bluuebunny/crossref_metadata_2025 huggingface dataset:
Extended Lateral Orbital Craniotomy: Anatomic Study and Initial Clinical Series of a Novel Minimally Invasive Pterional Approach
Authors: Sattur Mithun G. , Abi-Aad Karl R. , Welz Matthew E. , Aoun Rami James , Krishna Chandan , Purnell Chad , Alghoul Mohammed , Bendok Bernard R.
Published: February 2019

Background Of the minimally invasive “keyhole” alternatives to the pterional region, the supraorbital eyebrow approach is the most widely adopted. Yet it can prove disadvantageous when a more direct lateral microsurgical trajectory of attack to the Sylvian fissure and anterior middle fossa are needed.

Objective The extended lateral orbital (XLO) approach was designed to be direct and minimally invasive, with the sphenoid ridge at the center of exposure.

Methods Five injected cadaver heads were used for anatomic study of the XLO approach. The anatomic course of the frontalis branch of facial nerve was studied in relation to the XLO incision. Following XLO incision, the bone exposure was measured. The intracranial microsurgical exposure was assessed subjectively. Application of the technique in representative clinical operative cases is provided.

Results The frontalis nerve was protected in the subgaleal fat pad, with an average minimum distance of 2.3 cm from the XLO incision. The mean calvarial area exposure was 4.95 cm2 and consistently centered on the sphenoid ridge. Excellent access to ipsilateral Sylvian's fissure, perisylvian regions, and supra-/parasellar structures was possible. The main limitations related to exposure of the posterior Sylvian fissure and the expected limitations of microsurgical instrument manipulation from a smaller craniotomy.

Conclusions The XLO approach is a minimally invasive keyhole approach to the pterional region that affords a unique lateral trajectory via a craniotomy centered on the sphenoid ridge. Excellent exposure to properly selected lesions is possible. The incision is at a safe distance from the frontalis branch and shows excellent cosmetic healing.
Innovative Service Delivery Models for Serving Children with Speech Sound Disorders
Authors: Greenwell Tamar , Brosseau-Lapré Françoise
Published: February 2019

Service delivery variables that may have an impact on the treatment outcomes of children with speech sound disorders include the number and duration of intervention sessions, distribution of the sessions over time, and the format (group intervention or individual intervention). In this article, we briefly review these variables and the recommendations for the most effective service delivery components for children with speech sound disorders. We then describe innovative, collaborative service delivery models for preschoolers and school-age children with speech sound disorder. The models include “Quick Articulation!” conducted in a local elementary school by clinical MS-SLP students from Purdue University, as well as Summer Speech and Literacy Laboratory, which takes place in the department of Speech, Language, and Hearing Sciences at Purdue and involves participation from clinical and research faculty, and graduate and undergraduate students. The article provides useful information to help guide clinicians and clinical supervisors in implementing components of these models into their practice with children with speech sound disorder.
Influence of Luminal Communication on Aortic Enlargement after Hemiarch Replacement for Acute Type A Aortic Dissection
Authors: Uchino Gaku , Yoshida Takeshi , Kakii Bunpachi , Furui Masato
Published: February 2019

Background Aortic enlargement after hemiarch replacement (HAR) for acute type A aortic dissection (AAAD) is a serious problem. We reviewed our experience and analyzed the risk factors for aortic enlargement.

Methods During April 2005 to December 2017, 364 patients underwent HAR for AAAD. Seventy-three patients fulfilled the inclusion criteria. We analyzed the change in aortic diameter, aortic growth rate, and major adverse aortic events (MAAEs) and their association with luminal communication of the aortic arch.

Results Anastomotic communication, supra-aortic communication (SAC), and distal aortic communication were found in 34 (46.6%), 28 (38.4%), and 20 (27.4%) patients, respectively. The aortic growth rate was high because of the presence of SAC, distal aortic communication, and the number of coexisting aortic communication. Univariate analysis showed that the presence of SAC and an initial aortic diameter > 35 mm at 20 mm distal to the left subclavian artery and at the pulmonary artery bifurcation (PAB) were risk factors for MAAEs. Multivariate analysis showed that SAC and an initial aortic diameter > 35 mm at the PAB were independent risk factors for MAAEs.

Conclusion SAC, distal aortic communication, and the number of coexisting aortic communication are significant risk factors for aortic enlargement after HAR for AAAD. SAC and an initial aortic diameter > 35 mm at the PAB are independent risk factors for MAAEs after this procedure.
Psychoonkologische Versorgung von Melanom-Patienten
Authors: Braitmaier Dr. Helmine
Published: February 2019

Der Nationale Krebsplan fordert, dass alle Patienten bei Bedarf psychoonkologisch betreut werden sollen. In zertifizierten Hautkrebszentren ist man diesem Ziel deutlich näher gekommen. Deutlichen Nachholbedarf gibt es vor allem bei ambulant versorgten Patienten. Doch nicht nur der Patient selbst sollte im Fokus stehen. Die Familie und vor allem die Kinder krebskranker Eltern sollten nicht vergessen werden. Über den aktuellen Versorgungsstand berichtete Dr. Frank Meiß, Freiburg, auf dem ADO-Kongress 2018.
Mammakarzinom-Risiko bei BRCA1-Carriern
Authors: Krome Dr. Susanne
Published: February 2019

