bluuebunny/crossref_metadata_2025 huggingface dataset:
Recent Advances on the Application of Electrocyclic Reactions in Complex Natural Product Synthesis
Authors: Bian Ming , Ding Hanfeng , Li Lekai
Published: August 2017

The electrocyclic reaction is one of the most powerful tools for the construction of complex polycyclic scaffolds in a highly stereocontrolled fashion. In this review, recent advances in its application in the total synthesis of representative natural products are discussed, with the aim of providing a complement to existing reviews.

1 Introduction

2 4π Electrocyclization

2.1 Neutral 4π Electrocyclization

2.2 Cationic 4π Electrocyclization

3 6π Electrocyclization

3.1 All-Carbon 6π Electrocyclization

3.2 Oxa-6π Electrocyclization

3.3 Aza-6π Electrocyclization

3.4 Retro-6π Electrocyclization

4 8π Electrocyclization

5 Conclusion and Outlook
Highly Active Manganese-Mediated Acylation of Alcohols with Acid Chlorides or Anhydrides
Authors: Kim Seung-Hoi , Joo Seong-Ryu , Youn Young-Jin , Hwang Young-Ran
Published: August 2017

To explore further the practical uses of highly active manganese (Mn*), a variety of alcohols were treated with Mn*, and the resulting complexes were coupled with acid chlorides and/or acetic anhydride in the absence of any extra catalyst. The subsequent reactions took place smoothly under mild conditions, providing the corresponding O-acylation products in good to excellent isolated yields.
TBI and Sleep–Wake Disorders: Pathophysiology, Clinical Management, and Moving towards the Future
Authors: Baumann Christian , Werner J.
Published: August 2017

After experiencing a traumatic brain injury (TBI), the majority of patients will develop sleep–wake disorders (SWD). These can include insomnia, pleiosomnia, excessive daytime sleepiness, obstructive and/or central sleep apnea, circadian sleep–wake disorders, and potentially a variety of parasomnias. Untreated SWD may impede the recovery process and can negatively impact attention, executive function, and working memory. Importantly, these patients tend to misperceive their posttraumatic sleep problems. Consequently, interviews performed in standard clinical practice will not sufficiently capture SWD patients, potentially compromising safety and productivity.

In this review, the authors outline the state of current TBI-related SWD, highlighting proposed mechanisms, treatment modalities, and areas for further clinical investigation. They highlight data examining a role for slow wave sleep (SWS) in the enhancement of neural repair. They also examine the utility of enhanced cohort recruitment and SWD biomarker discovery via use of social media, smart-devices, and data-sharing networks.
Chronic Insomnia
Authors: Bianchi Matt
Published: August 2017

Insomnia is characterized by difficulty falling asleep or staying asleep, with consequent daytime impairment of mental and/or physical function. A detailed clinical history reveals the relative impact of a variety of different contributing and perpetuating factors, which then informs prioritization among different treatment options. Nonpharmacological approaches, especially the validated approach of cognitive–behavioral therapy for insomnia, are preferred over hypnotic medications. If hypnotics are chosen, the goal is short-term interventions after a careful risk-benefit assessment and shared decision-making with the patient. Although objective testing via polysomnography is not routinely indicated, such investigations can be informative in those at risk for concurrent primary sleep disorders, and in those who are treatment refractory. Circadian rhythm disorders can present with insomnia complaints, but are managed with chronotherapy. Whatever management pathway is pursued, the response to therapy should be anchored in improvements in daytime function.
A Single-Center Experience with Very Low Birth Weight Infants and Focal Intestinal Perforation: Comparison of Primary Anastomosis versus Stoma Opening
Authors: Consonni Dario , Macchini Francesco , Parente Giovanni , Zanini Andrea , Franzini Stefania , Colnaghi Mariarosa , Mosca Fabio , Leva Ernesto , Brisighelli Giulia
Published: August 2017

Introduction We present a single-center experience with very low birth weight (VLBW) infants with focal intestinal perforation (FIP), comparing the results of primary anastomosis (PA) and stoma opening (SO).

Materials and Methods Clinical records of VLBW infants with FIP who underwent surgery between 2006 and 2015 were reviewed. Patients were divided into two groups according to the procedure performed: limited bowel resection and PA or SO. Patients with gastric perforation or patients who underwent clip and drop were excluded. Information regarding birth weight (BW), gestational age (GA), weight at surgery (WS), number of abdominal reoperations, duration of parenteral nutrition (PN), and demise was recorded.

Results In this study, 40 patients were included: 22 in PA group and 18 in SO group. BW was 865 g in PA and 778 in SO (p-value: 0.2). GA was 26.1 weeks in PA and 25.6 in SO (p-value: 0.3). WS was 1,014 g in PA and 842 in SO (p-value: 0.09). Duration of surgery was 115 minutes in PA and 122 in SO (p-value: 0.67). Five patients (23%) belonging to PA group developed complications and required SO. Five patients (23%) demised in PA group and six (33%) in SO (p-value: 0.2). Seventeen abdominal reoperations were performed in PA group and 22 in SO group (p-value: 0.08).

Conclusion Both procedures appear to be safe. When possible, PA should be performed as it reduces the number of abdominal reinterventions.
Role of Early Pulmonary Hypertension as a Risk Factor for Late Pulmonary Hypertension in Extremely Preterm Infants
Authors: Kaluarachchi Dinushan , Woo Kaitlin , Colaizy Tarah
Published: August 2017

Objective The evidence on the role of early pulmonary vascular disease (PVD) in the development of late pulmonary hypertension (PH) in the extremely preterm infants is limited. Objectives were to determine the incidence of early and late PH in extreme preterm infants and to evaluate the role of early PH as a risk factor for development of clinically detected late PH.

