bluuebunny/crossref_metadata_2025 huggingface dataset:
A Thermally Stratified Reservoir Module for Large‐Scale Distributed Stream Temperature Models With Application in the Tennessee River Basin
Authors: Niemeyer Ryan J. , Cheng Yifan , Mao Yixin , Yearsley John R. , Nijssen Bart
Published: October 2018

River temperatures affect water quality, power plant cooling, and freshwater ecosystems. Stream temperature models that treat river reaches and reservoirs as well‐mixed segments do not capture thermal stratification in reservoirs. To account for the effects of reservoir stratification on downstream water temperatures, we developed a two‐layer stratified reservoir module, which was integrated into the River Basin Model (RBM) to simulate river temperature across a river network with multiple large thermally stratified reservoirs. To evaluate the performance of this model configuration compared to RBM without thermally stratified reservoirs, we simulated river temperature in the Tennessee River Basin in the southeastern United States. We simulated land surface hydrologic fluxes using the Variable Infiltration Capacity (VIC) model and routed runoff using the river routing model RVIC. The two‐layer model configuration reduced the bias in simulated summer river temperature from 6.7 to −1.2 °C downstream of a reservoir with a residence time of 92 days and from 3.0 to −0.7 °C downstream of a reservoir with a residence time of 8 days. Improvement in fall and winter, when reservoirs tend to be well mixed, is minimal. RBM with the two‐layer module also captured the observed longitudinal river temperature variation downstream of a reservoir, with cool temperatures immediately downstream of the reservoir and gradual warming of the river as it flows downstream. Incorporating a simple stratified reservoir module into RBM improves model performance and increases the ability to apply the river temperature model to large basins with multiple large reservoirs.
Kinetic Interface Sensitive Tracers: Experimental Validation in a Two‐Phase Flow Column Experiment. A Proof of Concept
Authors: Tatomir A. , De Vriendt K. , Zhou D. , Gao H. , Duschl F. , Sun F. , Licha T. , Sauter M.
Published: October 2018

The quantification of the interfacial area between fluids in a multiphase system in porous media has been a subject of growing interest in disciplines where mass transfer across fluid interfaces is of importance. In this study, a proof of concept for a novel kinetic interface sensitive (KIS) tracer is provided by employing a simple, low‐cost, well‐controlled dynamic column experiment in conjunction with a macroscale two‐phase flow reactive transport model. The steel column is filled with a well‐characterized porous medium consisting of well‐sorted normally distributed glass beads (d50 = 240 μm). KIS tracers were designed to determine the specific interfacial area, awn, between a nonwetting fluid and a wetting fluid, by evaluating the chemical reaction rates and mass transfer across the fluid‐fluid interface. This study shows for the first time a general framework behind the use of KIS tracers and their potential in assessing the awn for a known capillary pressure‐saturation relationship under laboratory conditions. A two‐phase flow four‐component reactive transport and a two‐phase flow two‐component transport numerical model were developed to simulate the oil flooding of the initially water saturated column and tracer breakthrough curves obtained from experimental data. These breakthrough curves were subsequently used to approximate awn using a polynomial relationship. The interpretation of the KIS tracer column experiments indicates that the range for maximum value of awn is between 500 and 540 m2/m3. The results also show that despite the use of two independently synthesized tracers, if the reaction kinetics are well quantified, similar awn values can be obtained.
Geochemical Exports to River From the Intrameander Hyporheic Zone Under Transient Hydrologic Conditions: East River Mountainous Watershed, Colorado
Authors: Dwivedi Dipankar , Steefel Carl I. , Arora Bhavna , Newcomer Michelle , Moulton J. David , Dafflon Baptiste , Faybishenko Boris , Fox Patricia , Nico Peter , Spycher Nicolas , Carroll Rosemary , Williams Kenneth H.
Published: October 2018

To understand how redox processes influence carbon, nitrogen, and iron cycling within the intrameander hyporheic zone, we developed a biotic and abiotic reaction network and incorporated it into the reactive transport simulator PFLOTRAN. Two‐dimensional reactive flow and transport simulations were performed (1) to evaluate how transient hydrological conditions control the lateral redox zonation within an intrameander region of the East River in Colorado and (2) to quantify the impact of a single meander on subsurface exports of carbon and other geochemical species to the river. The meander's overall contribution to the river was quantified by integrating geochemical outfluxes along the outside of the meander bend. The model was able to capture the field‐observed trends of dissolved oxygen, nitrate, iron, pH, and total inorganic carbon along a 2‐D transect. Consistent with field observations, simulated dissolved oxygen and nitrate decreased along the intrameander flow paths while iron (Fe2+) concentration increased. The simulation results further demonstrated that the reductive potential of the lateral redox zonation was controlled by groundwater velocities resulting from river stage fluctuations, with low‐water conditions promoting reducing conditions. The sensitivity analysis results showed that permeability had a more significant impact on biogeochemical zonation compared to the reaction pathways under transient hydrologic conditions. The simulation results further indicated that the meander acted as a sink for organic and inorganic carbon as well as iron during the extended baseflow and high‐water conditions; however, these geochemical species were released into the river during the falling limb of the hydrograph.
From 1D ordered linear polymers to discrete macrocycles: surface adsorption and pH take control
Authors: Cao Lili , Yu Yanxia , Lei Shengbin
Published: October 2018

