bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtual Reality As A Spatial Experience For Architecture Design: A Study of Effectiveness for Architecture Students
Authors: Sapto Pamungkas Luhur , Meytasari Cinthyaningtyas , Trieddiantoro Hendro
Published: January 2018

Studios. This ability gained through visual design thinking. The spatial experience honed by three dimensional thinking from the medium diversity. The spatial experience learned through a room layout, proportion, and composition. This research used an experimental method and the primary data obtained by a “Likert” scale questionnaire. The Respondents are 50 students of the Architectural Design Studio. Moreover, the analysis focuses on the VR for spatial experience. The result was a descriptive explanation of the effectiveness of Virtual Reality for a spatial experience of architecture students at Technology University of Yogyakarta.
Effect of Maternal Body Mass Index and Amniotic Fluid Index on the Accuracy of Sonographic Estimation of Fetal Weight in Late Gestation
Authors: Rochelson Burton , Stork Leah , Augustine Stephanie , Greenberg Meir , Sison Cristina , Vohra Nidhi , Blitz Matthew
Published: January 2018

Objective The objective of this study was to determine the effect, if any, of maternal body mass index (BMI) and amniotic fluid index (AFI) on the accuracy of sonographic estimated fetal weight (EFW) at 40 to 42 weeks' gestation.

Methods This was a retrospective cohort study of singleton gestations with ultrasound performed at 40 to 42 weeks from 2010 to 2013. In this study, patients with documented BMI and sonographic EFW and AFI, concurrently, within 7 days of delivery were included. Chronic medical conditions and fetal anomalies were excluded from this study. The primary variable of interest was the rate of substantial error in EFW, defined as absolute percentage error (APE) >10%.

Results A total of 1,000 pregnancies were included. Overall, the APE was 6.0 ± 4.5% and the rate of substantial error was 17.4% (n = 174). There was no significant difference in APE or rate of substantial error between BMI groups. In the final multivariable logistic regression model, the rate of substantial error was increased in women with oligohydramnios (OR 1.79; 95% CI: 1.10–2.92). Furthermore, oligohydramnios was significantly more likely to overestimate EFW while polyhydramnios was more likely to underestimate EFW. Maternal BMI did not affect the accuracy of sonographic EFW.

Conclusion Sonographic EFW may be affected by extremes of AFI in the postdates period. Maternal BMI does not affect EFW accuracy at 40 to 42 weeks.
A modified and calibrated drift-diffusion-reaction model for time-domain analysis of charging phenomena in electron-beam irradiated insulators
Authors: Raftari Behrouz , Budko Neil , Vuik Kees
Published: January 2018

This paper presents a modified self-consistent drift-diffusion-reaction model suitable for the analysis of electron-beam irradiated insulators at both short and long time scales. A novel boundary condition is employed that takes into account the reverse electron current and a fully dynamic trap-assisted generation-recombination mechanism is implemented. Sensitivity of the model with respect to material parameters is investigated and a calibration procedure is developed that reproduces experimental yield-energy curves for uncharged insulators. Long-time charging and yield variations are analyzed for stationary defocused and focused beams as well as moving beams dynamically scanning composite insulators.
Measurement of He neutral temperature in detached plasmas using laser absorption spectroscopy
Authors: Aramaki M. , Tsujihara T. , Kajita S. , Tanaka H. , Ohno N.
Published: January 2018

The reduction of the heat load onto plasma-facing components by plasma detachment is an inevitable scheme in future nuclear fusion reactors. Since the control of the plasma and neutral temperatures is a key issue to the detached plasma generation, we have developed a laser absorption spectroscopy system for the metastable helium temperature measurements and used together with a previously developed laser Thomson scattering system for the electron temperature and density measurements. The thermal relaxation process between the neutral and the electron in the detached plasma generated in the linear plasma device, NAGDIS-II was studied. It is shown that the electron temperature gets close to the neutral temperature by increasing the electron density. On the other hand, the pressure dependence of electron and neutral temperatures shows the cooling effect by the neutrals. The possibility of the plasma fluctuation measurement using the fluctuation in the absorption signal is also shown.
Magnetic and thermodynamic properties of Heusler alloys Ni55Mn26Al19
Authors: Ito Masakazu , Onda Keijiro , Taira Atsushi , Sonoda Kazuki , Hiroi Masahiko , Uwatoko Yoshiya
Published: January 2018

The temperature dependence of magnetization, M(T), specific heat, Cp(T), and thermal expansion, ΔL/L300K(T) were investigated for the Heusler compound Ni55Mn26Al19 with B2 structure. M(T) has a cusp-type anomaly for the antiferromagnetic (AF) transition at the Néel temperature TN = 280 K that is irreversible between the field-cooled and zero-field-cooled processes below Tf ∼ 60 K, which is characteristic of spin glass. Cp(T) also has an anomaly at TN = 280 K. For temperatures T < 280 K, Cp(T) shows no anomaly without indicating any phase transition. These results mean that with decreasing T Ni55Mn26Al19 has a reentrant spin glass below Tf from the AF state. ΔL/L300K(T) shows no discontinuity indicating a structural transition in the range 5 < T < 300 K, i.e., Ni55Mn26Al19 has no martensitic transformation. TN increases proportionally with pressure, P, because of the enhancement of the AF interaction. The value of its initial rate is estimated to be dTNdP= 5.25 K/GPa. Tf also increases proportionally with P with dTfdP= 2.21 K/GPa, and hence magnetic frustration, which promotes the spin glass system, is enhanced under pressurization.
The effect of CuAl addition on the magnetic property, thermal stability and corrosion resistance of the sintered NdFeB magnets
Authors: Liu Y. L. , Liang J. , He Y. Ch. , Li Y. F. , Wang G. F. , Ma Q. , Liu F. , Zhang Y. , Zhang X. F.
Published: January 2018