Methods It was a retrospective analysis of early echocardiograms (day of life 5–14) in preterm infants, 22 to 27 weeks' gestation, admitted to the University of Iowa NICU between July 01, 2012 to June 30, 2015. Late echocardiograms performed for clinical suspicion of PH were also analyzed.

Results A total of 154 infants were included in the study. Early PH was diagnosed in 31 (20%) infants. Twenty-four (16%) infants were evaluated for clinically suspected PH. Eight (5%) infants were diagnosed with late PH. Infants with early PH had echocardiograms performed earlier than infants without the evidence of early PH. Early PH was not associated with the development of late PH (p = 0.99).

Conclusion Early PH is common among extremely preterm infants (20%). Five percent of infants had clinically detected late PH. Infants with early PH had echocardiograms performed earlier than infants without the evidence of early PH. Early PH was not associated with the development of clinically detected late PH.
Maternal–Fetal Medicine Physician and Fellow Perceptions of Business in Medicine
Authors: Iriye Brian , Ghamsary Mark , Porter Blake
Published: August 2017

Objective Principles of practice management provide a foundation for clinical success and performance improvement. Scant data exist regarding maternal–fetal medicine (MFM) physicians' knowledge of these topics. We hypothesize that physicians enter practice with inadequate education in practice management.

Study Design Surveys were emailed to members of the Society for Maternal–Fetal Medicine rating their knowledge and capabilities in practice management topics, and respondents assessed their current institution's business in the medical curriculum.

Results A total of 325 (14.4%) physicians responded: 63 fellows in training and 262 MFM physician subspecialists. Practicing physicians reported learning most of their knowledge “in practice after fellowship” (85%) or “never at all” (10%). Only 3% of respondents had adequate business education during fellowship, and only 5% felt prepared to teach business principles. However, 85% of those surveyed agreed that this material should be taught during the fellowship. Among MFM subspecialists and fellows in training at institutions with fellowships, 60% reported no current curriculum for practice management, and those with current curricula reported it had “limited” or “no value” (76%).

Conclusion There is a significant desire for practice management curricula during MFM fellowship, and current training is insufficient. With many MFM physicians ill-prepared to teach these principles, professional education from other financial fields, and standardized education in practice management from current expert sources is needed.
Frührehabilitation ist erstes Glied einer nahtlosen Rehabilitationskette
Authors: Beyer Joachim , Seidel Egbert
Published: August 2017

Eine frühe, intensive rehabilitative Therapie beschleunigt die Wiederherstellung von Funktionen schwerbetroffener Patienten. Sie trägt zu einer Verminderung der Komplikationsrate sowie zu einer Verbesserung der körperlichen und sozialen Funktionsfähigkeit bzw. Teilhabe im Langzeit-Follow-up bei. Die Frührehabilitation muss aufbauend auf den bestehenden Strukturen gestärkt werden: Schaffung und Erhaltung adäquat qualifizierter Frührehabilitationseinrichtungen mindestens in Krankenhäusern mit Schwerpunkt- und Maximalversorgungsaufträgen. Die Patienten mit Langzeitintensivbehandlung und Polytrauma müssen frühestmöglich rehabilitativ erreicht werden (intensivmedizinische Rehabilitation).

Fachärzte für Physikalische und Rehabilitative Medizin, rehabilitativ arbeitende Geriater, Neurologen, Orthopäden und Unfallchirurgen und andere Gebietsärzte müssen zielgerichtet zusammenwirken. Ausschlusskriterien über entsprechende OPS-Codes müssen aufgehoben werden. Weitere Gebietsärzte (Anästhesisten und Intensivmediziner, Allgemeinmediziner, Unfall- und Thoraxchirurgen, Internisten) müssen für die Bedeutung der Frührehabilitation sensibilisiert werden.

In den länderspezifischen Bettenbedarfsplänen sollten 5 % der Krankenhausbetten (ca. 25 000 von ca. 500 000) als alters- und diagnoseunabhängige Frührehabilitationsbetten ausgewiesen sein. Eine kostendeckende Finanzierung der zweifelsfrei personal- und kostenintensiven Frührehabilitation muss gewährleistet sein. Ein Phasenmodell, analog dem Modell der BAR zur neurologischen-neurochirurgischen Frührehabilitation sollte für weitere Krankheitsentitäten geschaffen werden.

Um den Rehabilitationsprozess möglichst erfolgreich zu gestalten, müssen medizinische (Akut-)Behandlung, medizinische Rehabilitation, berufliche Eingliederung und soziale Integration als ganzheitliches Geschehen verstanden werden und wirksam ineinandergreifen, als kontinuierlicher, die gesamte Krankheit phasenhaft begleitender Prozess. Hierzu ist ein kontinuierliches Case Management bzw. eine Reha-Begleitung zu etablieren.
Improved perovskite film quality and solar cell performances using dual single solution coating
Authors: Baltakesmez Ali , Biber Mehmet , Tüzemen Sebahattin
Published: August 2017