In this work we demonstrate that the surface adsorption and pH play a determining role in controlling the final product of a Schiff base reaction.
Construction of the highly oxidized bicyclo[3.2.1]octane CD ring system of aconitine via a late stage enyne cycloisomerization
Authors: Zhou Xiao-Han , Liu Ying , Zhou Rui-Jie , Song Hao , Liu Xiao-Yu , Qin Yong
Published: October 2018

An enyne cycloisomerization enables assembly of the highly oxidized bicyclo[3.2.1]octane CD rings of the complex diterpenoid alkaloid aconitine.
Real-time prediction of crystal/melt interface shape during Czochralski crystal growth
Authors: Ding Junling , Liu Lijun
Published: October 2018

A novel method for real-time prediction of the varied interface shape for CZ crystal growth.
Efficient green phosphor realized by Ce3+→Tb3+ energy transfer in Li3Sc2(PO4)3 for ultraviolet white light-emitting diodes
Authors: Jiao Mengmeng , Xu Qinfeng , Liu Mingliang , Yang Chuanlu , Yu Yongjiang
Published: October 2018

UV excited green-emitting Li3Sc2(PO4)3:Ce3+,Tb3+ phosphors have been obtained, and their electronic structures and luminescence properties have been investigated in detail.
Constructing multi-interface Mo2C/Co@C nanorods for a microwave response based on a double attenuation mechanism
Authors: Dai Sisi , Quan Bin , Zhang Baoshan , Liang Xiaohui , Ji Guangbin
Published: October 2018

A simple method to prepare 1D Mo2C/Co@C nanorods with a double attenuation mechanism to achieve good microwave absorption is shown.
An AceDAN–porphyrin(Zn) dyad for fluorescence imaging and photodynamic therapy via two-photon excited FRET
Authors: Zhu Mengliang , Su Chaorui , Xing Peipei , Zhou Yabin , Gong Lei , Zhang Jinghui , Du Hongwu , Bian Yongzhong , Jiang Jianzhuang
Published: October 2018

A FRET based AceDAN–porphyrin(Zn) dyad was designed to generate red emission and singlet oxygen (1O2) simultaneously, which were utilized successfully for two-photon excited fluorescence imaging and PDT of cancer cells.
Direct Z-scheme Cs2O–Bi2O3–ZnO heterostructures for photocatalytic overall water splitting
Authors: Hezam Abdo , Namratha K. , Drmosh Q. A. , Ponnamma Deepalekshmi , Nagi Saeed Adel Morshed , Ganesh V. , Neppolian B. , Byrappa K.
Published: October 2018

In this work, a direct Z-scheme Cs2O–Bi2O3–ZnO heterostructure without any electron mediator is fabricated by a simple solution combustion route.
Superior cycling stability of a crystalline/amorphous Co3S4 core–shell heterostructure for aqueous hybrid supercapacitors
Authors: Liang Miaomiao , Zhao Mingshu , Wang Haiyang , Zheng Qingyang , Song Xiaoping
Published: October 2018

In this article, a novel crystalline/amorphous Co3S4 core–shell heterostructure supported on nickel foam is fabricated through a facile method.
Hybrid NiO–CuO mesoporous nanowire array with abundant oxygen vacancies and a hollow structure as a high-performance asymmetric supercapacitor
Authors: Fang Zhenbin , Rehman Sajid ur , Sun Mingze , Yuan Yupeng , Jin Shaowei , Bi Hong
Published: October 2018

This work presents an asymmetric supercapacitor based on advanced 3D hollow architectures of NiO–CuO mesoporous nanowires with high areal/specific capacitances and cycling stability.
Construction of a novel near-infrared fluorescent probe with multiple fluorescence emission and its application for SO2 derivative detection in cells and living zebrafish
Authors: Liu Keyin , Chen Yunling , Sun Hui , Wang Shoujuan , Kong Fangong
Published: October 2018

Construction of a novel near-infrared fluorescent probe with multiple fluorescence emission and its application for SO2 derivative detection.
New heterobimetallic Au(i)–Pt(ii) polyynes achieving a good trade-off between transparency and optical power limiting performance
Authors: Tian Zhuanzhuan , Yang Xiaolong , Liu Boao , Zhong Daokun , Zhou Guijiang , Wong Wai-Yeung
Published: October 2018

Two series of heterobimetallic Au(i)–Pt(ii) polyynes achieve consistency between enhanced transparency and high optical power limiting performances.
Importance of subject‐dependent classification and imbalanced distributions in driver sleepiness detection in realistic conditions
Authors: Silveira Cláudia Sofia , Cardoso Jaime S. , Lourenço André L. , Ahlström Christer
Published: October 2018

The first in‐depth study on the use of electrocardiogram and electrooculogram for subject‐dependent classification in driver sleepiness/fatigue under realistic driving conditions is presented in this work. Since acquisitions in simulated environments may be misleading for sleepiness assessment, performing studies on road are required. For that purpose, the authors present a database resulting from a field driving study performed in the SleepEye project. Based on previous research, supervised machine learning methods are implemented and applied to 16 heart‐ and 25 eye‐based extracted features, mostly related to heart rate variability and blink events, respectively, in order to study the influence of subject dependency in sleepiness classification, using different classifiers and dealing with imbalanced class distributions. Results showed a significantly worse performance in subject‐independent classification: a decrease of ∼40 and 20% in the detection rate of the ‘sleepy’ class for two and three classes, respectively. Since physiological signals are the ones that present the most individual characteristics, a subject‐independent classification can be even harder to perform. Transfer learning techniques and methods for imbalanced distributions are promising approaches and need further investigation.
Phase mixing of Alfvén waves in two-dimensional magnetic plasma configurations with exponentially decreasing density
Authors: Ruderman Michael S. , Petrukhin Nikolai S.
Published: October 2018

