bluuebunny/crossref_metadata_2025 huggingface dataset:
Slow hot carrier cooling in cesium lead iodide perovskites
Authors: Shen Qing , Ripolles Teresa S. , Even Jacky , Ogomi Yuhei , Nishinaka Koji , Izuishi Takuya , Nakazawa Naoki , Zhang Yaohong , Ding Chao , Liu Feng , Toyoda Taro , Yoshino Kenji , Minemoto Takashi , Katayama Kenji , Hayase Shuzi
Published: October 2017

Lead halide perovskites are attracting a great deal of interest for optoelectronic applications such as solar cells, LEDs, and lasers because of their unique properties. In solar cells, heat dissipation by hot carriers results in a major energy loss channel responsible for the Shockley–Queisser efficiency limit. Hot carrier solar cells offer the possibility to overcome this limit and achieve energy conversion efficiency as high as 66% by extracting hot carriers. Therefore, fundamental studies on hot carrier relaxation dynamics in lead halide perovskites are important. Here, we elucidated the hot carrier cooling dynamics in all-inorganic cesium lead iodide (CsPbI3) perovskite using transient absorption spectroscopy. We observe that the hot carrier cooling rate in CsPbI3 decreases as the fluence of the pump light increases and the cooling is as slow as a few 10 ps when the photoexcited carrier density is 7 × 1018 cm−3, which is attributed to phonon bottleneck for high photoexcited carrier densities. Our findings suggest that CsPbI3 has a potential for hot carrier solar cell applications.
On the analysis of chemical kinetics system pertaining to a fractional derivative with Mittag-Leffler type kernel
Authors: Singh Jagdev , Kumar Devendra , Baleanu Dumitru
Published: October 2017

The pivotal aim of this paper was to analyze a new fractional model of chemical kinetics system related to a newly discovered Atangana-Baleanu derivative with fractional order having non-singular and non-local kernel. The numerical solution is derived by making use of the iterative scheme. The existence of the solution of chemical kinetics system of arbitrary order is examined by implementing the fixed-point theorem. The uniqueness of the special solution of the studied model is shown. The effect of different variables and order of arbitrary ordered derivative on concentrations is demonstrated in tabular and graphical forms. The numerical results for chemical kinetics system pertaining to the newly derivative with fractional order are compared with the chemical kinetics system involving classical derivative.
Estimation of photovoltaic potential for electricity self-sufficiency: A study case of military facilities in northwest Spain
Authors: Suárez-García Andrés , Fariña Elena Arce , Álvarez-Feijoo Miguel , González-Peña David , Alonso-Tristán Cristina , Díez-Mediavilla Montserrat
Published: October 2017

Renewable energies, including photovoltaic energy, are attracting widespread international attention, in reaction to worsening environmental problems and the diminishing long-term sustainability of fossil fuel energies. In this work, the potential benefits of installing photovoltaic panels on several buildings at the Spanish Naval Military School (Escuela Naval Militar, ENM) of Marín are considered. The two salient advantages are significant economic savings from the production and the sale of electricity to the Spanish Electricity Network and achieving self-sufficiency in electricity requirements. Consequently, the main objective of this work is to estimate the energy potential of photovoltaic installations on the roofs of the ENM buildings. This is the first time that a project of this nature and size is presented to the Spanish Navy. To that end, a three-dimensional geographic analysis of the buildings is performed using three freeware software: Trimble SketchUp, Skelion, and Photovoltaic Geographical Information System. An economic study is also conducted to determine the feasibility of the installations, by estimating the Net Present Value of the photovoltaic installation and the Internal Rate of Return associated with the project. Subsequently, a sensitivity analysis that considers the most important parameters for the calculation of the amortization period is reported. The results show that the installation could fulfill the ENM electrical demands and could, in addition, generate significant economic benefits. The conclusions end with a recommendation to consider the merits of the proposed solution.
Multi-planar amorphous silicon photonics with compact interplanar couplers, cross talk mitigation, and low crossing loss
Authors: Chiles Jeff , Buckley Sonia , Nader Nima , Nam Sae Woo , Mirin Richard P. , Shainline Jeffrey M.
Published: October 2017

We propose and experimentally demonstrate a photonic routing architecture that can efficiently utilize the space of multi-plane (3D) photonic integration. A wafer with three planes of amorphous silicon waveguides was fabricated and characterized, demonstrating <3×10−4 dB loss per out-of-plane waveguide crossing, 0.05±0.02 dB per interplane coupler, and microring resonators on three planes with a quality factors up to 8.2×104. We also explore a phase velocity mapping strategy to mitigate the cross talk between co-propagating waveguides on different planes. These results expand the utility of 3D photonic integration for applications such as optical interconnects, neuromorphic computing and optical phased arrays.
ESR identification of the nitrogen acceptor in 2H-polytype synthetic MoS2: Dopant level and activation
Authors: Schoenaers B. , Stesmans A. , Afanas’ev V. V.
Published: October 2017