In this study, we present high quality perovskite CH3NH3PbI3−xClx thin films prepared by a combination of static and dynamic coating approaches, named dual single solution coating. Static coating, dynamic coating and the combination of these are comparatively studied. Scanning electron microscopy, X-ray diffraction, atomic force microscopy, UV-visible spectroscopy, and photoluminescence techniques are used for the determination of morphological, structural, and optical properties of thin films prepared using different coating approaches and deposition temperatures. All the coating approaches are repeated at room temperature and with hot deposition. The high quality and density CH3NH3PbI3−xClx films with full surface coverage are obtained using the dual single solution coating, particularly with hot-deposition. The perovskite solar cells prepared by the dual coating approach with hot deposition have better values for all the performance parameters in comparison to the other coating approaches, resulting in high efficiencies. The best device has a short circuit current of 22.03 mA/cm2, an open circuit voltage of 0.91 V, a fill factor of 0.73, and a power conversion efficiency of 14.68% from short-circuit to forward bias, and 22.39 mA/cm2, 0.91 V, 75% and 15.32% for the vice-versa, respectively.
Long-lived spin polarization in n-doped MoSe2 monolayers
Authors: Schwemmer M. , Nagler P. , Hanninger A. , Schüller C. , Korn T.
Published: August 2017

Transition metal dichalcogenide monolayers are highly interesting for potential valleytronic applications due to the coupling of spin and valley degrees of freedom and valley-selective excitonic transitions. However, ultrafast recombination of excitons in these materials poses a natural limit for applications so that a transfer of polarization to resident carriers is highly advantageous. Here, we study the low-temperature spin-valley dynamics in nominally undoped and n-doped MoSe2 monolayers using time-resolved Kerr rotation. In the n-doped MoSe2, we find a long-lived component of the Kerr signal which we attribute to the spin polarization of resident carriers. This component is absent in the nominally undoped MoSe2. The long-lived spin polarization is stable under applied in-plane magnetic fields. Spatially resolved measurements allow us to determine an upper boundary for the electron spin diffusion constant in MoSe2.
Accelerating and guiding of C6+ by an intense laser irradiating on a foil target with a tapered channel
Authors: Lv Chong , Wan Feng , Hou Ya-Juan , Hong Xue-Ren , Jia Mo-Ran , Sang Hai-Bo , Xie Bai-Song
Published: August 2017

A novel scheme with a tapered channel attached to an ultra-thin carbon foil is proposed to accelerate and guide carbon ions via breakout afterburner mechanism. Also, the problems involved are investigated by using two-dimensional particle-in-cell simulations. It is demonstrated that the tapered channel can efficiently accelerate and guide carbon ions and result in a much better quality beam with an order of magnitude higher in density and 22% larger in cut-off energy than that without the tapered channel. The enhanced reasons are analyzed in detail, which are mainly attributed to the guidance of the longitudinal electric field and the focus of the transverse electric field, as well as the convergence effect of the tapered channel. All of them are certified to guide greatly carbon ions to move along the longitudinal direction. Besides, during the simulation time, the ion beam with a tapered channel can remain eight times smaller in divergence angle than that without the tapered channel. Such a target may be beneficial to many applications such as ion fast ignition in inertial fusion, high-energy physics, and proton therapy.
The dynamics of peptide-water interactions in dialanine: An ultrafast amide I 2D IR and computational spectroscopy study
Authors: Feng Chi-Jui , Tokmakoff Andrei
Published: August 2017

We present a joint experimental and computational study of the dynamic interactions of dialanine (Ala–Ala) with water, comparing the results of ultrafast 2D IR and infrared transient absorption spectroscopy of its amide I vibration with spectra modeled from molecular dynamics (MD) simulations. The experimental data are analyzed to describe vibrational frequency fluctuations, vibrational energy relaxation, and chemical exchange processes. The origin of these processes in the same underlying fluctuating forces allows a common description in terms of the fluctuations and conformational dynamics of the peptide and associated solvent. By comparing computational spectroscopy from MD simulations with multiple force fields and water models, we describe how the dynamics of water hydrogen bond fluctuations and switching processes act as a source of friction that governs the dephasing and vibrational relaxation, and provide a description of coupled water and peptide motions that give rise to spectroscopic exchange processes.
A specially curved wedge for eliminating wedge angle effect in unsteady shock reflection
Authors: Wang He , Zhai Zhigang , Luo Xisheng , Yang Jiming , Lu Xiyun
Published: August 2017

A curved wedge with a specific shape is designed and manufactured to guarantee the wedge angle unvaried during the cylindrically converging shock moving along the wedge. Thus the variation of the wedge angle caused by the wedge will be eliminated in unsteady shock reflection. Different initial wedge angles are considered to observe regular reflection and Mach reflection. When Mach reflection occurs, it is found that direct Mach reflection is persisted over the wedge without wave pattern transitions, which differs from our previous work with varied wedge angles [Zhang et al. “Reflection of cylindrical converging shock wave over a plane wedge,” Phys. Fluids 28, 086101 (2016)]. Moreover, the Mach stem is nearly straight when the wedge angle is relatively large, and the trajectory of triple point can be well predicted by three-shock theory. It is believed that the straight Mach stem results from the coupling effect of the converging shock and the convexly curved wedge, which exert opposite effects on the Mach stem curvature. As the wedge angle reduces, the three-shock theory prediction deviates from the present results owing to the curved Mach stem. Stronger vortices are produced near the wall, which are caused by the interaction of two shear layers, and whether the stronger vortices will be generated near the wall depends on the reflection number of the shock wave over the tube wall and wedge. The length of disturbed shock front in the Mach reflection is found to increase nonlinearly due to the unsteady feature of the flow. The growth rate of length reduces as the shock converges because of the geometrical contraction effect. Further the lengths of the Mach stem and the disturbed shock front are compared, and the results show that although the difference exists between them, both of them show a similar variation tendency. Compared with our previous work with varied wedge angles, the variation of the wedge angle has great effects on the Mach stem length and wave pattern transitions. It is believed that the differences between the present study and the pseudo-steady shock reflection are mainly induced by the unsteady feature of the flow because the variation of the shock Mach number is limited and the wedge angle is constant.
Nonlinear interaction between underwater explosion bubble and structure based on fully coupled model
Authors: Zhang A. M. , Wu W. B. , Liu Y. L. , Wang Q. X.
Published: August 2017

