bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of iron oxide nanoparticles on fibrin gel formation and its fractal dimension
Authors: Kirichenko M. N. , Chaikov L. L. , Krivokhizha S. V. , Kirichenko A. S. , Bulychev N. A. , Kazaryan M. A.
Published: April 2019

In this paper, we studied the influence of nonmagnetic iron oxide nanoparticles on fibrin gel formation and its structure using dynamic light scattering. The surface of nanoparticles produced by a new method in acoustoplasma discharge with cavitation has specific morphology and accelerates the rate of fibrin gel formation, i.e., activates the enzyme thrombin. We studied changes in the form of autocorrelation functions of the scattered light intensity for fibrinogen-thrombin samples with different thrombin concentrations as well as the nanoparticles addition. Appearance of the power-law term in the function was an indicator of gel formation in the sample. Application of Martin’s theory allows estimating the exponent φ of power-law function and the contribution of the diffusive mode of protofibrils. We found that an increase in thrombin concentration or its activation with iron oxide nanoparticles leads to decreasing contribution of the diffusive mode, and increasing contribution of the exponent of power-law function. The values of fractal dimension Df calculated using Muthukumar’s theory are 1.61 ± 0.13 and 1.69 ± 1.11 for samples with low and high concentrations of thrombin respectively and 1.77 ± 0.08 for the sample with thrombin activated by nanoparticles. Such an increase in fractal dimension shows an increase in the complexity of the fibrin gel structure (or density).
Energetics of counterion adsorption in the electrical double layer
Authors: Voukadinova Adelina , Gillespie Dirk
Published: April 2019

The energetics of the electrical double layer (EDL) is studied in a systematic way to define how different components of the chemical potential help or hinder cation adsorption at a negatively charged wall. Specifically, the steric (i.e., excluded-volume interactions), mean electrostatic, and screening (i.e., electrostatic correlations beyond the mean field) components were computed using classical density functional theory of the primitive model of ions (i.e., ions as charged, hard spheres in a background dielectric). The reduced physics of the primitive model allows for an extensive analysis over a large parameter space: cation valences +1, +2, and +3, cation diameters 0.15, 0.30, 0.60, and 0.90 nm, bulk concentrations ranging from 1 µM to 1M, and surface charges ranging from 0 to −0.50 C/m2. Our results show that all components are necessary to understand the physics of the EDL. The screening component is always significant; for small monovalent cations such as K+, it is generally much larger than the steric component, and for multivalent ions, charge inversion cannot occur without it. At moderate surface charges, the screening component makes the electrostatic potential less negative than in classical Poisson-Boltzmann theory, sometimes even positive (charge inversion). At high surface charges, this is overcome by the repulsive potential of the steric component as the first ion layer becomes extremely crowded. Large negative electrostatic potentials counteract this to draw even more cations into the first layer. Although we used an approximate model of the EDL, the physics inherent in these trends appears to be quite general.
Laser irradiation modulating the acoustic radiation force acting on a liquid ball in a plane progressive wave
Authors: Yu Hai-Qun , Yao Jie , Wu Da-Jian , Wu Xue-Wei , Liu Xiao-Jun
Published: April 2019

We present a theoretical study of the modulation using laser irradiation of an acoustic radiation force (ARF) acting on a liquid ball. The ARFs acting on a laser-irradiated oleic acid (OA) sphere were investigated using a mathematical model and were verified using the finite element method (FEM). It was found that, when the influence of the photoacoustic (PA) effect on the ARF is stronger than that from the acoustic scattering, a negative ARF can be realized. The ARF on a laser-irradiated OA sphere can be greatly modulated by the laser intensity and the phase difference between the plane acoustic wave and the laser beam. There is a region of the phase difference in which a negative ARF can be achieved by changing the laser intensity. In addition, we found that increasing the radius of the OA sphere enhanced the ARF and that a surrounding medium with a higher acoustic impedance enabled a larger negative ARF. Our results may be beneficial to the acoustic manipulation of liquid particles such as biological cells and protein drugs.
A general method for the derivation of the functional forms of the effective energy terms in coarse-grained energy functions of polymers. III. Determination of scale-consistent backbone-local and correlation potentials in the UNRES force field and force-field calibration and validation
Authors: Liwo Adam , Sieradzan Adam K. , Lipska Agnieszka G. , Czaplewski Cezary , Joung InSuk , Żmudzińska Wioletta , Hałabis Anna , Ołdziej Stanisław
Published: April 2019

The general theory of the construction of scale-consistent energy terms in the coarse-grained force fields presented in Paper I of this series has been applied to the revision of the UNRES force field for physics-based simulations of proteins. The potentials of mean force corresponding to backbone-local and backbone-correlation energy terms were calculated from the ab initio energy surfaces of terminally blocked glycine, alanine, and proline, and the respective analytical expressions, derived by using the scale-consistent formalism, were fitted to them. The parameters of all these potentials depend on single-residue types, thus reducing their number and preventing over-fitting. The UNRES force field with the revised backbone-local and backbone-correlation terms was calibrated with a set of four small proteins with basic folds: tryptophan cage variant (TRP1; α), Full Sequence Design (FSD; α + β), villin headpiece (villin; α), and a truncated FBP-28 WW-domain variant (2MWD; β) (the NEWCT-4P force field) and, subsequently, with an enhanced set of 9 proteins composed of TRP1, FSD, villin, 1BDC (α), 2I18 (α), 1QHK (α + β), 2N9L (α + β), 1E0L (β), and 2LX7 (β) (the NEWCT-9P force field). The NEWCT-9P force field performed better than NEWCT-4P in a blind-prediction-like test with a set of 26 proteins not used in calibration and outperformed, in a test with 76 proteins, the most advanced OPT-WTFSA-2 version of UNRES with former backbone-local and backbone-correlation terms that contained more energy terms and more optimizable parameters. The NEWCT-9P force field reproduced the bimodal distribution of backbone-virtual-bond angles in the simulated structures, as observed in experimental protein structures.
Radical pair intersystem crossing: Quantum dynamics or incoherent kinetics?
Authors: Fay Thomas P. , Manolopoulos David E.
Published: April 2019

