bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultra‐low frequency magnetic field probe for field measurements in gradient coils during medical device testing
Authors: Attaran A. , Wawrzyn C.M. , Handler W.B. , Chronik B.A.
Published: April 2019

In this Letter ultra‐low frequency probes for measuring time‐varying magnetic field produced in gradient coils were designed, fabricated, and tested. A 1 cm radius induction loop antenna followed by an instrumentational amplifier with a gain of 40 dB and a cutoff frequency of 30 KHz was designed to measure the magnetic field. The probe was fabricated on a single‐sided PCB, FR4 of thickness 1.57 mm and copper of thickness 35 μm was employed in a dB/dt exposure system within a saline phantom using 3D printed waterproofed cover. Simulation and measurement results of the magnetic field were in good agreements.
VCSEL pumped VECSEL concept with compact design
Authors: Herper M. , van der Lee A. , Kolb J. , Gronenborn S. , Moench H. , Loosen P.
Published: April 2019

The authors present a new compact optically pumped vertical external‐cavity surface‐emitting laser (OP‐VECSEL), which consists of an optically pumped semiconductor chip surrounded by vertical‐cavity surface‐emitting laser (VCSEL) chips mounted together on one heat sink. This configuration allows to reach 10 W optical output power in single‐mode operation with a very compact design. Furthermore, the authors reveal further improvements, which lead to a compact laser module with high power, highest beam quality and potentially low manufacturing costs.
Perturbation theory to model shielding effectiveness of cavities loaded with electromagnetic dampeners
Authors: Campione Salvatore , Reines Isak C. , Warne L. K. , Grimms Caleb , Williams Jeffery T. , Gutierrez Roy K. , Coats Rebecca S. , Basilio Lorena I.
Published: April 2019

It is well‐known that a slotted resonant cavity with high‐quality factor exhibits interior electromagnetic (EM) fields that may be even larger than the external field. The authors aim to reduce the cavity's EM fields and quality factor over a frequency band analytically, numerically, and experimentally by introducing microwave absorbing materials in the cavity. A perturbation model approach was developed to estimate the quality factor of loaded cavities, which is validated against full‐wave simulations and experiments. Results with 78.7 mils (2 mm) thick ECCOSORB‐MCS absorber placed on the inside cavity wall above and below the aperture slot (with only 0.026% cavity volume) result in a reduction of shielding effectiveness >19 dB and reductions in quality factor >91%, providing confirmation of the efficacy of this approach.
Automatic detection of sleep apnea events based on inter‐band energy ratio obtained from multi‐band EEG signal
Authors: Saha Suvasish , Bhattacharjee Arnab , Fattah Shaikh Anowarul
Published: April 2019

Sleep apnea is a potentially serious sleep disorder characterised by abnormal pauses in breathing. Electroencephalogram (EEG) signal analysis plays an important role for detecting sleep apnea events. In this research work, a method is proposed on the basis of inter‐band energy ratio features obtained from multi‐band EEG signals for subject‐specific classification of sleep apnea and non‐apnea events. The K‐nearest neighbourhood classifier is used for classification purpose. Unlike conventional methods, instead of classifying apnea patient and healthy person, the objective here is to differentiate apnea and non‐apnea events of an apnea patient, which makes the task very challenging. Extensive experimentation is carried out on EEG data of several subjects obtained from a publicly available database. Comprehensive experimental results reveal that the proposed method offers very satisfactory classification performance in terms of sensitivity, specificity and accuracy.
Stochastic optimal transmission switching considering the correlated wind power
Authors: Zhang Heng , Cheng Haozhong , Zhang Shenxi
Published: April 2019

