bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-Reported Functional and Satisfaction Outcomes after Robotic-Arm-Assisted Total Knee Arthroplasty: Early Results of a Prospective Multicenter Investigation
Authors: Khlopas Anton , Sodhi Nipun , Hozack William J. , Chen Antonia F. , Mahoney Ormonde M. , Kinsey Tracy , Orozco Fabio , Mont Michael A.
Published: April 2019

The purpose of this study was to perform a 3-month interim comparative analysis on outcomes between robotic-arm-assisted total knee arthroplasty (RATKA) and manual TKA patients. Specifically, we evaluated (1) patient self-reported symptoms, (2) expectations and satisfaction, and (3) functional activities, based on the 2011 Knee Society Scoring System. Between June 1, 2016, and March 31, 2018, 252 patients (102 manual and 150 robotic) were enrolled into a prospective, nonrandomized, open-label, multicenter comparative cohort study. Functional activity scores, patient-reported symptoms, as well as satisfaction and expectation scores were obtained from the 2011 Knee Society Scoring System preoperatively, at 4 to 6 weeks, and at 3 months postoperatively. Student's t-tests, Wilcoxon rank-sum tests, and chi-square tests with α set at 0.05 were used to compare between-group mean improvements from baseline. At 4 to 6 weeks postoperatively, RATKA patients were found to have significantly larger improvements in walking and standing (1.4 vs. –1.2 points; p = 0.019). RATKA patients were also found to have larger improvements in advanced activities (1.3 vs. 2.3 points), pain with walking (3.3 vs. 3.2 points), satisfaction score (12.4 vs. 12 points), and expectations score (5.1 vs. 4.4 points) when compared with manual TKA patients. At 3 months, RATKA patients were also found to have larger improvements in walking and standing (6.0 vs. 4.8 points), standard activities (11.4 vs. 10.1 points), advanced activities (6.2 vs. 4.6 points), functional activities total score (22.8 vs. 21.2 points), pain with walking (4.3 vs. 4.1 points), total symptoms score (10.5 vs. 10.3 points), satisfaction score (17.0 vs. 15.5 points), expectations score (4.8 vs. 4.0 points) when compared with manual TKA patients. The data indicate RATKA patients to have equal or greater improvements in 9 out of 10 of the Knee Society Scoring System components assessed at 3 months postoperatively, though not all findings were statistically significant. Since this is an early results report, this study will be continued for a longer follow-up, but we are encouraged by these interim results.
The place of the humanities in today’s knowledge society
Authors: Costa Rosário Couto
Published: April 2019

Over the past four decades, the humanities have been subject to a progressive devaluation within the academic world, with early instances of this phenomenon tracing back to the USA and the UK. There are several clues as to how the university has generally been placing a lower importance on these fields, such as through the elimination of courses or even whole departments. It is worth mentioning that this discrimination against humanities degrees is indirect in nature, as it is in fact mostly the result of the systematic promotion of other fields, particularly, for instance, business management. Such a phenomenon has nonetheless resulted in a considerable reduction in the percentage of humanities graduates within a set of 30 OECD countries, when compared to other areas. In some countries, a decline can even be observed in relation to their absolute numbers, especially with regards to doctorate degrees. This article sheds some light on examples of international political guidelines, laid out by the OECD and the World Bank, which have contributed to this devaluation. It takes a look at the impacts of shrinking resources within academic departments of the humanities, both inside and outside of the university, while assessing the benefits and value of studying these fields. A case is made that a society that is assumed to be ideally based on knowledge should be more permeable and welcoming to the different and unique disciplines that produce it, placing fair and impartial value on its respective fields.
Microscopic calculation of absorption spectra of macromolecules: An analytic approach
Authors: Carli Matteo , Turelli Michele , Faccioli Pietro
Published: April 2019

We develop a cross-disciplinary approach to analytically compute optical response functions of open macromolecular systems by exploiting the mathematical formalism of quantum field theory (QFT). Indeed, the entries of the density matrix for the electronic excitations interacting with their open dissipative environment are mapped into vacuum-to-vacuum Green’s functions in a fictitious relativistic closed quantum system. We show that by re-summing appropriate self-energy diagrams in this dual QFT, it is possible to obtain analytic expressions for the response functions in Mukamel’s theory. This yields physical insight into the structure and dynamics of vibronic resonances, since their frequency and width is related to fundamental physical constants and microscopic model parameters. For illustration, we apply this scheme to compute the linear absorption spectrum of the Fenna-Matthews-Olson light harvesting complex, comparing analytic calculations, numerical Monte Carlo simulations, and experimental data.
Particle-in-cell simulations of the ion extraction and acceleration processes in the alternative low power hybrid ion engine (ALPHIE)
Authors: González J. , Conde L.
Published: April 2019