To improve the coercivity of the Nd-Fe-B sintered magnets, the Cu29.8Al70.2 (at.%) powders with low melting point were introduced into the Nd-Fe-B magnets. The magnetic properties, microstructure, thermal stability and corrosion behavior of the sintered magnets with different amount of Cu29.8Al70.2 (0,0.25,0.50,0.75,1.0 wt.%) were investigated. When the amount of doped Cu29.8Al70.2 was less than 0.75 wt.%, the coercivity was improved, especially that of the magnets with 0.25 wt.% Cu29.8Al70.2, markedly increased to 13.97 kOe from 12.67 kOe (without CuAl). The improvement of magnetic properties could be attributed to enhanced wettability between Nd2Fe14B phase and Nd-rich phase and decreased exchange coupling between grains, which depended on the optimization of grain boundary microstructure and their distribution by codoping Cu and Al. With the addition of 0-1.0 wt.% Cu29.8Al70.2 powders, the reversible temperature coefficients of remanence and coercivity of the magnets could be also improved. The corrosion resistances was also found to be improved through small addition of Cu29.8Al70.2 powder in 3.5 wt.% NaCl solution by electrochemical and immersion tests, which could be due to the enhancement of the Nd-rich intergranular phase by addition Cu29.8Al70.2.
Domain wall resistance in a Co and Py transverse “coercivity heterostructures” configuration
Authors: Wang L. , Zhang R. Y. , Wang X. Q. , Xu W. T. , Zhao W. L. , Li G. , Liu Y. F.
Published: January 2018

A negative magnetoresistance (MR) was observed at room temperature in a Co/Py transverse “coercivity heterostructures” configuration thin film, and it can be explained by domain wall scattering at the boundaries of the Co and Py. We point out that the novel “soft” and “hard” transverse “coercivity heterostructures” not only can be used to study domain wall resistance of variety magnetic materials, but also have potential application in fabricating domain wall devices.
Fabrication of n-type Si nanostructures by direct nanoimprinting with liquid-Si ink
Authors: Takagishi Hideyuki , Masuda Takashi , Yamazaki Ken , Shimoda Tatsuya
Published: January 2018

Nanostructures of n-type amorphous silicon (a-Si) and polycrystalline silicon (poly-Si) with a height of 270 nm and line widths of 110-165 nm were fabricated directly onto a substrate through a simple imprinting process that does not require vacuum conditions or photolithography. The n-type Liquid-Si ink was synthesized via photopolymerization of cyclopentasilane (Si5H10) and white phosphorus (P4). By raising the temperature from 160 °C to 200 °C during the nanoimprinting process, well-defined angular patterns were fabricated without any cracking, peeling, or deflections. After the nanoimprinting process, a-Si was produced by heating the nanostructures at 400°C-700 °C, and poly-Si was produced by heating at 800 °C. The dopant P diffuses uniformly in the Si films, and its concentration can be controlled by varying the concentration of P4 in the ink. The specific resistance of the n-type poly-Si pattern was 7.0 × 10−3Ω ⋅ cm, which is comparable to the specific resistance of flat n-type poly-Si films.
Whiskered foam surface traps secondary electrons in simulations
Authors: Liebendorfer Adam
Published: January 2018

Analysis of simulations describe how fuzz-covered foam surfaces can reduce secondary electron emission that can be problematic in some systems, such as particle accelerators and spacecraft propulsion.
Saving rainforests in the South Pacific: challenges in ex situ conservation
Authors: Sommerville Karen D. , Clarke Bronwyn , Keppel Gunnar , McGill Craig , Newby Zoe-Joy , Wyse Sarah V. , James Shelley A. , Offord Catherine A.
Published: January 2018

Rainforests in the South Pacific hold a considerable amount of plant diversity, with rates of species endemism >80% in some countries. This diversity is rapidly disappearing under pressure from logging, clearing for agriculture or mining, introduced pests and diseases and other anthropogenic sources. Ex situ conservation techniques offer a means to limit the loss of plant diversity. Seed banking is considered the most efficient and cost effective of these techniques but is applicable only to seed capable of tolerating desiccation and cold storage. Data on the degree of tolerance of these conditions was lacking for more than half of the 1503 South Pacific rainforest genera examined for this review. Of the 710 genera for which data were available, the storage behaviour of 324 was based on an assessment of only one or two species, although 76% of those genera contained at least 10 species. Many of the unstudied or poorly studied genera are shared across several South Pacific nations, providing an excellent opportunity for collaboration on future ex situ research and conservation. Of the 386 genera for which three or more species have been studied, 343 have a very high proportion of species (>95% of those tested) that are suitable for seed banking. Seed banking could therefore provide a suitable means for preserving a large proportion of the rainforest flora before it becomes extinct in the wild. Alternatives for preserving species that are not suitable for seed banking are also discussed.
In situ observation on microstructural development of high-speed steel during carbon partitioning process
Authors: Zhou Lina , Tang Guangze , Ma Xinxin , Wang Liqin , Fan Guohua
Published: January 2018