Bei Frauen mit einer Keimbahnmutation von BRCA1 beträgt das Risiko für Ovarialkarzinome 44 %. Der prophylaktischen bilateralen Ovarektomie folgt bei den meist jungen Frauen eine Hormonersatztherapie (HRT). 2004 zeigten Daten der Women´s Health Initiative ein gesteigertes Mammakarzinom-Risiko durch eine HRT mit der Kombination Östrogen/Progesteron. Kotsopoulos et al. führten eine prospektive Studie durch und ermittelten die Wahrscheinlichkeit bei BRCA1-Trägerinnen mit und ohne HRT nach Ovarektomie.
Fortgeschrittenes Mammakarzinom
Authors: Krome Dr. Susanne
Published: February 2019

Tumorzellen mit BRCA1/2-Mutation weisen defiziente Reparaturmechanismen für DNA-Doppelstrangbrüche auf und sind deshalb auf den alternativen Mechanismus für Einzelstrangbrüche angewiesen. Talazoparib beeinträchtigt dessen Regulation durch die Hemmung der PAR-Polymerase. In der EMBRACA-Studie erwies sich Talazoparib bei lokal fortgeschrittenen und metastasierten Mammakarzinomen mit BRAF1/2-Mutation als wirksamer als eine Standard-Chemotherapie.
The Rare Case of Anti-VGKC Limbic Encephalitis Secondary to High-Grade Glioma
Authors: Johnson DeJarra Caprii , Kline Feldman David Edward , Marri Preethi
Published: February 2019

Paraneoplastic limbic encephalitis secondary to a glial tumor is rare, and limited reports on this occurrence have been made in the pediatric population. This case involves a 13-year-old female patient with anti-voltage gated potassium channel (anti-VGKC) limbic encephalitis secondary to a high-grade glioma (HGG) in the suprasellar region. HHGs, associated with anti-VGKC antibodies, are a rare occurrence. This case highlights the need for the inclusion of glial neoplasms in the differential diagnosis for patients presenting with symptoms associated with paraneoplastic encephalitis.
Microplasma thruster powered by X-band microwaves
Authors: Takahashi Takeshi , Mori Daisuke , Kawanabe Tetsuo , Takao Yoshinori , Eriguchi Koji , Ono Kouichi
Published: February 2019

A microplasma thruster of the electrothermal type has been developed with X-band (f = 11 GHz) microwaves and Ar as a propellant. The emphasis was placed on an understanding of distinguished features of the microplasma generation and thrust performance by X-band microwaves, compared with those by S-band (f = 4 GHz) ones. The thruster consisted of a microplasma source 2 mm in the inner diameter and 3–12 mm long with a rod antenna on the axis, followed by a converging-diverging micronozzle. Azimuthally symmetric surface wave-excited plasmas were established by microwaves at powers of ≤6 W, with the source pressure in the range 2–50 kPa at flow rates of 10–70 sccm. The plasma generation, nozzle flow, and thrust performance were numerically analyzed using a two-dimensional fluid model, coupled with an electromagnetic model for microwaves interacting with plasmas in the source region. Simulations indicated that higher frequency f = 11 GHz with the source chamber length Ls ≈ 1/4 of the driving wavelength λ is preferred for the microplasma thruster in terms of efficient plasma generation, gas heating, and thus thrust performance as well as system compactness; moreover, in f = 11 GHz discharges with longer Ls ≈ 3λ/4, standing-wave striation-like plasma structures occur in the axial direction. Experiments were made for f = 11 and 4 GHz microwaves with the respective Ls ≈ λ/4, where the plasma electron density and gas temperature in the microplasma source were measured by optical emission spectroscopy with a small amount of H2 and N2 added. The electron density and gas temperature were in the range of (4–12) × 1019 m−3 and 800–1000 K for f = 11 GHz, being ∼10%–50% higher than those for f = 4 GHz. The thrust performance was also measured by a target-type microthrust stand, giving a thrust, specific impulse, and thrust efficiency in the range 0.2–1.8 mN, 65–90 s, and 2%–14% for f = 11 GHz, which were ∼10%–15% higher than those for f = 4 GHz. These experimental results were consistent with those of simulations, depending on microwave frequency, power, chamber size, and gas flow rate.
Influence of baroclinic vorticity production on unsteady drag coefficient in shock–particle interaction
Authors: Fujisawa K. , Jackson T. L. , Balachandar S.
Published: February 2019

The influence of baroclinic vorticity production on the unsteady drag coefficient in shock–particle interaction is numerically studied. Numerical simulations are performed for shock–particle interaction utilizing a high–resolution axisymmetric solver for the Euler equations that allows for multi-material interface and shock propagation in both the particle and surrounding medium. We consider an aluminum particle in nitromethane and allow for particle deformation. We compute the vorticity production and unsteady drag coefficient as a function of time to explain the complex physical mechanisms that occur during shock–particle interaction. We observe baroclinic vorticity production as the shock propagates over the particle and find that the vorticity is primarily generated at the surface of the particle. After the passage of the shock over the particle, the generated vortex traverses downstream, thus creating a sharpened particle edge and low pressure on the downstream side of the particle, followed by the trapping of the vortex at the particle edge. These mechanisms lead to the generation of a quasi-steady drag force even after the passage of the shock, thus suggesting the importance of baroclinic vorticity production to the unsteady drag coefficient. Finally, we compute the unsteady drag coefficient for various shock Mach numbers and particle ellipticities.
Formation of distorted rutile-type NbO2, MoO2, and WO2 films by reactive sputtering
Authors: Fujiwara Kohei , Tsukazaki Atsushi
Published: February 2019

