bluuebunny/crossref_metadata_2025 huggingface dataset:
A gated Thomson parabola spectrometer for improved ion and neutral atom measurements in intense laser produced plasmas
Authors: Tata Sheroy , Mondal Angana , Sarkar Soubhik , Lad Amit D. , Krishnamurthy M.
Published: August 2017

Ions of high energy and high charge are accelerated from compact intense laser produced plasmas and are routinely analysed either by time of flight or Thomson parabola spectrometry. At the highest intensities where ion energies can be substantially large, both these techniques have limitations. Strong electromagnetic pulse noise jeopardises the arrival time measurement, and a bright central spot in the Thomson parabola spectrometer affects the signal to noise ratio of ion traces that approach close to the central spot. We present a gated Thomson parabola spectrometer that addresses these issues and provides an elegant method to improvise ion spectrometry. In addition, we demonstrate that this method provides the ability to detect and measure high energy neutral atoms that are invariably present in most intense laser plasma acceleration experiments.
Delay-induced locking in bursting neuronal networks
Authors: Zhu Jinjie , Liu Xianbin
Published: August 2017

In this paper, the collective behaviors for ring structured bursting neuronal networks with electrical couplings and distance-dependent delays are studied. Each neuron is modeled by the Hindmarsh-Rose neuron. Through changing time delays between connected neurons, different spatiotemporal patterns are obtained. These patterns can be explained by calculating the ratios between the bursting period and the delay which exhibit clear locking relations. The holding and the failure of the lockings are investigated via bifurcation analysis. In particular, the bursting death phenomenon is observed for large coupling strengths and small time delays which is in fact the result of the partial amplitude death in the fast subsystem. These results indicate that the collective behaviors of bursting neurons critically depend on the bifurcation structure of individual ones and thus the variety of bifurcation types for bursting neurons may create diverse behaviors in similar neuronal ensembles.
Stranski–Krastanov InAs/GaAsSb quantum dots coupled with sub-monolayer quantum dot stacks as a promising absorber for intermediate band solar cells
Authors: Kim Yeongho , Cho Il-Wook , Ryu Mee-Yi , Kim Jun Oh , Lee Sang Jun , Ban Keun-Yong , Honsberg Christiana B.
Published: August 2017

The optical properties of the Stranski–Krastanov (S–K) grown InAs/GaAsSb quantum dots (QDs) coupled to sub-monolayer (SML) InAs QD stacks are investigated using photoluminescence (PL) spectroscopy. The PL emission peak of the S–K QDs shifts to shorter wavelengths with increasing the number of SML stacks (NSML) due to the increasing strain fields from the SML QDs. The PL peak energy is linearly increased with increasing the cube root of excitation power, with a different ratio of the absorption coefficient to radiative recombination rate for all the QD samples. The total carrier lifetime for the S–K QDs is increased with increasing NSML, most probably caused by the increase in the ground-state transition energy of the S–K QDs. The nonmonotonic behavior of the thermal activation energy of electrons in the S–K QDs is observed due to the NSML-dependent variation of the strain and Coulombic interaction within the QDs.
Elucidation of luminescent mechanisms of size-controllable MoSe2 quantum dots
Authors: Luan Chun-Yan , Xie Shuang , Ma Chunyan , Wang Shengping , Kong Yuhan , Xu Mingsheng
Published: August 2017

Transition metal dichalcogenides such as MoS2 and WS2 quantum dots (QDs) have been found to show a dramatic enhancement of photoluminescence (PL) quantum efficiency as compared with their planar sheet counterparts. However, the mechanisms of PL enhancement remain not to be very clear. In this work, MoSe2 QDs with the size ranging from about 5.30 nm to 1.55 nm were prepared by a probe-assistant ultrasonication exfoliation approach. The as-prepared MoSe2 QDs are strongly fluorescent, suggesting the existence of quantum confinement effects, and show two distinct PL emissions in the ultraviolet and visible ranges, which are attributed to a band-edge state and a surface related defect state, respectively. We observed blue shifts of the PL peak position and the absorption band edge with the change in the QD size, and the discrepancy of the shifted energies between the PL emission and the estimation based on documented models is briefly addressed.
Inhomogeneous degradation in metal halide perovskites
Authors: Yang Rong , Zhang Li , Cao Yu , Miao Yanfeng , Ke You , Wei Yingqiang , Guo Qiang , Wang Ying , Rong Zhaohua , Wang Nana , Li Renzhi , Wang Jianpu , Huang Wei , Gao Feng
Published: August 2017

Although the rapid development of organic-inorganic metal halide perovskite solar cells has led to certified power conversion efficiencies of above 20%, their poor stability remains a major challenge, preventing their practical commercialization. In this paper, we investigate the intrinsic origin of the poor stability in perovskite solar cells by using a confocal fluorescence microscope. We find that the degradation of perovskite films starts from grain boundaries and gradually extend to the center of the grains. Firmly based on our findings, we further demonstrate that the device stability can be significantly enhanced by increasing the grain size of perovskite crystals. Our results have important implications to further enhance the stability of optoelectronic devices based on metal halide perovskites.
Improving the performance of aeroelastic energy harvesters by an interference cylinder
Authors: Zhang L. B. , Dai H. L. , Abdelkefi A. , Wang L.
Published: August 2017