The electric charge transport through the two-grid systems of the Alternative Low Power Ion Engine is studied using a particle-in-cell (PIC) code. In this plasma thruster design, the ionizing electrons from the only cathode and the ions extracted from the ionization chamber flow in opposite directions through the open spaces of its grids. This configuration differs from classical gridded ion engines where only positive ions are accelerated. The electric charge transport is simulated, and the results are in agreement with previous experimental observations. The numerical simulations are performed for a single beamlet domain in a 2D axial symmetry, and only two aligned holes of the grid system are studied. The extracted ions move outwards from the ionization chamber reaching supersonic velocities of 43–51 km/s which are controlled by an acceleration voltage. The ionizing electrons from the only cathode are accelerated along the opposite direction and achieve energies in the range of 400–600 eV inside the ionization chamber. Additionally, the PIC simulations predict the development of an electric field close to the exit section of the thruster not observed previously because of the practical limitations of experiments. The imbalance of electric charge in the region where the electrons are injected from the only cathode creates a positive field that further accelerates the electric charges, preventing low energy ions from the plasma stream from returning to the plasma thruster.
A simple numerical approach for reconstructing the atomic stresses at grain boundaries from quantum-mechanical calculations
Authors: Cui Yue , Chew Huck Beng
Published: April 2019

The atomistic stress state at a metal grain boundary is an intrinsic attribute which affects many physical and mechanical properties of the metal. While the virial stress is an accepted measure of the atomistic stress in molecular dynamics simulations, an equivalent definition is not well-established for quantum-mechanical density functional theory (DFT) calculations. Here, we introduce a numerical technique, termed the sequential atom removal (SAR) approach, to reconstruct the atomic stresses near a symmetrical-tilt Σ5(310)[001] Cu grain boundary. In the SAR approach, individual atoms near the boundary are sequentially removed to compute the pair (reaction) force between atoms, while correcting for changes to the local electron density caused by atom removal. We show that this SAR approach accurately reproduces the spatially-varying virial stresses at a grain boundary governed by an embedded atom method potential. The SAR approach is subsequently used to extract the atomistic stresses of the grain boundary from DFT calculations, from which we reconstruct a continuum-equivalent grain boundary traction distribution as a quantitative descriptor of the grain boundary atomic structure.
Valley aspect of lateral tunneling transport
Authors: Huang Bing-Chen , Chen Feng-Wu , Chen Yen-Chun , Wu G. Y.
Published: April 2019

We theoretically study the valley aspect of lateral tunneling transport in valleytronic materials, using AB-stacked (Bernal-stacked) bilayer graphene as a material example. A lateral structure with multiple well/barrier interfaces is considered. A full-zone tight-binding method is employed, allowing for the study of intervalley mixing in electron states. We study the degree of tunneling current valley contrast under the condition of a source-drain bias or barrier asymmetry. For a single-barrier structure, it is found that the intervalley mixing is negligible, and the contrast is positively correlated with the barrier width and height. For a double-barrier structure, the effect of resonant tunneling is investigated. The intervalley mixing is shown to be significantly enhanced at resonant tunneling. In addition, the resonant levels are found valley split, and a proposal is given which exploits the splitting for the generation of a sizable tunneling current valley polarization. Based on a simple model using momentum-shifted thermal distribution for obliquely incident electrons, the temperature dependence of tunneling current valley polarization is also examined. An interesting crossover from the valley-orbit interaction-dominant polarization to the warping-dominant polarization is found to occur as the temperature is increased.
Galvanic replacement induced electromotive force to propel Janus micromotors
Authors: Bastos-Arrieta Julio , Bauer Christoph , Eychmüller Alexander , Simmchen Juliane
Published: April 2019

Electrochemistry is a highly versatile part of chemical research which is involved in many of the processes in the field of micromotion. Its input has been crucial from the synthesis of microstructures to the explanation of phoretic mechanisms. However, using electrochemical effects to propel artificial micromotors is still to be achieved. Here, we show that the forces generated by electrochemical reactions can not only create active motion, but they are also strong enough to overcome the adhesion to the substrate, caused by the increased ionic strength of the solutions containing the ions of more noble metals themselves. The galvanic replacement of copper by platinum ions is a spontaneous process, which not only provides a sufficiently strong electromotive force to propel the Janus structures but also results in asymmetric Pt-hatted structures, which can be further used as catalytic micromotors.
All-dielectric metasurfaces with trapped modes: Group-theoretical description
Authors: Yu Pengchao , Kupriianov Anton S. , Dmitriev Victor , Tuz Vladimir R.
Published: April 2019

An all-dielectric metasurface featuring resonant conditions of the trapped mode excitation is considered. It is composed of a lattice of subwavelength particles which are made of a high-refractive-index dielectric material structured in the form of disks. Each particle within the lattice behaves as an individual dielectric resonator supporting a set of electric and magnetic modes. In order to access a trapped mode (which is the TE01δ mode of the resonator), a round eccentric penetrating hole is made in the disk. In the lattice, the disks are arranged into clusters (unit supercells) consisting of four particles. Different orientations of holes in the supercell correspond to different symmetry groups producing different electromagnetic responses of the overall metasurface when it is irradiated by the linearly polarized waves with normal incidence. We perform a systematic analysis of the electromagnetic response of the metasurface as well as conditions of the trapped mode excitation involving the group-theoretical description, the representation theory, and the microwave circuit theory. Both polarization-sensitive and polarization-insensitive arrangements of particles and conditions for dynamic ferromagnetic and antiferromagnetic orders are derived. Finally, we observe the trapped mode manifestation in the microwave experiment.
Investigation on the effects of the operating conditions on electron energy in the atmospheric-pressure helium plasma jet
Authors: Liu Yadi , Tan Zhenyu , Wang Xiaolong , Li Xiaotong , Chen Xinxian
Published: April 2019