We report the film growth of distorted rutile-type NbO2 (4d1 system), MoO2 (4d2), and WO2 (5d2) by radio-frequency (RF) magnetron reactive sputtering. Through optimization of growth conditions for the three oxides on Al2O3(0001), we found that the increase/decrease in the RF power had an equivalent role to that of the decrease/increase in the oxygen ratio in the Ar–O2 sputtering gas. X-ray photoelectron spectroscopy supported the d1 electronic configuration of NbO2 and d2 electronic configurations of MoO2 and WO2. An electrical transport measurement confirmed that NbO2 was insulating, while MoO2 and WO2 were metallic, consistent with the d-electron filling in the molecular orbital bonding band. The growth scheme presented in this study will be useful for valence control in various oxide thin films with a simple sputtering technique.
Semiconducting carbon nanotubes in photovoltaic blends: The case of pTB7:PC60BM:(6,5) SWNT
Authors: Figueroa del Valle Diana Gisell , Paternò Giuseppe M. , Farina Andrea , Scotognella Francesco
Published: February 2019

Blends of carbon nanotubes with conjugated polymer and fullerene derivatives are complex nanocomposite systems, which have recently attracted great research interest for their photovoltaic ability. Therefore, gaining a better understanding of the excitonic dynamics in such materials can be important to boost the efficiency of excitonic solar cells. Here, we studied the photophysics of a ternary system in which the polymer PTB7 and the fullerene derivative PCBM are integrated with (6,5) single walled carbon nanotubes. We highlight the contribution of SWNTs in the exciton dissociation and in the charge transfer process. These findings can be useful for the exploitation of these multi-component systems for organic photovoltaic and, in general, optoelectronic applications.
Down-regulation of FZD3 receptor suppresses growth and metastasis of human melanoma independently of canonical WNT signaling
Authors: Li Chen , Nguyen Vincent , Clark Kaitlyn N. , Zahed Tara , Sharkas Shawn , Filipp Fabian V. , Boiko Alexander D.
Published: February 2019

Significance

In malignant melanoma, one of the most aggressive cancers, the components of the WNT pathway are frequently deregulated and have been shown to drive self-renewal and metastatic progression of melanoma cells. Identifying tumorigenic properties of key members of the WNT signaling network in the pathogenesis of melanoma represents a pivotal task in the field and underlies successful design of targeted therapeutic approaches. In the present study, we characterized Frizzled 3 receptor (FZD3) as a critical factor underlying tumorigenic properties of aggressive human melanoma. Using in vivo and in vitro tumorigenic assays, combined with functional transcriptomics analysis of FZD3 knockdown in human patient-derived cells, we determined key signaling nodes regulated by FZD3 activity during malignant transformation.
Seductive Movements in Lysistrata and Spike Lee’s Chi-Raq: Activism, Adaptation, and Immersive Theatre in Film
Authors: Klein Emily
Published: February 2019

This article investigates how Spike Lee’s 2015 Lysistrata adaptation, Chi-Raq, reaches beyond the screen—‘in excess’ of its medium—by using the techniques of immersive theatre to revive Aristophanes’ classical plot as well as his urgent call to citizenly collective action (McGowan, Todd. Spike Lee. Champaign, IL: University of Illinois Press, 2014). Lee’s seductive activist fairytale in rhyming verse imagines a worldwide sex strike led by Chicago’s women of colour. Like its Classical predecessor, the film both critiques and reinforces the spectacular objectification of female bodies; that tension is always in play, even as it successfully brings about a peace treaty between two warring Englewood gangs. To explore this and other socio-political tensions, Lee’s film employs many of the ‘physical, sensual and participatory’ elements that Josephine Machon understands as central to immersive performance (Machon, Josephine. Immersive Theatres: Intimacy and Immediacy in Contemporary Performance. London: Palgrave Macmillan, 2013. xv). Crucial to this immersive adaptation is Lee’s transgressive coordination of sight, touch, and sound to aptly update Lysistrata’s acts of refusal as deeply gendered and racialized calls for intimate justice. In effect, audiences learn, move, chant, yearn, and envision a better world alongside the characters in the film. As a result, the goals of Chi-Raq are achieved in ways that are both more compellingly relevant and more radical than any other contemporary Lysistrata adaptation in recent memory.
The PD-1/PD-L1 Axis in HER2+ Ductal Carcinoma In Situ (DCIS) of the Breast
Authors: Ubago Julianne M , Blanco Luis Z , Shen Tiansheng , Siziopikou Kalliopi P
Published: February 2019

Objectives

The aims were to evaluate the programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) axis in ductal carcinoma in situ (DCIS) of the breast.

Methods

We reviewed 85 pure DCIS cases treated with surgical excision at our institution, including 51 luminal A (estrogen receptor [ER] positive/human epidermal growth factor 2 [HER2] negative), 15 luminal B (ER+/HER2+), 13 HER2 (ER–/HER2+), and six basal-like (ER–/HER2–/CK5/6+). The extent and intensity of PD-1 and PD-L1 immunohistochemical staining in the tumor-infiltrating lymphocytes (TILs) and in the tumor cells were recorded.