Multi-frequency electron spin resonance (ESR) study of p-type synthetic 2H MoS2 reveals a previously unreported signal of axial-symmetry [g// = 2.032(2); g⊥ = 2.270(2)] characteristic for a hole-type center in MoS2. It is identified as originating from N acceptor dopants, the N atoms substituting for S sites, with a density of ∼2.3 x 1017 cm-3, thus predominantly accounting for the p-type sample doping. For the applied magnetic field along the c-axis, the signal is mainly comprised of a 14N hyperfine 1:1:1 triplet of splitting A// = 14.7 ± 0.2 G with, on top, a center line accounting for ∼26% of the total signal intensity. The additional observation of a weak half-field signal (g = 3.92) correlating with the main full-field Zeeman response points to the presence of spin S ≥ 1 N agglomerates. The overall signal properties indicate that only ∼74% of the N acceptors occur as isolated decoupled dopants. Monitoring of the ESR signal intensity over a broad temperature range unveils the N dopant as a shallow acceptor of activation energy Ea = 45 ± 7 meV, thus well fit for stable substitutional p-type doping in MoS2-based novel nanoelectronic devices.
Packaging and transfer of mitochondrial DNA via exosomes regulate escape from dormancy in hormonal therapy-resistant breast cancer
Authors: Sansone Pasquale , Savini Claudia , Kurelac Ivana , Chang Qing , Amato Laura Benedetta , Strillacci Antonio , Stepanova Anna , Iommarini Luisa , Mastroleo Chiara , Daly Laura , Galkin Alexander , Thakur Basant Kumar , Soplop Nadine , Uryu Kunihiro , Hoshino Ayuko , Norton Larry , Bonafé Massimiliano , Cricca Monica , Gasparre Giuseppe , Lyden David , Bromberg Jacqueline
Published: October 2017

Significance

Increasing evidence suggests that extracellular vesicles (EVs) can transfer genetic material to recipient cells. However, the mechanism and role of this phenomenon are largely unknown. Here we have made a remarkable discovery: EVs can harbor the full mitochondrial genome. These extracellular vesicles can in turn transfer their mtDNA to cells with impaired metabolism, leading to restoration of metabolic activity. We determined that hormonal therapy induces oxidative phosphorylation-deficient breast cancer cells, which can be rescued via the transfer of mtDNA-laden extracellular vesicles. Horizontal transfer of mtDNA occurred in cancer stem-like cells and was associated with increased self-renewal potential of these cells, leading to resistance to hormonal therapy. We propose that mtDNA transfer occurs in human cancer via EVs.
FGF4
retrogene on CFA12 is responsible for chondrodystrophy and intervertebral disc disease in dogs
Authors: Brown Emily A. , Dickinson Peter J. , Mansour Tamer , Sturges Beverly K. , Aguilar Miriam , Young Amy E. , Korff Courtney , Lind Jenna , Ettinger Cassandra L. , Varon Samuel , Pollard Rachel , Brown C. Titus , Raudsepp Terje , Bannasch Danika L.
Published: October 2017

Significance

Chondrodystrophy, characterized by short limbs and intervertebral disc disease (IVDD), is a common phenotype in many of the most popular dog breeds, including the dachshund, beagle, and French bulldog. Here, we report the identification of a
FGF4
retrogene insertion on chromosome 12, the second
FGF4
retrogene reported in the dog, as responsible for chondrodystrophy and IVDD. Identification of the causative mutation for IVDD will impact an incredibly large proportion of the dog population and provides a model for IVDD in humans, as FGF-associated mutations are responsible for IVDD and short stature in human achondroplasia. This is a report of a second retrogene copy of the same parental gene, each causing complementary disease phenotypes in a mammalian species.
Critical Habitats and Stock Assessment: Age‐Specific Bias in the Chesapeake Bay Blue Crab Population Survey
Authors: Ralph Gina M. , Lipcius Romuald N.
Published: October 2017

Population surveys used in stock assessments often ignore habitats that are difficult to sample under the assumption that these habitats harbor an inconsequential fraction of the population. We tested this assumption for the Chesapeake Bay population of blue crab Callinectes sapidus, which numbers in the hundreds of millions, supports one of the world's most productive crustacean fisheries, and is managed based on a rigorous stock assessment. The stock assessments rely on a baywide winter dredge survey (WDS), which produces an absolute estimate of abundance for age‐1 and older crabs. Although the WDS does not sample waters shallower than 1.5 m deep, where some age‐0 crabs overwinter, it has been assumed that abundance in these shallow habitats is not substantial. We sampled vegetated and nonvegetated shallow‐water habitats not sampled by the WDS at four locations in lower Chesapeake Bay in February‐April 2011. Age‐0 density in shallow vegetated habitats was about two orders of magnitude higher than in deeper vegetated habitats sampled by the WDS; density in shallow nonvegetated habitats was about 40 times that of deep nonvegetated habitats. Even after excluding juvenile crabs that would not be retained by WDS gear, juvenile density was still 50 times higher in shallow vegetated and 32 times higher in nonvegetated habitats than in deep nonvegetated habitats. Extrapolating these densities baywide, we estimated approximately 850‐1,500 million age‐0 crabs in Chesapeake Bay, in contrast to the 2011 WDS estimate of about 205 million age‐0 crabs. Thus, the WDS only sampled 14‐24% of age‐0 crabs. If the fraction of age‐0 crabs sampled by the WDS differs interannually, then empirical estimates of abundance and exploitation rate will be biased and potentially lead to risk‐prone management actions. Our findings provide an empirical example whereby inattention to habitat utilization as a function of age or ontogeny may introduce significant error into fishery management.

