molecules, which play an essential role in angiogenesis and inflammation. Recently, the double-stranded RNA-activated protein kinase (PKR) was shown to directly interact with NF-κB subunits to influence its transcriptional activity.

OBJECTIVE: To examine the expression of NF-κB signaling pathway components and PKR in CSDH outer membranes.

METHODS: Eight patients whose outer membranes were successfully obtained during trepanation surgery were included in this study. The IκBα, IKKβ, IKKγ, NF-κB, phosphorylated (p)-NF-κB, and PKR expression levels were examined using western blotting analysis. NF-κB expression was also examined using immunohistochemistry. We investigated whether CSDH fluid could activate NF-κB in cultured endothelial cells in Vitro.

RESULTS: The IκBα, IKKβ, IKKγ, and NF-κB levels were approximately the same. Additionally, p-NF-κB and PKR were detected at similar levels. Immunostaining showed that NF-κB was expressed in the vascular endothelium. p-NF-κB expression in endothelial cells was significantly induced immediately after treatment with CSDH fluid. Furthermore, NF-κB activation was significantly inhibited by treatment with antibodies directed against vascular endothelial growth factor.

CONCLUSION: PKR might activate NF-κB through vascular endothelial growth factor in endothelial cells, which might be associated with endothelial cell proliferation in the CSDH outer membrane. Thus, the NF-κB signaling pathway could play a critical role in CSDH growth.
Intraspinosum Middle Meningeal Artery Ligation: A Simple Technique to Control Bleeding in the Middle Fossa During the Anterior Transpetrosal Approach
Authors: Shibao Shunsuke , Borghei-Razavi Hamid , Yoshida Kazunari
Published: February 2018

BACKGROUND: Although the greater superficial petrosal nerve (GSPN) is an important landmark of the anterior transpetrosal approach (ATPA), bleeding from the interdural space around the foramen spinosum (FS), the GSPN, and the foramen ovale impedes the identification of the GSPN, during epidural dissection in the ATPA.

OBJECTIVE: To describe the technique of intraspinosum middle meningeal artery (MMA) ligation, which enables us to control bleeding from the interdural space.

METHODS: During epidural dissection, we identified the FS and partially drilled the lateral side of the FS. Next, we cut the convergence site of the neurovascular structures such as the MMA, middle meningeal vein, and the meningeal branch of the mandibular nerve with the periosteal dura within the FS and continued dural detachment epidurally to expose the petrous apex. Bleeding control around the FS and postoperative facial nerve paresis were assessed for 96 patients treated with the ATPA. Additionally, histological study was performed around the FS using Masson's trichrome stain.

RESULTS: In all cases, in which this technique was used, bleeding from the interdural space was well controlled and no persistent facial nerve paresis was identified. In the histological study, we confirmed that the MMA, the middle meningeal vein, and the meningeal branch of the mandibular nerve converged into the FS and many venous channels existed in the interdural space around the FS and the foramen ovale.

CONCLUSION: Intra-FS MMA ligation is an effective method for control of bleeding from the interdural space of the middle fossa during the ATPA.
Biomarkers and asthma management: analysis and potential applications
Authors: Richards Levi B. , Neerincx Anne H. , van Bragt Job J.M.H. , Sterk Peter J. , Bel Elisabeth H.D. , Maitland-van der Zee Anke H.
Published: February 2018

Purpose of review

Asthma features a high degree of heterogeneity in both pathophysiology and therapeutic response, resulting in many asthma patients being treated inadequately. Biomarkers indicative of underlying pathological processes could be used to identify disease subtypes, determine prognosis and to predict or monitor treatment response. However, the newly identified as well as more established biomarkers have different applications and limitations.

Recent findings

Conventional markers for type 2-high asthma, such as blood eosinophils, fraction of exhaled nitric oxide, serum IgE and periostin, feature limited sensitivity and specificity despite their significant correlations. More distinctive models have been developed by combining biomarkers and/or using omics techniques. Recently, a model with a positive predictive value of 100% for identification of type 2-high asthma based on a combination of minimally invasive biomarkers was developed.