Results

Our study found that moderate/severe inflammation around DCIS correlated with HER2 expression (20/28 HER2+ cases [71%] vs 21/57 HER2– cases [37%], P = .005). Of interest, over half of the TILs around the HER2 subtype expressed PD-L1 (7/13, 54%). In addition, about one-third of TILs around the HER2 subtype expressed PD-1 (4/13, 31%).

Conclusions

These findings suggest that immune-based therapeutic strategies may be used as a potential therapy in DCIS cases with PD-L1 overexpression, especially those of the HER2 molecular subtype.
Keynes, Kalecki and Metzler in a dynamic distribution model
Authors: Bibi Samuele
Published: February 2019

This paper focuses on the dynamics analysis from the ultra-short to the short period from a Post-Keynesian perspective. It is argued that the construction of both the short-run and the long-run models are based on the critical assumption of an equilibrium between aggregate demand and aggregate supply. Starting from the work by Metzler (1941. The nature and stability of inventory cycles, The Review of Economic Statistics, 113–29), the issue of equilibrium and stability is investigated inside a Keynesian–Kaleckian perspective. The suggested model analyses under which conditions the standard Kaleckian conclusions are still valid considering a disequilibrium situation. Two scenarios are simulated: one with fixed expectations as in Metzler (1941. The nature and stability of inventory cycles, The Review of Economic Statistics, 113–29) and another based on adaptive expectations and asymmetric behaviour of the wages–unemployment relation. The model questions the effective demand labour curve and suggests that an increase in real autonomous expenditures, mainly by the government, might be even more essential than what is generally considered in the Kaleckian literature, to avoid increasing unemployment a world with increasing wages.
Low-Dose Metronidazole is Associated With a Decreased Rate of Endoscopic Recurrence of Crohn’s Disease After Ileal Resection: A Retrospective Cohort Study
Authors: Glick Laura R , Sossenheimer Philip H , Ollech Jacob E , Cohen Russell D , Hyman Neil H , Hurst Roger D , Rubin David T
Published: February 2019

Background and Aims

Recurrence of Crohn’s disease after surgical resection and primary anastomosis is an important clinical challenge. Previous studies have demonstrated the benefit of imidazole antibiotics, but have been limited by adverse events and medication intolerance. We evaluated whether administration of low-dose metronidazole [250 mg three times per day] for 3 months reduces endoscopic postoperative recurrence rates.

Methods

We performed a retrospective cohort study of patients with Crohn’s disease who underwent ileal resection with a primary anastomosis and subsequently received care at our center. We compared the cases who received low-dose metronidazole for 3 months with control patients who did not receive this therapy. Data collected included demographics, risk factors for recurrence, and medications before and after surgery. The primary end point was the number of patients with ≥i2 [Rutgeerts] endoscopic recurrence by 12 months. Variables found to be predictive in univariate analysis at p < 0.10 were introduced in the Cox model for multivariate analysis.

Results

In all, 70 patients with Crohn’s disease [35 cases and 35 controls] met inclusion criteria. Risk factors for Crohn’s recurrence were similar between groups. The number of patients with ≥i2 endoscopic recurrence within 12 months following ileal resection was significantly lower in the metronidazole group [7 of 35 patients; 20%] compared with the number in the control group [19 of 35 patients; 54.3%] [p = 0.0058]. Eight participants [22.9%] in the metronidazole group experienced adverse events, and 3 of these patients [8.6%] discontinued the therapy.

Conclusion

Low-dose metronidazole reduces endoscopic recurrence of Crohn’s disease postoperatively and is well tolerated. This intervention should be considered as a therapy option following ileocolonic resection.
Management of Biological Therapy Before Elective Inflammatory Bowel Disease Surgeries
Authors: Hansen Tawnya M , Targownik Laura E , Karimuddin Ahmer , Leung Yvette
Published: February 2019

Increasing uptake of biologic therapy has contributed to declining surgical rates for inflammatory bowel disease (IBD). However, a significant number of patients on biologic therapy will go on to require surgery. The literature is conflicted with regard to the preoperative management of biologic therapy before urgent or elective IBD surgery. This article reviews the available data on postoperative complications following preoperative treatment with anti-tumor necrosis factor alpha therapy, anti-integrin therapy, and anti-interleukin therapy.
The Potential Global Distribution and Voltinism of the Japanese Beetle (Coleoptera: Scarabaeidae) Under Current and Future Climates
Authors: Kistner-Thomas Erica Jean
Published: February 2019