Received May 17, 2013; accepted February 18, 2014
Size‐Selective Mortality of Steelhead during Freshwater and Marine Life Stages Related to Freshwater Growth in the Skagit River, Washington
Authors: Thompson Jamie N. , Beauchamp David A.
Published: October 2017

We evaluated freshwater growth and survival from juvenile (ages 0–3) to smolt (ages 1–5) and adult stages in wild steelhead Oncorhynchus mykiss sampled in different precipitation zones of the Skagit River basin, Washington. Our objectives were to determine whether significant size‐selective mortality (SSM) in steelhead could be detected between early and later freshwater stages and between each of these freshwater stages and returning adults and, if so, how SSM varied between these life stages and mixed and snow precipitation zones. Scale‐based size‐at‐annulus comparisons indicated that steelhead in the snow zone were significantly larger at annulus 1 than those in the mixed rain–snow zone. Size at annuli 2 and 3 did not differ between precipitation zones, and we found no precipitation zone × life stage interaction effect on size at annulus. Significant freshwater and marine SSM was evident between the juvenile and adult samples at annulus 1 and between each life stage at annuli 2 and 3. Rapid growth between the final freshwater annulus and the smolt migration did not improve survival to adulthood; rather, it appears that survival in the marine environment may be driven by an overall higher growth rate set earlier in life, which results in a larger size at smolt migration. Efforts for recovery of threatened Puget Sound steelhead could benefit by considering that SSM between freshwater and marine life stages can be partially attributed to growth attained in freshwater habitats and by identifying those factors that limit growth during early life stages.

Received December 3, 2013; accepted February 25, 2014
Low‐Temperature Tolerance of Juvenile Spotted Seatrout in South Carolina
Authors: Anweiler Katie V. , Arnott Stephen A. , Denson Michael R.
Published: October 2017

Spotted Seatrout Cynoscion nebulosus are vulnerable to mortality in winter when water temperature decreases rapidly. Temporary fishery closures in response to population declines should be based on a thorough understanding of the magnitude of winter mortality. We used three methods to estimate the low‐temperature tolerance of Spotted Seatrout: the chronic lethal method (CLM) and the acclimated chronic exposure (ACE) method using both static and fluctuating temperatures. All three methods use an environmentally realistic temperature change of 1°C/d. Fish acclimated to 14°C (n = 24) for 10 d and subsequently exposed to constantly declining temperatures using the CLM experienced loss of equilibrium at a temperature of 3.57 ± 0.24°C (mean ± SD) and mortality at a temperature of 3.08 ± 0.31°C. The ACE method, which uses changing temperatures until a base temperature is reached, was used to evaluate how Spotted Seatrout are affected by prolonged, sublethal temperatures. The ACE method was performed with static and fluctuating temperatures at two base temperatures (5.25°C and 4.25°C). Fish exposed to static temperatures of 5.25°C (n = 46) and 4.25°C (n = 46) had significantly different survival rates (P < 0.001) and 4% and 91% mortality, respectively. Temperature fluctuations around a 5.25°C base temperature did not significantly affect loss of equilibrium or mortality compared with the static treatment at 5.25°C. Temperature fluctuations at the 4.25°C base temperature did not cause greater mortality, but did cause fish to lose equilibrium significantly faster than in the static treatment (P < 0.001). Results of this study suggest that temperatures below 5°C should be cause for concern for this species, though the duration of cold temperatures and the spatial distribution of temperature conditions will determine the severity of a winter mortality event. These data can be used to develop predictive mortality estimates for juvenile Spotted Seatrout (175–220 mm).

Received April 29, 2013; accepted March 4, 2014
Prevalence of External Skin Lesions and Polycyclic Aromatic Hydrocarbon Concentrations in Gulf of Mexico Fishes, Post‐Deepwater Horizon
Authors: Murawski Steven A. , Hogarth William T. , Peebles Ernst B. , Barbeiri Luiz
Published: October 2017

We surveyed offshore fish populations in the Gulf of Mexico in 2011 and 2012, following persistent reports of abnormal skin lesions and other pathologies in the aftermath of the Deepwater Horizon oil spill. The incidence of skin lesions in 2011 sampling was most frequent in some bottom‐dwelling species along the continental shelf edge north of the Deepwater Horizon site. Longline surveys revealed that by 2012 the overall frequency of lesions in northern Gulf of Mexico (NGM) fishes in the vicinity of the Deepwater Horizon had declined 53%, with severity also declining. Relatively high concentrations of polycyclic aromatic hydrocarbon (PAH) metabolites (up to 470,000 ng naphthalene equivalents/g bile wet weight), indicative of oil‐related pollution, were found in fish bile in 2011; concentrations of summed PAHs measured in fish liver and muscle were relatively low (<35 ng/g) due to the efficient metabolism of these compounds by teleost fish. Significant declines in bile concentrations of naphthalene and phenanthrene metabolites in Red Snapper Lutjanus campechanus between 2011 and 2012 indicate an episodic exposure to elevated levels of hydrocarbons of petrogenic origin. The composition of PAH parent compounds and alkylated homologs in Red Snapper liver samples was highly correlated with oil collected at the Deepwater Horizon wellhead but was less coherent with other PAH sources in the NGM. The elevated 2011 prevalence of skin lesions in some NGM species was unrelated to surface salinity or temperature anomalies and was not the result of an epizootic observable in our histopathology samples but was positively correlated with PAH concentration. Thus, we fail to reject the null hypothesis that elevated skin lesion frequency is unrelated to PAH exposure from the Deepwater Horizon oil spill.