An interference circular cylinder is introduced and placed downstream of the original circular cylinder for improving the output performance of energy harvesting from vortex-induced vibrations. The interference cylinder is fixed, but its spacing distance from the original cylinder can be adjusted. The experimental results show that the harvested power can be greatly enhanced and the bandwidth of the resonance region is also increased depending on the spacing distance and wind speed, compared to the original energy harvester without an interference cylinder. This is attributed to the fact that the flow pattern for the two cylinders changes with varying the spacing distance, resulting in distinctive characteristics of the Strouhal number and coefficients of fluctuating lift force and mean drag force. The present study gives a suggestive guidance in effectively harvesting energy from vortex-induced vibrations by adjusting the spacing distance according to the available wind speed.
The origin and mitigation of volcano-like morphologies in micron-thick AlGaN/AlN heteroepitaxy
Authors: Huang Chia-Yen , Chang Kai-Shiang , Huang Cheng-Yao , Lin Yun-Hsiang , Peng Wei-Chih , Yen Hung-Wei , Lin Ray-Ming , Kuo Hao-Chung
Published: August 2017

We investigated the origin of morphological instability in 2 μm thick Al0.6Ga0.4N/AlN heteroepitaxy. The primary morphology was driven by the residual epitaxial strain, forming hill-like morphologies via surface diffusion. The secondary morphology was driven by the interaction between the primary morphology and dislocation clusters in the epitaxial layers. The difference in the local growth rate yields volcano-like morphologies centering on deep pits. Insertion of multi-stack superlattice transition layers between AlGaN and GaN effectively suppressed the secondary morphologies by simultaneously pre-relaxing the template and filtering treading dislocations.
Relationships between climate of origin and photosynthetic responses to an episodic heatwave depend on growth CO2 concentration for Eucalyptus camaldulensis var. camaldulensis
Authors: Loik Michael E. , Resco de Dios Víctor , Smith Renee , Tissue David T.
Published: August 2017

Stressful episodic weather is likely to affect the C balance of trees as the climate changes, potentially altering survival. However, the role of elevated CO2 concentration ([CO2]) in tolerating off-season episodic extremes is not clear. We tested for interactive effects of elevated CO2 and springtime heat stress on photosynthesis for seven genotypes of Eucalyptus camaldulensis Dehnh. var. camaldulensis, representing its widespread distribution across south-eastern Australia. We grew clonal material under glasshouse conditions of ambient (aCO2; 400 parts per million (ppm)) or elevated (eCO2; 640 ppm) [CO2], and air temperatures of 25 : 17°C (day : night), and measured the electron transport rate in PSII (ETR), stomatal conductance to water vapour (gs) and net CO2 assimilation (A). Measurements were made before, during and after a four-day temperature excursion of 35 : 27°C. ETR and A were ~17% higher for plants grown in eCO2 than in aCO2. Photosynthesis remained stable for plants in eCO2 during the heatwave. Based on the effect size ratio (eCO2 : aCO2), gs and ETR were temporarily affected more by the heatwave than A. A reduction in ETR in eCO2 was the only lasting effect of the heatwave. There were no significant differences among genotypes. Correlations between photosynthesis and climate of origin differed for plants grown in aCO2 compared with eCO2, suggesting potential complex and multiple control points on photosynthesis.
Effect of two-way coupling on the calculation of forest fire spread: model development
Authors: Lopes A. M. G. , Ribeiro L. M. , Viegas D. X. , Raposo J. R.
Published: August 2017

The present work addresses the problem of how wind should be taken into account in fire spread simulations. The study was based on the software system FireStation, which incorporates a surface fire spread model and a solver for the fluid flow (Navier–Stokes) equations. The standard procedure takes the wind field computed from a single simulation in the absence of fire, but this may not be the best option, especially for large fires. The two-way coupling method, however, considers the buoyancy effects caused by the fire heat release. Fire rate of spread is computed with the semi-empirical Rothermel model, which takes as input local terrain slope, fuels properties and wind speed and direction. Wind field is obtained by solving the mass, momentum and energy equations. Effects of turbulence on the mean flow field are taken into account with the k – ϵ turbulence model. The calculation procedure consists of an interchange between the fire spread model and the wind model through a dynamic interaction. The present work describes the first part of this research, presenting the underlying models and a qualitative sensitivity analysis. It is shown that the update frequency for the dynamic interaction markedly influences the total calculation time. The best strategy for updating the wind field during the fire progression is presented. The dependence of results on mesh size is also described.
Modular tissue engineering for the vascularization of subcutaneously transplanted pancreatic islets
Authors: Vlahos Alexander E. , Cober Nicholas , Sefton Michael V.
Published: August 2017

Significance

In this study we show that pancreatic islets embedded in modules coated with endothelial cells and injected under the skin return streptozotocin-induced diabetic SCID/beige mice to normoglycemia. The transplanted islets became revascularized and directly integrated with host’s vasculature, a feature not seen previously in the subcutaneous space. These implants were also retrievable, an important clinical consideration. The success here means that islet transplantation can move away from inhospitable sites such as the peritoneal cavity or the liver.
論漢語方言的 m 聲母增生
Authors: Hsu Hui-chuan
Published: August 2017

抽象

本文探討漢語方言的 m 聲母增生，初步發現音變的條件是零聲母逢韻頭 ü，音變的動機在於元音的固有鼻音性。中古各組聲母或多或少都有方言實證;換言之，聲母一旦歸零，只要逢 ü 便可順理成章增生 m。同時，ü 或留、或銷聲匿跡、或以別的面貌示人，端視個別方言如何因應唇音限制。除了個別轄字的方言材料，諧聲系列的北京話今讀也見證 m-增生的演變歷程。方言對比一目瞭然之外，本文進一步闡述舌根音唇化兼及塞音和鼻音，從規律平行性看，聲母歸零後先增生 ŋ，然後根據韻頭調整發音部位。三個理論貢獻包括：（一）明泥(娘)疑母恐怕只是語音演變的中繼站，（二）非組和見組關係匪淺，（三）效流攝本是合三韻。與其拘泥中古分類，不如正視方言今讀，依循橫向比較的內在邏輯，條分縷析地演繹語音的縱向發展。
Are similes and metaphors interchangeable?
Authors: Romano Manuela
Published: August 2017