Individualisation of asthma treatment regimens on the basis of biomarkers is necessary to improve asthma control. However, the suboptimal properties of currently available conventional biomarkers limit its clinical utility. Newly identified biomarkers and models based on combinations and/or omics analysis must be validated and standardised before they can be routinely applied in clinical practice. The development of robust biomarkers will allow development of more efficacious precision medicine-based treatment approaches for asthma.
Current management of sarcoidosis I: pulmonary, cardiac, and neurologic manifestations
Authors: West Sterling G.
Published: February 2018

Purpose of review

Sarcoidosis is a systemic disease characterized by noncaseating granulomatous inflammation of multiple organ systems. Pulmonary, cardiac, and neurologic involvements have the worst prognosis. Current recommendations for the therapeutic management and follow-up of sarcoidosis involving these critical organs will be reviewed.

Recent findings

In those sarcoidosis patients requiring immunosuppressive therapy, corticosteroids are used first at varying doses depending on the presenting manifestation. Patients with symptomatic pulmonary, cardiac, or neurologic involvement will be maintained on corticosteroids for at least a year. Many require a second immunosuppressive agent with methotrexate used most commonly. Anti-tumor necrosis factor agents, especially infliximab, are effective and recommendations for their use have been proposed.

Evidence-based treatment guidelines do not exist for most sarcoidosis clinical manifestations. Therefore, clinical care of these patients must rely on expert opinion. Patients are best served by a multidisciplinary approach to their care. Future research to identify environmental triggers, genetic associations, biomarkers for treatment response, and where to position new steroid-sparing immunosuppressive agents is warranted.
SYSTEMIC BETA-BLOCKERS AND RISK OF PROGRESSION TO NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Kolomeyer Anton M. , Maguire Maureen G. , Pan Wei , VanderBeek Brian L.
Published: February 2018

Purpose:

To determine whether oral beta-blockers (BBs) are associated with the development of neovascular age-related macular degeneration (nAMD).

Methods:

Retrospective cohort study of patients from 2000 to 2014 using data from a large national U.S. insurer's administrative medical claims database. Patients with nonexudative AMD who initiated (index date) BB, a calcium channel blocker (CCB), an angiotensin-converting enzyme/angiotensin receptor blocker, or a diuretic. Patients were excluded for <2 years in the plan before the index date, any history of nAMD or diagnosis, or treatment for an ocular disease that could be confused with nAMD. Hazard of developing of nAMD was the main outcome measure. Primary analysis compared BB with CCB patients with BB versus the other classes as secondary analyses. In addition, a sensitivity analysis was performed between BB and CCB cohorts using 1:1 propensity score matching. Cox proportional hazard regression was performed to estimate the hazard ratio (HR) of developing nAMD at 90, 180, and 365 days for BB. Covariates of interest included demographic information, year of index date, number of antihypertensive medications, and other comorbid systemic conditions.

Results:

Eighteen thousand seven hundred and fifty-four BB patients and 12,784 CCB patients met criteria for inclusion. After controlling for covariates, patients on BB had a lower hazard for nAMD at both 90 and 180 days than patients on CCB (HRs: 0.67–0.71; P < 0.01 for both) and diuretics (HRs: 0.55–0.62; P < 0.01). Patients on BB versus angiotensin-converting enzyme/angiotensin receptor blocker at all time points and BB versus CCB and diuretics at 365 days did not have a significantly lower association with nAMD (HR: 0.73–0.85; P > 0.06 for all comparisons). A sensitivity analysis using propensity score matching yielded similar results with patients on BB significantly less likely to develop nAMD at 90 and 180 days (HR: 0.70–0.76; P < 0.049 for both) but not at 365 days (HR: 0.88; P = 0.30) compared with patients on CCB.