Received August 14, 2013; accepted March 26, 2014
Thermal Tolerance, Survival, and Recruitment of Cyprinids Exposed to Competition and Chronic Heat Stress in Experimental Streams
Authors: Dekar Matthew P. , McCauley Cagney , Ray Jesse W. , King Ryan S.
Published: October 2017

We examined survival, competition, and recruitment among cyprinids that were subjected to interspecific and intraspecific competition and chronic heat stress in large, outdoor experimental streams. The study was conducted in 2011 during the hottest summer (also one of the driest summers) recorded in Texas. We measured survival of Red Shiners Cyprinella lutrensis, Blacktail Shiners Cyprinella venusta, and Central Stonerollers Campostoma anomalum stocked at varying densities to examine competitive interactions. Trophic interactions among Blacktail Shiner density treatments were assessed with stable isotope analysis (SIA), and mitochondrial markers were used to examine the lineage of young‐of‐the‐year shiners spawned during the study. Stocking survival was significantly greater for Red Shiners, and both shiner species demonstrated higher overall survival rates than Central Stonerollers. Although SIA results were variable among replicate streams, more generalist foraging patterns were observed for Blacktail Shiners in the high‐density treatment (intraspecific competition; no Red Shiners present) relative to the low‐density Blacktail Shiner treatment. Less trophic redundancy was observed in the interspecific competition treatment (Blacktail Shiners and Red Shiners co‐occurring) compared with the same density of Blacktail Shiners only (high‐density treatment). Despite the potentially lethal water temperatures, including 4 d on which water temperatures exceeded 37°C, mitochondrial sequences showed that both Red Shiners and Blacktail Shiners were able to spawn during the study. These results collectively highlight potential mechanisms for explaining fish assemblage responses at local and landscape scales, such as the Red Shiner's recent range expansion and increased abundance in some areas of Texas. Our findings are relevant for forecasting regional changes in fish species distributions in response to more frequent droughts and warmer summers due to climate change.

Received March 1, 2013; accepted March 11, 2014
Fish Assemblages of Shoal‐ and Shoreline‐Associated Seagrass Beds in Eastern Gulf of Mexico Estuaries
Authors: De Angelo Jacquelyn A. , Stevens Philip W. , Blewett David A. , Switzer Theodore S.
Published: October 2017

Assemblage structure of fishes associated with seagrasses (order Alismatales) is affected by factors such as depth, seagrass coverage, location of seagrass beds, and proximity of seagrass beds to adjacent habitats. Although these relationships have been well explored for small‐bodied fishes, few studies have examined seagrass habitat use by large‐bodied fishes (>100 mm SL). To examine the effects of habitat characteristics on assemblages of large‐bodied fishes, two seagrass habitat types were sampled in three eastern Gulf of Mexico estuaries (2008–2010) with a 183‐m haul seine: (1) seagrasses immediately adjacent to shorelines and (2) seagrasses associated with shoals (seagrass beds >100 m from shoreline). Within each estuary, fish density was greater (as much as two times greater) in shoal seagrass beds than in those along shorelines. Fish assemblage structure also differed significantly between the two habitat types. Species that distinguished the seagrass shoreline (e.g., Spot Leiostomus xanthurus, Redfin Needlefish Strongylura notata) had affinities for habitats that were relatively shallow, gently sloped, less saline, and muddy with less seagrass coverage. Species that distinguished seagrass shoals (e.g., Pigfish Orthopristis chrysoptera, Silver Perch Bairdiella chrysoura) had affinities for habitats that were deeper, steeply sloped, sandy, and more saline, with greater seagrass coverage. Among economically important fishes, some were more abundant along shorelines (e.g., Common Snook Centropomus undecimalis, Sheepshead Archosargus probatocephalus, and Striped Mullet Mugil cephalus), while others were more abundant on shoals (e.g., Gag Mycteroperca microlepis, Spotted Seatrout Cynoscion nebulosus, and Scaled Sardine Harengula jaguana). This study demonstrates that seagrass shoals, which are being lost in some estuaries, provide different environmental conditions than those along shorelines, support unique fish assemblages, and host greater densities of several economically important species.

Received November 12, 2013; accepted March 18, 2014
Identification of a selective and direct NLRP3 inhibitor to treat inflammatory disorders
Authors: Jiang Hua , He Hongbin , Chen Yun , Huang Wei , Cheng Jinbo , Ye Jin , Wang Aoli , Tao Jinhui , Wang Chao , Liu Qingsong , Jin Tengchuan , Jiang Wei , Deng Xianming , Zhou Rongbin
Published: October 2017

The NLRP3 inflammasome has been implicated in the pathogenesis of a wide variety of human diseases. A few compounds have been developed to inhibit NLRP3 inflammasome activation, but compounds directly and specifically targeting NLRP3 are still not available, so it is unclear whether NLRP3 itself can be targeted to prevent or treat diseases. Here we show that the compound CY-09 specifically blocks NLRP3 inflammasome activation. CY-09 directly binds to the ATP-binding motif of NLRP3 NACHT domain and inhibits NLRP3 ATPase activity, resulting in the suppression of NLRP3 inflammasome assembly and activation. Importantly, treatment with CY-09 shows remarkable therapeutic effects on mouse models of cryopyrin-associated autoinflammatory syndrome (CAPS) and type 2 diabetes. Furthermore, CY-09 is active ex vivo for monocytes from healthy individuals or synovial fluid cells from patients with gout. Thus, our results provide a selective and direct small-molecule inhibitor for NLRP3 and indicate that NLRP3 can be targeted in vivo to combat NLRP3-driven diseases.
Some new computable structures of high rank
Authors: Harrison-Trainor Matthew , Igusa Gregory , Knight Julia
Published: October 2017

We give several new examples of computable structures of high Scott rank. For earlier known computable structures of Scott rank

ω
1

C
K

\omega _1^{CK}

, the computable infinitary theory is

ℵ
0

\aleph _0

-categorical. Millar and Sacks asked whether this was always the case. We answer this question by constructing an example whose computable infinitary theory has non-isomorphic countable models. The standard known computable structures of Scott rank

ω
1

C
K

+
1

\omega _1^{CK}+1

have infinite indiscernible sequences. We give two constructions with no indiscernible ordered triple.
On branches of positive solutions for 𝑝-Laplacian problems at the extreme value of the Nehari manifold method
Authors: Ilyasov Yavdat , Silva Kaye
Published: October 2017