Magnetic field effects on radical pair reactions arise due to the interplay of coherent electron spin dynamics and spin relaxation effects, a rigorous treatment of which requires the solution of the Liouville-von Neumann equation. However, it is often found that simple incoherent kinetic models of the radical pair singlet-triplet intersystem crossing provide an acceptable description of experimental measurements. In this paper, we outline the theoretical basis for this incoherent kinetic description, elucidating its connection to exact quantum mechanics. We show, in particular, how the finite lifetime of the radical pair spin states, as well as any additional spin-state dephasing, leads to incoherent intersystem crossing. We arrive at simple expressions for the radical pair spin state interconversion rates to which the functional form proposed recently by Steiner et al. [J. Phys. Chem. C 122, 11701 (2018)] can be regarded as an approximation. We also test the kinetic master equation against exact quantum dynamical simulations for a model radical pair and for a series of PTZ•+–Phn–PDI•− molecular wires.
On the distinguishable cluster approximation for triple excitations
Authors: Kats Daniel , Köhn Andreas
Published: April 2019

The distinguishable cluster approximation applied to coupled cluster doubles equations greatly improves absolute and relative energies. We apply the same approximation to the triples equations and demonstrate that it can also improve the results of the coupled cluster method with singles, doubles, and triples. The resulting method has a nominal computational scaling of O(N7) in the real-space representation, and is orbital invariant, size extensive, and exact for three electrons.
Effective diameter: A new parameter for THz transmission line fabrication
Authors: Frank Jodi
Published: April 2019

Researchers address otherwise ignored substrate integrated waveguide (SIW) transmission line parameters in low-frequency devices to come up with a new parameter in considering conventional manufacturing methods for THz devices.
Going to ground: implications of ground use for the conservation of an arboreal marsupial
Authors: Van Helden Bronte E. , Close Paul G. , Stewart Barbara A. , Speldewinde Peter C. , Comer Sarah J.
Published: April 2019

On the basis of previous observations, the critically endangered western ringtail possum (Pseudocheirus occidentalis) has been described as strictly arboreal. Using motion-sensing cameras placed in bushland remnants and residential gardens, we demonstrate that the species uses the ground during its nocturnally active period. To acknowledge that ground use may make the species more susceptible to terrestrial predators than previously thought, we propose that the species should not be described as ‘strictly’ arboreal.
Transcription factors IRF8 and PU.1 are required for follicular B cell development and BCL6-driven germinal center responses
Authors: Wang Hongsheng , Jain Shweta , Li Peng , Lin Jian-Xin , Oh Jangsuk , Qi Chenfeng , Gao Yuanyuan , Sun Jiafang , Sakai Tomomi , Naghashfar Zohreh , Abbasi Sadia , Kovalchuk Alexander L. , Bolland Silvia , Nutt Stephen L. , Leonard Warren J. , Morse Herbert C.
Published: April 2019

The IRF and Ets families of transcription factors regulate the expression of a range of genes involved in immune cell development and function. However, the understanding of the molecular mechanisms of each family member has been limited due to their redundancy and broad effects on multiple lineages of cells. Here, we report that double deletion of floxedIrf8andSpi1(encoding PU.1) by Mb1-Cre (designated DKO mice) in the B cell lineage resulted in severe defects in the development of follicular and germinal center (GC) B cells. Class-switch recombination and antibody affinity maturation were also compromised in DKO mice. RNA-seq (sequencing) and ChIP-seq analyses revealed distinct IRF8 and PU.1 target genes in follicular and activated B cells. DKO B cells had diminished expression of target genes vital for maintaining follicular B cell identity and GC development. Moreover, our findings reveal that expression of B-cell lymphoma protein 6 (BCL6), which is critical for development of germinal center B cells, is dependent on IRF8 and PU.1 in vivo, providing a mechanism for the critical role for IRF8 and PU.1 in the development of GC B cells.
Modular, stereocontrolled C
β
–H/C
α
–C activation of alkyl carboxylic acids
Authors: Shang Ming , Feu Karla S. , Vantourout Julien C. , Barton Lisa M. , Osswald Heather L. , Kato Nobutaka , Gagaring Kerstin , McNamara Case W. , Chen Gang , Hu Liang , Ni Shengyang , Fernández-Canelas Paula , Chen Miao , Merchant Rohan R. , Qin Tian , Schreiber Stuart L. , Melillo Bruno , Yu Jin-Quan , Baran Phil S.
Published: April 2019