Quenching–partitioning–tempering (Q–P–T) process was applied to treat high-speed steel. Microstructural development and properties were studied using high-resolution transmission electron microscopy (HRTEM), scanning electron microscopy, X-ray diffraction and a drop hammer impact toughness tester. The results of impact toughness test showed that the impact absorption energy increased to 16.2–20.1 J along the Q–P–T process, namely 56–93% higher than that of traditional Q–T approach (10.4 J). The results of in situ HRTEM showed that the interface of martensite/austenite ( α/ γ) migrated from martensite towards austenite with the increase of holding time, which led to a reduction of retained austenite. One of the migration planes was (110) α/(111) γ. The cementite precipitation and slight decomposition of retained austenite were observed during carbon partitioning process.
Receptor for advanced glycation end products (RAGE)-mediated cytotoxicity of 3-hydroxypyridinium derivatives
Authors: Murakami Yoto , Fujino Takayuki , Hasegawa Toshiki , Kurachi Ryotaro , Miura Aya , Daikoh Takumi , Usui Teruyuki , Hayase Fumitaka , Watanabe Hirohito
Published: January 2018

Advanced glycation end products (AGEs) formed from glyceraldehyde (Gcer) and glycolaldehyde (Gcol) are involved in the pathogenesis of diabetic complications, via interactions with a receptor for AGEs (RAGE). In this study, we aimed to elucidate the RAGE-binding structure in Gcer and Gcol-derived AGEs and identify the minimal moiety recognized by RAGE. Among Gcer and Gcol-derived AGEs, GLAP (glyceraldehyde-derived pyridinium) and GA-pyridine elicited toxicity in PC12 neuronal cells. The toxic effects of GLAP and GA-pyridine were suppressed in the presence of anti-RAGE antibody or the soluble form of RAGE protein. Furthermore, the cytotoxicity test using GLAP analog compounds indicated that the 3-hydroxypyridinium (3-HP) structure is sufficient for RAGE-dependent toxicity. Surface plasmon resonance analysis showed that 3-HP derivatives directly interact with RAGE. These results indicate that GLAP and GA-pyridine are RAGE-binding epitopes, and that 3-HP, a common moiety of GLAP and GA-pyridine, is essential for the interaction with RAGE.
Just us
Authors: Turner R. Eugene
Published: January 2018

Introduction:
A thorough understanding of ecology is a necessity as the Earth becomes crowded, there is more intense resource use and exhaustion, and the exposure to pollutants has diversified.

Outcomes:
Everyone must be involved as we develop the moral compass and maps for a desirable world. The transition will be made within the context of complex social forces, which must be engaged in purposeful collaboration and action. All individuals have the embryonic need and possess diverse abilities to contribute to the transcendence of problems arising from the human response to social inequities.

Discussion:
These will be difficult and nuanced transitions. One example is the Balinese water distribution system, whose site-specific adjustments developed over thousands of years. Examples from country-to-country comparisons show that Eco-civilizations, to be ‘civil’, must be fair, inclusive, and joyful, and more than about misleading metrics like Gross Domestic Product, individuality, material accumulations and competition.

Conclusion:
We are in this together; it is not ‘them or us’ - it is only ‘Us’.
Chemical modulation of valance band in delafossite structured CuFeO2 thin film and its photoresponse
Authors: Bera Arun , Deb Krishna , Sinthika S , Thapa Ranjit , Saha Biswajit
Published: January 2018

Using simple spin coating process we report the development of delafossite structured CuFeO2 ceramic thin film on florine doped tin oxide (FTO) coated glass substrate and found improved electrical conductivity, through possible modulation of valance band with high photoresponse of these structures. The valance band of CuFeO2 predominantly comprising of localized Cu 3d and O 2p orbitals, has been chemically modulated through post annealing of the film in oxygen rich atmosphere in order to obtain delocalized holes as carriers. During post annealing of the film in the oxygen rich environment for substantially long time (8, 16 and 24 h) oxygen atoms are introduced in the crystal as interstitials, and thus brings a chemical modulation of valance band without any external doping. The crystal structure, optical band gap and p-type conductivity have been studied experimentally, and theoretical first-principle based density functional calculations estimate that the oxygen atoms create mid gap states and are responsible for the states in the conduction band. A fivefold increase in the electrical conductivity was observed upon 24 h of annealing. More interestingly an excellent photoresponse behavior of the CuFeO2 films in its J–V characteristics have been observed and reported in this article, which must appear very significant in exploring its prospect of application as a p type semiconductor in optoelectronic devices with appropriate energy band gap.
Analysis of the thresholds for transcriptional activation by the yeast MAP kinases Fus3 and Kss1
Authors: Winters Matthew J. , Pryciak Peter M.
Published: January 2018

Signaling in the pheromone response pathway of budding yeast activates two distinct MAP kinases (MAPKs), Fus3 and Kss1. Either MAPK alone can mediate pheromone-induced transcription, but it has been unclear to what degree each one contributes to transcriptional output in wild-type cells. Here, we report that transcription reflects the ratio of active to inactive MAPK, and not simply the level of active MAPK. For Kss1 the majority of MAPK molecules must be converted to the active form, whereas for Fus3 only a small minority must be activated. These different activation thresholds reflect two opposing effects of each MAPK, in which the inactive forms inhibit transcription, whereas the active forms promote transcription. Moreover, negative feedback from Fus3 limits activation of Kss1 so that it does not meet its required threshold in wild-type cells but does so only when hyperactivated in cells lacking Fus3. The results suggest that the normal transcriptional response involves asymmetric contributions from the two MAPKs, in which pheromone signaling reduces the negative effect of Kss1 while increasing the positive effect of Fus3. These findings reveal new functional distinctions between these MAPKs, and help illuminate how inhibitory functions shape positive pathway outputs in both pheromone and filamentation pathways.
iPat: intelligent prediction and association tool for genomic research
Authors: Chen Chunpeng James , Zhang Zhiwu
Published: January 2018