Japanese beetle, Popillia japonica (Newman), is a severe invasive insect pest of turf, landscapes, and horticultural crops. It has successfully colonized much of the United States and has recently established in mainland Europe. The distribution and voltinism of P. japonica will undoubtedly change as a consequence of climate change, posing additional challenges to the management of this species. To assess these challenges, a process-oriented bioclimatic niche model for P. japonica was developed to examine its potential global distribution under current (1981–2010) and projected climatic conditions (2040–2059) using one emission scenario (representative concentration pathway [RCP] 8.5) and two global climate models, ACCESS1-0 and CNRM-CM5. Under current climatic conditions, the bioclimatic niche model agreed well with all credible distribution data. Model projections indicate a strong possibility of further range expansion throughout mainland Europe under both current and future climates. In North America, projected increases in temperature would enable northward range expansion across Canada while simultaneously shifting southern range limits in the United States. In Europe, the suitable range for P. japonica would increase by 23% by midcentury, especially across portions of the United Kingdom, Ireland, and Scandinavia. Under the RCP 8.5 scenario, cumulative growing degree-days increased, thereby reducing the probability of biannual life cycles in northern latitudes where they can occur, including Hokkaido, Japan, northeastern portions of the United States, and southern Ontario, Canada. The results of this study highlight several regions of increasing and emerging risk from P. japonica that should be considered routinely in ongoing biosecurity and pest management surveys.
Temperature and precipitation, but not geographic distance, explain genetic relatedness among populations in the perennial grass Festuca rubra
Authors: Šurinová Maria , Hadincová Věroslava , Vandvik Vigdis , Münzbergová Zuzana
Published: February 2019

Aims

Knowledge of genetic structure of natural populations and its determinants may provide key insights into the ability of species to adapt to novel environments. In many genetic studies, the effects of climate could not be disentangled from the effects of geographic proximity. We aimed to understand the effects of temperature and moisture on genetic diversity of populations and separate these effects from the effects of geographic distance. We also wanted to explore the patterns of distribution of genetic diversity in the system and assess the degree of clonality within the populations. We also checked for possible genome size variation in the system.

Methods

We studied genetic variation within and among 12 populations of the dominant grass Festuca rubra distributed across a unique regional-scale climatic grid in western Norway, Europe and explored the importance of temperature, precipitation and geographic distance for the observed patterns. We also explored the distribution of genetic diversity within and among populations, identified population differentiation and estimated degree of clonality. The analyses used microsatellites as the genetic marker. The analyses were supplemented by flow cytometry of all the material.

Important Findings

All the material corresponds to hexaploid cytotype, indicating that ploidy variation does not play any role in the system. The results indicate that temperature and precipitation were better predictors of genetic relatedness of the populations than geographic distance, suggesting that temperature and precipitation may be important determinants of population differentiation. In addition, precipitation, alone and in interaction with temperature, strongly affected population genotypic diversity suggesting increased clonality towards the coldest and especially the coldest wettest climates. At the same time, individuals from the coldest and wettest climates also had the highest individual genetic diversity, suggesting that only the most heterozygous individuals survive under these harsh climates. Most of the genetic variation was distributed within populations, suggesting that most populations have sufficient genetic diversity to adapt to novel climatic conditions. The alpine populations, i.e. populations which are likely the most endangered by climate change, however, lack this potential due to the high levels of clonality as detected in our study.
An Active Duty Sailor With Worsening Headaches and Blurry Vision
Authors: Thompson Chad A , Barnes Eric
Published: February 2019

Headaches are a typical presentation to a military medical department or emergency room. Having a broad differential diagnosis and utilizing a thorough physical exam can assist providers in honing down the list of pathology and in identifying potentially life-threatening causes of cephalgia such as intracranial tumors. In this case, a 27-year-old man presented with progressive headaches along with vision changes for the preceding 2–3 months. On initial physical exam, he was found to have bilateral papilledema using a panoptic ophthalmoscope, confirmed after sending the patient to optometry. Neurology evaluated him and found a pineoblastoma on MRI. He underwent eventual neurosurgical debulking and radiation. The highlight of this case is the critical history components along with physical exam techniques that can assist providers in the identification of life-threatening causes of a headache. Direct ophthalmoscopy was vital in this case to encourage referral for further management. In selected studies, emergency medicine providers performed ophthalmoscopy in 14% of patients, with roughly 10% of those patients having erroneous findings. Another study showed that 13% of all cases presenting to a large academic center had fundoscopic findings that were important to the final diagnosis.
An Embedded Health Engagement Team Pilot Test
Authors: Burkett Edwin K
Published: February 2019

Introduction

As an innovative test of an alternative health engagement method during CONTINUING PROMISE 2011 a joint embedded health engagement team (EHET) was created and executed. EHETs may serve as US military alternatives for improved outcomes in global health engagement activities.

Materials and Methods

The EHET concept was to integrate into the host nation’s public health system to collaborate in direct patient care, contribute to comprehensive preventive health, and achieve intellectual exchange between professionals of similar disciplines.

Results

EHET resulted in greater satisfaction on behalf of the host nation and US health professionals, smaller footprint of US personnel and equipment, emphasis on host nation existing infrastructure and system, action upon needs already identified by the host nation health strategy, and optimal US military and security cooperation outcomes. Although this pilot test was a military to civilian engagement the concept is applicable for military to military engagement and across the full range of US military operations. The pilot test was well received by the host nation. Participants on both sides expressed positive feedback that EHETs should be the preferred method for health engagements.

Conclusions

Thoroughly planned and executed EHET engagements should bring greater, measurable positive effects than typical mass patient care activities. EHETs are especially suitable for longer duration or recurrent missions to build partnership, capacity, and security. EHETs should replace legacy mass care missions as the primary health engagement capability to achieve mutual goals while using US military resources on legitimate local health needs.
Impact of Fire Arms Training in a Virtual Reality Environment on Occupational Performance (Marksmanship) in a Polytrauma Population
Authors: Oliver Robert A , Cancio Jill M , Rábago Christopher A , Yancosek Kathleen E
Published: February 2019

Introduction

Polytrauma, to include major limb amputation, in a military population presents unique rehabilitation challenges with the overarching goal of restoring function leading to the primary question, “Is this Service Member (SM) capable of returning to duty following rehabilitation?” The US military has a vested interest in maximizing injured SMs occupational performance to allow for return to duty. The purpose of this report is to describe marksmanship (shot grouping and weapon qualification) and return to duty outcomes following a course of VRE-based firearm training in a polytrauma patient population.