This paper is concerned with variational continuation of branches of solutions for nonlinear boundary value problems, which involve the

p
p

-Laplacian, an indefinite nonlinearity, and depend on a real parameter

λ
\lambda

. A special focus is given to the extreme value

λ
∗

\lambda ^*

of the Nehari manifold that determines the threshold of applicability of the Nehari manifold method. In the main result the existence of two branches of positive solutions for the cases where the parameter

λ
\lambda

lies above the threshold

λ
∗

\lambda ^*

is obtained.
Sociodemographic and Clinical Factors Associated With Increasing Bacterial Sexually Transmitted Infection Diagnoses in Men Who Have Sex With Men Accessing Care at a Boston Community Health Center (2005–2015)
Authors: Mayer Kenneth H , Maloney Kevin M , Levine Kenneth , King Dana , Grasso Chris , Krakower Douglas S , Rosenberg Eli S , Boswell Stephen L
Published: October 2017

Background

The reasons why bacterial sexually transmitted infections (BSTIs) are increasing in US men who have sex with men (MSM) have not been fully characterized.

Methods

An open cohort of MSM accessing medical care at a Boston community health center was used to assess secular trends in BSTI diagnoses. Frequency of infection and the estimated population size were used to calculate diagnosis rates. Poisson models were fit for multivariable analyses.

Results

Between 2005 and 2015, 19 232 men had at least 1 clinic visit. Most (72.4%) were white; 6.0% were black, and 6.1% were Latino. Almost half had documented self-report of identifying as gay (42.6%) or bisexual (3.2%). Most had private health insurance (61.7%); 5.4% had Medicare, 4.6% had Medicaid, and 8.4% reported no insurance. Between 2005 and 2015, BSTI diagnoses increased more than 8-fold. In 2015, of 1319 men who were diagnosed with at least 1 BSTI; 291 were diagnosed with syphilis, 554 with gonorrhea (51.4% rectal, 31.0% urogenital), and 679 with chlamydia (69.1% rectal, 34.3% urogenital). In 2015, 22.7% of BSTIs were diagnosed among HIV-infected patients (15.4% of the clinic population), and 32.8% of BSTIs were diagnosed among HIV-uninfected patients using pre-exposure prophylaxis (PrEP; 10.1% of all men in care). In multivariable analyses, age 18 to 24 years, being HIV-infected, using PrEP, being nonwhite, or reporting Medicaid or not reporting having private insurance or Medicare were independently associated with being diagnosed with a new BSTI.

Conclusions

Over the past decade, BSTI diagnosis rates increased in HIV-infected and uninfected MSM, with disproportionate increases in PrEP users, racial and ethnic minority MSM, those aged 25 to 34 years, and those without stable health insurance, warranting focused education, screening, and accessible services for these key subpopulations.
Outpatient Macrolide Antibiotic Prescribing in the United States, 2008–2011
Authors: Sanchez Guillermo V , Shapiro Daniel J , Hersh Adam L , Hicks Lauri A , Fleming-Dutra Katherine E
Published: October 2017

National Ambulatory Medical Care Survey data were used to assess outpatient macrolide prescribing and selection. Conditions for which macrolides are firstline therapy represented 5% of macrolide prescribing. Family practitioners selected macrolides for children more frequently than pediatricians. Macrolides are an important antibiotic stewardship target.
“Greening out” Treating cannabis-related problems in the ED
Authors: Murphy Kathryn
Published: October 2017

Emergency visits are on the rise as states legalize recreational marijuana.
Implementation and Evaluation of the Z-Score System for Normalizing Residency Evaluations
Authors: Wanderer Jonathan P. , de Oliveira Filho Getulio R. , Rothman Brian S. , Sandberg Warren S. , McEvoy Matthew D.
Published: October 2017

Background

Assessment of clinical competence is essential for residency programs and should be guided by valid, reliable measurements. We implemented Baker’s Z-score system, which produces measures of traditional core competency assessments and clinical performance summative scores. Our goal was to validate use of summative scores and estimate the number of evaluations needed for reliable measures.

Methods

We performed generalizability studies to estimate the variance components of raw and Z-transformed absolute and peer-relative scores and decision studies to estimate the evaluations needed to produce at least 90% reliable measures for classification and for high-stakes decisions. A subset of evaluations was selected representing residents who were evaluated frequently by faculty who provided the majority of evaluations. Variance components were estimated using ANOVA.

Results

Principal component extraction from 8,754 complete evaluations demonstrated that a single factor explained 91 and 85% of variance for absolute and peer-relative scores, respectively. In total, 1,200 evaluations were selected for generalizability and decision studies. The major variance component for all scores was resident interaction with measurement occasions. Variance due to the resident component was strongest with raw scores, where 30 evaluation occasions produced 90% reliable measurements with absolute scores and 58 for peer-relative scores. For Z-transformed scores, 57 evaluation occasions produced 90% reliable measurements with absolute scores and 55 for peer-relative scores. The results were similar for high-stakes decisions.

Conclusions

The Baker system produced moderately reliable measures at our institution, suggesting that it may be generalizable to other training programs. Raw absolute scores required few assessment occasions to achieve 90% reliable measurements.
The SPOT GRADE
Authors: Spotnitz William D. , Zielske Dirk , Centis Valerie , Hoffman Rachel , Gillen Daniel L. , Wittmann Catherine , Guyot Vincent , Campos Doris M. , Forest Patricia , Pearson Alan , McAfee Paul C.
Published: October 2017

Study Design.