Optimal transmission switching (OTS) is widely used in mitigating transmission congestion and reducing power losses. However, with large‐scale renewable energy integration to the grid, making a decision for the randomness characteristic of renewable energy (e.g. wind and solar power) is complicated in OTS. In this study, a novel stochastic optimal power flow‐based point estimation method (PEM) is presented to model the uncertainties of wind power and load in OTS. Polynomial normal transformation is introduced to handle the correlations between random variables, and percentile matching method is employed to obtain the coefficients of polynomial normal transformation, which can avoid the integral operation. Moreover, the expected value of power flow obtained by the PEM is applied to the presented model to control the line overload risk. Two indexes, namely, population sample mean and mean of population sample standard deviation, are proposed to investigate the effect of correlations on OTS strategies. The proposed model is finally transformed into a mixed‐integer second‐order cone programming to consider bus voltage and reactive power, and the modified IEEE RTS 24‐bus system and IEEE 118 system are presented to test the model.
Predictive auto‐reclosure approach to enhance transient stability of grid‐connected DGs
Authors: Abedini Moein , Sanaye‐Pasand Majid , Davarpanah Mahdi , Lesani Hamid , Shahidehpour Mohammad
Published: April 2019

This study introduces a predictive auto‐reclosure scheme based on faster‐than‐real‐time (FTRT) analysis for synchronous generator type of distributed generation (DG) units to decrease DG oscillations after successful reclosure and also enhance transient stability margin of the unit after unsuccessful reclosure. The FTRT analysis, as a new concept for the protective relaying, represents a powerful predictive auto‐reclosure scheme which is based on a state‐space model of the DG unit. After a fault scenario and the first operation of the associated breaker, the FTRT analysis predicts energy level of the DG unit and determines an optimum dead‐time corresponding to the minimum energy level of the DG unit for reclosure that can provide an appropriate margin for transient stability. The effectiveness and accuracy of the proposed method are verified based on a test system. The results confirm that the proposed approach can effectively enhance transient stability for unsuccessful reclosure and reduce the corresponding oscillations after reclosure.
Accurate fault location and faulted section determination based on deep learning for a parallel‐compensated three‐terminal transmission line
Authors: Mirzaei Mahdi , Vahidi Behrooz , Hosseinian Seyed Hossein
Published: April 2019

Parallel flexible AC transmission systems (FACTS) devices affect the performance of protection relays and conventional phasor‐based fault location schemes in transmission lines. This study focuses on both multi‐terminal and parallel‐compensated lines, not investigated simultaneously in previous works. An algorithm based on deep neural networks is proposed for fault location in a three‐terminal transmission line with the presence of parallel FACTS device. The line model and fault occurrence are simulated in SIMULINK and features are extracted from voltages at the three terminals by wavelet transform. The generated features are used to train a deep neural network which determines faulted line section and fault distance simultaneously. The adopted intelligence‐based approach has the advantage of not requiring pre‐knowledge of line specifications, FACTS devices modelling and the uncertainty in compensator parameters. A large number of fault scenarios are investigated. The faulted section is recognised correctly in 100% of test cases. The algorithm performance is acceptable for both symmetrical and unsymmetrical fault types, small fault inception angles and high fault resistance. The accuracy of fault location is improved compared to previous schemes (total mean error of 0.0993%). The proposed algorithm provides an accurate, fast and robust tool for fault location in parallel‐compensated three‐terminal transmission lines.
TDD‐net: a tiny defect detection network for printed circuit boards
Authors: Ding Runwei , Dai Linhui , Li Guangpeng , Liu Hong
Published: April 2019

Tiny defect detection (TDD) which aims to perform the quality control of printed circuit boards (PCBs) is a basic and essential task in the production of most electronic products. Though significant progress has been made in PCB defect detection, traditional methods are still difficult to cope with the complex and diverse PCBs. To deal with these problems, this article proposes a tiny defect detection network (TDD‐Net) to improve performance for PCB defect detection. In this method, the inherent multi‐scale and pyramidal hierarchies of deep convolutional networks are exploited to construct feature pyramids. Compared with existing approaches, the TDD‐Net has three novel changes. First, reasonable anchors are designed by using k‐means clustering. Second, TDD‐Net strengthens the relationship of feature maps from different levels and benefits from low‐level structural information, which is suitable for tiny defect detection. Finally, considering the small and imbalance dataset, online hard example mining is adopted in the whole training phase in order to improve the quality of region‐of‐interest (ROI) proposals and make more effective use of data information. Quantitative results on the PCB defect dataset show that the proposed method has better portability and can achieve 98.90% mAP, which outperforms the state‐of‐arts. The code will be publicly available.
Channel‐wise attention model‐based fire and rating level detection in video
Authors: Wu Yirui , He Yuechao , Shivakumara Palaiahnakote , Li Ziming , Guo Hongxin , Lu Tong
Published: April 2019