This work presents a numerical investigation on the effects of the operating conditions on electron energy in the atmospheric-pressure helium plasma jets based on a needle-plane discharge system. The investigation is carried out by using a 2-D fluid model. The considered operating conditions refer to the needle radius, the gap width, and both the inner diameter and the relative permittivity of the dielectric tube. The mechanisms governing the operating condition effects of electron energy have also been analyzed in detail. This work gives the following significant results. The needle radius has only a slight effect on the averaged electron energy whether in the entire plasma jet or in the plasma bullet. The averaged electron energy decreases obviously with the increase in the gap width. The effect of the dielectric tube on electron energy becomes evident only when its inner diameter is smaller than 4 mm in the present simulation. The relative permittivity of the dielectric tube slightly affects electron energy. In particular, the present work shows that the plasma bullet has a substantial contribution to high-energy electrons in contrast to the other region in the plasma jet. This is of importance for the study on the mass transfer of the reactive species in the aqueous solutions in plasma biomedicine because in the mass transfer, the penetration depth of the reactive species can be improved via the dissociative electron attachment to water molecules when increasing the electron energy in plasmas, which helps deliver the reactive species to the surface of living matter and even into its interior for inducing the expected biomedical effects.
Charge transfer excitation energies from ground state density functional theory calculations
Authors: Mei Yuncai , Yang Weitao
Published: April 2019

Calculating charge transfer (CT) excitation energies with high accuracy and low computational cost is a challenging task. Kohn-Sham density functional theory (KS-DFT), due to its efficiency and accuracy, has achieved great success in describing ground state problems. To extend to excited state problems, our group recently demonstrated an approach with good numerical results to calculate low-lying and Rydberg excitation energies of an N-electron system from a ground state KS or generalized KS calculations of an (N − 1)-electron system via its orbital energies. In the present work, we explore further the same methodology to describe CT excitations. Numerical results from this work show that performance of conventional density functional approximations (DFAs) is not as good for CT excitations as for other excitations due to the delocalization error. Applying localized orbital scaling correction (LOSC) to conventional DFAs, a recently developed method in our group to effectively reduce the delocalization error, can improve the results. Overall, the performance of this methodology is better than time dependent DFT (TDDFT) with conventional DFAs. In addition, it shows that results from LOSC-DFAs in this method reach similar accuracy to other methods, such as ΔSCF, G0W0 with Bethe-Salpeter equations, particle-particle random phase approximation, and even high-level wavefunction methods like CC2. Our analysis shows that the correct 1/R trend for CT excitation can be captured from LOSC-DFA calculations, stressing that the application of DFAs with the minimal delocalization error is essential within this methodology. This work provides an efficient way to calculate CT excitation energies from ground state DFT.
Tuning magnetic monopole population and mobility in unidirectional array of nanomagnets as a function of lattice parameters
Authors: Gonçalves R. S. , Loreto R. P. , de Paiva T. S. , Borme J. , Freitas P. P. , de Araujo C. I. L.
Published: April 2019

Sets of nanomagnets are often utilized to mimic cellular automata in the design of nanomagnetic logic devices or frustration and emergence of magnetic monopoles in artificial spin ice systems, once that unidirectional arrangement of nanomagnets can behave as artificial spin ice, with frustration arising from second neighbors' dipolar interaction, and present good magnetic monopole mobility due to the low string tension among charges. Here, we present an experimental investigation of magnetic monopole population and mobility as a function of lateral and longitudinal distance among nanomagnets. The observed results could be useful in the nanomagnet logic device design and bring new insights about several possible designs for tuning magnetic monopole unidirectional mobility and transport under a low external magnetic field for further application in magnetricity.
Transport of active particles in an open-wedge channel
Authors: Caprini Lorenzo , Cecconi Fabio , Marini Bettolo Marconi Umberto
Published: April 2019

The transport of independent active Brownian particles within a two-dimensional narrow channel, modeled as an open-wedge, is studied both numerically and theoretically. We show that the active force tends to localize the particles near the walls, thus reducing the effect of the entropic force which, instead, is prevailing in the case of passive particles. As a consequence, the exit of active particles from the smaller side of the channel is facilitated with respect to their passive counterpart. By continuously re-injecting particles in the middle of the wedge, we obtain a steady regime whose properties are investigated in the presence and absence of an external constant driving field. We characterize the statistics and properties of the exit process from the two opposite sides of the channel, also by making a comparison between the active case and passive case. Our study reveals the existence of an optimal value of the persistence time of the active force which is able to guarantee the maximal efficiency in the transport process.
Fano-resonance collapse induced terahertz magnetic dipole oscillation in complementary meta-atoms via local symmetry breaking
Authors: Gu Zhidong , Zhao Zhenyu , Zhao Hui , Peng Wei , Zhang Jianbing , Shi Wangzhou
Published: April 2019