Conclusion:

No evidence was found that BB usage increased the hazard for nAMD relative to other antihypertensive medications.
Secondary Glaucoma due to Iridescent Crystalline Particles Masquerading as Refractory Hypertensive Uveitis in an Eye With Irradiated Iris Melanoma
Authors: Chahal Rupinder , Mohite Abhijit A. , Heimann Heinrich , Bansal Atul
Published: February 2018

Purpose:

We report a previously unrecognized mechanism of secondary glaucoma due to iridescent crystalline particles released from an irradiated iris melanoma. It masqueraded as refractory hypertensive uveitis following uncomplicated phacoemulsification.

Materials and Methods:

A 58-year-old gentleman had an iris melanoma that underwent successful regression following irradiation with proton beam radiotherapy. Three years later an uncomplicated phacoemulsification with intraocular lens implant was performed and subsequently the patient presented with apparently “refractory hypertensive uveitis.” Closer examination identified unique iridescent crystalline particles originating from a disintegrating tumor and dispersing within the anterior chamber and drainage angle. The patient developed a unilateral secondary open-angle glaucoma attributable to these particles. Ultrasound biomicroscopy of the anterior segment confirmed absence of tumor recurrence or intrascleral spread and systemic investigations ruled out distant metastases.

Results:

The intraocular pressure was refractory to maximal medical treatment, but was eventually controlled with trans-scleral diode laser cyclo-photocoagulation.

Conclusions:

This is the first report of a secondary glaucoma attributable to trabecular blockage with iridescent crystalline particulate material released from a disintegrating, previously irradiated, iris melanoma. Proton beam radiotherapy and possibly phacoemulsification may have played a role in triggering the release of these previously undescribed particles from the atrophied tumor surface. This unique mechanism of secondary glaucoma needs to be kept in mind in such rare cases. Trans-scleral cyclodiode laser may be used as a good initial option in such cases to minimize potential risk of tumor seeding with incisional glaucoma surgery.
Microcatheter-assisted Trabeculotomy Versus 2-site Trabeculotomy With the Rigid Probe Trabeculotome in Primary Congenital Glaucoma
Authors: El Sayed Yasmine M. , Gawdat Ghada I.
Published: February 2018

Purpose:

The purpose of this study was to compare the outcomes of microcatheter-assisted trabeculotomy to circumferential trabeculotomy using the rigid probe trabeculotome in primary congenital glaucoma.

Methods:

This retrospective study was performed in an institutional setting. The medical records of primary congenital glaucoma patients who underwent circumferential trabeculotomy (≥270 degrees incised) using Glaucolight-illuminated microcatheter or a rigid probe trabeculotome were reviewed. The primary outcomes were the percent reduction of intraocular pressure (IOP) and success rates. Complete success was defined as achieving an IOP<18 mm Hg without medications. Secondary outcomes were the postoperative IOP and glaucoma medications.

Results:

The study included 92 eyes of 92 patients. Of these, 33 eyes of 33 patients aged 6.4±8.7 months underwent microcatheter-assisted trabeculotomy creating a 336±34-degree incision, with 19 eyes (58%) having a complete 360-degree incision. The other 59 eyes of 59 patients aged 8.2±13.1 months underwent 2-site trabeculotomy, using a rigid probe trabeculotome through a combined superonasal and inferotemporal approach, creating a 338±29-degree incision, with 33 eyes (56%) having a complete incision. After a follow-up of 21.2±8.9 months, there was a 42%±25% IOP reduction and a 73% rate of complete success in the microcatheter group, compared with 40%±22% IOP reduction and an 80% success rate in the rigid probe group (P=0.7 and 0.3, respectively). There was no significant difference in survival time in both groups (P=0.6).