We study damping of phase-mixed Alfvén waves propagating in axisymmetric magnetic plasma configurations. We use the linear magnetohydrodynamic (MHD) equations in the cold plasma approximation. The only dissipative process that we take into account is shear viscosity. We reduce the MHD equations describing the Alfvén wave damping to a Klein–Gordon-type equation. We assume that the two terms in this equation, one describing the effect of inhomogeneity and the other the effect of viscosity, are small. Then we use the WKB method to derive the expression describing the wave energy flux attenuation with the height. We apply the general theory to particular equilibria with the exponentially divergent magnetic field lines with the characteristic scale H. The plasma density exponentially decreases with the height with the characteristic scale Hρ. We study the wave damping for typical parameters of coronal plumes and various values of the wave period, the characteristic scale of the magnetic field variation H, and kinematic shear viscosity ν. We show that to have an appreciable wave damping at the height 6H we need to increase shear viscosity by at least six orders of magnitude in comparison with the value given by the classical plasma theory. Another important result is that the efficiency of wave damping strongly depends on the ratio H/Hρ. It increases fast when H/Hρ decreases. We present a physical explanation of this phenomenon.
Real-time, multiframe, blind deconvolution of solar images
Authors: Asensio Ramos A. , de la Cruz Rodríguez J. , Pastor Yabar A.
Published: October 2018

The quality of images of the Sun obtained from the ground are severely limited by the perturbing effect of the Earth’s turbulent atmosphere. The post-facto correction of the images to compensate for the presence of the atmosphere require the combination of high-order adaptive optics techniques, fast measurements to freeze the turbulent atmosphere, and very time-consuming blind deconvolution algorithms. Under mild seeing conditions, blind deconvolution algorithms can produce images of astonishing quality. They can be very competitive with those obtained from space, with the huge advantage of the flexibility of the instrumentation thanks to the direct access to the telescope. In this contribution we make use of deep learning techniques to significantly accelerate the blind deconvolution process and produce corrected images at a peak rate of ∼100 images per second. We present two different architectures that produce excellent image corrections with noise suppression while maintaining the photometric properties of the images. As a consequence, polarimetric signals can be obtained with standard polarimetric modulation without any significant artifact. With the expected improvements in computer hardware and algorithms, we anticipate that on-site real-time correction of solar images will be possible in the near future.
Matched-Pair Analysis of Local Infiltration Analgesia in Total Knee Arthroplasty: Patient Satisfaction and Perioperative Pain Management in 846 Cases
Authors: Greimel Felix , Maderbacher Günther , Baier Clemens , Schwarz Timo , Zeman Florian , Meissner Winfried , Grifka Joachim , Benditz Achim
Published: October 2018

In the recent past, numerous studies evaluating local infiltration analgesia (LIA) with controversial results have been reported. Efforts have been made to improve patients' outcome regarding operation techniques and material, as well as pain management and anesthetic methods. In this study, postoperative pain management and patient satisfaction were evaluated in patients undergoing total knee replacement surgery with or without intraoperative LIA. Within the context of the “Quality Improvement in Postoperative Pain Management” (QUIPS) project, parameters were collected on the first postoperative day. All patients included in this study underwent primary knee replacement surgery with general anesthesia. Parameters were compared after performing a 1:1 matched-pair analysis within 14 orthopaedic departments. Pain levels and pain management satisfaction were measured using the numerous rating scales, and pain medication use was compared. From 2010 to 2015, 2,789 patients who underwent primary knee arthroplasty with general anesthesia were evaluated within the project, of whom a total of 846 patients could be compared after performing a matched-pair analysis. Pain scores were significantly better in the LIA group (p = 0.019 for activity pain, p = 0.043 for maximum pain, p < 0.001 for minimum pain), but pain management satisfaction was not superior (p = 0.083). Patients with LIA required less opioids in the recovery room (p = 0.048), while nonopioid medication did not differ significantly (p = 0.603). At the ward, 24 hours postoperatively, no significant difference in the use for nonopioids (p = 0.789) could be measured, whereas patients in the LIA group received significantly more opioids (p < 0.001). Although LIA achieved improvement in pain score outcome, and a comparable patient satisfaction level in the immediate postoperative course, the use of LIA in knee arthroplasty, controversially discussed in the current literature, was not able to reduce the need for opioid pain medication in this study.
Cueing Refrains in the Medieval Conductus
Authors: Caldwell Mary Channen
Published: October 2018