Significance

The combination of two newly emerging methods for chemical synthesis enables access to molecular space that was previously challenging or impossible to access. Thus, a C–H activation of ubiquitous carboxylic acids followed by their decarboxylative functionalization provides modular access to difunctionalized carbon frameworks with distinctly controlled stereochemistry. Application of this strategy to simplify the synthesis of medicinally important entities and to discover potent antimalarial compounds is described.
The role of input in native Spanish Late learners’ production and perception of English phonetic
segments
Authors: Flege James E. , Wayland Ratree
Published: April 2019

This study evaluated the effect of input variation on the production and perception of English phonetic segments by native Spanish
adults who had immigrated to the United States after the age of 16 years. The native Spanish (NS) participants were assigned to
three groups of 20 each according to years of English input (years of U.S. residence multiplied by percent English use outside the
home). Experiment 1 assessed the perceived relation between English and Spanish vowels. It yielded similar results for the NS
groups designated “Low input” (M = 0.2 years of input), “Mid” (M = 1.2 years) and “High”
(M = 3.0 years). Experiments 2–4 examined English vowel discrimination, vowel production and consonant
discrimination. Apart from a modest improvement in vowel discrimination, these experiments showed little improvement as years of
English input increased. One possible explanation for the essentially null finding of this study is that input matters little or
not at all when an L2 is learned naturalistically following the closure of a critical period. Another possibility is that adequate
native speaker input is crucial for L2 speech learning but the input differences evaluated here were insufficient to yield
measurable improvements in performance. We conclude the article by illustrating a new technique that might be used to choose
between these competing explanations.
Enacting voices
Authors: LaScotte Darren K.
Published: April 2019

The present study supports the idea of heteroglossia and its contributions to language learning in second language
acquisition (SLA) theory and bilingualism. Bakhtin’s (1934/1981) theory of
heteroglossia differs from variety and register in that when acquiring a language, one internalizes the voices of others. Viewing
interlanguage through a heteroglossic lens, it is possible that these voices in heteroglossia may have an effect on second
language (L2) users’ language production. By blending sociolinguistic and sociocultural frameworks, this study analyzed the
complexity, accuracy, and fluency of two French-English bilinguals’ narratives. Findings demonstrate a clear shift in all three
measures of the CAF framework when participants enacted the voice of a perceived interlocutor or perceived self, versus when they
recounted a narrative. These findings support the notion that an individual may have variable linguistic systems, and raise other
important theoretical and practical implications for SLA research and L2 instruction.
What is effective second language exposure and how does it relate to content-based instruction and language across the curriculum?
Authors: Chu Edward Y. W.
Published: April 2019

Second language acquisition cannot take place in the absence of exposure to input. However, despite extensive L2 instruction and/or learning content subjects in L2, many struggle to communicate adequately in their L2 in social and/or academic contexts. A clearer delineation of the concept of ‘exposure’, which requires a review of relevant language acquisition theories and findings, is needed. As such, substantial bodies of work in L2 acquisition by well-known language educators, namely Jim Cummins (‘BICS’ and ‘CALP’), Stephen Krashen (‘Comprehensible Input Hypothesis’), Michael Long (Interaction Hypothesis) and Merril Swain (Output Hypothesis) are reviewed. A review is also made of relevant neuroscience research. Two educational approaches, Content-based instruction (CBI) and Language across the curriculum (LAC), are discussed in relation to the insights obtained, with special reference to contexts influenced by Confucian heritage culture (CHC). To allow subject networking to take place, school managers/L2 policy makers need to actively revamp the curriculum.
Recovery profiles following single and multiple matches per week in professional football
Authors: Howle Kieran , Waterson Adam , Duffield Rob
Published: April 2019

Objectives: To investigate player responses 48 h post single (SM) and multi‐match (MM) weeks on two subjective and three objective outcome measures to infer recovery status. Methods: From 42 professional players over 2 seasons, outcome measures relevant to recovery status were collected 48 h following matches, as well as during pre‐season training weeks as a comparative baseline. These included (1) 5‐item subjective wellness questionnaire, (2) total quality recovery (TQR) scale, (3) hip adduction squeeze test, ankle knee to wall (KTW) test, and active knee extension (AKE) flexibility test. These outcome measures 48 h post‐match were compared for SM (n = 79) and MM (n = 86) weeks where players completed >75 min of match time in only one (SM) or if both matches were played and had <96 h recovery (MM). Internal match load was collected from each match based on session rating of perceived exertion (sRPE) multiplied by match duration. Results: Subjective wellness (specifically fatigue, sleep and soreness), TQR and hip adduction squeeze test were all significantly reduced following match 1 at 48 h post for both SM and MM (p < 0.05), and further reduced following match 2 in MM (p < 0.05). No other outcome measures to infer recovery showed significant differences (p > 0.05) within or between‐conditions. Conclusions: Subjective wellness, TQR and hip adduction strength showed reduction 48 h post match for players competing in multiple matches with <96 h recovery. Therefore, these outcome measures may be of use to practitioners to assess readiness to compete during congested competition schedules.
Post-translational regulation of ubiquitin signaling
Authors: Song Lei , Luo Zhao-Qing
Published: April 2019