Since Aristotle, scholars have regarded similes and metaphors as equivalent figures of speech sharing very similar comprehension, interpretation and usage patterns. By analysing the use of similes in real discourse, the aim of this study is to show that these two analogical figures reflect different cognitive processes, as well as different discursive functions, using as a framework cognitive models. To this end, this work presents, first, the main differentiating features of the two figures existing in the literature. And, second, it analyses 100 natural-occurring similes in English opinion discourse (news, interviews and commentary sections) in order to explain the conceptual-semantic and formal-syntactic factors which explain why similes and metaphors are not interchangeable in the discourse type under study; that is, why metaphors can usually be transformed into similes by addinglike, whereas the opposite process seems to depend on specific conditions of structure, use and interpretation.
Figures and the senses
Authors: Strik Lievers Francesca
Published: August 2017

It is usually taken for granted that synaesthesia (e.g.,sweet voice) is a metaphor. However, the fact that partly different interpretations have also been proposed suggests that further research is needed. Based on a critical review of the alternative positions on the topic and on a detailed analysis of relevant data, I argue in this paper that synaesthesia (in both its conventional and living instances) is indeed a metaphor, displaying a conflict between separate sensory concepts that cannot be connected in terms of a consistent conceptual relationship. The clearer and more explicit account of synaesthesia proposed in this paper in turn fosters clearer understanding of (a) the relationship with other figures that can involve the senses, such as metonymy, hypallage, and simile, and (b) the possible role of (multi)sensory perceptual experience in conditioning association preferences in linguistic synaesthesia (e.g.,loud colourvs. a less likely to occurcoloured loudness).
On constructional blocking of metonymies
Authors: Brdar Mario , Brdar-Szabó Rita
Published: August 2017

The interaction between metonymy and grammar is commonly understood, in keeping with the classical cognitive linguistic doctrine about cognitive operations motivating linguistic structures, as unilateral – conceptual metaphor and metonymy shaping the grammatical system. However, we argue in this article that one of the possible corollaries of the Equipollence Hypothesis (Mairal & Ruiz de Mendoza, 2009;Ruiz de Mendoza & Luzondo Oyón, 2012) covers a truly bilateral interaction between grammatical structures and cognitive processes. The Equipollence Hypothesis is shown to allow for grammatical phenomena facilitating or constraining, i.e. blocking, the application of conceptual metonymies and their expressions across domains of linguistic inquiry. Specifically, we show in four case studies that grammatical constructions may actually pre-empt lexical (and grammatical) metonymy.
Spiritual Care of the Sick
Authors: Vélez Fr. Juan R.
Published: August 2017

In the Gospel we see how people bring the sick to Christ to be healed. As physicians, nurses, and chaplains we are God's instruments bringing physical and spiritual healing to the sick. It is important for those of us who care for the sick to ask them about their religious affiliation and spiritual needs, and then following their cues and in a respectful way to encourage them to pray and, in the case of Catholics, to receive the sacraments. We should also pray for our patients, and when we think they would like it, to pray with them.

Physicians and nurses, not only chaplains, should ask patients about their religious beliefs, offer to find spiritual assistance for them, and when appropriate pray with them.
Effects of isothermal treatment parameters on the microstructure of semisolid alloys
Authors: Wang Yongfei , Zhao Shengdun , Zhao Xuzhe , Zhao Yongqiang
Published: August 2017

Cold-rolled 6061 aluminium alloys are used to prepare semisolid billets by recrystallisation and partial melting. The effects of isothermal treatment parameters on the microstructures were investigated. The results indicated that the high isothermal holding temperature increases the experimental liquid fraction, average grain size and shape factor. A long isothermal holding time also increases the experimental liquid fraction and improves the spheroidisation degree of solid grains, but the average grain size also increases. Moreover, when the isothermal holding time at high temperature is increased, the size of intragranular liquid droplets increases, but their quantity decreases. The optimal isothermal holding temperature and time during semisolid isothermal treatment were 635°C and 5 – 10 min, respectively.
Cyclin A2 modulates kinetochore–microtubule attachment in meiosis II
Authors: Zhang Qing-Hua , Yuen Wai Shan , Adhikari Deepak , Flegg Jennifer A. , FitzHarris Greg , Conti Marco , Sicinski Piotr , Nabti Ibtissem , Marangos Petros , Carroll John
Published: August 2017

Cyclin A2 is a crucial mitotic Cdk regulatory partner that coordinates entry into mitosis and is then destroyed in prometaphase within minutes of nuclear envelope breakdown. The role of cyclin A2 in female meiosis and its dynamics during the transition from meiosis I (MI) to meiosis II (MII) remain unclear. We found that cyclin A2 decreases in prometaphase I but recovers after the first meiotic division and persists, uniquely for metaphase, in MII-arrested oocytes. Conditional deletion of cyclin A2 from mouse oocytes has no discernible effect on MI but leads to disrupted MII spindles and increased merotelic attachments. On stimulation of exit from MII, there is a dramatic increase in lagging chromosomes and an inhibition of cytokinesis. These defects are associated with an increase in microtubule stability in MII spindles, suggesting that cyclin A2 mediates the fidelity of MII by maintaining microtubule dynamics during the rapid formation of the MII spindle.
An injectivity theorem with multiplier ideal sheaves of singular metrics with transcendental singularities
Authors: Matsumura Shin-ichi
Published: August 2017