As lyrical refrain forms flourished beginning in the twelfth century and increased attention was paid to the mise en page of song in manuscript sources, scribes faced the dilemma of how to cue frequent repetition of poetry and music. Owing to a lack of shared conventions among these scribes, the signalling of repetition varied greatly among sources, the resulting inconsistencies furnishing what Ardis Butterfield calls ‘glimpses of scribal thinking’. Nowhere is this more evident than in approaches to notating the Latin refrain, a structural feature in a range of genres and an inexact yet related parallel to the French refrain. I argue in this article that the graphic treatment of refrains in Latin song exposes assumptions that both scribes and performers made about form, genre and the realization of song in performance. Attending to the visual cueing of refrains clarifies textual and musical ambiguities arising from the simultaneously oral, written and performative milieu within which Latin song was cultivated and disseminated.
Pacing profile in the main international open‐water swimming competitions
Authors: Baldassarre Roberto , Bonifazi Marco , Piacentini Maria Francesca
Published: October 2018

Purpose: Different aspects of pacing in endurance events have been investigated, however, there are very limited information on pacing strategies during open‐water swimming. The aim was to describe and compare the pacing profile used by male and female open‐water swimmers (OW‐swimmers) during the 5‐, 10‐ and 25 km races in the main international competitions. Methods: A total of 438 performances were analysed for 5 km, 579 for 10 km and 189 for 25 km, from 2012 to 2017. Swimmers were divided into four groups based on finishing time. G1 whose finishing times were within 0.5% of the winner's time, G2 between 0.51% and 1% slower than winner's time; G3 between 1.1% and 2% slower than winner's time; G4 over 2% of winner's time. Kolmogorov–Smirnov test was used to verify the normal distribution of data and repeated measures ANOVA was performed. Results: G1 adopted a negative pacing and significantly increased the speed in the last split compared with the other groups during the 5‐, 10‐ and 25‐km races in both males and females (p < .001). During the 5‐ and 10‐km race, the last split speed of G1 was significantly faster compared to the other groups in both males and females (p < .05). Conclusions: OW‐swimmers that used a conservative approach remaining in G1 until the finish of the race, increase the possibility to win a medal in the main international competitions.
A Bottom-up picture of intra-national welfare regimes: the case of marginalised communities in Puerto Rico
Authors: Cruz-Martínez Gibrán
Published: October 2018

The main purpose of this article is twofold: (1) an examination of welfare regimes using a bottom-up approach, which enables a comprehensive analysis of welfare production based on recipients perceptions; and (2) an examination of more than one type of welfare-mix coexisting inside the national level across policy sectors. A classification of welfare regimes is carried out following a bottom-up approach and relying on the basis of the importance of welfare providers to satisfy social risks and promote well-being. Three traditional (e.g. state, market, family) and one alternative welfare providers (e.g. community) are considered. Data is collected through twenty semi-structured interviews in seven marginalised communities of Puerto Rico. The results show five configurations of intra-national welfare-mixes across the following welfare areas: housing, nourishment, health, education, maternity/paternity, disability, work-unemployment and older-age. This paper contributes to the theoretical proposals of intra-national welfare regimes, and alternatives providers in the welfare-mix.
Federalism and the politics of the Canada and Quebec Pension Plans
Authors: Béland Daniel , Weaver R. Kent
Published: October 2018

Drawing on the literature on federalism and public policy, the present article explores the recent politics of two highly-similar and closely integrated Canadian public pension programs created in the mid-1960s: the Canada Pension Plan (CPP) and the Quebec Pension Plan (QPP). This article argues that the parallel evolution of CPP/QPP can be understood by examining how the unique jurisdictional arrangements for the CPP/QPP interacted with other factors to generate by these linked programs have led to the emergence of specific federalism policy dynamics, while muting or foreclosing other potential policy dynamics. As shown, governments have engaged in a process of ‘collusive benchmarking’ that has limited the scope of the available policy options. Differing demographic trends in Quebec and the ‘Rest of Canada’ have strained but also reinforced this policymaking dynamic in recent years. Simultaneously, intergovernmental race to the top dynamics have facilitated the recent push for both CPP and, later, QPP expansion.
Cumulative incidence regression for dynamic treatment regimens
Authors: Chen Ling-Wan , Yavuz Idil , Cheng Yu , Wahed Abdus S
Published: October 2018

Recently dynamic treatment regimens (DTRs) have drawn considerable attention, as an effective tool for personalizing medicine. Sequential Multiple Assignment Randomized Trials (SMARTs) are often used to gather data for making inference on DTRs. In this article, we focus on regression analysis of DTRs from a two-stage SMART for competing risk outcomes based on cumulative incidence functions (CIFs). Even though there are extensive works on the regression problem for DTRs, no research has been done on modeling the CIF for SMART trials. We extend existing CIF regression models to handle covariate effects for DTRs. Asymptotic properties are established for our proposed estimators. The models can be implemented using existing software by an augmented-data approximation. We show the improvement provided by our proposed methods by simulation and illustrate its practical utility through an analysis of a SMART neuroblastoma study, where disease progression cannot be observed after death.
Neurobiological substrates underlying the effect of genomic risk for depression on the conversion of amnestic mild cognitive impairment
Authors: Xu Jiayuan , Li Qiaojun , Qin Wen , Jun Li Mulin , Zhuo Chuanjun , Liu Huaigui , Liu Feng , Wang Junping , Schumann Gunter , Yu Chunshui
Published: October 2018