Conclusion:

Circumferential trabeculotomy using either the illuminated microcatheter or rigid probe trabeculotome yielded comparable results; however, the added cost of the microcatheter should be considered.
Urrets-Zavalia Syndrome After Combined Trabeculotomy-Trabeculectomy Surgery
Authors: Klezlova Adela , Liebezeit Sarah , Prokosch-Willing Verena , Gericke Adrian , Pfeiffer Norbert , Hoffmann Esther M.
Published: February 2018

We report a case of a rare complication after trabeculotomy combined with a small trabeculectomy with mitomycin C in a young patient with juvenile glaucoma. The patient underwent uneventful surgery. However, postoperatively, he experienced a long-lasting hypotony with the need of 2 revision surgeries and 2 short episodes of high-intraocular pressure. He developed a fixed dilated pupil over time.
Baerveldt Attached to XEN: A New Technique to Manage Failed XEN Glaucoma Surgery
Authors: Laroche Daniel , Ng Chester , Lynch Giselle
Published: February 2018

Purpose:

To describe a new surgical technique for refractory glaucoma with failed XEN gel stent surgery with insertion of the Baerveldt implant.

Surgical Technique:

In a patient with a failed XEN gel stent, a gentle conjunctival dissection was performed to expose the XEN and remove subconjunctival obstruction thus restoring patency and flow. A Baerveldt 250 implant was inserted in the superonasal quadrant above the extraocular muscles and sutured to the sclera. The Baerveldt tube was correctly positioned to accept insertion of the present XEN gel stent. The double lumen was sutured to secure the position. Two corneal patches were sutured over the tube to prevent exposure. The usual conjunctival suturing closure was performed.

Conclusion:

This technique is simple and restores lowering of intraocular pressure in patient with failed XEN and potentially increases the safety of refractory glaucoma surgeries in these patients.
Complicated Fusobacterium Sinusitis: A Case Report
Authors: Sheth Saloni P. , Ilkanich Paul , Congeni Blaise
Published: February 2018

Fusobacterium infections and Lemierre syndrome are traditionally associated with pharyngitis. We report 3 cases of Fusobacterium sinusitis that resulted in Pott puffy tumor. One of these cases also had Lemierre Syndrome. We encourage expansion of the clinical spectrum of Lemierre syndrome to include complicated Fusobacterium sinusitis.
The Experiences of Fathers Whose Spouses Are Hospitalized for Pregnancy Termination Due to Fetal Chromosome Abnormality in Taiwan
Authors: SUN Jui-Chiung , REI Wenmay , CHANG Min-Yu , SHEU Shuh-Jen
Published: February 2018

Background:

Hospitals, where most births and terminations of pregnancy take place in modern society, tend to focus on addressing the perinatal loss experiences of mothers rather than fathers. Healthcare providers often overlook the loss experiences of fathers when pregnancy has been terminated because of chromosome abnormality. Little literature exists on the perceptions of these losses from the point of view of fathers in Taiwan.

Purpose:

The aims of this study were to explore and reveal the essence and structure of the experiences of Taiwanese fathers whose spouses are hospitalized for pregnancy termination due to fetal chromosome abnormality.

Methods:

A descriptive phenomenological approach was applied to collect data. In-depth interviews using individualized, semistructured, open-ended questions were conducted with 20 fathers whose spouses were hospitalized for termination of pregnancy due to fetal chromosomal abnormalities. Data were analyzed according to Giorgi’s methods.

Results:

The participants described their experiences as distressing and involving painful decisions. Four themes emerged: (a) “a dismayed father: the unexpected process of terminating pregnancy,” (b) “a hidden source of grief: neglected care,” (c) “a stressful decision: difficulty handling the deceased offspring,” and (d) “a regretful father: inadequate treatment of the baby’s remains.”