The ultimate goal of genomic research is to effectively predict phenotypes from genotypes so that medical management can improve human health and molecular breeding can increase agricultural production. Genomic prediction or selection (GS) plays a complementary role to genome-wide association studies (GWAS), which is the primary method to identify genes underlying phenotypes. Unfortunately, most computing tools cannot perform data analyses for both GWAS and GS. Furthermore, the majority of these tools are executed through a command-line interface (CLI), which requires programming skills. Non-programmers struggle to use them efficiently because of the steep learning curves and zero tolerance for data formats and mistakes when inputting keywords and parameters. To address these problems, this study developed a software package, named the Intelligent Prediction and Association Tool (iPat), with a user-friendly graphical user interface. With iPat, GWAS or GS can be performed using a pointing device to simply drag and/or click on graphical elements to specify input data files, choose input parameters and select analytical models. Models available to users include those implemented in third party CLI packages such as GAPIT, PLINK, FarmCPU, BLINK, rrBLUP and BGLR. Users can choose any data format and conduct analyses with any of these packages. File conversions are automatically conducted for specified input data and selected packages. A GWAS-assisted genomic prediction method was implemented to perform genomic prediction using any GWAS method such as FarmCPU. iPat was written in Java for adaptation to multiple operating systems including Windows, Mac and Linux.

Availability and implementation

The iPat executable file, user manual, tutorials and example datasets are freely available at http://zzlab.net/iPat.
A rapid epistatic mixed-model association analysis by linear retransformations of genomic estimated values
Authors: Ning Chao , Wang Dan , Kang Huimin , Mrode Raphael , Zhou Lei , Xu Shizhong , Liu Jian-Feng
Published: January 2018

Motivation

Epistasis provides a feasible way for probing potential genetic mechanism of complex traits. However, time-consuming computation challenges successful detection of interaction in practice, especially when linear mixed model (LMM) is used to control type I error in the presence of population structure and cryptic relatedness.

Results

A rapid epistatic mixed-model association analysis (REMMA) method was developed to overcome computational limitation. This method first estimates individuals’ epistatic effects by an extended genomic best linear unbiased prediction (EG-BLUP) model with additive and epistatic kinship matrix, then pairwise interaction effects are obtained by linear retransformations of individuals’ epistatic effects. Simulation studies showed that REMMA could control type I error and increase statistical power in detecting epistatic QTNs in comparison with existing LMM-based FaST-LMM. We applied REMMA to two real datasets, a mouse dataset and the Wellcome Trust Case Control Consortium (WTCCC) data. Application to the mouse data further confirmed the performance of REMMA in controlling type I error. For the WTCCC data, we found most epistatic QTNs for type 1 diabetes (T1D) located in a major histocompatibility complex (MHC) region, from which a large interacting network with 12 hub genes (interacting with ten or more genes) was established.

Availability and implementation

Our REMMA method can be freely accessed at https://github.com/chaoning/REMMA.

Supplementary information

Supplementary data are available at Bioinformatics online.
Computational deconvolution of transcriptomics data from mixed cell populations
Authors: Avila Cobos Francisco , Vandesompele Jo , Mestdagh Pieter , De Preter Katleen
Published: January 2018

Gene expression analyses of bulk tissues often ignore cell type composition as an important confounding factor, resulting in a loss of signal from lowly abundant cell types. In this review, we highlight the importance and value of computational deconvolution methods to infer the abundance of different cell types and/or cell type-specific expression profiles in heterogeneous samples without performing physical cell sorting. We also explain the various deconvolution scenarios, the mathematical approaches used to solve them and the effect of data processing and different confounding factors on the accuracy of the deconvolution results.

Supplementary information

Supplementary data are available at Bioinformatics online.
‘Hidden’ occupational allergens such as additives
Authors: Quirce Santiago , Antolín-Amérigo Darío , Domínguez-Ortega Javier
Published: January 2018

Purpose of review

With the development of innovative technologies, new agents are continually introduced to the workplace. Some of these agents can act as hidden allergens whenever they are not declared in the product labels or whenever their health hazards are unknown. This review article focuses on the identification and description of unusual and/or hidden allergens recently incriminated in occupational diseases.

Recent findings

Occupational exposure is an important global health issue that can induce respiratory and cutaneous disorders, as well as life-threatening anaphylaxis. Apart from the classic forms of occupational exposure, reports have emerged from nonconventional or newly identified allergens or additives. These compounds are substances added to another in order to alter or improve the general quality or to counteract undesirable properties, and some of them may behave as potent and frequently hidden allergens. These highly uncommon and/or hidden allergens belong to several categories: foods, spices, cosmetics, insects, enzymes, chemicals, drugs, preservatives, and coloring agents, among others.

A high level of suspicion and awareness about the potential hidden allergens is necessary to ascertain the allergens implicated. It is of utmost importance to identify the specific eliciting agents of the occupational diseases in order to avoid strictly further exposure to them.
Jet lavage in primary total knee arthroplasty: a comparative study
Authors: Abdeldayem Sherif Mostafa , Zakaria Zeiad M. , Metwaly Radwan G. , Eid Mohamed A.
Published: January 2018

Background:

The aim of the study was to determine whether the incidence of radiolucent lines can be reduced and cement penetration enhanced by using jet lavage before cementing the tibial component in total knee arthroplasty (TKA).