Depression increases the conversion risk from amnestic mild cognitive impairment to Alzheimer’s disease with unknown mechanisms. We hypothesize that the cumulative genomic risk for major depressive disorder may be a candidate cause for the increased conversion risk. Here, we aimed to investigate the predictive effect of the polygenic risk scores of major depressive disorder-specific genetic variants (PRSsMDD) on the conversion from non-depressed amnestic mild cognitive impairment to Alzheimer’s disease, and its underlying neurobiological mechanisms. The PRSsMDD could predict the conversion from amnestic mild cognitive impairment to Alzheimer’s disease, and amnestic mild cognitive impairment patients with high risk scores showed 16.25% higher conversion rate than those with low risk. The PRSsMDD was correlated with the left hippocampal volume, which was found to mediate the predictive effect of the PRSsMDD on the conversion of amnestic mild cognitive impairment. The major depressive disorder-specific genetic variants were mapped into genes using different strategies, and then enrichment analyses and protein–protein interaction network analysis revealed that these genes were involved in developmental process and amyloid-beta binding. They showed temporal-specific expression in the hippocampus in middle and late foetal developmental periods. Cell type-specific expression analysis of these genes demonstrated significant over-representation in the pyramidal neurons and interneurons in the hippocampus. These cross-scale neurobiological analyses and functional annotations indicate that major depressive disorder-specific genetic variants may increase the conversion from amnestic mild cognitive impairment to Alzheimer’s disease by modulating the early hippocampal development and amyloid-beta binding. The PRSsMDD could be used as a complementary measure to select patients with amnestic mild cognitive impairment with high conversion risk to Alzheimer’s disease.
Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries
Authors: Wang Chuangshi , Bangdiwala Shrikant I , Rangarajan Sumathy , Lear Scott A , AlHabib Khalid F , Mohan Viswanathan , Teo Koon , Poirier Paul , TSE Lap Ah , Liu Zhiguang , Rosengren Annika , Kumar Rajesh , Lopez-Jaramillo Patricio , Yusoff Khalid , Monsef Nahed , Krishnapillai Vijayakumar , Ismail Noorhassim , Seron Pamela , Dans Antonio L , Kruger Lanthé , Yeates Karen , Leach Lloyd , Yusuf Rita , Orlandini Andres , Wolyniec Maria , Bahonar Ahmad , Mohan Indu , Khatib Rasha , Temizhan Ahmet , Li Wei , Yusuf Salim
Published: October 2018

Aims

To investigate the association of estimated total daily sleep duration and daytime nap duration with deaths and major cardiovascular events.

Methods and results

We estimated the durations of total daily sleep and daytime naps based on the amount of time in bed and self-reported napping time and examined the associations between them and the composite outcome of deaths and major cardiovascular events in 116 632 participants from seven regions. After a median follow-up of 7.8 years, we recorded 4381 deaths and 4365 major cardiovascular events. It showed both shorter (≤6 h/day) and longer (>8 h/day) estimated total sleep durations were associated with an increased risk of the composite outcome when adjusted for age and sex. After adjustment for demographic characteristics, lifestyle behaviours and health status, a J-shaped association was observed. Compared with sleeping 6–8 h/day, those who slept ≤6 h/day had a non-significant trend for increased risk of the composite outcome [hazard ratio (HR), 1.09; 95% confidence interval, 0.99–1.20]. As estimated sleep duration increased, we also noticed a significant trend for a greater risk of the composite outcome [HR of 1.05 (0.99–1.12), 1.17 (1.09–1.25), and 1.41 (1.30–1.53) for 8–9 h/day, 9–10 h/day, and >10 h/day, P  trend < 0.0001, respectively]. The results were similar for each of all-cause mortality and major cardiovascular events. Daytime nap duration was associated with an increased risk of the composite events in those with over 6 h of nocturnal sleep duration, but not in shorter nocturnal sleepers (≤6 h).

Conclusion

Estimated total sleep duration of 6–8 h per day is associated with the lowest risk of deaths and major cardiovascular events. Daytime napping is associated with increased risks of major cardiovascular events and deaths in those with >6 h of nighttime sleep but not in those sleeping ≤6 h/night.
Impetigo incidence and treatment: a retrospective study of Dutch routine primary care data
Authors: Loadsman Madelyn E N , Verheij Theo J M , van der Velden Alike W
Published: October 2018

Background

There is a lack of recently published data on impetigo presentation incidence and treatment practices in the routine Western European primary care setting.

Objectives

To investigate impetigo incidence, treatments and recurrence in primary care in the Netherlands.

Methods

A retrospective, observational study. Electronic records of patients treated for impetigo in 2015 at 29 general practices in Utrecht and surrounds were reviewed. An episode of impetigo was defined as one or more patient–doctor contacts within 8 weeks of the index consultation. Within an episode, patient demographics and prescribing patterns were analysed including number of treatments, and the category and sequence of individual medicines.

Results

A total of 1761 impetigo episodes were managed, with an incidence rate of 13.6 per 1000 person years. Impetigo peaked in summer. Most patients, the majority children, experienced a single episode (93%), and 25% had eczema as comorbidity. Topical antibiotics (primarily fusidic acid) were the most prescribed initial treatments (85%), followed by oral antibiotics (14%). Topical antibiotics were progressively used less over subsequent treatments, while there was an inverse increase in oral antibiotic use. Topical fusidic acid as the most common first line treatment seemed satisfactory as only 12% of initial treatments with this drug received further therapy. Repeat treatments generally occurred within 7 days.