Methods

The medical records, stored in the Armed Forces Health Longitudinal Technology Application (AHLTA), of all patients who received rehabilitative care at the Center for the Intrepid (CFI) to include VRE-based firearms training between 01OCT2015 and 01AUG2016 were manually reviewed for inclusion. Subjects included all adult (18 years and older) SMs (active duty at time of admission) with a diagnosis of polytrauma who had been referred to and treated (received additional services such as physical and or occupational therapy) at the CFI. Approval for this research was received from the Brooke Army Medical Center Department of Clinical Investigation Office of the Institutional Review Board.

Results

Medical records of 30 SMs with a polytrauma diagnosis met the inclusion criteria. Mean shot group sizes for the M9 and M4 weapon decreased between initial and post training time points for the M9 zero (p = 0.009) and M4 zero (p = 0.020). There was no significant difference between initial and post training time points at the other shooting distances with either weapon. There was an 89% qualification rate for both the M9 (n = 18) and M4 (n = 19) weapons for those who attempted qualification; 43% of the population (n = 13) did not attempt qualification with either weapon.

Conclusion

SMs with polytrauma demonstrated a high rate of weapon qualification (accuracy) following VRE-based firearm training. Shot group size (precision) at short distances with a M9 pistol and M4 rifle also improved with training. While overall marksmanship appeared to improve, high return to duty rates were not directly related to firearm training or marksmanship. Future efforts need to focus on consistent clinical documentation of firearm training procedure and the establishment of psychometric properties for marksmanship outcome measures.
A multiwavelength analysis of a collection of short-duration GRBs observed between 2012 and 2015
Authors: Pandey S B , Hu Y , Castro-Tirado Ao J , Pozanenko A S , Sánchez-Ramírez R , Gorosabel J , Guziy S , Jelinek M , Tello J C , Jeong S , Oates S R , Zhang B-B , Mazaeva E D , Volnova A A , Minaev P Yu , van Eerten H J , Caballero-García M D , Pérez-Ramírez D , Bremer M , Winters J-M , Park I H , Guelbenzu A Nicuesa , Klose S , Moskvitin A , Sokolov V V , Sonbas E , Ayala A , Cepa J , Butler N , Troja E , Chernenko A M , Molkov S V , Volvach A E , Inasaridze R Ya , Egamberdiyev Sh A , Burkhonov O , Reva I V , Polyakov K A , Matkin A A , Ivanov A L , Molotov I , Guver T , Watson A M , Kutyrev A , Lee W H , Fox O , Littlejohns O , Cucchiara A , Gonzalez J , Richer M G , Román-Zúñiga C G , Tanvir N R , Bloom J S , Prochaska J X , Gehrels N , Moseley H , de Diego J A , Ramírez-Ruiz E , Klunko E V , Fan Y , Zhao X , Bai J , Wang Ch , Xin Y , Cui Ch , Tungalag N , Peng Z-K , Kumar Amit , Gupta Rahul , Aryan Amar , Kumar Brajesh , Volvach L N , Lamb G P , Valeev A F
Published: February 2019

We investigate the prompt emission and the afterglow properties of short-duration gamma-ray burst (sGRB) 130603B and another eight sGRB events during 2012–2015, observed by several multiwavelength facilities including the Gran Canarias Telescope 10.4 m telescope. Prompt emission high energy data of the events were obtained by INTEGRAL-SPI-ACS, Swift-BAT, and Fermi-GBM satellites. The prompt emission data by INTEGRAL in the energy range of 0.1–10 MeV for sGRB 130603B, sGRB 140606A, sGRB 140930B, sGRB 141212A, and sGRB 151228A do not show any signature of the extended emission or precursor activity and their spectral and temporal properties are similar to those seen in case of other short bursts. For sGRB 130603B, our new afterglow photometric data constrain the pre-jet-break temporal decay due to denser temporal coverage. For sGRB 130603B, the afterglow light curve, containing both our new and previously published photometric data is broadly consistent with the ISM afterglow model. Modeling of the host galaxies of sGRB 130603B and sGRB 141212A using the LePHARE software supports a scenario in which the environment of the burst is undergoing moderate star formation activity. From the inclusion of our late-time data for eight other sGRBs we are able to: place tight constraints on the non-detection of the afterglow, host galaxy, or any underlying ‘kilonova’ emission. Our late-time afterglow observations of the sGRB 170817A/GW170817 are also discussed and compared with the sub-set of sGRBs.
3D simulations of planet trapping at disc–cavity boundaries
Authors: Romanova M M , Lii P S , Koldoba A V , Ustyugova G V , Blinova A A , Lovelace R V E , Kaltenegger L
Published: February 2019