The purpose of this paper is to establish an injectivity theorem generalized to pseudo-effective line bundles with transcendental (non-algebraic) singular hermitian metrics and multiplier ideal sheaves. As an application, we obtain a Nadel type vanishing theorem. For the proof, we study the asymptotic behavior of the harmonic forms with respect to a family of regularized metrics, and give a method to obtain

L

2

L^{2}

-estimates of solutions of the

∂
¯

\overline {\partial }

-equation by using the de Rham-Weil isomorphism between the

∂
¯

\overline {\partial }

-cohomology and the

C
ˇ

\rm {\check {C}}

ech cohomology.
Knockout of the Golgi stacking proteins GRASP55 and GRASP65 impairs Golgi structure and function
Authors: Bekier Michael E. , Wang Leibin , Li Jie , Huang Haoran , Tang Danming , Zhang Xiaoyan , Wang Yanzhuang
Published: August 2017

Golgi reassembly stacking protein of 65 kDa (GRASP65) and Golgi reassembly stacking protein of 55 kDa (GRASP55) were originally identified as Golgi stacking proteins; however, subsequent GRASP knockdown experiments yielded inconsistent results with respect to the Golgi structure, indicating a limitation of RNAi-based depletion. In this study, we have applied the recently developed clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 technology to knock out GRASP55 and GRASP65, individually or in combination, in HeLa and HEK293 cells. We show that double knockout of GRASP proteins disperses the Golgi stack into single cisternae and tubulovesicular structures, accelerates protein trafficking, and impairs accurate glycosylation of proteins and lipids. These results demonstrate a critical role for GRASPs in maintaining the stacked structure of the Golgi, which is required for accurate posttranslational modifications in the Golgi. Additionally, the GRASP knockout cell lines developed in this study will be useful tools for studying the role of GRASP proteins in other important cellular processes.
The molecular architecture of the yeast spindle pole body core determined by Bayesian integrative modeling
Authors: Viswanath Shruthi , Bonomi Massimiliano , Kim Seung Joong , Klenchin Vadim A. , Taylor Keenan C. , Yabut King C. , Umbreit Neil T. , Van Epps Heather A. , Meehl Janet , Jones Michele H. , Russel Daniel , Velazquez-Muriel Javier A. , Winey Mark , Rayment Ivan , Davis Trisha N. , Sali Andrej , Muller Eric G.
Published: August 2017

Microtubule-organizing centers (MTOCs) form, anchor, and stabilize the polarized network of microtubules in a cell. The central MTOC is the centrosome that duplicates during the cell cycle and assembles a bipolar spindle during mitosis to capture and segregate sister chromatids. Yet, despite their importance in cell biology, the physical structure of MTOCs is poorly understood. Here we determine the molecular architecture of the core of the yeast spindle pole body (SPB) by Bayesian integrative structure modeling based on in vivo fluorescence resonance energy transfer (FRET), small-angle x-ray scattering (SAXS), x-ray crystallography, electron microscopy, and two-hybrid analysis. The model is validated by several methods that include a genetic analysis of the conserved PACT domain that recruits Spc110, a protein related to pericentrin, to the SPB. The model suggests that calmodulin can act as a protein cross-linker and Spc29 is an extended, flexible protein. The model led to the identification of a single, essential heptad in the coiled-coil of Spc110 and a minimal PACT domain. It also led to a proposed pathway for the integration of Spc110 into the SPB.
Uncertainty estimation and model selection in stock assessment models with non-parametric effects on fishing mortality
Authors: Citores Leire , Ibaibarriaga Leire , Jardim Ernesto
Published: August 2017

Uncertainty coming from assessment models leads to risk in decision making and ignoring or misestimating it can result in an erroneous management action. Some parameters, such as selectivity or survey catchabilities, can present a wide range of shapes and the introduction of smooth functions, which up to now have not been widely used in assessment models, allows for more flexibility to capture underlying nonlinear structures. In this work a simulation study emulating a sardine population is carried out to compare three different methods for uncertainty estimation: multivariate normal distribution, bootstrap (without and with relative bias correction) and Markov chain Monte Carlo (MCMC). In order to study their performance depending on the model complexity, five different scenarios are defined depending on the shape of the smooth function of the fishing mortality. From 100 simulated datasets, performance is measured in terms of point estimation, coefficients of variation, bias, skewness, coverage probabilities, and correlation. In all approaches model fitting is carried out using the a4a framework. All three methods result in very similar performance. The main differences are found for observation variance parameters where the bootstrap and the multivariate normal approach result in underestimation of these parameters. In general, MCMC is considered to have better performance, being able to detect skewness, showing small relative bias and reaching expected coverage probabilities. It is also more efficient in terms of time consumption in comparison with bootstrapping.
The mitochondrial ABC transporter Atm1 plays a role in iron metabolism and virulence in the human fungal pathogen Cryptococcus neoformans
Authors: Do Eunsoo , Park Seho , Li Ming-Hui , Wang Jia-Mei , Ding Chen , Kronstad James W , Jung Won Hee
Published: August 2017