Conclusion

This study of impetigo prescribing patterns in primary care highlighted that Dutch general practitioners were generally adherent to national treatment guidelines. Topical treatment, and if needed systemic small-spectrum antibiotic treatment, appeared satisfactory; these findings aid in antimicrobial stewardship.
Unmarried Older People: Are They Socially Better Off Today?
Authors: van Tilburg Theo G , Suanet Bianca
Published: October 2018

Objectives

Previous studies have shown that unmarried older adults are generally at disadvantage in personal networks and social well-being compared with the married. It can be questioned whether their situation has improved in contemporary society, as among others the stigma of divorce and being never-married has declined. We hypothesize differential developments in networks and well-being according to marital status (married, widowed, divorced, and never-married) across birth cohorts.

Method

Data are from the 1993 and 2013 observations of the Longitudinal Aging Study Amsterdam on Dutch people aged 55–69 (N = 2,894) and 70–84 years (N = 2,317). We employ general linear modeling of network size and diversity, received emotional and instrumental support, emotional and social loneliness, and depressive symptoms.

Results

The widowed are better off socially in 2013 than in 1993. Similar to the divorced they have a larger network, and similar to the never-married they receive more emotional support and are less emotional lonely. We find some gender differences in these developments.

Discussion

Societal change has not radically altered networks and well-being of unmarried older people. The widowed seem to benefit most, possibly because they are better able to retain relationships after widowhood.
Biological Aspects and Clinical Applications of Serum Biomarkers in Ovarian Cancer
Authors: Ali-Fehmi Rouba , Abdulfatah Eman
Published: October 2018

Ovarian cancer, the most aggressive gynecological malignancy, presents at advanced stages with metastatic disease. Diagnosis at an early stage is the most important determinant of survival; however, the majority of patients are asymptomatic at early stages and the current diagnostic tools used in clinics show limited success in early detection and hence the need for new diagnostic biomarkers. With the advance of techniques in genomic and proteomics, numerous biomarkers are emerging which may serve as a platform for early detection of ovarian cancer. These include gene-, protein-, miRNAs, and metabolite- based biomarkers. Examples of gene-based biomarkers include HE4, FLOR1, p16INK4a, BRCA1, BRCA2, MLH1, and MSH2. Protein- based biomarkers include leptin, prolactin, osteopontin, IGF-II, and MIF. This chapter discusses the serum tumor markers (CA-125) in current use for screening, diagnosis and monitoring of ovarian cancer as well as the novel biomarkers that are under investigation and validation.
Ovarian Cancer Immunity
Authors: Lavoué Vincent , Legembre Patrick , Levêque Jean , Foucher Fabrice , Henno Sébastien , Cabillic Florian
Published: October 2018

Epithelial ovarian cancer (EOC) is a significant cause of cancer-related mortality in women, and there has been no substantial decrease in the death rates due to EOC in the past three decades. Thus, basic knowledge regarding ovarian tumor cell biology is urgently needed to allow the development of innovative treatments for EOC. Traditionally, EOC has not been considered an immunogenic tumor, but there is evidence of an immune response to EOC in patients. Clinical data demonstrate that an anti-tumor immune response and immune evasion mechanisms are correlated with a better and lower survival, respectively, providing evidence for the immunoediting hypothesis in EOC. This chapter focuses on the immune response and immune suppression in EOC.
Antibody-Based Therapy for Ovarian Cancer
Authors: Alharbi Yousef , Patankar Manish S. , Whelan Rebecca J.
Published: October 2018

With their role in connecting disease-associated antigens to the cellular immune response, antibodies hold considerable promise as therapeutic agents. This chapter discusses three classes of therapeutic antibodies that have been developed for use in ovarian cancer therapy. The first includes antibodies selected against tumor-associated antigens such as MUC16/CA125, mesothelin, epithelial cell adhesion molecule, and folate receptor α‎. Antibodies in the second class target proteins such as CTLA-4 and PD1 that act as immune response checkpoint receptors. The third class of antibodies target secreted factors that promote tumor growth: targets in this class include vascular endothelial growth factor, cytokines, and chemokines. The development of each of these is described. The chapter also discusses the complications presented by soluble antigens, which serve to limit the applicability of antigens (such as MUC16/CA125) that are both cell-surface associated and circulating and the prospects for the combination of antibody-based immunotherapy and chemotherapy.
Dendritic Cell Vaccine Therapy for Ovarian Cancer
Authors: Stashwick Caitlin , Czerniecki Brian J. , Tanyi Janos L.
Published: October 2018

Dendritic cell vaccine therapy has emerged as an exciting new field in immunotherapy in ovarian cancer over the past two decades. This chapter reviews the biology of dendritic cells, including dendritic cell subsets, development, activation, and maturation as well as strategies for clinical use of dendritic cell vaccines. While there is encouraging data in preclinical work for dendritic cell vaccine, the outcomes of clinical trials have not shown robust responses. A summary of the clinical trials using dendritic cell vaccines in ovarian cancer is reviewed. Treatment-related toxicities and potential therapies to increase clinical efficacy are also discussed.
PD-1/PDL-1 Inhibitors as Immunotherapy for Ovarian Cancer
Authors: Moerdler Scott , Zang Xingxing
Published: October 2018