The interaction between an underwater explosion bubble and an elastic-plastic structure is a complex transient process, accompanying violent bubble collapsing, jet impact, penetration through the bubble, and large structural deformation. In the present study, the bubble dynamics are modeled using the boundary element method and the nonlinear transient structural response is modeled using the explicit finite element method. A new fully coupled 3D model is established through coupling the equations for the state variables of the fluid and structure and solving them as a set of coupled linear algebra equations. Based on the acceleration potential theory, the mutual dependence between the hydrodynamic load and the structural motion is decoupled. The pressure distribution in the flow field is calculated with the Bernoulli equation, where the partial derivative of the velocity potential in time is calculated using the boundary integral method to avoid numerical instabilities. To validate the present fully coupled model, the experiments of small-scale underwater explosion near a stiffened plate are carried out. High-speed imaging is used to capture the bubble behaviors and strain gauges are used to measure the strain response. The numerical results correspond well with the experimental data, in terms of bubble shapes and structural strain response. By both the loosely coupled model and the fully coupled model, the interaction between a bubble and a hollow spherical shell is studied. The bubble patterns vary with different parameters. When the fully coupled model and the loosely coupled model are advanced with the same time step, the error caused by the loosely coupled model becomes larger with the coupling effect becoming stronger. The fully coupled model is more stable than the loosely coupled model. Besides, the influences of the internal fluid on the dynamic response of the spherical shell are studied. At last, the case that the bubble interacts with an air-backed stiffened plate is simulated. The associated interesting physical phenomenon is obtained and expounded.
Superregular breathers in a complex modified Korteweg-de Vries system
Authors: Liu Chong , Ren Yang , Yang Zhan-Ying , Yang Wen-Li
Published: August 2017

We study superregular (SR) breathers (i.e., the quasi-Akhmediev breather collision with a certain phase shift) in a complex modified Korteweg-de Vries equation. We demonstrate that such SR waves can exhibit intriguing nonlinear structures, including the half-transition and full-suppression modes, which have no analogues in the standard nonlinear Schrödinger equation. In contrast to the standard SR breather formed by pairs of quasi-Akhmediev breathers, the half-transition mode describes a mix of quasi-Akhmediev and quasi-periodic waves, whereas the full-suppression mode shows a non-amplifying nonlinear dynamics of localized small perturbations associated with the vanishing growth rate of modulation instability. Interestingly, we show analytically and numerically that these different SR modes can be evolved from an identical localized small perturbation. In particular, our results demonstrate an excellent compatibility relation between SR modes and the linear stability analysis.
Effects of thickness ratio of InGaN to GaN in superlattice strain relief layer on the optoelectrical properties of InGaN-based green LEDs grown on Si substrates
Authors: Qi Weijing , Zhang Jianli , Mo Chunlan , Wang Xiaolan , Wu Xiaoming , Quan Zhijue , Wang Guangxu , Pan Shuan , Fang Fang , Liu Junlin , Jiang Fengyi
Published: August 2017

InGaN-based multiple quantum well (MQW) green light-emitting diodes with a InGaN/GaN superlattice as a strain relief layer (SSRL) were grown on Si(111) substrates by metal organic chemical vapor deposition. The influences of the thickness ratio of InGaN to GaN in SSRL on the optoelectrical properties have been investigated. Electrical measurements show that the sample with a higher thickness ratio has a lower series resistance. This is mainly ascribed to the improvement of carrier vertical transport due to the thinner GaN in SSRL. However, it is found that the leakage current increases with the thickness ratio from 1:1 to 2.5:1, which could be attributed to the larger density of small size V-pits forming at the first few QW pairs. Compared with the smaller thickness ratio, the sample with a higher thickness ratio of InGaN to GaN in SSRL is found to exhibit larger strain relaxation (about 33.7%), but the electroluminescence measurement exhibits inferior emission efficiency. Carrier leakage via the small V-pits and the rougher interface of MQW are believed to be responsible for the reduction of emission efficiency.
Impact of phase-locked loop on system dynamics of a CCGT incorporated diverse source system employed with AC/DC interconnection
Authors: Saha Debdeep , Saikia L. C.
Published: August 2017

Nowadays, research on renewable generation penetration in a power system has facilitated the use of power electronics with improved grid-support functionalities. This article addresses the automatic generation control of a three-area interconnected system with combined cycle gas turbine and two thermal generating units in area1 and a wind and two thermal units in other areas. All areas are employed with delayed communication channels, and appropriate generation rate constraints and governor deadband are provided in thermal systems. A recent metaheuristic algorithm, namely stochastic fractal search (SFS), is applied for optimization of secondary controller gains and other system parameters. The performance of various two-degrees-of-freedom proportional-integral-derivative (2DOF PID) controller structures are compared with single-degree-of-freedom proportional-integral-derivative controllers, and results explore the superiority of 2DOF PID controllers. An attempt to explore the impact of AC/DC links considering delayed phase-locked loop (PLL) dynamics during coordination with diverse source interconnected AC systems is presented and discussed. Results clearly outline overshoots and settling time of frequency, tie-power, and temperature deviation increases owing to the inclusion of PLL. A detailed numerical analysis is presented to understand the system dynamic responses due to parametric changes in PLL function. However, with optimum parametric selection, the deviations and settling time decrease. Last, sensitivity analysis implies that SFS optimized controller parameters need not be reset for ±25% changes in loading condition; inertia constant; and ±10%, ±20%, and –25% changes in tie-power synchronizing co-efficient. But system responses deteriorate during +25% changes in the latter owing to very strong ties between the areas, which are not recommended.
Rediscovery of the plains mouse (Pseudomys australis) (Rodentia : Muridae) in New South Wales
Authors: Leggett Keith E. A. , Welaratne Thanuri , Letnic Michael , McLeod Steven , Dawson Terence
Published: August 2017