Ubiquitination regulates many essential cellular processes in eukaryotes. This post-translational modification (PTM) is typically achieved by E1, E2, and E3 enzymes that sequentially catalyze activation, conjugation, and ligation reactions, respectively, leading to covalent attachment of ubiquitin, usually to lysine residues of substrate proteins. Ubiquitin can also be successively linked to one of the seven lysine residues on ubiquitin to form distinctive forms of polyubiquitin chains, which, depending upon the lysine used and the length of the chains, dictate the fate of substrate proteins. Recent discoveries revealed that this ubiquitin code is further expanded by PTMs such as phosphorylation, acetylation, deamidation, and ADP-ribosylation, on ubiquitin, components of the ubiquitination machinery, or both. These PTMs provide additional regulatory nodes to integrate development or insulting signals with cellular homeostasis. Understanding the precise roles of these PTMs in the regulation of ubiquitin signaling will provide new insights into the mechanisms and treatment of various human diseases linked to ubiquitination, including neurodegenerative diseases, cancer, infection, and immune disorders.
Source or Sink? A comparison of Landfire- and FIA-based estimates of change in aboveground live tree carbon in California’s forests
Authors: Holland Tim G , Stewart William , Potts Matthew D
Published: April 2019

Forests play a central role in addressing climate change, and accurate estimates of forest carbon are critical for the development of actions that reduce emissions from forests and that maximize sequestration by forests. Methodological challenges persist regarding how best to estimate forest carbon stocks and flux at regulatory-relevant scales. Using California, USA as a case study, we compare two approaches to stock-difference forest carbon estimation for aboveground live trees: one based on ground inventories and one on land cover classification of remotely-sensed data. Previous work using ground inventory data from the Forest Inventory and Analysis Program (FIA) showed net aboveground carbon (AGC) sequestration by live trees in California forests, while estimates using land cover classification from the Landscape Fire and Resource Management Planning Tools (Landfire) showed net reductions in live tree AGC over a similar time period. We examined the discrepancy by re-analyzing the FIA inventory data through the lens of a category-change analysis based on Landfire. This analysis showed more than 50% of the live tree AGC in fewer than 4% of Landfire-equivalent categories and that the overwhelming majority (>80%) of forest area did not change height category between measurement periods. Despite the lack of categorical change, the majority of FIA plots increased in both 95th percentile tree height and in live tree AGC. These findings suggest that an approach based on observing categorical changes risks undercounting AGC sequestration resulting from growth and thus overstating the relative importance of AGC reductions that result from disturbances. This would bias AGC flux estimates downward, leading us to validate the conclusion that live trees in California were a net sink of aboveground carbon in the decade ending in 2016. Our findings suggest an inventory-based or hybrid approach is preferable to methods that depend on categorical bins for estimating AGC in disturbance-prone forest ecosystems.
Shorter time to achieve endoscopic eradication is not associated with improved long-term outcomes in Barrett's esophagus
Authors: Soroush Ali , Poneros John M , Lightdale Charles J , Abrams Julian A
Published: April 2019

Quality indicators have been proposed for endoscopic eradication therapy of Barrett's esophagus (BE). One such measure suggests that complete eradication of intestinal metaplasia (CE-IM) should be achieved within 18 months of starting treatment. The aim of this study was to assess whether achievement of CE-IM within 18 months is associated with improved long-term clinical outcomes. This was a retrospective cohort study of BE patients who underwent endoscopic eradication. Time to CE-IM was recorded and categorized as ≤ or > 18 months. The main outcome measures were recurrence of IM and of dysplasia after CE-IM, defined as a single endoscopy without endoscopic evidence of BE or histologic evidence of intestinal metaplasia. Recurrence was analyzed using the Kaplan–Meier method and multivariable Cox proportional hazards modeling. A total of 290 patients were included in the analyses. The baseline histology was high-grade dysplasia or intramucosal carcinoma in 74.2% of patients. CE-IM was achieved in 85.5% of patients, and 54.1% of the cohort achieved CE-IM within 18 months. Achieving CE-IM within 18 months was not associated with reduced risk of recurrence of IM or dysplasia in both unadjusted and adjusted analyses. In this cohort, older age and increased BE length were associated with IM recurrence, and increased hiatal hernia size was associated with dysplasia recurrence. Compared to longer times, achieving CE-IM within 18 months was not associated with a reduced risk of recurrence of IM or dysplasia. Alternative evidence-based quality metrics for endoscopic eradication therapy should be identified.
Differential miRNA Expression in Ileal and Colonic Tissues Reveals an Altered Immunoregulatory Molecular Profile in Individuals With Crohn’s Disease versus Healthy Subjects
Authors: Mohammadi Aylia , Kelly Orlaith B , Smith Michelle I , Kabakchiev Boyko , Silverberg Mark S
Published: April 2019

Background

MicroRNAs [miRNAs] are key modulators of gene expression in Crohn’s disease [CD] and may drive tissue-specific molecular alterations underlying CD susceptibility. In this study, we analysed differential miRNA expression between CD and healthy subjects across ileal and colonic tissues.

Methods

A cohort of CD and healthy control [HC] subjects was recruited and clinical data collected. Endoscopically quiescent CD [CDq] was defined as inactive or mild by the Simple Endoscopic Score for CD. Total RNA was extracted from endoscopic biopsies taken from the terminal ileum and sigmoid colon. miRNA expression was quantified using NanoString Technologies. Statistical significance was assessed across biopsy site and diagnosis per miRNA, and corrected for multiple testing.