A novel phenomenon is observed in the meta-atoms composed of a complementary rectangular double split-ring resonator (SRR). An intrinsic Fano-resonance collapses with the outer SRR deformed asymmetrically. Alternatively, a trapped mode emerges at an adjacent frequency region, of which its strength grows up with increasing the asymmetric deviation. However, the asymmetric deformation in the inner SRR has influence neither on the evolution of this intrinsic Fano-resonance nor on the excitation of the aforementioned trapped mode. The results of electromagnetic field simulation indicate that an interference of two magnetic dipoles leads to the intrinsic Fano-resonance on the outer SRR. The asymmetric deviation destructs coherent interference so that the Fano-resonance collapses. To the trapped mode, the surface current passes through the metal gap of the outer SRR, leading to a couple of antiparallel currents, which results in a couple of magnetic dipole oscillations. The intrinsic modes are kept constant, even though the inner SRR is asymmetrically deformed. The outer SRR plays the role of a Faraday cage, which electromagnetically shields the trapped mode on the inner SRR.
A fragmented, permutationally invariant polynomial approach for potential energy surfaces of large molecules: Application to N-methyl acetamide
Authors: Qu Chen , Bowman Joel M.
Published: April 2019

We describe and apply a method to extend permutationally invariant polynomial (PIP) potential energy surface (PES) fitting to molecules with more than 10 atoms. The method creates a compact basis of PIPs as the union of PIPs obtained from fragments of the molecule. An application is reported for trans-N-methyl acetamide, where B3LYP/cc-pVDZ electronic energies and gradients are used to develop a full-dimensional potential for this prototype peptide molecule. The performance of several fragmented bases is verified against a benchmark PES using all (66) Morse variables. The method appears feasible for much larger molecules.
Micro-channel design efficiently creates high-energy electron accelerations
Authors: Kearns Sarah
Published: April 2019

New laser-driven micro-channel plasma target successfully produces high-energy electron accelerations in new experimental and simulation paper.
Drought tolerance traits do not vary across sites differing in water availability in Banksia serrata (Proteaceae)
Authors: Li Ximeng , Blackman Chris J. , Choat Brendan , Rymer Paul D. , Medlyn Belinda E. , Tissue David T.
Published: April 2019

Interspecific variation in plant hydraulic traits plays a major role in shaping species distributions across climates, yet variation within species is poorly understood. Here we report on intraspecific variation of hydraulic traits in Banksia serrata (L.f.) sampled from three sites characterised by contrasting climates (warm-wet, warm-dry and cool-wet). Hydraulic characteristics including vulnerability to embolism, hydraulic conductance, pressure-volume traits and key morphological traits were measured. Vulnerability to embolism in leaf and stem, defined by the water potential inducing 50 and 88% loss of hydraulic conductivity (P50 and P88 respectively), did not differ across sites. However, plants from the warm-dry environment exhibited higher stem conductivity (Ks) than the cool-wet environment. Leaf turgor loss point (TLP) did not vary among sites, but warm-dry site plants showed lower leaf capacitance (C*FT) and higher modulus of elasticity (ε) than the other two sites. Plants from the cool-wet site had lower specific leaf area (SLA) and plants from the warm-dry site had lower sapwood density (WD). Overall, key hydraulic traits were generally conserved across populations despite differences in mean site water availability, and the safety-efficiency trade-off was absent in this species. These results suggest that B. serrata has limited ability to adjust hydraulic architecture in response to environmental change and thus may be susceptible to climate change-type drought stress.
Can a common snake provide conservation insights?
Authors: Goldingay Ross L.
Published: April 2019

The small-eyed snake (Cryptophis nigrescens) is a common non-threatened species in eastern Australia. It coexists with the threatened broad-headed snake (Hoplocephalus bungaroides), a species adversely affected by habitat disturbance and subject to poaching. The small-eyed snake is a habitat generalist and not subject to poaching. It may prey on other snakes, including the broad-headed snake, and, like the broad-headed snake, may shelter under thermally favourable loose rocks during the cooler months of the year. This may lead to interactions between these species due to the limited availability of such rocks, and possibly exacerbate other threats to the broad-headed snake, such as poaching and the loss of thermally favourable rocks. I conducted repeat surveys for snakes at 64 rock outcrops in Royal National Park over a 16-year period. I predicted that site use by the small-eyed snake would not be influenced by a disturbance variable previously documented to influence site use by the broad-headed snake. Observations were consistent with this prediction, confirming the unique vulnerability of the broad-headed snake. I used my long-term data to analyse the co-occurrence of the two species. The broad-headed snake was detected as frequently at sites with and without the small-eyed snake, suggesting that these species occupy outcrops independently of each other. Therefore, interactions with the small-eyed snake will not reduce the effectiveness of habitat restoration for the broad-headed snake in Royal National Park.
Synergy of topoisomerase and structural-maintenance-of-chromosomes proteins creates a universal pathway to simplify genome topology
Authors: Orlandini Enzo , Marenduzzo Davide , Michieletto Davide
Published: April 2019