We report the rediscovery of the rare and endangered native rodent, the plains mouse (Pseudomys australis) in New South Wales (NSW). Two plains mice were trapped in the far west of the state at Fowlers Gap Arid Zone Research Station and another in the NSW section of the Strzelecki Desert. Until these captures, the plains mouse was thought to have been extinct in NSW. Subfossil records indicate that these observations are within the pre-European settlement range of the species. It is uncertain whether these captures represent a range expansion from known populations in northern South Australia or reflect a local refuge population. Ensuring the conservation of P. australis in NSW requires further study to determine its distribution and the factors influencing its abundance.
Comparative proteomic analysis of drought response in roots of two soybean genotypes
Authors: Yu Xingwang , Yang Aijun , James Andrew T.
Published: August 2017

Water deficit is a serious environmental stress during the soybean growth and production season in Australia. Soybean has evolved complex response mechanisms to cope with drought stress through multiple physiological processes. In this study, the roots of a previously identified drought-tolerant soybean genotype, G21210, and a sensitive genotype, Valder, were subjected to comparative proteomic analysis based on 2-dimensional electrophoresis, under mild or severe drought conditions. The analysis showed that the abundance of 179 protein spots significantly changed under stress. In total, 155 unique proteins were identified from these spots, among which 70 protein spots changed only in G2120 and 89 spots only in Valder, with 20 proteins changed in both soybean genotypes. Bioinformatics analysis revealed that these drought-induced changes in proteins were largely enriched in the biological function categories of defence response, protein synthesis, energy metabolism, amino acid metabolism and carbohydrate metabolism. For the drought-tolerant genotype, the differential abundance was decreased for 24 proteins and increased for 46 proteins. For the drought-sensitive genotype, the abundance was reduced for 46 proteins, increased for 40 proteins and changed differently for three proteins in mild and severe drought. The different patterns of change of these proteins in G2120 and Valder might be attributed to the difference in their drought-tolerance capacity. This study, combined with our previously reported proteomics study in soybean leaves, further clarifies the change in proteins under drought stress in different organs and provides a better understanding of the molecular mechanisms under drought stress in soybean production.
The Gender Feeling Amplitude: an instrument to assist clinicians with the assessment of gender diverse adolescents
Authors: Riley Elizabeth
Published: August 2017

Background
The Gender Feeling Amplitude (GFA) is a 68-item list of words and phrases with which to identify the feelings and severity of a young person’s distress regarding their gender identity and gender diversity, and takes ~1 min to administer. Method: For this pilot study, 67 adolescents and youth who sought support, confirmation or intervention (either via themselves or their parents) regarding gender diversity or gender transition were given the GFA in a face-to-face meeting before the beginning of an assessment procedure for gender diversity. Forty-three assigned females and 24 assigned males aged between 10 and 20 years were analysed by frequency of item, age and assigned gender. Results: Of the 68 items, those circled by close to 50% or more of the participants were ‘self-conscious’, ‘awkward’ and ‘don’t fit in’. One-third or more circled the words ‘shy’, ‘supported’, ‘hopeful’, ‘discomfort’, ‘as if I’m not being seen properly’, ‘forced to be something I’m not’, ‘depressed’ and ‘stressed’. Conclusion: Comparisons showed some variations in responses by both assigned gender and age, and the discussion includes ways the GFA may be able to assist a health practitioner with explorations of gender diversity and interventions for counselling.
Distinct effects of tubulin isotype mutations on neurite growth inCaenorhabditis elegans
Authors: Zheng Chaogu , Diaz-Cuadros Margarete , Nguyen Ken C. Q. , Hall David H. , Chalfie Martin
Published: August 2017

Tubulins, the building block of microtubules (MTs), play a critical role in both supporting and regulating neurite growth. Eukaryotic genomes contain multiple tubulin isotypes, and their missense mutations cause a range of neurodevelopmental defects. Using the Caenorhabditis elegans touch receptor neurons, we analyzed the effects of 67 tubulin missense mutations on neurite growth. Three types of mutations emerged: 1) loss-of-function mutations, which cause mild defects in neurite growth; 2) antimorphic mutations, which map to the GTP binding site and intradimer and interdimer interfaces, significantly reduce MT stability, and cause severe neurite growth defects; and 3) neomorphic mutations, which map to the exterior surface, increase MT stability, and cause ectopic neurite growth. Structure-function analysis reveals a causal relationship between tubulin structure and MT stability. This stability affects neuronal morphogenesis. As part of this analysis, we engineered several disease-associated human tubulin mutations into C. elegans genes and examined their impact on neuronal development at the cellular level. We also discovered an α-tubulin (TBA-7) that appears to destabilize MTs. Loss of TBA-7 led to the formation of hyperstable MTs and the generation of ectopic neurites; the lack of potential sites for polyamination and polyglutamination on TBA-7 may be responsible for this destabilization.
Meningococcal Carriage Following a Vaccination Campaign With MenB-4C and MenB-FHbp in Response to a University Serogroup B Meningococcal Disease Outbreak—Oregon, 2015–2016
Authors: McNamara Lucy A , Thomas Jennifer Dolan , MacNeil Jessica , Chang How Yi , Day Michael , Fisher Emily , Martin Stacey , Poissant Tasha , Schmink Susanna E , Steward-Clark Evelene , Jenkins Laurel T , Wang Xin , Acosta Anna ,   Oregon Meningococcal Carriage Team, Angelo Kristina , Blain Amy , Cassiday Pam , Changayil Shankar , Church Elizabeth Chandler , Diebold Kasey , Ewumi Sinmisola , Faulkner Amanda , Fisun Helen , Haberman Holly , Harcourt Brian , Haring Sterling , Hughes Lauren , Joseph Sandeep , Kumaran Nivritti , Lee Adria , Lennon Tanya , Link-Gelles Ruth , Lu Lihan (Diana) , Marcinkevage Jessica , Mayer Leonard , Milucky Jenny , Miner Christine , Nelson Jennifer , Patel Manisha , Paulos Simon , Pinell-McNamara Veronica , Quinn Conrad , Rajam Gowrisankar , Redman Romany , Retchless Adam , Rosenthal Mariana , Semenova Vera , Skoff Tami , Smulian Elizabeth , Stanley Toscha , Stratton Erin , Talley Pam , Tiwari Tejpratep , Toews Karrie-Ann , Westercamp Matt , Cieslak Paul , DeSilva Malini , Alviani Nick , Biel Frances , Burkhalter Bailey , Francis Matt , Howe Phebe , Jackson Esther , Johnson Tina , Luedtke Patrick , Manning Zach , Muno Ester , Roberts Todd , Roberts Zack , Eyster Michael , Hollands Charles
Published: August 2017