Inward migration of low-mass planets and embryos of giant planets can be stopped at the disc–cavity boundaries due to co-orbital corotation torque. We performed the first global three-dimensional (3D) simulations of planet migration at the disc–cavity boundary, and have shown that the boundary is a robust trap for low-mass planets and embryos. A protoplanetary disc may have several such trapping regions at various distances from the star, such as at the edge of the stellar magnetosphere, the inner edge of the dead zone, the dust-sublimation radius and the snow lines. Corotation traps located at different distances from a star, and moving outward during the disc dispersal phase, may possibly explain the observed homogeneous distribution of low-mass planets with distance from their host stars.
The Interdependence of Motor and Social Skill Development: Influence on Participation
Authors: Holloway Jamie M , Long Toby M
Published: February 2019

Participation is a major outcome area for physical therapists serving young children with disabilities. Contemporary models of disability such as the International Classification of Function, developmental theories such as the system perspective, and evidence-based early childhood practices recognize the interdependence of developmental domains, and suggest that change in 1 area of development influences change in another. Physical therapy provided in naturally occurring activities and routines, considered the preferred service delivery method, promotes participation of young children with disabilities. Research indicates that: (1) children develop skills, become independent, and form relationships through participation; and (2) with developing skills, children can increasingly participate. The purpose of this Perspective article is to synthesize the literature examining the relationship between motor skill development and the social interaction dimension of participation in young children. Current research examining the influence of motor skill development on social interactions in children with autism spectrum disorder will be discussed, exemplifying the interdependence of developmental domains. Implications for physical therapist practice and recommendations for future research are provided.
Head MagnetoMyography (hMMG): a novel approach to monitor face and whole-head muscular activity
Authors: Barchiesi Guido , Demarchi Gianpaolo , Wilhelm Frank H. , Hauswald Anne , Sanchez Gaëtan , Weisz Nathan , Barchiesi Guido
Published: February 2019

Muscular activity recording is of high basic science and clinical relevance and is typically achieved using electromyography (EMG). While providing detailed information about the state of a specific muscle, this technique has limitations such as the need for a-priori assumptions about electrode placement and difficulty with recording muscular activity patterns from extended body areas at once. For head and face muscle activity, the present work aimed to overcome these restrictions by exploiting magnetoencephalography (MEG) as a whole-head myographic recorder (head magnetomyography, hMMG). This is in contrast to common MEG studies, which treat muscular activity as artifact in electromagnetic brain activity. In a first proof-of-concept step, participants imitated emotional facial expressions performed by a model. Exploiting source projection algorithms, we were able to reconstruct muscular activity, showing spatial activation patterns in accord with the hypothesized muscular contractions. Going one step further, participants passively observed affective pictures with negative, neutral, or positive valence. Applying multivariate pattern analysis to the reconstructed hMMG signal, we were able to decode above chance the valence category of the presented pictures. Underlining the potential of hMMG, a searchlight analysis revealed that generally neglected neck muscles exhibit information on stimulus valence. Results confirm the utility of hMMG as a whole-head electromyographic recorder to quantify muscular activation patterns including muscular regions that are typically not recorded with EMG. This key advantage beyond conventional EMG has substantial scientific and clinical potential.
Male evolution under relaxed selection: Evidence for degeneration in sperm produced by male snails from asexual lineages
Authors: Jalinsky Joseph , Logsdon John M. , Neiman Maurine
Published: February 2019

How drastic changes in selective regimes affect trait evolution is an important open biological question. We take advantage of naturally occurring and repeated transitions from sexual to asexual reproduction in a New Zealand freshwater snail species to address how relaxed selection on male-specific traits influences sperm morphology. The occasional production of male offspring by the otherwise all-female asexual lineages allows a unique and powerful opportunity to assess the fate of sperm traits in a context where males are unnecessary. These comparisons revealed that the sperm produced by “asexual” males are markedly distinct from sexual counterparts. In particular, the asexual male sperm harbored markedly higher phenotypic variation and was much more likely to be morphologically abnormal. Together, these data suggest that transitions to asexual reproduction might be irreversible at least in part because male function is likely to be compromised. More broadly, our results are consistent with a scenario where relaxed selection translates into rapid trait degeneration.
Interplay between historical and current features of the cityscape in shaping the genetic structure of the house mouse (Mus musculus domesticus) in Dakar (Senegal, West Africa)
Authors: Stragier Claire , Piry Sylvain , Loiseau Anne , Kane Mamadou , Sow Aliou , Niang Youssoupha , Diallo Mamoudou , Ndiaye Arame , Gauthier Philippe , Borderon Marion , Granjon Laurent , Brouat Carine , Berthier Karine
Published: February 2019