Iron–sulfur clusters (ISC) are indispensable cofactors for essential enzymes in various cellular processes. In the model yeast Saccharomyces cerevisiae, the precursor of ISCs is exported from mitochondria via a mitochondrial ABC transporter Atm1 and used for cytosolic and nuclear ISC protein assembly. Although iron homeostasis has been implicated in the virulence of the human fungal pathogen Cryptococcus neoformans, the key components of the ISC biosynthesis pathway need to be fully elucidated. In the current study, a homolog of S. cerevisiae Atm1 was identified in C. neoformans, and its function was characterized. We constructed C. neoformans mutants lacking ATM1 and found that deletion of ATM1 affected mitochondrial functions. Furthermore, we observed diminished activity of the cytosolic ISC-containing protein Leu1 and the heme-containing protein catalase in the atm1 mutant. These results suggested that Atm1 is required for the biosynthesis of ISCs in the cytoplasm as well as heme metabolism in C. neoformans. In addition, the atm1 mutants were avirulent in a murine model of cryptococcosis. Overall, our results demonstrated that Atm1 plays a critical role in iron metabolism and virulence for C. neoformans.
Observational evidence for mass ejection accompanying short gamma-ray bursts
Authors: Moharana Reetanjali , Piran Tsvi
Published: August 2017

The plateau in the duration distribution of long gamma-ray bursts (LGRBs) provides a direct observational evidence for the Collapsar model. The plateau reflects the fact that the observed duration satisfies: T90 = te − tb where te is the time that the central engine operates and tb is the threshold time, interpreted within the Collapsar model as the time it takes for the relativistic jet to penetrate the stellar envelope. Numerical simulation and macronova observations suggest that compact binary mergers involve mass ejection. If short-gamma ray bursts (sGRBs) arise from such mergers, their jets should cross this surrounding ejecta before producing the prompt emission. Like in LGRBs, this should result in a distinct short plateau in the GRBs’ duration distribution. We present a new analysis of the duration distribution for the three GRB satellites: BATSE, Swift and Fermi. We find a clear evidence for a short (∼0.4 s) plateau in the duration distribution. This plateau is consistent with the expected jet crossing time, provided that the ejecta is of order of a few percent of solar masses.
CMS MDS 3.0 Section M Skin Conditions in Long-term Care: Pressure Ulcers, Skin Tears, and Moisture-Associated Skin Damage Data Update
Authors: Ayello Elizabeth A.
Published: August 2017

GENERAL PURPOSE:

The purpose of this learning activity is to provide information about the updates to the Centers for Medicare & Medicaid Services (CMS) MDS 3.0 Section M, Skin Conditions documentation in long-term care.

TARGET AUDIENCE:

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES:

After participating in this educational activity, the participant should be better able to:

1. Explain the use of the CMS MDS 3.0 tool for documenting skin problems in long-term care.

2. Demonstrate examples of proper documentation for specific skin problems.

This manuscript reviews some of the key parts of the October 2016 revised Long-term Care Resident Assessment Instrument manual for Minimum Data Set (MDS) 3.0 Section M Skin Conditions. It also reports the Centers for Medicare & Medicaid’s publicly reported frequency data in long-term care for selected items on the MDS 3.0 Section M Skin Conditions. Percentages and trends of pressure ulcers/injuries, skin tears, and moisture-associated skin damage are assessed.
Relative Temperature Maximum in Wound Infection and Inflammation as Compared with a Control Subject Using Long-Wave Infrared Thermography
Authors: Chanmugam Arjun , Langemo Diane , Thomason Korissa , Haan Jaimee , Altenburger Elizabeth A. , Tippett Aletha , Henderson Linda , Zortman Todd A.
Published: August 2017

OBJECTIVE:

The purpose of this retrospective case series was to determine whether a long-wave infrared thermography (LWIT, or thermal imaging) camera can detect specific temperature changes that are associated with wound infection and inflammation as compared with normal control subjects with similar anatomical wound locations.

DESIGN:

A retrospective, observational, collective, multiple case series of patients who underwent digital and thermal imaging of wounds in various states.

SETTING:

The subjects were selected from multiple sites including an outpatient wound care clinic, a wound care physician’s office, a rehabilitation hospital, and a home healthcare organization.

PATIENTS:

Six subjects were selected for inclusion, including 2 each for the infection, inflammation, and normal control groups.

MAIN OUTCOME MEASURE:

The study collected relative temperature maximums as obtained and recorded by LWIT and digital imaging.

MAIN RESULTS:

In this case series, the authors demonstrate the use of an FDA-approved Scout (WoundVision, Indianapolis, Indiana) dual-imaging long-wave infrared and digital cameras to analyze images of wounds. In the 2 cases with clinically diagnosed wound infection, LWIT showed an elevation of temperature as evidenced by a maximum temperature differential between the wound and healthy skin of +4° C to 5° C. Also, LWIT was able to identify relative thermal changes of +1.5° C to 2.2° C in subjects presenting with clinical signs of inflammation. In addition, LWIT was able to show that the normal control subjects without diagnosis of infection or signs of inflammation had relative temperature differentials of +1.1° C to 1.2° C. Finally, LWIT could detect adequate treatment of infected wounds with antibiotics as evidenced by a return to normal temperature differences gradient of +0.8° C to 1.1° C, as compared with normal control subjects with wounds in the same anatomical location.

CONCLUSIONS:

Long-wave infrared thermography can collect and record objective data, including relative temperature maximums associated with infection, inflammation, and normal healing wounds.
Src Kinase Inhibition Attenuates Morphine Tolerance without Affecting Reinforcement or Psychomotor Stimulation
Authors: Bull Fiona A. , Baptista-Hon Daniel T. , Sneddon Claire , Wright Lisa , Walwyn Wendy , Hales Tim G.
Published: August 2017

Background

Prolonged opioid administration leads to tolerance characterized by reduced analgesic potency. Pain management is additionally compromised by the hedonic effects of opioids, the cause of their misuse. The multifunctional protein β-arrestin2 regulates the hedonic effects of morphine and participates in tolerance. These actions might reflect µ opioid receptor up-regulation through reduced endocytosis. β-Arrestin2 also recruits kinases to µ receptors. We explored the role of Src kinase in morphine analgesic tolerance, locomotor stimulation, and reinforcement in C57BL/6 mice.