Following a serogroup B meningococcal disease outbreak at an Oregon university, a meningococcal carriage evaluation was conducted in conjunction with a MenB-FHbp and MenB-4C vaccination campaign. Neither vaccine was associated with reduced meningococcal carriage among participants.
Pulmonary valve disease
Authors: Katritsis Demosthenes G. , Gersh Bernard J. , Camm A. John
Published: August 2017

Pulmonary valve regurgitation is mainly discussed in this chapter. Pulmonary valve stenosis is discussed under RVOT obstruction in Chapter 1 on GUCH.
Classification and pathophysiology of hypertension
Authors: Katritsis Demosthenes G. , Gersh Bernard J. , Camm A. John
Published: August 2017

Definition, epidemiology, pathophysiology, and classification of arterial hypertension are presented. Methods of blood pressure measurement are also discussed.
PENTACLE: Parallelized particle–particle particle-tree code for planet formation
Authors: Iwasawa Masaki , Oshino Shoichi , Fujii Michiko S. , Hori Yasunori
Published: August 2017

We have newly developed a parallelized particle–particle particle-tree code for planet formation, PENTACLE, which is a parallelized hybrid N-body integrator executed on a CPU-based (super)computer. PENTACLE uses a fourth-order Hermite algorithm to calculate gravitational interactions between particles within a cut-off radius and a Barnes–Hut tree method for gravity from particles beyond. It also implements an open-source library designed for full automatic parallelization of particle simulations, FDPS (Framework for Developing Particle Simulator), to parallelize a Barnes–Hut tree algorithm for a memory-distributed supercomputer. These allow us to handle 1–10 million particles in a high-resolution N-body simulation on CPU clusters for collisional dynamics, including physical collisions in a planetesimal disc. In this paper, we show the performance and the accuracy of PENTACLE in terms of $\tilde{R}_{\rm cut}$ and a time-step Δt. It turns out that the accuracy of a hybrid N-body simulation is controlled through $\Delta t / \tilde{R}_{\rm cut}$ and $\Delta t / \tilde{R}_{\rm cut} \sim 0.1$ is necessary to simulate accurately the accretion process of a planet for ≥106 yr. For all those interested in large-scale particle simulations, PENTACLE, customized for planet formation, will be freely available from https://github.com/PENTACLE-Team/PENTACLE under the MIT licence.
Neuraxial Analgesia to Increase the Success Rate of External Cephalic Version: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Magro-Malosso E.R. , Saccone G. , Di Tommaso M. , Mele M. , Berghella V.
Published: August 2017

(Am J Obstet Gynecol. 2016;215(3):276–286)

The objective of this study was to gauge the effectiveness of neuraxial analgesia in increasing the success rate of external cephalic version. Breech or transverse presentations of the fetus is one of the most common causes for the increased cesarean delivery rate. External cephalic version is a medical technique in which the malpresenting fetus is externally manipulated to assume the cephalic birth position.
Antenatal Corticosteroids for Maturity of Term or Near Term Fetuses: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Saccone Gabriele , Berghella Vincenzo
Published: August 2017

(BMJ. 2016;355:i5044)

One of the significant causes of early neonatal morbidity and mortality in the United States is respiratory distress syndrome (RDS). The use of prophylactic corticosteroids in preterm pregnancies is known to hasten lung maturation and decrease the occurrence of RDS.
Persistent Opioid Use Following Cesarean Delivery: Patterns and Predictors Among Opioid-naive Women
Authors: Bateman B.T. , Franklin J.M. , Bykov K. , Avorn J. , Shrank W.H. , Brennan T.A. , Landon J.E. , Rathmell J.P. , Huybrechts K.F. , Fischer M.A. , Choudhry N.K.
Published: August 2017

(Am J Obstet Gynecol. 2016;215(3):353.e1–353.e18)