Results

In total, 23 CDq and 38 HC subjects were enrolled; 112 samples were included in the analysis, 51 from the ileum and 61 from the colon. We found 47 miRNAs differentially expressed by biopsy site in healthy tissue. Nine miRNAs were differentially expressed across HC and CDq, accounting for biopsy location. One of these, miR-223-3p, showed age and sex effects. We identified miRNA expression driven by diagnosis targeting genes involved in chemokine and cytokine signalling. miR-31-5p expression was driven by location and may be a biomarker for location subtypes in CD.

Conclusions

We identified differentially expressed miRNAs in healthy ileal and colonic tissues. We discovered spatial miRNA expression patterns in CD and HC, suggesting site-specific regulation in subjects with no or minimal intestinal inflammation. These miRNAs target genes involved in immunoregulatory processes, suggesting a functional, tissue-specific role in CD.
A 30-year Trend Analysis in the Epidemiology of Inflammatory Bowel Disease in the Songpa-Kangdong District of Seoul, Korea in 1986–2015
Authors: Park Sang Hyoung , Kim Ye-Jee , Rhee Kyoung Hoon , Kim Young-Ho , Hong Sung Noh , Kim Kyung Ho , Seo Seung In , Cha Jae Myung , Park Sun Yong , Jeong Seung Kyu , Lee Ji Hyun , Park Hyunju , Kim Joo Sung , Im Jong Pil , Yoon Hyuk , Kim Sung Hoon , Jang Jisun , Kim Jeong Hwan , Suh Seong O , Kim Young Kyun , Ye Byong Duk , Yang Suk-Kyun ,   Songpa-Kangdong Inflammatory Bowel Disease [SK-IBD] Study Group
Published: April 2019

Background and Aims

Although the incidence of inflammatory bowel disease [IBD] is increasing in Asia, data on long-term epidemiological trends are limited. We performed a 30-year longitudinal study to investigate temporal trends in the epidemiology of Crohn’s disease [CD] and ulcerative colitis [UC] in Seoul, Korea.

Methods

This population-based study included 1431 IBD patients [418 CD, 1013 UC] diagnosed between 1986 and 2015 in the Songpa-Kangdong district of Seoul, Korea. Temporal trends in incidence, prevalence, and disease phenotype at diagnosis were analysed.

Results

The adjusted mean annual incidence rates of CD and UC per 100 000 inhabitants increased from 0.06 (95% confidence interval [CI], 0.05–0.07) and 0.29 [95% CI, 0.27–0.31], respectively, in 1986–1990 to 2.44 [95% CI, 2.38–2.50] and 5.82 [95% CI, 5.73–5.92], respectively, in 2011–2015. Average annual percentage change in IBD incidence was 12.3% in 1986–1995, 12.3% in 1996–2005, and 3.3% in 2006–2015. The male-to-female ratio of the adjusted incidence rate was 3.3:1 for CD and 1.2:1 for UC. Perianal fistula/abscess was present in 43.3% of patients before or at CD diagnosis. At diagnosis, 54.3% of UC patients presented only with proctitis. The adjusted prevalence rate in 2015 was 31.59/100 000 [95% CI, 31.10–32.07] for CD and 76.66/100 000 [95% CI, 75.91–77.42] for UC.

Conclusions

The incidence and prevalence of IBD in Korea have continued to increase over the past three decades. Korean patients have distinct demographic and phenotypic characteristics, including a male predominance and high frequency of perianal fistula/abscess in CD and high proportion of proctitis in UC.
Comparative study of the frozen elephant trunk and classical elephant trunk techniques to supplement total arch replacement for acute type A aortic dissection†
Authors: Inoue Yosuke , Matsuda Hitoshi , Omura Atsushi , Seike Yoshimasa , Uehara Kyokun , Sasaki Hiroaki , Kobayashi Junjiro
Published: April 2019

OBJECTIVES

In patients with acute type A aortic dissection, the use of the frozen elephant trunk (FET) procedure with total arch replacement (TAR) has been indicated for emergency operations to obtain thrombosis of the distal false lumen (FL). However, data comparing the FET and the classical elephant trunk (CET) procedures, including the incidences of mortality, morbidity, spinal cord injury and aortic remodelling, have not yet been reported. The goal of this study was to compare the early outcomes of TAR with the FET and the CET procedures.

METHODS

The past 7 years of medical records of 323 patients with type A aortic dissection who underwent emergency surgery were reviewed retrospectively, and 148 patients who underwent TAR were shortlisted for the study. First, the patients were divided into 2 groups, the CET group (n = 115; age 65 ± 12 years) and FET group (n = 33; 67 ± 11 years), to compare the early operative outcomes, including mortality and morbidity. Second, 86 patients (CET 56; FET 30) fulfilling the inclusive criteria (inserted length of elephant trunk ≥5 cm, involvement of dissection at the descending aorta and sufficient computed tomographic evaluation at ≥6 months after the operation) were compared to evaluate the patency and diameter of the FL at each segment of the downstream aorta.

RESULTS

The in-hospital mortality rate was 8.1% (12/148), without significant differences between the 2 groups (CET 8.7% vs FET 6.1%; P = 1). No spinal cord ischaemia was encountered in either group. The incidence of postoperative FL patency at the level of the left lower pulmonary vein was 30% in the FET group, which was significantly lower than that in the preoperative state (73%) and in the CET group (77%). The downsizing of the aortic diameter at the distal edge of the CET or the FET, the left lower pulmonary vein and the coeliac axis was significant in the FET group 6 months after TAR.