Significance

Vital biological processes such as gene transcription and cell division may be severely impaired by inevitable entanglements ensuing from the extreme length and confinement of the genome. The family of topoisomerase proteins has independently evolved in different organisms to resolve these topological problems, yet no existing model can explain how topoisomerase alone can reduce the topological complexity of DNA in vivo. We propose that a synergistic mechanism between topoisomerase and a family of slip-link–like proteins called structural maintenance of chromosomes (SMC) can provide a pathway to systematically resolve topological entanglements even under physiological crowding and confinement. Given the ubiquity of topoisomerase and SMC, we argue that the uncovered mechanism is at work throughout the cell cycle and across different organisms.
Thinking globally, acting locally
Authors: Baider Fabienne H.
Published: April 2019

The aim of this study is to show how trans-national right-wing linguistic strategies and global xenophobic attitudes are reworked at national levels, and how, as a result, specialized country- and culture-specific coercion and legitimization strategies arise. Using a detailed, quantitative-qualitative method of analysis, we look at the Greek Cypriot extreme-right party ELAM to see how the party’s anti-migration rhetoric construes any foreign presence as threat, by proximizing it linguistically as ‘invasion.’ This strategy allows the conflation of the current ‘Other’ (migrants) with archetypical adversaries, such as Turkey. Indeed, anchoring the migration issue in the main national narrative, i.e., the long-standing Cypriot conflict, gives their xenophobic language conceptual coherence and strengthens its textual cohesion. In particular two figures of speech are the basis of this invasion script, the word metanasteftiko ‘the immigration phenomenon’ conceptualized as the kipriako (the Cyprus problem, i.e., the political division of the island). This parallelism opens the way for a number of inferences, while it also enables a conceptual shift from the real phenomenon known as globalization and multiculturalism to the imagined idea of a (white/Western) genocide. Data include comments responding to ELAM followers’ YouTube videos and mainstream press representations. Methodology includes corpus linguistics and discourse analysis focused on the fundamental metaphors found in the data such as MIGRATION AS UNBEARABLE WEIGHT and MIGRATION AS DIRT.
Conditional support for territorial migrations in Serbian national discourse
Authors: Petrovic Jelena
Published: April 2019

After more than a decade of Serbia’s investment in the EU integration, its
citizens are still imagining their national identities from the externally assigned
position of ‘flawed’ Europeans. To respond to this subject position in the context
of ongoing migration trends in Europe, these individuals engage in identity
politics that both celebrate elements of otherness, and also locate them in the
country’s own internal and Eastern Others. This study uses critical discourse
analysis to examine the ideological effects of these negotiations in response to
the 2010/2011 asylum-seeking crisis, when a number of Serbian citizens applied
for asylum in several EU countries, which defined this as an abuse of Schengen
system. The analysis of more than 1,000 online comments shows that newsreaders offer conditional support for asylum seekers to (re)inscribe preferred social hierarchies. Represented simultaneously as suffering citizens and immoral internal other, asylum seekers serve as the strategic means by which ethnic discrimination becomes an invisible element of everyday nationalism.
Donald Trump supporters and the denial of racism
Authors: Subtirelu Nicholas Close
Published: April 2019

Donald Trump’s campaign to become president of the United States was shocking for many people. His negative representations of racialized immigrant
groups were one of the most controversial aspects of the campaign, leading to
frequent accusations of racism. This study explores how his supporters responded to such accusations. Discussions of racism within a pro-Trump reddit
community, called “The_Donald”, were analyzed. The_Donald users adamantly
denied that Trump’s statements or proposed policies were racist. Their dismissal
of these accusations drew on and extended the logic of color-blind racism. They
argued that such accusations were merely cynical political tactics and advocated that Trump supporters respond to them as such. Their favored response strategies superficially resembled genuine debate but were apparently intended to incite emotional responses from accusers and to compel them to disengage from conversations. The article discusses these strategies in light of the ongoing polarization of political debate around immigration.
Coherent impurity transport in an attractive binary Bose–Einstein condensate
Authors: Edmonds M J , Helm J L , Busch Th
Published: April 2019

We study the dynamics of a soliton-impurity system modeled in terms of a binary Bose–Einstein condensate. This is achieved by ‘switching off’ one of the two self-interaction scattering lengths, giving a two component system where the second component is trapped entirely by the presence of the first component. It is shown that this system possesses rich dynamics, including the identification of unusual ‘weak’ dimers that appear close to the zero inter-component scattering length. It is further found that this system supports quasi-stable trimers in regimes where the equivalent single-component gas does not, which is attributed to the presence of the impurity atoms which can dynamically tunnel between the solitons, and maintain the required phase differences that support the trimer state.
Hospices and palliative care for children: converging stories
Authors: Hain Richard D W
Published: April 2019

Introduction

Children’s hospices offer support to children and their families according to a model that is quite different from adult hospices and has evolved in parallel with specialist paediatric palliative medicine services.