According to the US Centers for Disease Control and Prevention and other leading health care organizations, between 1999 and 2010 the rate of opioid medication overdose resulting in death among women increased 5-fold. With over a third of all deliveries in the United States being cesarean deliveries and opioids being prescribed as postsurgical analgesics to these patients, the risk of overdose increases. Hence, the purpose of this study was to identify the risks and behavior patterns of women with initial opioid exposure (opioid-naive women) in the setting of routine medical care (eg, postcesarean pain medicine prescriptions) associated with them becoming persistent opioid users.
Proposed Diagnostic Criteria for the Case Definition of Amniotic Fluid Embolism in Research Studies
Authors: Clark S.L. , Romero R. , Dildy G.A. , Callaghan W.M. , Smiley R.M. , Bracey A.W. , Hankins G.D. , D’Alton M.E. , Foley M. , Pacheco L.D. , Vadhera R.B. , Herlihy J.P. , Berkowitz R.L. , Belfort M.A.
Published: August 2017

(Am J Obstet Gynecol. 2016;215(4):408–412)

A lack of diagnostic criteria for amniotic fluid embolism (AFE) has hindered the understanding and management of this uncommon but often fatal condition. Some previous reports have defined AFE by criteria not specific to AFE, and included only patients who died, possibly excluding women less severely affected by AFE. Other reports have used widely varying criteria and likely included patients suffering from conditions other than AFE. The possibly skewed results of these studies and the lack of a definition of AFE are troubling as AFE is one of the leading causes of maternal death in developed countries.
Selective Serotonin Reuptake Inhibitor (SSRI) Use During Pregnancy and Risk of Preterm Birth: A Systematic Review and Meta-Analysis
Authors: Eke A.C. , Saccone G. , Berghella V.
Published: August 2017

(BJOG. 2016;123(12):1900–1907)

Depression affects approximately 10% of women during pregnancy and when untreated can lead to poor self-care. Untreated depression during pregnancy also increases a woman’s risk of postpartum depression, and there is an association between depression persisting into the postpartum period and impaired maternal-infant bonding.
Mode of Anesthesia and Clinical Outcomes of Patients Undergoing Cesarean Delivery for Invasive Placentation: A Retrospective Cohort Study of 50 Consecutive Cases
Authors: Nguyen-Lu N. , Carvalho J.C. , Kingdom J. , Windrim R. , Allen L. , Balki M.
Published: August 2017

(Can J Anaesth. 2016;63(11):1233–1244)

The main aim of this retrospective cohort study of 50 consecutive cases at the authors’ institution between 2000 and 2012 was to analyze the impact of mode of anesthesia on maternal and neonatal outcomes in patients with invasive placentation undergoing cesarean delivery (CD). In the cohort, 25 women (50%) underwent elective CD, while the remaining had unplanned CD (50%); 34 of these women (68%) underwent surgery under regional anesthesia (RA) while the other 16 received general anesthesia (GA) (32%). Of these 50 patients with invasive placentation, 36 (72%) required cesarean hysterectomies (CHyst).
Lower Uterine Segment Thickness to Prevent Uterine Rupture and Adverse Perinatal Outcomes: A Multicenter Prospective Study
Authors: Jastrow N. , Demers S. , Chaillet N. , Girard M. , Gauthier R.J. , Pasquier J.C. , Abdous B. , Vachon-Marceau C. , Marcoux S. , Irion O. , Brassard N. , Boulvain M. , Bujold E.
Published: August 2017

(Am J Obstet Gynecol. 2016;215(5):604.e1–604.e6)

Worldwide, cesarean delivery has been on the rise over the past 30 years, in part due to a declining rate of trial of labor after cesarean delivery (TOLAC). Intrapartum uterine rupture is a very serious complication of TOLAC, and can result in severe maternal and perinatal outcomes, including perinatal asphyxia or death. Studies have suggested that the risk of uterine rupture can be predicted by assessing lower uterine segment (LUS) thickness. Utilizing a large prospective cohort of women attempting TOLAC, this study aimed to evaluate the occurrence of uterine rupture when LUS thickness was used to inform decision making.
Birth Defects Among Fetuses and Infants of US Women With Evidence of Possible Zika Virus Infection During Pregnancy
Authors: Honein M.A. , Dawson A.L. , Petersen E.E. , Jones A.M. , Lee E.H. , Yazdy M.M. , Ahmad N. , Macdonald J. , Evert N. , Bingham A. , Ellington S.R. , Shapiro-Mendoza C.K. , Oduyebo T. , Fine A.D. , Brown C.M. , Sommer J.N. , Gupta J. , Cavicchia P. , Slavinski S. , White J.L. , Owen S.M. , Petersen L.R. , Boyle C. , Meaney-Delman D. , Jamieson D.J.
Published: August 2017

(JAMA. 2017;317(1):59–68)

Fetal microcephaly and other brain abnormalities have been associated with Zika virus infection during pregnancy. However, the magnitude of risk for fetuses of infected parturients remains unknown. It is also unclear whether women with symptomatic Zika virus disease are more likely to have adverse pregnancy outcomes than those with asymptomatic infection. This report analyzed data obtained from the US Zika Pregnancy Registry (USZPR) to determine the proportion of fetuses or infants with birth defects likely to be associated with maternal Zika virus infection among women in the United States. The investigators also evaluated whether the proportion of infants with birth defects differed based on the presence of maternal symptoms of Zika virus infection or by trimester of possible infection.
Association of Placental Weight With Cerebral Palsy: Population-based Cohort Study in Norway
Authors: Strand K.M. , Andersen G.L. , Haavaldsen C. , Vik T. , Eskild A.
Published: August 2017

(BJOG. 2016;123(13):2131–2138)

Cerebral palsy (CP) involves permanent disorders of movement that result from injuries to the developing brain. While it has been common to associate CP with hypoxia during birth, most cases of CP have now been found to be unrelated to delivery and probably result from antenatal events although the exact causes are usually unknown.
Performance of the Angle Labor Pain Questionnaire During Initiation of Epidural Analgesia in Early Active Labor
Authors: Angle P.J. , Kurtz Landy C. , Djordjevic J. , Barrett J. , Kibbe A. , Sriparamananthan S. , Lee Y. , Hamata L , Zaki P. , Kiss A.
Published: August 2017