Methods

Analgesic (tail withdrawal latency; percentage of maximum possible effect, n = 8 to 16), locomotor (distance traveled, n = 7 to 8), and reinforcing (conditioned place preference, n = 7 to 8) effects of morphine were compared in wild-type, µ+/–, µ–/–, and β-arrestin2–/– mice. The influence of c-Src inhibitors dasatinib (n = 8) and PP2 (n = 12) was examined.

Results

Analgesia in morphine-treated wild-type mice exhibited tolerance, declining by day 10 to a median of 62% maximum possible effect (interquartile range, 29 to 92%). Tolerance was absent from mice receiving dasatinib. Tolerance was enhanced in µ+/– mice (34% maximum possible effect; interquartile range, 5 to 52% on day 5); dasatinib attenuated tolerance (100% maximum possible effect; interquartile range, 68 to 100%), as did PP2 (91% maximum possible effect; interquartile range, 78 to 100%). By contrast, c-Src inhibition affected neither morphine-evoked locomotor stimulation nor reinforcement. Remarkably, dasatinib not only attenuated tolerance but also reversed established tolerance in µ+/– mice.

Conclusions

The ability of c-Src inhibitors to inhibit tolerance, thereby restoring analgesia, without altering the hedonic effect of morphine, makes c-Src inhibitors promising candidates as adjuncts to opioid analgesics.
Clinical Effectiveness of Intravenous Exenatide Infusion in Perioperative Glycemic Control after Coronary Artery Bypass Graft Surgery
Authors: Besch Guillaume , Perrotti Andrea , Mauny Frederic , Puyraveau Marc , Baltres Maude , Flicoteaux Guillaume , Salomon du Mont Lucie , Barrucand Benoit , Samain Emmanuel , Chocron Sidney , Pili-Floury Sebastien
Published: August 2017

Background

We aimed to assess the clinical effectiveness of intravenous exenatide compared to insulin in perioperative blood glucose control in coronary artery bypass grafting surgery patients.

Methods

Patients more than 18 yr old admitted for elective coronary artery bypass grafting were included in a phase II/III nonblinded randomized superiority trial. Current insulin use and creatinine clearance of less than 60 ml/min were exclusion criteria. Two groups were compared: the exenatide group, receiving exenatide (1-h bolus of 0.05 µg/min followed by a constant infusion of 0.025 µg/min), and the control group, receiving insulin therapy. The blood glucose target range was 100 to 139 mg/dl. The primary outcome was the proportion of patients who spent at least 50% of the study period within the target range. The consumption of insulin (Cinsulin) and the time to start insulin (Tinsulin) were compared between the two groups.

Results

In total, 53 and 51 patients were included and analyzed in the exenatide and control groups, respectively (age: 70 ± 9 vs. 68 ± 11 yr; diabetes mellitus: 12 [23%] vs. 10 [20%]). The primary outcome was observed in 38 (72%) patients in the exenatide group and in 41 (80%) patients in the control group (odds ratio [95% CI] = 0.85 [0.34 to 2.11]; P = 0.30). Cinsulin was significantly lower (60 [40 to 80] vs. 92 [63 to 121] U, P < 0.001), and Tinsulin was significantly longer (12 [7 to 16] vs. 7 [5 to 10] h, P = 0.02) in the exenatide group.

Conclusions

Exenatide alone at the dose used was not enough to achieve adequate blood glucose control in coronary artery bypass grafting patients, but it reduces overall consumption of insulin and increases the time to initiation of insulin.
Prevention of Exposure Keratopathy in Critically Ill Patients: A Single-Center, Randomized, Pilot Trial Comparing Ocular Lubrication With Bandage Contact Lenses and Punctal Plugs
Authors: Bendavid Itai , Avisar Inbal , Serov Volach Irena , Sternfeld Amir , Dan Brazis Idit , Umar Lewaa , Yassur Yiftach , Singer Pierre , Cohen Jonathan David
Published: August 2017

Objectives:

To compare the effectiveness of bandage contact lenses and punctal plugs with ocular lubricants in preventing corneal damage in mechanically ventilated and sedated critically ill patients.

Design:

Single-center, prospective, randomized, pilot study.

Setting:

Sixteen-bed, general ICU at a tertiary academic medical center.

Patients:

Adults admitted to the ICU and anticipated to require mechanical ventilation and continuous sedation for greater than or equal to 4 days.

Interventions:

Patients were randomized to receive eye care with ocular lubricants (n = 38), bandage contact lenses (n = 33), or punctal plugs (n = 33). The bandage contact lenses were changed every 4 days, whereas the punctal plugs remained in situ for the entire study.

Measurements and Main Results:

The primary endpoint was the presence or absence of corneal damage as assessed by the grade of keratopathy. Patients were examined by an ophthalmologist blinded to the study group every 4 days and at the time of withdrawal from the study, due to cessation of sedation, discharge from the ICU, or death. The mean duration of the study was 8.6 ± 6.2 days. The grade of keratopathy in the ocular lubricant group increased significantly in both eyes (p = 0.01 for both eyes) while no worsening was noted in either the lens or punctal plugs groups. In a post hoc analysis of patients with an initially abnormal ophthalmic examination, significant healing of keratopathy was noted in the lens group (p = 0.02 and 0.018 for left and right eyes, respectively) and in the right eye of the plugs group (p = 0.005); no improvement was noted in the ocular lubricant group.