Conclusions:

Health professionals must better understand the experiences of fathers, learn to be sensitive and empathetic, and keep communication lines open to create and maintain a more compassionate and caring environment. Health professionals should provide the opportunity for fathers to discuss the decisions that they face, treat the deceased infant with dignity, and acknowledge the grief of both parents as qualitatively equal. Both mother and father should receive appropriate care while the mother is in the hospital for a pregnancy termination.
A Multidisciplinary Program Reduces Over 24 Hours of Physical Restraint in Neurological Intensive Care Unit
Authors: LIN Yu-Li , LIAO Cheng-Chih , YU Wen-Pin , CHU Tsung-Lan , HO Lun-Hui
Published: February 2018

Background:

Physical restraint (PR) has to be performed in a well-organized, structured, and careful manner. The safety and effectiveness of the PR procedure in clinical practice are crucial to patient care.

Purposes:

The aim of this study was to examine the effect in neurological intensive care units of a multidisciplinary PR reduction program on the overall incidence rate of PR, the monthly rate of PR, and the monthly rate of PR of more than and less than 24 hours, respectively, after controlling for associated factors.

Methods:

A before-and-after study design was conducted in three neurological intensive care units (total of 45 beds) of a medical center in northern Taiwan. A multidisciplinary PR reduction program was implemented, with four phases of data collection. Data on the number and duration of PR were extracted from a database. In the first preintervention phase, data on the rate (number or frequency) and duration of PR were collected for 12 months before program implementation. The next three data collection phases were 1 month (introduction), 3 months (intermediate), and 6 months (maintenance) after program implementation. The chi-square test, one-way analysis of variance with Scheffe’s post hoc tests, and logistic regression method were used for data analysis.

Results:

The results showed that PR was used 72.8 mean times per month before program implementation. After implementation, the mean times per month fell to 40 after the first postimplementation month (introduction), 53.3 after 3 months (intermediate), and 36.2 after 6 months (maintenance). Implementation of the PR reduction program resulted in a decreased incidence rate of PR from 6.1% to 3.2% (event/total patient day) and a decrease in the percentage of patients who were restrained for more than 24 hours from 69.6% to 34.1%. The results of the logistic regression model showed that PR of more than 24 hours was significantly less in the postintervention phases: introduction phase (odds ratio [OR] = 0.31), intermediate phase (OR = 0.16), and maintenance phase (OR = 0.18). Moreover, PR of more than 24 hours was significantly higher in patients with endotracheal intubation (OR = 1.51) and nasogastric intubation (OR = 2.16) and with Glasgow Coma Scale scores of 6–8 (OR = 2.36), 9–12 (OR = 2.40), and 13–15 (OR = 2.15).

Conclusions/Implications for Practice:

The results support that a multidisciplinary collaborative program has the potential to decrease the incidence of PR in neurological intensive care units. A standardized protocol and policies are essential for healthcare professionals to effectively use PR as well as to effectively improve the quality of care that is provided to intensive care patients.
Defining anabolic resistance: implications for delivery of clinical care nutrition
Authors: Morton Robert W. , Traylor Daniel A. , Weijs Peter J.M. , Phillips Stuart M.
Published: February 2018

Purpose of review

Skeletal muscle mass with aging, during critical care, and following critical care is a determinant of quality of life and survival. In this review, we discuss the mechanisms that underpin skeletal muscle atrophy and recommendations to offset skeletal muscle atrophy with aging and during, as well as following, critical care.

Recent findings

Anabolic resistance is responsible, in part, for skeletal muscle atrophy with aging, muscle disuse, and during disease states. Anabolic resistance describes the reduced stimulation of muscle protein synthesis to a given dose of protein/amino acids and contributes to declines in skeletal muscle mass. Physical inactivity induces: anabolic resistance (that is likely exacerbated with aging), insulin resistance, systemic inflammation, decreased satellite cell content, and decreased capillary density. Critical illness results in rapid skeletal muscle atrophy that is a result of both anabolic resistance and enhanced skeletal muscle breakdown.