Sources of data

Published research, Together for Short Lives.

Areas of agreement

The services hospices offer are highly valued by families.

Areas of controversy

It is not always clear that hospices can be described as ‘specialist’, which can make it difficult for hospices to negotiate appropriate commissioning arrangements with the statutory sector.

Growing points

Children’s palliative care generally is poorly developed compared with the adult specialty, and local providers should work with hospices to help redress the inequity that children face in accessing specialist palliative care.

Areas timely for developing research

If hospices are to continue to be important providers of palliative care in children they must develop robust and fair relationships with local healthcare providers. That would be facilitated by development of a funding formula for children that properly acknowledges the part hospices already play in palliative care.
Lower carbohydrate diets and all-cause and cause-specific mortality: a population-based cohort study and pooling of prospective studies
Authors: Mazidi Mohsen , Katsiki Niki , Mikhailidis Dimitri P , Sattar Naveed , Banach Maciej
Published: April 2019

Aims

Little is known about the long-term association between low-carbohydrate diets (LCDs) and mortality. We evaluated the link between LCD and overall or cause-specific mortality using both individual data and pooled prospective studies.

Methods and results

Data on diets from the National Health and Nutrition Examination Survey (NHANES; 1999–2010) were analysed. Multivariable Cox proportional hazards were applied to determine the hazard ratios and 95% confidence intervals (CIs) for mortality for each quartile of the LCD score, with the lowest quartile (Q1—with the highest carbohydrates intake) used as reference. We used adjusted Cox regression to determine the risk ratio (RR) and 95% CI, as well as random effects models and generic inverse variance methods to synthesize quantitative and pooled data, followed by a leave-one-out method for sensitivity analysis. Overall, 24 825 participants from NHANES study were included (mean follow-up 6.4 years). After adjustment, participants with the lowest carbohydrates intake (quartile 4 of LCD) had the highest risk of overall (32%), cardiovascular disease (CVD) (50%), cerebrovascular (51%), and cancer (36%) mortality. In the same model, the association between LCD and overall mortality was stronger in the non-obese (48%) than in the obese (19%) participants. Findings on pooled data of nine prospective cohort studies with 462 934 participants (mean follow-up 16.1 years) indicated a positive association between LCD and overall (RR 1.22, 95% CI 1.06–1.39, P < 0.001, I2 = 8.6), CVD (RR 1.13, 95% CI 1.02–1.24, P < 0.001, I2 = 11.2), and cancer mortality (RR 1.08, 95% CI 1.01–1.14, P = 0.02, I2 = 10.3). These findings were robust in sensitivity analyses.

Conclusion

Our study suggests a potentially unfavourable association of LCD with overall and cause-specific mortality, based on both new analyses of an established cohort and by pooling previous cohort studies. Given the nature of the study, causality cannot be proven; we cannot rule out residual bias. Nevertheless, further studies are needed to extend these important findings, which if confirmed, may suggest a need to rethink recommendations for LCD in clinical practice.
Population-based analysis of BAP1 germline variations in patients with uveal melanoma
Authors: Repo Pauliina , Järvinen Reetta-Stiina , Jäntti Johannes E , Markkinen Salla , Täll Martin , Raivio Virpi , Turunen Joni A , Kivelä Tero T
Published: April 2019

Pathogenic germline variants in the BRCA1-associated protein 1 (BAP1) gene cause the BAP1 tumor predisposition syndrome (BAP1-TPDS) with increased risk of several cancers, the most frequent of which is uveal melanoma (UM). Pathogenicity of loss-of-function (LOF) BAP1 variants is clear, as opposed to that of missense and regulatory region variants. We sequenced the coding, promoter, untranslated region (UTR) and intronic regions of BAP1 and analyzed copy number variations (CNVs). In this nationwide study, the cohort comprised UM patients diagnosed between 2010 and 2017. These included 432 of 520 consecutive Finnish UM patients, 16 of whom were familial, and one additional patient from a Finnish–Swedish family. Twenty-one different rare variants were found: seven exonic, seven intronic, four 3′ UTR and three promoter. We considered five variants likely to be pathogenic by effect on splicing, nuclear localization or deubiquitination activity. Intron 2 (c.67+1G>T) and exon 14 (c.1780_1781insT) LOF variants were presumed founder mutations, occurring in two and four families, respectively; both abolished nuclear localization in vitro. Intron 2, exons 5 (c.281A>G) and 9 (c.680G>A) missense variants markedly reduced deubiquitinating activity. A deep intronic 25 base pair deletion in intron 1 caused aberrant splicing in vitro. On the basis of functional studies and family cancer history, we classified four exon 13 missense variants as benign. No CNVs were found. The prevalence of pathogenic variants was 9/433 (2%) and 4/16 (25%) in Finnish UM families. Family cancer history and functional assays are indispensable when establishing the pathogenicity of BAP1 variants. Deep intronic variants can cause BAP1-TPDS.
Prevalence of Fistulizing Crohn’s Disease in the United States: Estimate From a Systematic Literature Review Attempt and Population-Based Database Analysis
Authors: Schwartz David A , Tagarro Ignacio , Carmen Díez Mary , Sandborn William J
Published: April 2019

Background

Fistulas may arise as a relevant complication of Crohn’s disease (CD). Despite their clinical significance and the substantial burden imposed on patients, limited data are available on the epidemiology of fistulizing CD in the United States.