Conclusions:

Compared with ocular lubrication, bandage contact lenses and punctal plugs were more effective in limiting keratopathy, and their use, particularly of bandage contact lenses, was associated with significant healing of existing lesions.
Epidemiology of Obesity in the Hispanic Adult Population in the United States
Authors: Forrest Kimberly Y. Z. , Leeds Marcy J. , Ufelle Alexander C.
Published: August 2017

Obesity is a major health concern in Hispanic populations. This study evaluated the epidemiology of obesity and associated factors among Hispanics using the data from the 2013-2014 National Health and Nutrition Examination Survey. Among the 1241 participants (20 years of age or older), the prevalence rates were as follows: overweight, 77.1%; obesity, 42.4%; and central obesity, 57.0%. These rates were consistent throughout most age groups. Significantly, more females than males were obese. Higher obesity rates were seen among those with diabetes, high cholesterol, hypertension, heart disease, and arthritis. Those born in the United States were more likely to be obese. Effective obesity prevention programs are vital for this population.
Impact of Targeted Education on Colorectal Cancer Screening Knowledge and Psychosocial Attitudes in a Predominantly Hispanic Population
Authors: Molokwu Jennifer C. , Shokar Navkiran , Dwivedi Alok
Published: August 2017

Colorectal cancer remains a leading cause of cancer-related morbidity and mortality, with screening behavior found to be influenced by knowledge and other psychosocial attitudes. We recruited 784 participants 50 to 70 years of age. The intervention arm received a culturally sensitive, literacy-appropriate educational intervention by a promotora. Surveys were completed at baseline and 6 months post. Our intervention significantly increased knowledge at 6 months when compared with control (0.74 vs 0.18, P < .0001). We also report increase in perceived susceptibility to colorectal cancer and perceived benefits of colorectal cancer screening while decreasing sense of fatalism. Perceived barriers to screening did significantly increase.
Inhibiting Protein Tyrosine Phosphatase 1B to Improve Regenerative Functions of Endothelial Cells
Authors: Wang Yuan , Yan Feng , Zhang Wenjing , Pang Shu , Jiang Fan
Published: August 2017

Protein tyrosine phosphatase-1B (PTP1B) is an important negative regulator of insulin receptor– and vascular endothelial growth factor receptor–dependent signalings in endothelial cells. Genetic or pharmacological inhibition of PTP1B has been shown to enhance endothelial cell proliferation and migration and increase nitric oxide production. In vivo, inhibiting PTP1B can reverse endothelial dysfunction, promote angiogenesis, and accelerate wound healing. Intense research is currently continuing in an effort to discover novel selective PTP1B inhibitors, primarily for treating insulin resistance. We propose that these drugs may also represent a new horizon for boosting the regenerative capacities of endothelial cells.
Defining the Association between Diabetes and Plastic Surgery Outcomes: An Analysis of Nearly 40,000 Patients
Authors: Goltsman David , Morrison Kerry A. , Ascherman Jeffrey A.
Published: August 2017

Background:

Diabetes is an increasingly prevalent comorbidity in patients presenting for surgery, impacting nearly 14% of adults in the United States. Although it is known that diabetic patients are at an increased risk for postoperative complications, there is a paucity of literature on the specific ramifications of diabetes on different surgical procedures.

Methods:

Using the American College of Surgeons National Surgical Quality Improvement Program dataset, demographics, outcomes, and length of in-patient hospitalization were examined for patients who underwent plastic surgery between 2007 and 2012. Adjusted multivariable logistic regression models were used to assess the relationship between diabetes status and a spectrum of medical and surgical postoperative outcomes.

Results:

Thirty-nine thousand four hundred seventy-five plastic surgery patients were identified, including 1,222 (3.10%) with insulin-dependent diabetes mellitus (IDDM) and 1,915 (4.75%) with non–insulin-dependent diabetes mellitus (NIDDM), who had undergone breast, hand/upper and lower extremity, abdominal, or craniofacial procedures. Logistic regression analyses showed that only insulin-dependent diabetics had a higher likelihood of surgical complications (IDDM: P value < 0.0001; NIDDM: P value < 0.103), whereas patients with both IDDM and NIDDM had increased likelihoods of medical complications (IDDM: P value < 0.001; NIDDM: P value = 0.0093) compared with nondiabetics. Average hospital stay for diabetics was also longer than for nondiabetics.

Conclusions:

Diabetes is associated with an increase in a multitude of postoperative complications and in hospital length of stay, in patients undergoing plastic surgery. Diabetes status should thus be evaluated and addressed when counseling patients preoperatively. Risks may be further stratified based on IDDM versus NIDDM status.
Tacrolimus Eye Drops as Adjunct Therapy in Severe Corneal Endothelial Rejection Refractory to Corticosteroids
Authors: Ghaffari Reza , Ghassemi Hamed , Zarei-Ghanavati Mehran , Latifi Golshan , Dehghani Shima , Haq Zeeshan , Djalilian Ali R.
Published: August 2017

Purpose:

To evaluate the safety and efficacy of tacrolimus eye drops as adjunctive therapy in the treatment of severe corneal endothelial rejection after penetrating keratoplasty refractory to corticosteroids.