Insofar as atrophic loss of skeletal muscle mass is concerned, anabolic resistance is a principal determinant of age-induced losses and appears to be a contributor to critical illness-induced skeletal muscle atrophy. Older individuals should perform exercise using both heavy and light loads three times per week, ingest at least 1.2 g of protein/kg/day, evenly distribute their meals into protein boluses of 0.40 g/kg, and consume protein within 2 h of retiring for sleep. During critical care, early, frequent, and multimodal physical therapies in combination with early, enteral, hypocaloric energy (∼10–15 kcal/kg/day), and high-protein (>1.2 g/kg/day) provision is recommended.
Virtual Chromoendoscopy With FICE for the Classification of Polypoid and Nonpolypoid Raised Lesions in Ulcerative Colitis
Authors: Cassinotti Andrea , Buffoli Federico , Fociani Paolo , Staiano Teresa , Villanacci Vincenzo , Nebuloni Manuela , Duca Piergiorgio , Fichera Maria , Grassia Roberto , Manes Gianpiero , Salemme Marianna , Molteni Paola , Sampietro Gianluca , Foschi Diego , de Franchis Roberto , Ardizzone Sandro
Published: February 2018

Goals:

The aim of this study was to analyze the performance of Fuji Intelligent Color Enhancement (FICE) using the classification of Kudo in the differentiation of neoplastic and non-neoplastic raised lesions in ulcerative colitis (UC).

Background:

The Kudo classification of mucosal pit patterns is an aid for the differential diagnosis of colorectal polyps in the general population, but no systematic studies are available for all forms of raised lesions in UC.

Study:

All raised, polypoid and nonpolypoid, lesions found during consecutive surveillance colonoscopies with FICE for long-standing UC were included. In the primary prospective analysis, the Kudo classification was used to predict the histology by FICE. In a post hoc analysis, further endoscopic markers were also explored.

Results:

Two hundred and five lesions (mean size, 8 mm; range, 2 to 30 mm) from 59 patients (mean age, 56 y; range, 21 to 79 y) were analyzed. Twenty-three neoplastic (11%), 18 hyperplastic (9%), and 164 inflammatory (80%) lesions were found. Thirty-one lesions (15%), none of which were neoplastic, were unclassifiable according to Kudo. After logistic regression, a strong negative association resulted between endoscopic activity and neoplasia, whereas the presence of a fibrin cap was significantly associated with endoscopic activity. Using FICE, the sensitivity, specificity, and positive and negative likelihood ratios of the Kudo classification were 91%, 76%, 3.8, and 0.12, respectively. The corresponding values by adding the fibrin cap as a marker of inflammation were 91%, 93%, 13, and 0.10, respectively.

Conclusions:

FICE can help to predict the histology of raised lesions in UC. A new classification of pit patterns, based on inflammatory markers, should be developed in the setting of UC to improve the diagnostic performance.
Recovery of reproductive function following androgen abuse
Authors: Christou Maria A. , Tigas Stelios
Published: February 2018

Purpose of review

To summarize recent data on the adverse reproductive consequences of androgen abuse, focusing on the recovery of reproductive function following androgen discontinuation.

Recent findings

Evidence is mostly based on case reports and observational studies. Androgen abuse leads to a state of hypogonadotropic hypogonadism associated with impaired spermatogenesis, testicular atrophy, gynecomastia as well as menstrual irregularities, virilization and subfertility. Recovery of the hypothalamic–pituitary–gonadal axis following androgen withdrawal depends on the type and characteristics of androgen administration (dose, duration of use) as well as those of the user (age, previous reproductive function). Biochemical and clinical features of hypogonadism may be evident months or even years following androgen discontinuation. To prevent androgen-related adverse effects and accelerate recovery of gonadal function, users take androgens in a cyclical fashion and use drugs such as human chorionic gonadotropin, antiestrogens and aromatase inhibitors, even though there is limited evidence to support efficacy of these strategies. As few studies refer to female androgen users, there is a lack of data concerning recovery from androgen-related reproductive side effects in women.

Androgen abuse has profound and commonly under-recognized effects on the reproductive system; recovery following androgen withdrawal may be prolonged and occasionally incomplete.