Programmed death 1 (PD-1), a member of the B7-CD28 immunoglobulin superfamily, and its ligands PD-L1/PD-L2 inhibit T-cell activation. They also play a key role in the tumor microenvironment, allowing for cancer immune escape. PD-1 is induced on a variety of immune cells, including tumor-infiltrating lymphocytes (TILs), while PD-L1 is found on many types of solid tumors including ovarian cancer and some TILs. The use of immunocheckpoint inhibitors like anti-PD-1 and anti-PD-L1 therapies has been shown to reactivate the immune system to attack tumor cells. Ovarian cancers have been shown to be responsive to anti-PD-1 and anti-PD-L1 therapies, though immunocheckpoint inhibitors are not enough. Current research is evaluating combination therapies to improve response rates.
Growth Factors and Their Corresponding Receptors as Targets for Ovarian Cancer Therapy
Authors: Cimpean Anca Maria , Adriana Jitariu Andreea , Raica Marius
Published: October 2018

Ovarian cancer remains one of the most aggressive and difficult to manage malignancies regarding evaluation and therapeutic options. The high mortality persists despite extensive research in the field. Current conventional chemotherapy does not improve disease-free survival and does not decrease recurrences amongst patients. This calls for a stringent reconsideration of the drugs selection, focused on the most targeted strategies and personalization of the therapy. Targeted agents against growth factors and their corresponding receptors are already approved as first- or second-line neoadjuvant therapy with controversial results. This chapter critically discusses the role of growth factors as vascular endothelial growth factor, fibroblast growth factors, or platelet-derived growth factors and their corresponding receptors in the pathogenesis, progression, and selection of therapeutic strategies. Other growth factors, such as nerve growth factor or endocrine gland derived growth factor, seem to have a strong involvement in ovarian carcinogenesis but their actual impact is not fully understood.
DSM-5 Diagnostic Criteria for PTSD
Authors: Weathers Frank W.
Published: October 2018

The diagnostic criteria for posttraumatic stress disorder (PTSD) have evolved substantially since the disorder was introduced in DSM-III. The latest revision for DSM-5 involved several notable changes, including moving PTSD to a new chapter of trauma- and stressor-related disorders, reconceptualizing the stressor criterion, expanding from three to four symptom clusters, adding three new symptoms and revising others, adding a dissociative subtype, and creating separate criteria for children six years and younger. This chapter traces the evolution of the PTSD criteria and describes the DSM-5 criteria in detail. Since PTSD has been a controversial diagnosis since its inception, this chapter also provides an overview of the conceptual issues and empirical findings that influenced its development over time and motivated its current iteration.
PTSD and Traumatic Brain Injury
Authors: Bryant Richard A.
Published: October 2018

One of the more hotly debated issues in the field of post-traumatic stress disorder (PTSD) is the role of traumatic brain injury (TBI), and particularly mild traumatic brain injury (mTBI). This topic became increasingly the focus of attention in the context of recent wars in Iraq and Afghanistan, where many troops suffered PTSD and mTBIs. Over three-quarters of injuries sustained in these conflicts arose from encounters with explosive devices, and accordingly it was often claimed that the “signature injuries” of the wars in Iraq and Afghanistan were both PTSD and mTBI. Clinicians and researchers have thus given renewed attention to the interplay of these two conditions. This chapter reviews definitional issues of PTSD and mTBI, how PTSD can develop after mTBI, the impact mTBI may have on stress responses, the distinctive role of postconcussive syndrome, and how to manage PTSD following mTBI.
PTSD and Neurodegenerative Disorders
Authors: Loewenstein David A. , Curiel Rosie E. , Raffo Arlene
Published: October 2018

This chapter examines the potential effects of post-traumatic stress disorder (PTSD) on cognitive function, evaluates mechanisms that may mediate this relationship, determines the potential effects of PTSD on neurobiological systems such as the hypothalamic–pituitary–adrenal axis and different limbic and frontal lobe pathways, and discusses how this might be related to an increased risk for neurodegeneration. The chapter propose that associations and increased odds ratios associated with PTSD and dementia, while worthy of study, do not firmly establish a causative relationship between PTSD and dementia. The barriers to studying the associations between PTSD and dementia as they relate to causal mechanisms are also examined. Further research is needed, with more precise definitions, diagnostic rigor, and a focus on examining actual brain–behavior mechanisms that may shed light on potential causation.
Trauma and PTSD in Europe
Authors: Trautmann Sebastian , Wittchen Hans-Ulrich
Published: October 2018

The chapter gives an overview about the epidemiological studies of traumatic events and post-traumatic stress disorder (PTSD) in European countries with a focus on data from recent cross-national research initiatives. About two-thirds of the European population have experienced at least one traumatic event in their lifetime. Between 1% and 3% of the European population, however, have developed PTSD suffering from symptoms during the past year; this corresponds to about 7.7 million people. The PTSD prevalence varies considerably between European countries, with differences regarding trauma exposure, exposure to war and combat events, cultural factors, and health care utilization. The chapter highlights significant research gaps, the need for more complete and nationally representative data for many European countries, and in-depth examination of reasons for the apparent large prevalence differences.
Executive Function in Post-Traumatic Stress Disorder
Authors: Newman Jennifer , Marmar Charles R.
Published: October 2018