Methods:

We prospectively studied a consecutive series of 86 cemented TKAs. In group A (n=44) jet lavage and in group B (n=42) conventional syringe lavage were used to clean the cancellous bone. A standardized cementing technique was applied in all patients. At a minimum follow-up of 1 yr, patients were evaluated clinically and radiographically. The cement bone interface under the tibial component baseplate was divided into four zones according to the Knee Society radiographic evaluation system and evaluated for the presence of radiolucent lines.

Results:

At latest follow up, all radiographs were evaluated (n=86), and radiolucent lines in different zones were recorded in 7.2 % in group A and in 26% in group B (P<0.05). Cement penetration showed a mean of 2.5±0.9 mm in group A and 1.7±0.8 mm in group B (P<0.001).

Conclusions:

Routine use of jet lavage in cemented TKA is recommended to reduce the incidence of radiolucent lines, enhance cement penetration, and improve the long-term durability of fixation.
Evaluation of postoperative MRI in pediatric patients after orthopaedic hardware implantation
Authors: Schroeder Katherine M. , Haruno Lee S. , Browne Theodora S. , Snow Erica E. , Kan J. Herman , Hill Jaclyn F.
Published: January 2018

Background:

MRI is a valuable diagnostic tool in musculoskeletal imaging. However, concerns exist regarding MRI examinations in the presence of metallic implants, including loosening, heating, and migration of the implant, and magnetic field interactions. Few studies have discussed the safety of MRI in the presence of orthopaedic implants, particularly in the immediate postoperative period. This study aimed to evaluate the safety of MRI within 24 hr after orthopaedic hardware implantation and whether MRI may compromise the integrity of fixation.

Methods:

A retrospective chart review was performed at a single tertiary care pediatric hospital to identify patients who underwent postoperative MRI after hardware implantation (open reduction and femoral osteotomy) for the treatment of developmental dysplasia of the hip during the 6-year study period. Patient records and follow-up imaging were reviewed to assess time between implantation and postoperative MRI, magnetic field strength, implant type, and patient outcomes.

Results:

Twenty-eight patients (ages 6 mo to 5 yr) were included in this study, accounting for 32 postoperative MRIs. All MRIs were performed within 8 hr postoperatively (average time to MRI 131 min). Implants consisted of four-hole stainless steel plates and four screws in all patients. No complications were observed regarding implant migration, loosening, nonunion, compromised fixation, or thermal effects to soft tissues.

Conclusions:

To our knowledge, this is the largest cohort studied for the safety of postoperative MRIs, and the only exclusively pediatric study. Based on these findings, we conclude that orthopaedic implants can safely be imaged in the immediate postoperative period.
Waist–Hip Ratio Surrogate Is More Predictive Than Body Mass Index of Wound Complications After Pelvic and Acetabulum Surgery
Authors: Jaeblon Todd , Perry Kevin J. , Kufera Joseph A.
Published: January 2018

Objectives:

To determine whether a novel surrogate of waist–hip ratio (WHR) is more predictive of wound complications after pelvis or acetabulum stabilization than body mass index (BMI) and describe the method of measuring a WHR proxy (WHRp).

Design:

Retrospective review.

Setting:

One Level 1 Trauma Center.

Patients:

One hundred sixty-one patients after operative repair of pelvis and acetabulum fractures.

Intervention:

Operative stabilization of a pelvic ring injury or acetabular fracture.

Main Outcome Measurements:

Infection (pin, superficial, and deep) and wound healing complication.

Methods:

We retrospectively reviewed 161 subjects after operative repair of pelvic and acetabular fractures. Primary outcome was any wound complication. BMI was acquired from medical records. WHRp was derived from anteroposterior and lateral computed tomography scout images. BMI and WHRp results were analyzed as continuous and categorical variables. BMI was grouped into high-risk categories of ≥30 and ≥40. WHRp data were grouped utilizing the WHO's high-risk profile for females (>0.85) and males (>0.90). An alternative optimal WHR was also assessed. Covariate analysis included demographic data, Injury Severity Score, mechanism, tobacco use, presence and types of open approach, injury type, associated injuries and comorbidities, failure of fixation, and thromboembolism.

Results:

The mean follow-up was 15.9 months. Twenty-four (15%) patients developed wound complications. Increasing BMI (P < 0.007) and WHRp (P < 0.001) as continuous variables and female sex (P < 0.009) were associated with wound complications. Applying unadjusted continuous data to a receiver operating characteristic curve revealed a greater area under the curve for WHRp than for BMI (P < 0.001). The optimal predictive WHRp was ≥1.0 (P < 0.001, odds ratio 43.11). The receiver operating characteristic curve from adjusted data demonstrated a greater area under the curve for WHRp ≥1.0 (0.93) compared with BMI ≥30 (0.78) or ≥40 (0.75) and WHO WHRp (0.82). Computed tomography generated WHRp demonstrated excellent interrater reliability (0.99).