CONCLUSIONS

According to our initial experience, the FET compared to the CET procedure showed comparable early complications and an advantage concerning FL thrombosis and aortic remodelling at early follow-up examinations.
Injectable RANKL sustained release formulations to accelerate orthodontic tooth movement
Authors: Chang Joy H , Chen Po-Jung , Arul Michael R , Dutra Eliane H , Nanda Ravindra , Kumbar Sangamesh G , Yadav Sumit
Published: April 2019

Background

Accelerating orthodontic tooth movement (OTM) through biologically effective methods, such as increasing osteoclast-mediated alveolar resorption, could effectively shorten treatment time.

Objective

To evaluate an injectable formulation containing receptor activator of nuclear factor kappa-B ligand (RANKL) on the OTM.

Materials and methods

We fabricated a RANKL formulation from 100 µl of 100 µg/ml RANKL adsorbed on 10 mg of poly(lactic acid-co-glycolic acid) microspheres embedded in a 10 wt% aqueous hydroxyethyl cellulose carrier gel. We characterized these formulations for the rate of RANKL release, and then tested for bioactivity using in vitro cell culture. In vivo OTM studies were conducted using 15 week old male Wistar rats for 14 days. We injected the RANKL formulations palatal to the left maxillary first molar and accomplished OTM with a nickel–titanium (NiTi) coil spring applying 5–8 g force. Control groups involved the application of NiTi coil spring with and without placebo formulation. The outcome measure included the distance of tooth movement, bone volume fraction, tissue density, and root volume determined with micro-computed tomography. We determined the amount of osteoclast activity using tartrate-resistant acid phosphatase (TRAP) staining.

Results

These formulations were able to sustain the release of RANKL for more than 30 days, and the released RANKL showed a positive effect on mice osteoclast precursor cells (RAW 264.7). Reported injectable RANKL formulations were effective in accelerating OTM compared with other control groups, with 129.2 per cent more tooth movement than no formulation and 71.8 per cent more than placebo formulation, corresponding with a significant increase in the amount of TRAP activity. We did not observe any significant differences in root resorption between the groups.

Conclusion

Our study shows a significant increase in OTM with injectable formulations containing RANKL.
Back to Square One: Revisiting How We Analyse the Right of Access to Environmental Information
Authors: Whittaker Sean , Mendel Jonathan , Reid Colin T
Published: April 2019

The right of access to environmental information has become a key aspect of contemporary efforts to promote environmental governance in the UK. The right is enshrined in international law through the Aarhus Convention which, alongside other legal developments, has influenced how academics analyse the right in the UK. How research into the right has been conducted is significant because it has led to gaps in how we understand the right and undermines environmental protection efforts. This article identifies and critiques the common analytical trends used to analyse the right of access to environmental information in the UK. The article considers two of these trends, examining their negative impact and the role of the Aarhus Convention in creating these trends. The article concludes by discussing the need to critically engage with these knowledge gaps to improve how the right is guaranteed and, ultimately, the implementation of environmental protection efforts.
Gentzen sequent calculi for some intuitionistic modal logics
Authors: Lin Zhe , Ma Minghui
Published: April 2019

Intuitionistic modal logics are extensions of intuitionistic propositional logic with modal axioms. We treat with two modal languages ${\mathscr{L}}_\Diamond $ and $\mathscr{L}_{\Diamond ,\Box }$ which extend the intuitionistic propositional language with $\Diamond $ and $\Diamond ,\Box $, respectively. Gentzen sequent calculi are established for several intuitionistic modal logics. In particular, we introduce a Gentzen sequent calculus for the well-known intuitionistic modal logic $\textsf{MIPC}$. These sequent calculi admit cut elimination and subformula property. They are decidable.
Utilization of Laboratory Testing Algorithms for Celiac Disease in a Pediatric Hospital
Authors: Ali Mahesheema , Danner Derek J , Fishman Douglas S , Devaraj Sridevi
Published: April 2019

Background

At Texas Children’s Hospital in Houston, numerous celiac tests are ordered from a wide range of nonspecialty healthcare providers.

Objective

To retrospectively examine the ordering of celiac tests before and after a test ordering initiative at our institution, to determine whether the initiative impacted appropriate usage of those tests and affected costs.

Methods

We carefully scrutinized all orders for comprehensive celiac testing from July 2016 through September 2017, implemented an in-house celiac-disease screening cascade, and reflexed it to the comprehensive celiac testing panel if an abnormal screening result was obtained.

Results

A total of 60 celiac test orders were issued during the 14-month study period. The ordering physician was a gastroenterologist in 6 cases and a nongastroenterologist in 54 cases. Of the 60 orders, only 4 were approved for sending out for comprehensive celiac testing; in 52 of the 60 cases, the order was altered to celiac screening. In the remaining 4 cases, the tests were canceled as a result of incorrect orders. Only 1 of the 52 celiac screenings yielded a positive result and thus was reflexed to the comprehensive panel.