Methods:

In this prospective interventional case series, 11 eyes of 11 patients assessed for severe corneal endothelial rejection, with an inadequate response to topical, local, and systemic corticosteroids, were treated with either 0.01% or 0.05% tacrolimus eye drops 4 times daily. Improvement in signs of rejection, visual function, and development of complications were monitored.

Results:

The duration of steroid treatment before intervention was 8.1 ± 1.4 days (range = 7–11). Patients were subsequently administered topical tacrolimus 0.01% or 0.05% qid. The time to clinical improvement was 10.3 ± 3.4 days (range = 3–17). The time to rejection reversal was 27.8 ± 16.3 days (range = 7–52). After 3 months, 10 patients (90.8%) demonstrated clinical improvement, and complete restoration of graft clarity was achieved in 5 patients (45.4%). In responsive cases, steroid therapy was successfully tapered off after 60.2 ± 19.7 days (range = 36–93). The best spectacle-corrected visual acuity improved from 1.7 ± 0.9 to 0.8 ± 0.5 logMAR (P= 0.0016). Reported side effects included stinging on drop instillation and punctate epithelial keratopathy.

Conclusions:

Tacrolimus eye drops may be able to play an adjunctive therapeutic role in patients with severe corneal endothelial rejection refractory to conventional steroid treatment. Controlled studies are needed to further investigate the role of tacrolimus in this setting.
Effects of Recent Concussion and Injury History on Instantaneous Relative Risk of Lower Extremity Injury in Division I Collegiate Athletes
Authors: Fino Peter C. , Becker Lauren N. , Fino Nora F. , Griesemer Brett , Goforth Michael , Brolinson Per Gunnar
Published: August 2017

Background:

Growing evidence suggests that concussion increases the risk of lower extremity (LE) musculoskeletal injury. However, it is unclear to how the effect of concussion on LE injury risk may be influenced by previous injuries. This study sought to examine the association between concussion, previous LE injuries, and the risk LE injury to the same previously injured limb (ipsilateral) or the opposite limb (contralateral).

Methods:

This retrospective study examined medical records from 110 concussed athletes and 110 matched controls for LE injuries in the 365 days before and after the concussion event. The effect of concussion on time to injury was assessed with a Cox proportional hazard model after adjusting for injury history. Fine and Gray subdistribution models assessed the cumulative risk of ipsilateral and contralateral injury by group.

Results:

Concussion was associated with an increased instantaneous relative risk of LE injury when adjusting for LE injury history [hazard ratio (HR) = 1.67, 95% confidence interval (CI) = 1.11–2.53], agreeing with previous results. Among individuals who had a history of LE injuries before the concussion event, a nonsignificant yet moderate effect of concussion on the instantaneous relative risk of ipsilateral injuries was found after adjusting for the competing risk of contralateral injuries and censored values (HR = 1.85, 95% CI = 0.76–4.46).

Conclusions:

This study provides independent confirmation of previous studies, reporting an association between concussion and LE injury risk. Furthermore, this study suggests that future large-scale studies should consider the competing risk of ipsilateral, contralateral, and new injuries in populations with an injury history.
Telmesani Radiological Classification of the Location of the Vertical Segment of the Facial Nerve: Impact on Surgical Approach in Cochlear Implant Surgery
Authors: Telmesani Laila Mohammed , Alrammah Mona Khalid
Published: August 2017

Objective:

This study was conducted to establish a radiological classification of the location of the vertical segment of the facial nerve (VSFN) and to see if this has implications on the surgical technique needed to access the round window niche (RWN) in cochlear implant (CI) surgery.

Study Design:

Observational case series study.

Setting:

Tertiary referral center.

Patients:

One hundred twenty seven patients underwent CI surgery, and high resolution computed tomography (HRCT) of 140 temporal bones was studied. The data that were collected consisted of the patient's age, sex, radiological inner ear malformations (IEM), and the surgical technique used to access the RWN.

Main Outcome Measures:

The radiologic location of the VSFN in relation to the lateral semicircular canal in the coronal plane of HRCT and its implication on the surgical approach used to access the RWN in CI surgery.

Results:

A statistically significant association is present between the radiological location of the VSFN and the surgical approach used (p < 0.001).

There was insignificant correlation between the locations of the VSFN and the patient's age, sex, and IEM as the p > 0.05.

Conclusions:

On HRCT (0.6 mm) in the coronal plane, the position of the VSFN in relation to the lateral semicircular canal is correlated with the alternative approaches that must be taken during CI surgery.
Postoperative renal dysfunction after noncardiac surgery
Authors: Vaara Suvi T. , Bellomo Rinaldo
Published: August 2017

Purpose of review

The narrative review aims to discuss recent results and important knowledge gaps regarding acute kidney injury (AKI) in postoperative patients undergone major noncardiac surgery.

Recent findings

Postoperative AKI affects approximately one-fifth of patients after major surgery, but the incidence varies according to the type of surgery. Preexisting chronic kidney disease is a major risk factor for postoperative AKI. It carries a substantial risk for postoperative adverse outcomes, as well as long-term mortality and morbidity. To prevent postoperative AKI, avoiding intraoperative hypotension and hypoperfusion as well as nephrotoxic substances are important. Currently, no efficient pharmacotherapy for prevention or treatment of AKI is available. In general, goal-directed management protocols have reduced the incidence of postoperative AKI. Additionally, a restrictive fluid management regimen might reduce organ edema and be beneficial also for the kidney function.

AKI is a frequent postoperative complication with a substantial risk for both short and long-term adverse events, and its incidence is likely to rise because of increasing major surgical procedures. Studies investigating better strategies to prevent and treat AKI in this population are urgently needed.