Abstract

Population genetic approaches may be used to investigate dispersal patterns of species living in highly urbanized environment in order to improve management strategies for biodiversity conservation or pest control. However, in such environment, population genetic structure may reflect both current features of the cityscape and urbanization history. This can be especially relevant when focusing on exotic commensal rodents that have been introduced in numerous primary colonial European settlements. Accounting for spatial and temporal cityscape heterogeneity to determine how past and recent demographic events may interplay to shape current population genetic structure of synanthropic rodents may provide useful insights to manage their populations. In this study, we addressed these issues by focusing on the house mouse,Mus musculus domesticus, in Dakar, Senegal, where the species may have been introduced as soon as Europeans settled in the middle of the nineteenth century. We examined genetic variation at one mitochondrial locus and 15 nuclear microsatellite markers from individuals sampled in 14 sampling sites representing different stages of urbanization history and different socio-economic environments in Dakar. We used various approaches, including model-based genetic clustering and model-free smoothing of pairwise genetic estimates. We further linked observed spatial genetic patterns to historical and current features of Dakar cityscape using random forest and Bayesian conditional autoregressive models. Results are consistent with an introduction of the house mouse at colonial time and the current genetic structure exhibits a gradient-like pattern reflecting the historical process of spatially continuous expansion of the city from the first European settlement. The genetic patterns further suggest that population dynamics of the house mouse is also driven by the spatial heterogeneity of the current cityscape, including socio-economics features, that translate in habitat quality. Our results highlight the potential importance of accounting for past demographic events to understand spatial genetic patterns of nonnative invasive commensal rodents in highly urbanized environment.
Polymodal Sensory Thalamic Inputs to the Rat Lateral Amygdala are Facilitated by Chronic Ethanol Exposure and Regulate Withdrawal-associated Anxiety
Authors: Morales Melissa , McGinnis Molly M. , Chappell Ann M. , Parrish Brian C. , McCool Brian A.
Published: February 2019

Thalamic projections to the lateral amygdala regulate the acquisition of conditioned aversive and reward-related behaviors. Recent work suggests that exposure to chronic ethanol up-regulates presynaptic function of lateral amygdala stria terminalis inputs which contain projections from somatosensory thalamic nuclei. To understand potential contributions by thalamic inputs and their role in the expression of withdrawal-associated aversive behaviors, we integrated optogenetic and chemogenetic approaches with in vitro measures of synaptic function and anxiety-like behavior. We found that expression of Channelrhodopsin in the caudal extension of the posterior thalamic group (cPO) produced monosynaptic glutamatergic synaptic responses in lateral amygdala principal neurons that could be inhibited by co-expression of the hM4-Gi-DREADD. Chronic ethanol exposure increased glutamate release from these cPO terminals but did not impact inhibition by the DREADD agonist, CNO. Systemic injection of CNO specifically reduced withdrawal-related increases in anxiety-like behaviors in animals expressing the Gi-DREADD in cPO. And, microinjection of CNO directly into the lateral amygdala mimicked this anti-anxiety effect. These findings suggest that the cPO-LA circuit is vulnerable to chronic ethanol exposure and plays an important role in regulating anxiety-like behavior following chronic ethanol exposure.
Women’s Decision-Making Autonomy and ICT Utilization on Access to Antenatal Care Services: Survey Results From Jinja and Kampala Cities, Uganda
Authors: Namatovu Hasifah K. , Oyana Tonny J. , Lubega Jude T.
Published: February 2019

There is growing evidence in Uganda that the non-attendance of antenatal care is largely influenced by the lack of decision-making autonomy, inadequate information and poor services offered in health facilities. Although previous studies have examined barriers and facilitators of antenatal care, a few of them have investigated the extent of decision making autonomy and ICT adoption among expectant mothers. A cross sectional design through focus group discussions and survey questionnaires was used to collect data. Three hundred and twenty households were randomly sampled in Kampala and Jinja districts. The Chi-square tests (χ2) for independence to analyze group differences among women’s socio-demographic characteristics and decision-making autonomy was used. Inclusion criteria included respondents aged 18 and 50 years, completion of primary school education, expectant mothers and mothers who gave birth two years prior to the study. A hundred and sixty-four respondents participated in this survey. About 59.5% of women lacked decision making autonomy. Midwives (37.6%) and village health teams (35%) were a major source of antenatal care information, and 49.5% of expectant mothers lacked ANC information. Ninety percent (90%) of mothers did not use any form of ICT’s to enhance their decisions yet 79% possessed mobile phones. We observed a strong association between antenatal care decision-making autonomy and women with higher education (χ2 = 8.63, ρ = 0.035), married (χ2 = 4.1, ρ = 0.043) and mature (36–50) (χ2 = 8.81, ρ = 0.032). The main findings in this study suggest that ICT adoption and decision making autonomy among expectant mothers is still low and less appreciated. Control measures and interventions should be geared towards empowering women to influence their decisions.
Exploiting the “survival of the likeliest” to enable evolution-guided drug design
Authors: Liu Chuan , Leighow Scott M. , Inam Haider , Zhao Boyang , Pritchard Justin R.
Published: February 2019

Theoretical treatments of evolutionary dynamics tend to model the probability that a single “resistant” species will arise in a population. However, experimental studies have identified a diversity of mutations that can lead to genetic resistance. By quantitatively predicting mutations that occur across an entire drug target during treatment, we identify and bridge a fundamental gap in drug resistance theory: that nucleotide/codon substitution biases can dictate which resistant variants arise in the clinic. We find that the likeliest mutation can beat the most resistant mutation. This creates a new paradigm in drug resistance that we term“survival of the likeliest”. We use epidemiological evidence in leukemia, isogenic experiments, stochastic dynamics, and large-scale simulations to support this theory. In addition, this work has strong implications for drug design because not all resistance liabilities are created equal. In pathogenic populations that exhibit survival of the likeliest, exploiting the least likely evolutionary path can minimize resistance across a population during widespread drug use, even when a vulnerability-free molecule or combination cannot be made.

Data and Code Availability

https://github.com/pritchardlabatpsu/SurvivalOfTheLikeliest/