Conclusions

We were able to induce appropriate celiac test usage by implementing a celiac-reflexive cascade. Also, our strategy proved to be extremely cost effective.
Doctors’ decisions when disclosing their mental ill-health
Authors: Rees S , Cohen D , Marfell N , Robling M
Published: April 2019

Background

Understanding of what prevents doctors from seeking help for mental ill-health has improved. However, less is known about what promotes timely disclosure and the nature of doctors’ decision making.

Aims

This study aimed to define how doctors make decisions about their own mental ill-health, and what facilitates disclosure. It explored the disclosure experiences of doctors and medical students; their attitudes to their decisions, and how they evaluate potential outcomes.

Methods

Qualitative, semi-structured interviews with UK doctors and medical students with personal experience of mental ill-health. Participants were recruited through relevant organizations, utilizing regular communications such as newsletters, e-mails and social media. Data were subject to a thematic analysis.

Results

Forty-six interviews were conducted. All participants had disclosed their mental ill-health to someone; not all to their workplace. Decision making was complex, with many participants facing multiple decisions throughout their careers. Disclosures were made despite the many obstacles identified in the literature; participants described enablers to and benefits of disclosing. The importance of appropriate responses to first disclosures was highlighted.

Conclusions

Motivations to disclose mental ill-health are complex and multifactorial. An obstacle for one was an enabler for another. Understanding this and the importance of the first disclosure has important implications for how best to support doctors and medical students in need.
Concluding Remarks
Authors: Hedrick Todd
Published: April 2019

These concluding reflections consider whether the paradigm of freedom through reconciliation articulated in the previous chapters is either too abstract or too accommodating to existing society to be considered genuinely emancipatory. It defends the book’s focus on law as a key site of reconciliation by highlighting the law’s role in identifying and transforming role-based social expectations. It also offers that while the type of object-relations psychoanalysis Honneth appeals to is not, by itself, sufficient to dismiss the concerns raised by “the culture industry,” it does suggest a mode of ego formation connected to a certain kind of ironical attitude toward the social world, through which inclusion in social systems structured by something like Habermas’ proceduralist paradigm of law could be experienced as emancipatory, despite that paradigm’s unfinished character.
Medical Training in the Maelstrom: The Call to Physician Advocacy and Activism in Turbulent Times
Authors: Paul Dereck W.
Published: April 2019

In this Invited Commentary, the author probes current events overlapping with his early medical education for unwritten lessons. Today’s generation of trainees studies the careful application of science to suffering in the roiling context of resurgent white supremacy, anti-immigrant hatred, climate disasters, contentious public health epidemics, and attacks on the structures undergirding access to health care for millions. The author reflects on the connections between sociopolitical events and his own experiences, as well as those of his classmates, friends, and family members. These experiences, he argues, have galvanized his and his fellow medical students’ commitment to decency, truth, diversity, and equity. He concludes that, in the current climate, the practice of healing is inextricably tied to the social and political context, such that advocacy and activism have become essential to a career in medicine.
Auditory Training for Adult Cochlear Implant Users: A Survey and Cost Analysis Study
Authors: Reis Mariana , Boisvert Isabelle , Beedell Emma , Mumford Virginia
Published: April 2019

Objectives:

The aims of this study were as follows: (a) to describe audiologists’ practices toward auditory training (AT) for adult cochlear implant (CI) users with a postlingual hearing loss; and (b) to assess the cost of different AT methods for clients and service providers in comparison with no AT delivery.

Design:

A survey was distributed to approximately 230 Australian CI audiologists to investigate the range, magnitude, and rationale of AT practices adopted as part of rehabilitation services with adult CI users. The cost of these different AT practices was then estimated from the perspectives of both clients and service providers, and compared against no AT delivery.

Results:

Seventy-eight audiologists responded to at least one section of the survey (16% to 33% response rate), of which 85.5% reported that they viewed AT as a necessary component of rehabilitation. Home-based and face-to-face were the methods most frequently adopted to deliver AT. Methods used during training, such as stimuli type, feedback, and encouragement for training adherence, varied across respondents. The cost analysis indicated that home-based training resulted in the lowest program costs, whereas face-to-face AT (when delivered independently from routine appointments) was the method with highest cost for clients and service providers.

Conclusions:

The type of AT, recommended frequency of sessions, and overall duration of programs varied widely across respondents. Costs incurred by clients depended mainly on whether the AT was home-based or clinician-led (i.e., face-to-face, group-based), program fees, and travel arrangements made by clients, as well as clinicians’ wages and the method chosen to deliver AT.
Otitis Media in Childhood and Disease in Adulthood: A 40-Year Follow-Up Study
Authors: Aarhus Lisa , Homøe Preben , Engdahl Bo
Published: April 2019

Objectives:

The pathogenesis of chronic suppurative otitis media (CSOM) includes complex interactions between microbial, immunologic, and genetic factors. To our knowledge, no study has focused on the association between childhood otitis media, immune regulation, inflammatory conditions, and chronic disease in adulthood. The present study aims to assess whether CSOM in childhood predicts immune-related inflammatory disorders or cardiovascular disease in adulthood. Another aim is to assess the association with oto-vestibular diseases in adulthood.

Design:

Population cohort study in Norway comprised 51,626 participants (mean age 52 years) who underwent a hearing investigation at 7 to 13 years of age where 189 were diagnosed with CSOM (otorhinolaryngologist diagnose) and 51,437 had normal hearing thresholds (controls). Data on adult disease were obtained from the Norwegian Patient Registry (ICD-10 codes from the specialist health services). We estimated associations with logistic regression analyses.