Benchtop model with prospective surgeon video testing.

Objective.

To create a surface bleeding severity scale, the SPOT GRADE (SG), for quantitative assessment of target bleeding site (TBS) blood loss. This is of particular interest for spinal surgery due to epidural bleeding and an inability to use diathermy and radiofrequency cautery close to nerve roots.

Summary of Background Data.

A novel apparatus perfusable at known flow rates and simulating different sized wounds was used to create movies to educate surgeons on specific degrees of bleeding.

Methods.

Training (36) and testing (108) videos were created using a benchtop apparatus employing different bleeding severities based on the six-level SG (none, minimal, mild, moderate, severe, and extreme) and TBS sizes (1, 10, and 50 cm2). Fourteen surgeons in four specialties (cardiothoracic, abdominal, spine, and orthopedic lower extremity) were trained and tested to evaluate SG characteristics including inter-rater and intrarater reliability.

Results.

The interclass correlation coefficient was estimated to be 0.89840 (95% confidence interval [CI]: 0.85771, 1), whereas the intraclass correlation coefficient was estimated to be 0.93673 (95% CI: 0.89603, 1). In 98% of cases (95% CI: 0.9736, 0.9927), surgeons correctly identified eligible bleeds for a future clinical trial (scores = 1, 2, or 3) and in 91% of cases (95% CI: 0.8895, 0.9344), surgeons correctly identified noneligible bleeds (scores = 4 or 5). In 98.6% of cases (95% CI: 0.9777, 0.9945), physicians correctly identified true hemostasis (score = 0). Based upon these data the probability of a physician rating a bleed incorrectly as hemostasis (score = 0) is estimated to be 1.51% (95% CI: 0.0061, 0.0363).

Conclusion.

This SG is reproducible and reliable providing a basis for educating surgeons on TBS blood loss. It appears to be a new standard for evaluating wound blood loss.

Level of Evidence:2
Syncope Episodes and Blood Flow Restriction Training
Authors: Martín-Hernández Juan , Santos-Lozano Alejandro , Foster Carl , Lucia Alejandro
Published: October 2017

The combination of low-load resistance training [or more recently, neuromuscular electrical stimulation (NMES)] with a moderate local blood flow restriction (BFR) is becoming a widespread training and rehabilitation method. Scientific data indicate the overall safety of BFR, at least in healthy young people. However, it has been associated with side effects, usually minor, and further research is warranted regarding the safety and efficacy of this technique, especially in clinical populations. We found 3 syncope/presyncopal episodes among 21 healthy people (9 men), all occurring in men and during familiarization sessions (in which BFR was applied alone) but not thereafter (BFR sessions combined with NMES): 1 subject experienced a brief syncope and 2 other subjects exhibited presyncopal symptoms (sweating, lightheadedness, and pallor). Our cases are evidence that cardiovascular complications may emerge during BFR. Caution is thus needed in the application of BFR, and gentle familiarization with this training modality is also recommended.
Septic shock resuscitation in the first hour
Authors: Simpson Nicholas , Lamontagne Francois , Shankar-Hari Manu
Published: October 2017

Purpose of review

We reviewed the recent advances in the initial approach to resuscitation of sepsis and septic shock patients.

Recent findings

Sepsis and septic shock are life-threatening emergencies. Two key interventions in the first hour include timely antibiotic therapy and resuscitation. Before any laboratory results, the need for resuscitation is considered if a patient with suspected infection has low blood pressure (BP) or impaired peripheral circulation found at clinical examination. Until now, this early resuscitation in sepsis and septic shock was supported by improvements in outcome seen with goal-directed therapy. However, three recent, goal-directed therapy trials failed to replicate the originally reported mortality reductions, prompting a debate on how this early resuscitation should be performed. As resuscitation is often focussed on macrociculatory goals such as optimizing central venous pressure, the discordance between microcirculatory and macrocirculatory optimization during resuscitation is a potential argument for the lack of outcome benefit in the newer trials. Vasoactive drug dose and large volume resuscitation-associated-positive fluid balance, are independently associated with worse clinical outcomes in critically ill sepsis and septic shock patients. As lower BP targets and restricted volume resuscitation are feasible and well tolerated, should we consider a lower BP target to reduce the adverse effects of catecholamine’ and excess resuscitation fluids. Evidence guiding fluids, vasopressor, and inotrope selection remains limited.

Though the early resuscitation of sepsis and septic shock is key to improving outcomes, ideal resuscitation targets are elusive. Distinction should be drawn between microcirculatory and macrocirculatory changes, and corresponding targets. Common components of resuscitation bundles such as large volume resuscitation and high-dose vasopressors may not be universally beneficial. Microcirculatory targets, individualized resuscitation goals, and reassessment of completed trials using the updated septic shock criteria should be focus areas for future research.
Comparison of fenofibrate and pioglitazone effects on patients with nonalcoholic fatty liver disease
Authors: Yaghoubi Malek , Jafari Sattar , Sajedi Behnam , Gohari Sepehr , Akbarieh Samira , Heydari Amir H. , Jameshoorani Maryam
Published: October 2017

Introduction

Nonalcoholic fatty liver disease (NAFLD) is known to be a health-related problem; there is no proven treatment for NAFLD. However, a wide range of possible therapies have been proposed and studied. In the current study, we aimed to compare the therapeutic effects of fenofibrate and pioglitazone on NAFLD.

Patients and methods

In this randomized clinical trial study (ethic number: ZUMS.REC.1393.133), patients with NAFLD and alanine aminotransferase in range of 1–1.5 folds of normal and BMI (25–35) were studied. Blood lipids and liver enzymes were measured. The patients were divided randomly into three groups (recipient of fenofibrate, pioglitazone, and exercise). After the patients completed the course of treatment, liver enzymes were measured.