Methods

A systematic literature review was conducted to identify data published between 1970 and 2017 on the epidemiology of fistulas in patients with CD, with the aim to estimate the number of prevalent cases in the United States. Retrieved titles and abstracts were screened by 2 independent researchers for inclusion criteria (US population-based studies reporting data on the epidemiology of fistulizing CD). To validate the literature-based estimate, data from a US claims database (Truven Health MarketScan database) were analyzed. This database has broad geographic coverage, with health care data for >60 million patients during the period of the analysis.

Results

The literature search retrieved 7 articles for full-text review, and only 1 met the criteria for inclusion. This study described the cumulative incidence of fistulas in a CD population from Minnesota over 20 years. From the reported data, the estimated number of prevalent cases with fistulizing CD in the United States was ~76,600 in 2017 (~52,900 anal, ~7400 rectovaginal, ~2300 enterocutaneous, and ~14,100 internal). Analysis from the US health care database resulted in an estimated number of ~75,700 patients, confirming the robustness of the original estimate from the literature.

Conclusions

Based on 2 separate analyses, the estimated number of patients with fistulizing CD in the United States is ~77,000 patients.
Transfer of primary care patients receiving chronic care: the next step in the continuum of care
Authors: Odayar Jasantha , Myer Landon
Published: April 2019

The burden of chronic conditions is increasing rapidly in low- and middle-income countries. Chronic conditions require long-term and continuous care, including for patients transferring between facilities. Patient transfer is particularly important in the context of health service decentralization, which has led to increasing numbers of primary care facilities at which patients can access care, and high levels of migration, which suggest that patients might require care at multiple facilities. This article provides a critical review of existing evidence regarding transfer of stable patients receiving primary care for chronic conditions. Patient transfer has received limited consideration in people living with HIV, with growing concern that patients who transfer are at risk of poor outcomes; this appears similar for people with TB, although studies are few. There are minimal data on transfer of patients with non-communicable diseases, including diabetes. Patient transfer for chronic conditions has thus received surprisingly little attention from researchers; considering the potential risks, more research is urgently required regarding reasons for and outcomes of transfers, transfer processes and interventions to optimize transfers, for different chronic conditions. Ultimately, it is the responsibility of health systems to facilitate successful transfers, and this issue requires increased attention from researchers and policy-makers.
Temporarily Unavailable: Memory Inhibition in Cognitive and Computer Science
Authors: Tempel Tobias , Niederée Claudia , Jilek Christian , Ceroni Andrea , Maus Heiko , Runge Yannick , Frings Christian
Published: April 2019

Inhibition is one of the core concepts in Cognitive Psychology. The idea of inhibitory mechanisms actively weakening representations in the human mind has inspired a great number of studies in various research domains. In contrast, Computer Science only recently has begun to consider concepts such as digital forgetting or suppression of irrelevant information to complement activation and highlighting of relevant information. Here, we review psychological research on inhibition in memory and link the gained insights with the current efforts and opportunities in Computer Science of incorporating inhibitory principles for reducing information overload and improving information retrieval in Personal Information Management. Four common aspects guide this review in both domains: (i) the purpose of inhibition to increase processing efficiency; (ii) its relation to activation; (iii) its links to contexts; (iv) its temporariness. In summary, the principle of suppressing information has been used by Computer Science for enhancing software in some ways already. Yet, we consider how novel methods for reducing information overload can be inspired by a more systematic involvement of the inhibition concept.
Epidemiology of MRSA CC398 in hospitals located in Spanish regions with different pig-farming densities: a multicentre study
Authors: Ceballos Sara , Aspiroz Carmen , Ruiz-Ripa Laura , Reynaga Esteban , Azcona-Gutiérrez José Manuel , Rezusta Antonio , Seral Cristina , Antoñanzas Fernando , Torres Luis , López Concepción , López-Cerero Lorena , Cercenado Emilia , Zarazaga Myriam , Torres Carmen ,   Study Group of clinical LA-MRSA, Leiva José , Ezpeleta Carmen , Martín Carmen , Castillo Javier , Arribas Jorge , Navarro Carmen , Betrán Ana , Hernández Jose Luis , Berdonces Pilar , de Benito Inés , Campo Ana Belén , Arias Antonina , Fortuño Blanca , Pereira Javier , Milagro Ana , Soria-Blanco Luis Miguel , Alonso Carla Andrea , Gimeno Carmen , Ulibarri Belén , Calleja Raquel , García Mercé , Navarro María , Vilamala Anna , Canut Andrés , Cordón Mª Luz , Álvarez Ledicia , Megías Gregoria , Gomáriz María , Calvo Jorge , Fernández Marina , López-Calleja Ana Isabel
Published: April 2019

Background

Tetracycline resistance (TetR) is a marker of livestock-associated MRSA of lineage CC398.