Conclusion:

The WHRp of ≥1.0 was more predictive than BMI of wound complications after operative treatment of pelvis and acetabulum fractures. In our series, WHRp calculated using scout images performed sufficiently well to predict wound complications.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Observed Length Increases of Magnetically Controlled Growing Rods are Lower Than Programmed
Authors: Gilday Sarah E. , Schwartz Mark S. , Bylski-Austrow Donita I. , Glos David L. , Schultz Lindsay , O’Hara Sara , Jain Viral V. , Sturm Peter F.
Published: January 2018

Background:

Magnetically controlled growing rods (MCGRs) are increasingly used in the treatment of early onset scoliosis (EOS). Few studies have reported whether desired lengthening can reliably be achieved, or if prior spine instrumentation and large tissue depths affect lengthening. In this clinical study of EOS patients, it was hypothesized that increases in rod length would equal programmed increases, patients with prior spine instrumentation would lengthen less than patients without prior surgery, and larger tissue depths would decrease lengthening success.

Methods:

A retrospective chart review was conducted on EOS patients with single and dual MCGRs placed between April 2014 to September 2015 and distracted at a single institution. Rod distraction was measured at each visit using ultrasound. Differences between programmed and actual distraction for each patient, and between groups with and without prior spine instrumentation, were determined by 2-tailed t tests. Regression and correlation were used to determine the relationship between tissue depth and length increases.

Results:

Thirty-one patients were included, 18 males, 13 females, age 8.1 (±2.5) years, with major curves measuring 60 (±14.6) degrees at time of MCGR insertion. In the 12 patients with prior instrumentation, time from initial growing rod placement to MCGR insertion was 23.1 (±10.6) months. The number of surgical procedures before MCGR insertion was 2.8 (±2.0). Total length increase relative to the programmed distraction was 86% (±21) (P<0.001). Length increases for patients with and without prior surgery were 87% (±23) and 86% (±19), respectively (P>0.9). Total lengthening was inversely proportional to tissue depth (r
2=0.38, P<0.01); the decrease in lengthening achieved was 2.1%/mm of tissue depth.

Conclusions:

Increases in rod length were 14% lower than the programmed distraction. Prior instrumentation did not impact the amount of rod distraction. Greater distance between the rod and the skin surface negatively affected the magnitude of distraction.
Factors Associated With Acute and Chronic Wound Complications in Patients With Soft Tissue Sarcoma With Long-term Follow-up
Authors: Karthik Naveen , Ward Matthew C. , Juloori Aditya , Scott Jacob , Mesko Nathan , Shah Chirag
Published: January 2018

Objectives:

To identify the rates of acute and chronic wound complications and factors associated in a cohort of patients treated for soft tissue sarcoma (STS) with modern radiotherapy (RT) and surgical techniques.

Materials and Methods:

An Institutional Review Board–approved database was used to identify all adult nonmetastatic patients treated for STS at a single institution between 2006 and 2015 with a minimum follow-up of 1 year. Factors associated with acute and chronic wound complications were analyzed using binomial logistic regression including interaction terms.

Results:

In all, 271 patients were identified with a median follow-up of 3.2 years. The rate of acute wound complications was 22.1%. On univariate analysis, trunk versus extremity location (P<0.001), radiation therapy (P=0.04), and preoperative therapy (P=0.03) were associated with acute wound complications and a trend was noted for reconstruction (P=0.07). On multivariate analysis, extremity tumors were associated with a higher rate of acute wound complications compared with trunk tumors without RT (P=0.02). Utilization of RT was associated with increased risk for extremity tumors (P=0.07). The rate of chronic wound complications was 3.3%. Radiation was associated with increased chronic wound complications (P=0.03) and trends were noted for trunk versus extremity location (P=0.08) and a history of acute wound complications (P=0.12).

Conclusions:

Several factors associated with acute and chronic wound complications were identified in STS patients including timing of RT, tumor site, and reconstruction use. The development of acute wound complications may also be associated with an increased risk of chronic wound complications.
Predictive Techniques for Neurotoxin Outcomes
Authors: Brown Liza , Taylor Drew , Weiss Eduardo
Published: January 2018

BACKGROUND

Botulinum-derived neurotoxins have become a substantial tool in dermatologists' armamentarium for facial/neck rejuvenation. Current literature discusses anatomical “danger zones” to avoid during neurotoxin injection to prevent brow ptosis, blepharoptosis, and lower facial ptosis.

OBJECTIVE

The aim of this study was to determine whether lidocaine 1% local anesthetic can be used to predict botulinum toxin treatment outcomes and prevent adverse effects of unwanted paralysis.

MATERIALS AND METHODS

One percent lidocaine was drawn up using BD ultra-fine 31 G (5/16″), 0.5-mL insulin syringes in the same quantity that would be drawn up for neurotoxin placement. The patient's face was cleansed and mapped; 0.1 mL of 1% lidocaine was injected × 5 sites in the glabella; and 3 sites were injected with 0.05 mL in the frontalis. The patient was assessed after 10 minutes.

RESULTS

Improvement in frontalis and glabellar rhytides was appreciated, with noted “spocking” of the lateral brows. This technique allowed the authors to visualize the need for placement of toxin more laterally with eventual successful predictive placement for neurotoxin.

CONCLUSION

This technique of using local 1% lidocaine allows the practitioner to devise a neurotoxin distribution map tailored for each patient to limit unwanted paralysis from improper neurotoxin placement.
Preventive Effects of Vitamin D on Seasonal Influenza A in Infants: A Multicenter, Randomized, Open, Controlled Clinical Trial
Authors: Zhou Jian , Du Juan , Huang Leting , Wang Youcheng , Shi Yimei , Lin Hailong
Published: January 2018

Objectives:

This study aimed to evaluate the clinical efficacy and safety of vitamin D for preventing influenza A in 400 infants in a multicenter, randomized, open, controlled clinical trial.