Results

According to the results of this study, 90 patients with NAFLD were divided into three groups of 30 patients. All variables at the beginning of the study showed no significant difference among the three groups, but after the treatment period, the results showed that the levels of alanine aminotransferase, aspartate transaminase, systolic blood pressure, diastolic blood pressure, and BMI changed significantly: the levels decreased in all groups.

Conclusion

This study showed beneficial effects of fenofibrate and pioglitazone in patients with fatty liver. Further studies with larger study populations on the effects of these drugs on fatty liver, lipid profile, blood glucose, and insulin are suggested.
Outcomes after Phalloplasty: Do Transgender Patients and Multiple Urethral Procedures Carry a Higher Rate of Complication?
Authors: Remington Austin C. , Morrison Shane D. , Massie Jonathan P. , Crowe Christopher S. , Shakir Afaaf , Wilson Stelios C. , Vyas Krishna S. , Lee Gordon K. , Friedrich Jeffrey B.
Published: October 2017

Background:

Phalloplasty is associated with improved quality-of-life in those with penile defects, and in female-to-male transgender (transmale) patients seeking gender-confirming surgery. However, aggregate complication and outcome data are sparse. This study compares phalloplasty outcomes between transmale and cismale patients and between those with primary versus staged urethroplasty.

Methods:

A comprehensive literature search of PubMed, MEDLINE, and Google Scholar databases was conducted for studies relating to phalloplasty. Data on techniques, complications, outcomes, and patient demographics were collected. Analysis using the random-effects model with subgroup analyses was performed.

Results:

A total of 50 studies (1351 patients) were included: 19 studies (869 patients) for transmale patients and 31 studies (482 patients) for cismale patients. The urethral complication rate in the transmale group was 39.4 percent (95 percent CI, 30.6 to 48.9 percent; p = 0.028) compared to 24.8 percent (95 percent CI, 16.5 to 35.4 percent; p < 0.001) in the cismale group. The overall flap complication rates for transmale and cismale patients were 10.8 percent (95 percent CI, 7.0 to 16.2 percent; p < 0.001) and 8.1 percent (95 percent CI, 5.5 to 11.7 percent; p < 0.001), respectively. Twenty-three studies (723 patients) used primary urethroplasty and 13 studies (210 patients) performed staged urethroplasty procedures. Flap complication rates of primary and staged urethroplasty were 8.6 percent (95 percent CI, 5.3 to 13.8 percent; p < 0.001) and 16.7 percent (95 percent CI, 10.7 to 24.9 percent; p < 0.001), respectively. Primary urethroplasty had superior outcomes of voiding while standing, sexual function, and patient satisfaction compared with staged urethroplasty.

Conclusions:

Cismale patients undergoing phalloplasty had lower urethral and flap complication rates compared with transmale patients. Staged urethroplasty had more flap complications, and worse outcomes and patient satisfaction compared with primary urethroplasty.
Application of Enhanced Recovery After Surgery in Single-incision Laparoscopic Distal Gastrectomy
Authors: Zhou Junfeng , He Qingliang , Wang Jiaxing , Liu Qicai , Wang Mi
Published: October 2017

Background:

Recently, enhanced recovery after surgery (ERAS) was widely used in the perioperative management of gastric cancer. The study aimed to evaluate the safety and effectiveness of ERAS in single-incision laparoscopic distal gastrectomy (SIDG).

Materials and Methods:

A total of 90 patients who received laparoscopic gastric cancer resection were divided into 3 groups: group A (n=30), underwent traditional multiport laparoscopic distal gastrectomy with conventional perioperative management; group B (n=30) underwent traditional multiport laparoscopic distal gastrectomy with ERAS concept; and group C (n=30), underwent SIDG with ERAS concept. Clinical data and gut function were assessed in 3 groups.

Results:

There were no significant differences in terms of postoperative complication, number of resected lymph nodes and blood loss among 3 groups. However, operation time was longer (P=0.003) and treatment cost was higher (P<0.001) in group C than that in group A and B. Group C had faster recovery of bowel function (P<0.001), shorter postoperative hospital stay (P=0.002), and less postoperative complication (P=0.044) than those in group A. There were no significant differences in terms of recovery of bowel function and postoperative hospital stay between group C and B (all P>0.05). The white blood cell counts were lower than group A and B (all P<0.05) and C-reactive protein in group C were lower than group A (P<0.05) and B (P>0.05).

Conclusions:

The findings suggest that SIDG with ERAS may be a feasible and safe procedure for early gastric cancer because it provides a favorable cosmetic result while not compromising postoperative complications, number of resected lymph nodes, and blood loss.
The promise of mesenchymal stem cell therapy for acute respiratory distress syndrome
Authors: Antebi Ben , Mohammadipoor Arezoo , Batchinsky Andriy I. , Cancio Leopoldo C.
Published: October 2017

This review describes the current state of the science on mesenchymal stem cell (MSC) treatment for acute lung injury (ALI). The general characteristics, regenerative potential, and mechanism of action of MSCs are first presented. Next, particular emphasis is placed on the application of MSCs for the treatment of acute respiratory distress syndrome (ARDS) in preclinical and clinical studies. Finally, we discuss current challenges and future directions in the field presented from a clinician-researcher perspective. The objective of this work is to provide the readership with a current review of the literature discussing the hurdles and overall promise of MSCs as therapeutic interventions for the treatment of ARDS.
Casein kinase II phosphorylation of cyclin F at serine 621 regulates the Lys48-ubiquitylation E3 ligase activity of the SCF
(cyclin F)
complex
Authors: Lee Albert , Rayner Stephanie L. , De Luca Alana , Gwee Serene S. L. , Morsch Marco , Sundaramoorthy Vinod , Shahheydari Hamideh , Ragagnin Audrey , Shi Bingyang , Yang Shu , Williams Kelly L. , Don Emily K. , Walker Adam K. , Zhang Katharine Y. , Yerbury Justin J. , Cole Nicholas J. , Atkin Julie D. , Blair Ian P. , Molloy Mark P. , Chung Roger S.
Published: October 2017