Due to natural disaster and global warning, one can expect unexpected fire, which causes panic among people and extent to death. To reduce the impact of fire, the authors propose a new method for predicting and rating fire in video through deep‐learning models in this work such that rescue team can save lives of people. The proposed method explores a hybrid deep convolutional neural network, which involves motion detection and maximally stable extremal region for detecting and rating fire in video. Further, the authors propose to use a channel‐wise attention mechanism of the deep neural network for detecting rating of fire level. Experimental results on a large dataset show the proposed method outperforms the existing methods for detecting and rating fire in video.
Krankheitskosten – Summieren sich die Krankheitskosten bei
multiplen psychiatrischen Erkrankungen?
Authors: Fietz Cornelia
Published: April 2019

Broder MS et al. Health Care Resource Use, Costs, and Diagnosis Patterns in
Patients With Schizophrenia and Bipolar Disorder: Real-world Evidence From US
Claims Databases. Clin Ther 2018; 40(10): 1670–1682

Schizophrenie und bipolare Störung sind schwerwiegende psychiatrische
Erkrankungen, die trotz eigener ICD-Klassifikation nicht immer klar
voneinander abzugrenzen sind. Bei vielen Patienten überlappen die Symptome
beider Krankheitsbilder. Die Autoren untersuchen Diagnose-Muster,
Ressourcenverbrauch und Krankheitskosten bei Patienten mit Schizophrenie und
bipolarer Störung allein und in Kombination.
Ambulante Pflege – Wodurch zeichnet sich gute ambulante
Pflege aus?
Authors: Thiem Helena
Published: April 2019

Lehnert T et al. Preferences for home- and community-based long-term care
services in Germany: a discrete choice experiment. Eur J Health Econ 2018;
19:1213–1223

Die alternde Gesellschaft in Deutschland verursacht viele ökonomische wie
soziale Veränderungen. Insbesondere im Bereich der Pflege sind zukünftig
weitere Versorgungsdefizite zu erwarten. Dabei ist es der Wunsch vieler
Betroffener, möglichst lange in ihren „eigenen vier Wänden“ gepflegt zu
werden. Die Autoren untersuchen, welche Präferenzen Pflegebedürftige in
Bezug auf eine ambulante Langzeitpflege haben.
Serious Games in Health Professions Education: Review of Trends and Learning Efficacy
Authors: Haoran Gong , Bazakidi Eleni , Zary Nabil
Published: April 2019

Objectives: To provide an overview of research trends and a review regarding the learning efficacy of serious games for health professions education taking into account short-term learning outcomes.

Methods: For the review of research trends, we performed the search on Web of Science from 1996 until the present. For the scoping review on learning efficacy, ERIC, Education Source, PsychINFO, Global Health, CINAHL, Web Of Science, and Medline were searched.

Results: The publications trend is characterized by three phases: (i) an exploratory phase up to 2006, (ii) an early growth from 2007 to 2012, and (iii) a development phase from 2013 onwards. A total of 25 studies were identified in the scoping review. Sixteen had both pre-test and post-test, all of them showed significant improvement in learning scores after the use of serious games. Eighteen publications conducted controlled experiments, of which 14 indicated that post-test scores after serious games were significantly higher than with conventional teaching methods. The review revealed the lack of integration of affective learning with other competencies, as well as the need for serious games targeting postgraduate education.