Objectives

To determine the MRSA CC398 prevalence among TetR-MRSA recovered in Spanish hospitals located in regions with different pig-farming densities, and the influence of pig density as a key risk factor for its acquisition.

Methods

TetR-MRSA isolates (n = 232) recovered from clinical and epidemiological samples during January–June 2016 in 20 hospitals in 13 regions with different pig-farming densities were analysed. MRSA CC398 identification, detection of spa types, methicillin resistance genes and immune evasion cluster (IEC) genes were performed by PCR/sequencing. Statistical analyses were performed to establish the relationships between MRSA CC398 prevalence and pig density.

Results

The global MRSA prevalence was 29.7% (6.9% TetR-MRSA/MRSA), with 137 CC398 isolates recovered, representing 4.1% of total MRSA and 59.1% of TetR-MRSA. Among MRSA CC398, 16 different spa types were recorded (t011: 72.3%), and all but two strains were IEC negative. Higher pig-density regions were associated with significant MRSA CC398 increases in hospitals located in adjacent regions (P < 0.001). Linear regression models explained the relationships between MRSA CC398 and pig density (P < 0.001), with an increase of 6.6 MRSA CC398 cases per 100 MRSA per increase of 100 pigs/km2 in a region.

Conclusions

High pig density leads to a significant increase in MRSA CC398 in hospitals in Spain, and its combination with a high human population could help its dissemination. In Spain, the prevalence of the zoonotic CC398 lineage is closely related to pig-farming density; therefore, specific tools could be implemented in order to detect its dissemination.
Ocean acidification alters thermal cardiac performance, hemocyte abundance, and hemolymph chemistry in subadult American lobsters Homarus americanus H. Milne Edwards, 1837 (Decapoda: Malcostraca: Nephropidae)
Authors: Harrington Amalia M , Hamlin Heather J
Published: April 2019

Increased anthropogenic input of carbon dioxide into the atmosphere has caused widespread patterns of ocean acidification (OA) and increased the frequency of extreme warming events. We explored the sublethal effects of OA on the hemolymph chemistry and physiological response to acute thermal stress in the American lobster (Homarus americanus H. Milne Edwards, 1837). We exposed subadult lobsters to current or predicted end-century pH conditions (8.0 and 7.6, respectively) for 60 days. Following exposure, we assessed hemolymph L-lactate and calcium concentrations (as indicators of oxygen carrying capacity), ecdysterone concentrations, total protein content, and total hemocyte counts (THCs) as an indicator of immune response. We also assessed cardiac performance in the context of an acute warming event using impedance pneumography. Calcium, total protein, and ecdysterone concentrations were not significantly altered (P ≥ 0.10) by OA exposure. Control lobsters, however, had significantly higher levels of L-lactate concentrations compared to acidified lobsters, suggesting reduced oxygen carrying capacity under OA. THCs were also 61% higher in control versus acidified lobsters, suggesting immunosuppression under chronic OA. Lobsters exposed to acidified conditions exhibited reduced cardiac performance under acute warming as indicated by significantly lower (P = 0.040) Arrhenius Break Temperatures compared to control lobsters. These results suggest that although some physiological endpoints of American lobster are not impacted by OA, the stress of OA will likely be compounded by acute heat shock and may present additional physiological challenges for this species in the face of future change.
Implementation Science in Pediatric Psychology: The Example of Type 1 Diabetes
Authors: Price Julia , Beidas Rinad S , Wolk Courtney Benjamin , Genuario Kimberly , Kazak Anne E
Published: April 2019

Objective

Evidence-based screening, assessment, and intervention practices for youth with type 1 diabetes (T1D) are underutilized. Implementation science (IS) offers theoretical models and frameworks to guide rigorous mixed methods research to advance comprehensive care for children and families.

Methods

We conducted a targeted review of applications of IS to T1D.

Results

Pediatric T1D research offers initial, but still limited studies on implementation of evidence-based psychosocial care. IS designates approaches to understanding multi-level factors that influence implementation, ways to alter these factors, and methods to evaluate strategies to improve implementation.

Conclusions

IS is promising for advancing the translation of pediatric psychology approaches into clinical care. Following the science of implementation, further documentation of the reach of evidence-based care and establishing practice guidelines are important initial steps. Examining the barriers and facilitators of evidence-based psychosocial care can guide the development of testable implementation strategies to improve integration of care. Successful strategies can be evaluated through multi-site controlled implementation trials to explore their effectiveness. These lines of inquiry can be considered within pediatric populations, but may also be used to examine similarities and differences in effectiveness of implementation strategies across populations and settings. Such research has the potential to improve the health and well-being of children and families.