This chapter discusses the role of executive function in post-traumatic stress disorder (PTSD), which is far from fully understood. Deficits are subtle and findings are often inconsistent. Impairments have been related to worsening of psychological symptoms, functioning, and quality of life. They can also negatively impact treatment. Functional imaging shows that neurocognitive deficits in PTSD may be related to an imbalance in brain connectivity, where emotion processing is enhanced and control is reduced. Structural findings show abnormalities in brain regions involved in higher-level functions. However, findings are often discrepant. Factors related to these inconclusive results are considered, including developmental course, premorbid functioning, and comorbidities such as traumatic brain injury, depression, substance use, attention deficit hyperactivity disorder, health behaviors, and medical concerns. Treatment implications, limitations of this work, and future directions are presented. The aim of future research is to advance scientific understanding of PTSD, neurocognitive impairments, and related conditions, with the goal of improving outcomes for those who encounter trauma.
Epigenetic Mechanisms and the Risk for PTSD
Authors: Meaney Michael J. , Yehuda Rachel
Published: October 2018

This chapter discusses the epigenetic mechanisms involved in individual variation in and persistence of post-traumatic stress disorder (PTSD). Such mechanisms make it possible to trace vulnerability for PTSD to effects that predate development of PTSD. While some may be genetic in origin, others may involve parental stress occurring pre-conception, in utero changes in the maternal environment contributing to developmental programming, and childhood adversity, resulting in modifications of genes’ contribution to PTSD risk. The chapter discusses epigenetic alterations implicated in hypothalamic–pituitary–adrenal (HPA) function in PTSD that mark increased risk. Unlike the transient alterations in neural, endocrine, or immunological signals that follow exposure to trauma, certain epigenetic markers can be chemically stable over extended periods and can serve as a basis for understanding the persistence of PTSD symptoms. The chapter concludes with a discussion of how epigenetic modification may offer insights into future treatments for PTSD.
Neurobiological Pathways Involved in Fear, Stress, and PTSD
Authors: Heim Christine , Schultebraucks Katharina , Marmar Charles R. , Nemeroff Charles B.
Published: October 2018

This chapter examines current findings relating to the molecular neuropharmacology of posttraumatic stress disorder (PTSD). Studies consistently show that neurochemical alterations after trauma exposure are associated with the development of PTSD and reflect in part stress sensitization in PTSD. We also review neuroendocrine, neurotransmitter, neuropeptide, and related molecular features that reflect preexisting vulnerability factors for the development of PTSD. In this chapter, we provide an overview of recent neuroendocrine findings mainly with regard to the influence of the hypothalamic-pituitary-axis. We also review recent neurochemical findings including the influence of different neurotransmitters such as catecholamines, serotonin, amino acids, neuropeptides, neurotrophins, and lipids. We incorporate these new and established neurobiological findings into a proposed integrative model of the neurobiology of PTSD.
Psychoneuroimmunology of Post-Traumatic Stress Disorder
Authors: Bind Rebecca Hannah , Pariante Carmine M.
Published: October 2018

This chapter reviews the evidence linking post-traumatic stress disorder (PTSD) with changes in immune function. The chapter starts with a brief explanation of the components of the immune system, including cytokines, and of the mechanisms linking psychological and psychiatric phenomena with changes in immune function (i.e., psychoneuroimmunology). Specific studies on PTSD are then described, including the potential neurobiological and health consequences of these immune changes and, finally, the effects of PTSD treatment on both symptomology and the immune system. While there is a consistent pattern of findings indicating increased immune activation in this condition, there is a paucity of research on the immunological correlates of PTSD, especially compared with the large number of immunological studies on depression and other psychiatric disorders.
The Psychophysiology of PTSD
Authors: Pineles Suzanne L. , Orr Scott P.
Published: October 2018

This chapter provides an overview of post-traumatic stress disorder (PTSD)-related psychophysiological research. Specific foci include psychophysiological reactivity to trauma-related stimuli and loud tones, conditioned fear acquisition and extinction, fear memory reconsolidation blockade, and the potential usefulness of psychophysiological measures in predicting PTSD development, maintenance, and treatment efficacy. A detailed discussion is provided on the contribution of reduced parasympathetic tone and increased sympathetic activity to the heightened psychophysiological reactivity associated with PTSD. Reduced parasympathetic tone may increase the risk of cardiovascular disease. Recent technological advances in physiological recording are also described.
Sleep and PTSD
Authors: Mellman Thomas A.
Published: October 2018

The Chapter reviews two long standing concerns of sleep research in PTSD. The first is characterizing dysregulations of arousal that manifest in relation to sleep including disturbances of sleep initiation, maintenance, and depth. The other is characterizing nightmare disturbances in PTSD and establishing the role of the neurophysiological substrate of dreams, rapid eye movement sleep (REMS), in the disorder. While there has been uncertainty and controversy regarding these issues, a comprehensive look at findings and their context (e.g. duration of PTSD, setting of recordings) allows some reconciliation of findings. Recent developments include assessment of autonomic balance during sleep and application of functional brain imaging. Emerging research on the role of sleep, particularly REMS, on emotional learning has been linked to PTSD. Treatments specifically targeting nightmares and other sleep disruptions, such as the alpha adrenergic antagonist prazosin and imagery rehearsal therapy, continue to be developed and evaluated.