Conclusion: Serious games research remains emergent. Using serious games for health professions education seems efficacious for short-term learning. Addressing more competencies and health professionals across the education continuum is needed before generalizable definitive statements can be made.
Quantum transport in zigzag graphene nanoribbons in the presence of vacancies
Authors: Kan Zhe , Khatun Mahfuza , Cancio Antonio
Published: April 2019

The effect of vacancies on electronic properties of a zigzag graphene nanoribbon is studied. Vacancies are created by removing carbon atoms on the edge and in the bulk. A tight-binding Huckel model and Green's function methodology are employed to calculate conductance, total density of states, and local density of states (LDOS). The results show interesting behaviors that are notably different from the perfect ribbon, including transmission zeros and modulation in conductance, and changes in the LDOS of neighboring atoms, indicating the formation of localized states. A drop in the highest conductance step by a unit of 2 e2/h is observed for all cases, suggesting the loss of a transmission mode with creation of a vacancy. Interestingly, large increases in LDOS of individual atoms are found at the same energy as transmission zeros or dips in conductance near the Fermi energy. These changes can be shown to be localized near the vacancy, suggesting the formation of localized states that may be causing the conductance dips because of destructive interference between channels.
Blow-up solutions of Helmholtz equation for a Kerr slab with a complex linear and nonlinear permittivity
Authors: Kalantarov Varga , Mostafazadeh Ali , Oflaz Neslihan
Published: April 2019

We show that the Helmholtz equation describing the propagation of transverse electric waves in a Kerr slab with a complex linear permittivity εl and a complex Kerr coefficient σ admits blow-up solutions, provided that the real part of σ is negative, i.e., the slab is defocusing. This result applies to homogeneous as well as inhomogeneous Kerr slabs if εl and σ are continuous functions of the transverse coordinate, and the real part of σ is bounded above by a negative number. It shows that a recently reported nonlinear optical amplification effect, which relies on the existence of blow-up solutions, persists the presence of losses and transverse inhomogeneities.
Coherent nonlinear oscillations in magnetohydrodynamic plasma
Authors: Mukherjee Rupak , Ganesh Rajaraman , Sen Abhijit
Published: April 2019

Single fluid magnetohydrodynamic (MHD) equations have been studied through direct numerical simulations using pseudospectral methods in two as well as three spatial dimensions. At Alfvén resonance, a reversible periodic exchange of energy between kinetic and magnetic variables is observed. The oscillations are identified as nonlinear dispersionless Alfvén waves that have been predicted earlier on theoretical grounds but not observed in large scale numerical simulations. A systematic study of their occurrence for various initial conditions and a range of Alfvén velocities is carried out. An analysis based on a finite mode representation of the incompressible single fluid MHD equations in two spatial dimensions reproduces the essential features of these oscillations.
Demonstration of mechanically exfoliated β-Ga2O3/GaN p-n heterojunction
Authors: Montes Jossue , Yang Chen , Fu Houqiang , Yang Tsung-Han , Fu Kai , Chen Hong , Zhou Jingan , Huang Xuanqi , Zhao Yuji
Published: April 2019

This work demonstrates the construction of p-n heterojunctions between mechanically exfoliated beta-phase gallium oxide (β-Ga2O3) and p-GaN. The detailed mechanical exfoliation process was developed and can be used for further device applications. The atomic force microscopy study showed that the exfoliated β-Ga2O3 flakes had a very smooth surface with a roughness of 0.65 nm. Transmission electron microscopy revealed a clearly defined interface between the exfoliated β-Ga2O3 and p-GaN. The p-n heterojunction exhibited a turn-on voltage of 3.6 V and a rectification ratio of ∼105. The heterojunction also showed good thermal performance up to 200 °C. Ideality factors and turn-on voltages decrease with temperature, tending toward the ideal threshold voltage of 3.2 V as determined by Silvaco simulations. This work provides valuable information on a mechanically exfoliated β-Ga2O3/GaN p-n heterojunction, which opens up the opportunities for a variety of photonic and electronic applications.
Metaphors for language contact and change
Authors: Čičin-Šain Višnja
Published: April 2019