Methods:

The infants were randomized into low-dose and high-dose vitamin D groups, and serum calcium, inorganic phosphorus and 25-hydroxyvitamin D levels were detected thrice in 4 months. Infants infected with influenza A were monitored for symptoms including fever, cough and wheezing. Pathogen levels and safety of vitamin D treatment were also evaluated.

Results:

Of 121 cases in total, 78 and 43 cases of influenza A infection occurred in the low-dose and high-dose vitamin D groups, respectively. There was a significant difference between the groups (χ
2 = 14.6324, P = 0.0001). Among the cases of influenza infection, the median durations for fever, cough and wheezing were shorter in the high-dose vitamin D group than in the low-dose vitamin D group. The viral loads showed a downward trend in both groups and were significantly different between the groups at the second and third detections. Additionally, the incidences of adverse events and severe adverse events were very low and not significantly different between the 2 groups.

Conclusion:

High-dose vitamin D (1200 IU) is suitable for the prevention of seasonal influenza as evidenced by rapid relief from symptoms, rapid decrease in viral loads and disease recovery. In addition, high-dose vitamin D is probably safe for infants.
Orbital Extranodal Marginal Zone Lymphoma Following Radiotherapy: A Report of 2 Cases
Authors: Tauqeer Zujaja , Jakobiec Frederick A. , Freitag Suzanne K. , Yoon Michael K. , Wolkow Natalie
Published: January 2018

Purpose:

To present 2 patients in whom orbital radiation preceded the development of periorbital extranodal marginal zone lymphoma by more than a decade and to investigate the likelihood of this representing irradiation-induced malignancy.

Methods:

Retrospective chart review and histopathologic study with immunohistochemistry of 2 cases.

Results:

The first patient was a 58-year-old woman who developed an orbital mass within the vicinity of the lateral rectus muscle 17 years after external beam proton radiation therapy for an inferotemporal choroidal melanoma. The second patient was a 32-year-old woman who developed a mass in the right lacrimal gland 12 years after external beam photon radiation therapy for chronic inflammatory dacryoadenitis. Histopathologic and immunohistochemical studies confirmed orbital extranodal marginal zone lymphoma in both cases. Retrospective review of older histopathologic slides from the second patient revealed underlying immunoglobulin G4–related disease.

Discussion:

The unusual sequence of events in these 2 cases raises the question of whether orbital radiation may in rare instances promote the development of orbital extranodal marginal zone lymphoma. The literature pertaining to irradiation-induced secondary malignancy in the orbit is reviewed.

Conclusions:

Clinicians should consider the possibility of a secondary malignancy when evaluating a patient with an orbital mass and a history of prior local radiation exposure.
Joint nociceptor nerve activity and pain in an animal model of acute gout and its modulation by intra-articular hyaluronan
Authors: Marcotti Aida , Miralles Ana , Dominguez Eduardo , Pascual Eliseo , Gomis Ana , Belmonte Carlos , de la Peña Elvira
Published: January 2018

The mechanisms whereby deposition of monosodium urate (MSU) crystals in gout activates nociceptors to induce joint pain are incompletely understood. We tried to reproduce the signs of painful gouty arthritis, injecting into the knee joint of rats suspensions containing amorphous or triclinic, needle MSU crystals. The magnitude of MSU-induced inflammation and pain behavior signs were correlated with the changes in firing frequency of spontaneous and movement-evoked nerve impulse activity recorded in single knee joint nociceptor saphenous nerve fibers. Joint swelling, mechanical and cold allodynia, and hyperalgesia appeared 3 hours after joint injection of MSU crystals. In parallel, spontaneous and movement-evoked joint nociceptor impulse activity raised significantly. Solutions containing amorphous or needle-shaped MSU crystals had similar inflammatory and electrophysiological effects. Intra-articular injection of hyaluronan (HA, Synvisc), a high-MW glycosaminoglycan present in the synovial fluid with analgesic effects in osteoarthritis, significantly reduced MSU-induced behavioral signs of pain and decreased the enhanced joint nociceptor activity. Our results support the interpretation that pain and nociceptor activation are not triggered by direct mechanical stimulation of nociceptors by MSU crystals, but are primarily caused by the release of excitatory mediators by inflammatory cells activated by MSU crystals. Intra-articular HA decreased behavioral and electrophysiological signs of pain, possibly through its viscoelastic filtering effect on the mechanical forces acting over sensitized joint sensory endings and probably also by a direct interaction of HA molecules with the transducing channels expressed in joint nociceptor terminals.
The effectiveness of online pain resources for health professionals: a systematic review with subset meta-analysis of educational intervention studies
Authors: Liossi Christina , Failo Alessandro , Schoth Daniel E. , Williams Glyn , Howard Richard F.
Published: January 2018