(Anesth Analg. 2016;123(6):1546–1553)

The Angle Labor Pain Questionnaire (A-LPQ) was developed to overcome difficulties associated with assessing women’s pain experiences during childbirth, experiences which are multidimensional but often measured using unidimensional and unreliable tools (eg, visual analog scale, numeric rating scale, etc.).
External Cephalic Version: Some Tricks of the Trade
Authors: Skupski Daniel W. , Ghidini Alessandro
Published: August 2017

(Birth. 2016;43(3):189–192)

One of the major causes of cesarean delivery with its higher risk of maternal morbidity and mortality is fetal malpresentation. External cephalic version (ECV) is a technique that has a success rate of about 50% in reversing breech presentation at term, thus reducing the risk of cesarean delivery. Yet in the Netherlands alone there is a varied rate of utilizing ECV (8% to 84%). This technique that promotes maternal and fetal safety would be more frequently used if more practitioners, such as obstetricians and midwives, were aware of the technique. Hence the purpose of this commentary was to highlight the features of ECV, including ECV timing, location, maternal characteristics and positioning, and use of ultrasonography, tocolytics and neuraxial analgesia as well as ensuring intravenous access.
The Use of Ultrasound in Planned Cesarean Delivery Under Spinal Anesthesia for Patients Having Nonprominent Anatomic Landmarks
Authors: Ekinci M. , Alici H.A. , Ahiskalioglu A. , Ince I. , Aksoy M. , Celik E.C. , Dostbil A. , Celik M. , Baysal P.K. , Golboyu B.E. , Yeksan A.N.
Published: August 2017

(J Clin Anesth. 2017;37:82–85)

Ultrasound (US) guidance for neuraxial procedures is simple, noninvasive, safe, quick, and relatively risk-free. However, there are limited data in the literature about US guidance for neuraxial injections. Consequently, the authors of the present study compared the conventional landmark method with US-guided spinal anesthesia in women undergoing cesarean delivery where spinous processes and interspinous spaces were not prominent on physical examination.
Does Preprocedural Ultrasound Increase the First-Pass Success Rate of Epidural Catheterization Before Cesarean Delivery? A Randomized Controlled Trial
Authors: Tawfik M.M. , Atallah M.M. , Elkharboutly W.S. , Allakkany N.S. , Abdelkhalek M.
Published: August 2017

(Anesth Analg. 2017;124(3):851–856)

Studies regarding the use of preprocedural ultrasound for epidural catheterization are largely unblinded and differ greatly in design, expertise of the operator, performance of epidural technique, and primary outcomes. To address this inconsistency, the authors of the present study compared preprocedural ultrasound with conventional palpation for epidural catheterization performed by a single experienced anesthesiologist as a component of double-interspace combined spinal-epidural anesthesia for cesarean delivery.
Maternal Tobacco Use and Extremely Premature Birth: A Population-based Cohort Study
Authors: Dahlin S. , Gunnerbeck A. , Wikström A.K. , Cnattingius S. , Edstedt Bonamy A.K.
Published: August 2017

(BJOG. 2016;123(12):1938–1946)

Preterm birth is a major cause of neonatal morbidity and mortality, especially in extremely preterm infants (<28 wk). Smoking or using snuff are preventable risk factors for preterm birth, with up to 8% of preterm births in the United States associated with maternal smoking. Smoking has been shown to have a dose-response relationship with the risk of preterm birth, and the risk increases with decreasing gestational age.
Changes in Qualitative and Quantitative Ultrasound Assessment of the Gastric Antrum Before and After Elective Caesarean Section in Term Pregnant Women: A Prospective Cohort Study
Authors: Rouget C. , Chassard D. , Bonnard C. , Pop M. , Desgranges F.P. , Bouvet L.
Published: August 2017

(Anaesthesia. 2016;71(11):1284–1290)

Ultrasound examination of the gastric antrum is used for qualitative analysis of gastric contents and to estimate gastric fluid volume before general anaesthesia in nonpregnant adults and children. There are published values correlating antral cross-sectional area (CSA) with a quantitative measure of gastric contents. In parturients, however, the relationship between the antral area and gastric contents might be altered as the gravid uterus changes the position and size of the stomach through direct compression. Therefore, a prospective study was carried out to determine the antral CSA and the quantitative estimate of gastric contents before and after cesarean section (CS).
Transcutaneous Carbon Dioxide Measurements in Women Receiving Intrathecal Morphine for Cesarean Delivery: A Prospective Observational Study
Authors: Bauchat J.R. , McCarthy R. , Fitzgerald P. , Kolb S. , Wong C.A.
Published: August 2017

(Anesth Analg. 2017;124(3):872–878)

Neuraxial morphine, which is commonly used after cesarean delivery, has a favorable safety profile with a reported incidence of respiratory depression of only 0.07% to 0.9%. However, there is no standard definition of respiratory depression. The most sensitive measure may be hypercapnia (threshold of 50 mm Hg), which can be measured using the noninvasive, transcutaneous Topological Oscillation Search with Kinematical Analysis (TOSCA) monitor, which estimates arterial carbon dioxide levels (TcCO2). Thus, the authors of the present study estimated the incidence of respiratory depression as defined by hypercapnia events (TcCO2 >50 mm Hg for ≥2 min) using the TOSCA monitor in women receiving 150 μg intrathecal morphine for postcesarean analgesia.