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder that is characterized by progressive weakness, paralysis and muscle loss often resulting in patient death within 3–5 years of diagnosis. Recently, we identified disease-linked mutations in the
CCNF
gene, which encodes the cyclin F protein, in cohorts of patients with familial and sporadic ALS and frontotemporal dementia (FTD) (Williams KL
et al
. 2016
Nat. Commun.
7
, 11253. (
doi:10.1038/ncomms11253
)). Cyclin F is a part of a Skp1-Cul-F-box (SCF) E3 ubiquitin-protein ligase complex and is responsible for ubiquitylating proteins for degradation by the proteasome. In this study, we investigated the phosphorylation status of cyclin F and the effect of the serine to glycine substitution at site 621 (S621G) on E3 ligase activity. This specific mutation (S621G) was found in a multi-generational Australian family with ALS/FTD. We identified seven phosphorylation sites on cyclin F, of which five are newly reported including Ser621. These phosphorylation sites were mostly identified within the PEST (proline, glutamic acid, serine and threonine) sequence located at the C-terminus of cyclin F. Additionally, we determined that casein kinase II (CK2) can phosphorylate Ser621 and thereby regulate the E3 ligase activity of the SCF
(cyclin F)
complex. Furthermore, the S621G mutation in cyclin F prevents phosphorylation by CK2 and confers elevated Lys48-ubiquitylation activity, a hallmark of ALS/FTD pathology. These findings highlight the importance of phosphorylation in regulating the activity of the SCF
(cyclin F)
E3 ligase complex that can affect downstream processes and may lead to defective motor neuron development, neuron degeneration and ultimately ALS and FTD.
Protein SUMOylation modification and its associations with disease
Authors: Yang Yanfang , He Yu , Wang Xixi , liang Ziwei , He Gu , Zhang Peng , Zhu Hongxia , Xu Ningzhi , Liang Shufang
Published: October 2017

SUMOylation, as a post-translational modification, plays essential roles in various biological functions including cell growth, migration, cellular responses to stress and tumorigenesis. The imbalance of SUMOylation and deSUMOylation has been associated with the occurrence and progression of various diseases. Herein, we summarize and discuss the signal crosstalk between SUMOylation and ubiquitination of proteins, protein SUMOylation relations with several diseases, and the identification approaches for SUMOylation site. With the continuous development of bioinformatics and mass spectrometry, several accurate and high-throughput methods have been implemented to explore small ubiquitin-like modifier-modified substrates and sites, which is helpful for deciphering protein SUMOylation-mediated molecular mechanisms of disease.
Whats, hows and whys of programmed DNA elimination inTetrahymena
Authors: Noto Tomoko , Mochizuki Kazufumi
Published: October 2017

Programmed genome rearrangements in ciliates provide fascinating examples of flexible epigenetic genome regulations and important insights into the interaction between transposable elements (TEs) and host genomes. DNA elimination inTetrahymena thermophilaremoves approximately 12 000 internal eliminated sequences (IESs), which correspond to one-third of the genome, when the somatic macronucleus (MAC) differentiates from the germline micronucleus (MIC). More than half of the IESs, many of which show high similarity to TEs, are targeted for elimination incisby the small RNA-mediated genome comparison of the MIC to the MAC. Other IESs are targeted for elimination intransby the same small RNAs through repetitive sequences. Furthermore, the small RNA–heterochromatin feedback loop ensures robust DNA elimination. Here, we review an updated picture of the DNA elimination mechanism, discuss the physiological and evolutionary roles of DNA elimination, and outline the key questions that remain unanswered.
A bird-like skull in a Triassic diapsid reptile increases heterogeneity of the morphological and phylogenetic radiation of Diapsida
Authors: Pritchard Adam C. , Nesbitt Sterling J.
Published: October 2017

The Triassic Period saw the first appearance of numerous amniote lineages (e.g. Lepidosauria, Archosauria, Mammalia) that defined Mesozoic ecosystems following the end Permian Mass Extinction, as well as the first major morphological diversification of crown-group reptiles. Unfortunately, much of our understanding of this event comes from the record of large-bodied reptiles (total body length > 1 m). Here we present a new species of drepanosaurid (small-bodied, chameleon-like diapsids) from the Upper Triassic Chinle Formation of New Mexico. Using reconstructions of micro-computed tomography data, we reveal the three-dimensional skull osteology of this clade for the first time. The skull presents many archaic anatomical traits unknown in Triassic crown-group reptiles (e.g. absence of bony support for the external ear), whereas other traits (e.g. toothless rostrum, anteriorly directed orbits, inflated endocranium) resemble derived avian theropods. A phylogenetic analysis of Permo-Triassic diapsids supports the hypothesis that drepanosaurs are an archaic lineage that originated in the Permian, far removed from crown-group Reptilia. The phylogenetic position of drepanosaurids indicates the presence of archaic Permian clades among Triassic small reptile assemblages and that morphological convergence produced a remarkably bird-like skull nearly 100 Myr before one is known to have emerged in Theropoda.