Results:

The associations between CSOM in childhood and disease in adulthood were as follows: chronic sinusitis (odds ratio 3.13, 95% confidence interval 1.15 to 8.52); cardiovascular disease (1.38, 1.01 to 1.88); hearing loss (5.58, 3.78 to 8.22); tinnitus (2.62, 1.07 to 6.41). The adult hearing loss among cases with childhood CSOM was most frequently registered as sensorineural. There was no statistically significant increased risk of later asthma (1.84 [0.98 to 3.48]), inflammatory bowel disease, inflammatory joint disease, systemic tissue disease, or vestibulopathy. The estimates were adjusted for age, sex, socio-economic status, and smoking.

Conclusion:

Our large cohort study, which is the first to focus on the link between otitis media in childhood and immune-related inflammatory disorders later in life, does not confer a clear association. CSOM in childhood was strongly related to adult tinnitus and hearing loss, which was most frequently registered as sensorineural.
Children With Congenital Unilateral Sensorineural Hearing Loss: Effects of Late Hearing Aid Amplification—A Pilot Study
Authors: Johansson Marlin , Asp Filip , Berninger Erik
Published: April 2019

Objectives:

Although children with unilateral hearing loss (uHL) have high risk of experiencing academic difficulties, speech-language delays, poor sound localization, and speech recognition in noise, studies on hearing aid (HA) outcomes are few. Consequently, it is unknown when and how amplification is optimally provided. The aim was to study whether children with mild-to-moderate congenital unilateral sensorineural hearing loss (uSNHL) benefit from HAs.

Design:

All 6- to 11-year-old children with nonsyndromic congenital uSNHL and at least 6 months of HA use were invited (born in Stockholm county council, n = 7). Participants were 6 children (9.7- to 10.8-years-old) with late HA fittings (>4.8 years of age). Unaided and aided hearing was studied with a comprehensive test battery in a within-subject design. Questionnaires were used to study overall hearing performance and disability. Sound localization accuracy (SLA) and speech recognition thresholds (SRTs) in competing speech were measured in sound field to study hearing under demanding listening conditions. SLA was measured by recording eye-gaze in response to auditory-visual stimuli presented from 12 loudspeaker–video display pairs arranged equidistantly within ±55° in the frontal horizontal plane. The SRTs were measured for target sentences at 0° in spatially separated (±30° and ±150°) continuous speech. Auditory brainstem responses (ABRs) were obtained in both ears separately to study auditory nerve function at the brainstem level.

Results:

The mean ± SD pure-tone average (0.5, 1, 2, and 4 kHz) was 45 ± 8 dB HL and 6 ± 4 dB HL in the impaired and normal hearing ear, respectively (n = 6). Horizontal SLA was significantly poorer in the aided compared with unaided condition. A significant relationship was found between aided SLA (quantified by an error index) and the impaired ear’s ABR I to V interval, suggesting a relationship between the two. Results from questionnaires revealed aided benefit in one-to-one communication, whereas no significant benefit was found for communication in background noise or reverberation. No aided benefit was found for the SRTs in competing speech.

Conclusions:

Children with congenital uSNHL benefit from late HA intervention in one-to-one communication but not in demanding listening situations, and there is a risk of degraded SLA. The results indicate that neural transmission time from the impaired cochlea to the upper brainstem may have an important role in unilaterally aided spatial hearing, warranting further study in children with uHL receiving early HA intervention.
The Impact of Burnout on the Obstetrics and Gynecology Workforce
Authors: VETTER MONICA HAGAN , SALANI RITU , WILLIAMS THOMAS E. , ELLISON CHRISTOPHER , SATIANI BHAGWAN
Published: April 2019

Although there has been discussion of a shortage of surgical specialties including OB/GYN, consensus is difficult because of the multiple variables involved in estimating both supply and demand. In addition, burnout has become more recognized as a variable that has not been taken into account in estimating a shortage of OB/GYNs. We estimate OB/GYN physician shortages of 17%, 24%, and 31% by 2030, 2040, and 2050, respectively. Here, we examine the impact of burnout on the OB/GYN workforce. Specifically, we address the associations of burnout, reduction in clinical productivity as well as early retirement. We also discuss the implications of the substantial increase of female OB/GYNs to ∼66% of workforce over the next 10 years and how this may impact the impending OB/GYN shortage. Finally, we briefly consider possible solutions to workforce issues causing burnout.
Prophylaxis Against Early-onset Group B Streptococcus Infections in Pregnant Women Who Are Allergic to Penicillin
Authors: NADEAU HUGH C.G. , EDWARDS RODNEY K.
Published: April 2019

Group B Streptococcus (GBS) infection remains a significant cause of neonatal morbidity and mortality. Adoption of screening for maternal genital tract colonization and intrapartum antibiotic prophylaxis has significantly reduced early-onset neonatal GBS infections. For women with an allergy to penicillin, recommended agents for prophylaxis have been well-outlined, but compliance with guideline recommendations is poor. There have been ongoing efforts in vaccine development, but no vaccination currently is available for either preconception or antenatal administration. This article will review established screening techniques, intrapartum antibiotic prophylactic regimens, and management specifically of the penicillin-allergic pregnant woman who is colonized with GBS.