Online educational interventions are increasingly developed for health professionals and students, although graduate and undergraduate medical curricula often contain limited information about how to assess and manage pain. This study reviews the literature on the effectiveness of pain-related online educational resources. Studies were identified through a search of Medline, PsychINFO, Web of Science, CINAHL, PubMed, Scopus, Cochrane Library, Google Scholar, and OpenGrey databases. Search terms included 3 concept blocks: (1) type of intervention—online education, computer-based, e-learning, web-based, and internet-based; (2) population—pediatrician, physician, nurse, psychologist, and medical; and (3) outcome—pain*. Thirty-two studies (13 randomised controlled trials, 5 nonrandomised controlled trials, and 14 single-group pre–post studies) were included. Ten provided data for inclusion in a series of between-groups meta-analyses. After intervention, participants receiving online instruction had significantly greater knowledge compared with those receiving training as usual/alternative training (Hedges' g = 0.80, 95% confidence interval [CI]: 0.12-1.49), and students had significantly greater skills compared with students receiving training as usual (g = 1.34, CI: 0.38-2.30). No significant differences were found for confidence/competence (g = 0.02, CI: −0.79 to 0.84) or attitudes/beliefs (g = 0.16, CI: −0.48 to 0.79). Although online educational resources show promise in improving learner knowledge, considerable heterogeneity exists between studies in quality, design, educational content, and outcomes. Furthermore, methodologically robust RCTs are required to establish the effectiveness of online educational interventions and a greater understanding of the key features of successful online resources, including cognitive interactivity. Few studies assessed health outcomes for patients, remaining a major priority for future investigations.
Comparison of somatosensory cortex excitability between migraine and “strict-criteria” tension-type headache: a magnetoencephalographic study
Authors: Chen Wei-Ta , Hsiao Fu-Jung , Ko Yu-Chieh , Liu Hung-Yu , Wang Pei-Ning , Fuh Jong-Ling , Lin Yung-Yang , Wang Shuu-Jiun
Published: January 2018

Tension-type headache (TTH) and migraine are both common types of headaches. Despite distinct symptoms, TTH and migraine are highly comorbid and exhibit many clinical similarities. This study enrolled consecutive patients with TTH and age- and sex-matched patients with migraine and healthy controls to investigate whether TTH and migraine are similar in brain excitability change assessed by magnetoencephalography. Patients with TTH were excluded if they reported any headache features or associated symptoms of migraine. In response to paired-pulse electrical stimulations, the gating responses obtained from the contralateral primary somatosensory cortex differed between groups. The first response, which reflected the preactivation excitability, was smaller in the migraine group (29.54 ± 2.31 pAm) compared with the TTH group (79.76 ± 8.36, P < 0.001) and controls (59.95 ± 4.26, P = 0.006). The gating ratio (ie, the ratio of the second vs first response strength) was 0.76 ± 0.03 in controls, 0.88 ± 0.03 in the migraine group, 0.93 ± 0.03 in the TTH group, with a significant increase in TTH (P = 0.003 vs controls) suggesting central disinhibition. The area under the receiver operating characteristic curve of the first response strength in differentiating between TTH and migraine was 0.85 ± 0.44, indicating excellent discrimination. In conclusion, TTH and migraine are different clinical entities in view of somatosensory cortex excitability. The preactivation excitability assessed through somatosensory gating is a potential marker for differentiating between TTH and migraine.
Disruption of nNOS–NOS1AP protein–protein interactions suppresses neuropathic pain in mice
Authors: Lee Wan-Hung , Li Li-Li , Chawla Aarti , Hudmon Andy , Lai Yvonne Y. , Courtney Michael J. , Hohmann Andrea G.
Published: January 2018

Elevated N-methyl-d-aspartate receptor (NMDAR) activity is linked to central sensitization and chronic pain. However, NMDAR antagonists display limited therapeutic potential because of their adverse side effects. Novel approaches targeting the NR2B-PSD95-nNOS complex to disrupt signaling pathways downstream of NMDARs show efficacy in preclinical pain models. Here, we evaluated the involvement of interactions between neuronal nitric oxide synthase (nNOS) and the nitric oxide synthase 1 adaptor protein (NOS1AP) in pronociceptive signaling and neuropathic pain. TAT-GESV, a peptide inhibitor of the nNOS–NOS1AP complex, disrupted the in vitro binding between nNOS and its downstream protein partner NOS1AP but not its upstream protein partner postsynaptic density 95 kDa (PSD95). Putative inactive peptides (TAT-cp4GESV and TAT-GESVΔ1) failed to do so. Only the active peptide protected primary cortical neurons from glutamate/glycine-induced excitotoxicity. TAT-GESV, administered intrathecally (i.t.), suppressed mechanical and cold allodynia induced by either the chemotherapeutic agent paclitaxel or a traumatic nerve injury induced by partial sciatic nerve ligation. TAT-GESV also blocked the paclitaxel-induced phosphorylation at Ser15 of p53, a substrate of p38 MAPK. Finally, TAT-GESV (i.t.) did not induce NMDAR-mediated motor ataxia in the rotarod test and did not alter basal nociceptive thresholds in the radiant heat tail-flick test. These observations support the hypothesis that antiallodynic efficacy of an nNOS–NOS1AP disruptor may result, at least in part, from blockade of p38 MAPK-mediated downstream effects. Our studies demonstrate, for the first time, that disrupting nNOS–NOS1AP protein–protein interactions attenuates mechanistically distinct forms of neuropathic pain without unwanted motor ataxic effects of NMDAR antagonists.
Improving Bar Code Medication Administration Compliance in a Community Hospital Through a Nursing Leadership Initiative
Authors: Van Ornum Michael
Published: January 2018

Achieving optimal compliance for bar code medication administration (BCMA) in mature medication use systems is challenging due to the iterative system refinements over time. A nursing leadership initiative increased BCMA compliance, measured as a composite across all hospital units, from 95% to 98%, discovering unanticipated benefits and unintended consequences in the process. The methodology used provides valuable insight into effective strategies for BCMA optimization with applicability for other, similar quality improvement initiatives.