This chapter analyses the discursive construction of Croatian language identity and demonstrates that figurative language plays a crucial role in the process of national and linguistic (dis)identification. The ideological nature and complexity of nations and languages make both concepts highly susceptible to figuration. Based on an analysis of ninety-seven sociolinguistic texts authored by influential social actors, published from 1995 up to the present day, I propose a schematic scenario – an unacceptable language phenomenon is a danger to the nation – that both underlies puristic language ideology and indirectly sustains the status of the Croatian language as a national emblem. Conceptualizations of language contact and change in terms of drowning, colonization, illness, and poisoning constitute the core of the metaphor-based scenario, discursively construing danger to the language and nation.
The role of metonymy and metaphor in the conceptualization of the nation
Authors: Perak Benedikt
Published: April 2019

This corpus-based study presents an emergent ontological analysis of syntactic-semantic constructions of the concept nation. Using large Croatian corpora, I analysed the ontological congruence of the collocations of the lexeme nacija ‘nation’ in five types of syntactic-semantic constructions. This approach enabled a formal hierarchical description of the metaphorical conceptualization of the nation and the cognitive mechanism of eliciting reification, personification and social appraisal of the nation. Metaphorical mappings are seen as a powerful instrument for conceptualizing the institutional status of the nation, reinforcing the interaction between members, and the creation of collective identity that influences a person’s self-appraisal, and vice versa.
Metaphorical and non-metaphorical dimensions of the term nacija in Croatian online discourse
Authors: Stanojević Mateusz-Milan
Published: April 2019

In this chapter I argue that the Croatian term nacija ‘nation’ exhibits local rather than global metaphoricity. The study is based on 990 concordances of nacija from the hrWaC corpus of online Croatian, combined with several threads focusing on the notion of the nation from an online forum. Metaphors account for one quarter of the corpus examples. They are related to the non-metaphorical aspects of meaning through motivational links, depend on the conceptual characteristics of the grammatical constructions in which they appear, and on conventional extensions of source-domain terms. Forum participants use metaphors to serve current communicative purposes. It is shown that global organizational conceptual metaphors are a sum of local conceptualizations.
Two-particle quantum correlations in stochastically-coupled networks
Authors: de J León-Montiel Roberto , Méndez Vicenç , Quiroz-Juárez Mario A , Ortega Adrian , Benet Luis , Perez-Leija Armando , Busch Kurt
Published: April 2019

Quantum walks in dynamically-disordered networks have become an invaluable tool for understanding the physics of open quantum systems. Although much work has been carried out considering networks affected by diagonal disorder, it is of fundamental importance to study the effects of fluctuating couplings. This is particularly relevant in materials science models, where the interaction forces may change depending on the species of the atoms being linked. In this work, we make use of stochastic calculus to derive a master equation for the dynamics of one and two non-interacting correlated particles in tight-binding networks affected by off-diagonal dynamical disorder. We show that the presence of noise in the couplings of a quantum network creates a pure-dephasing-like process that destroys all coherences in the single-particle Hilbert subspace. Moreover, we show that when two or more correlated particles propagate in the network, coherences accounting for particle indistinguishability are robust against the impact of off-diagonal noise, thus showing that it is possible, in principle, to find specific conditions for which many indistinguishable particles can traverse stochastically-coupled networks without losing their ability to interfere.
Calculation of the wide-angle neutron spectra from the 9Be(d, xn) reaction in a thick beryllium target *
Authors: Wei Zheng , Wang Jun-Run , Zhang Ya-Ling , Huang Zhi-Wu , Ma Zhan-Wen , Zhang Jie , Ding Yan-Yan , Xia Li , Li Jian-Yi , Lu Xiao-Long , Zhang Yu , Xu Da-Peng , Yang Lei , Yao Ze-En
Published: April 2019

The multi-layer computing model is developed to calculate wide-angle neutron spectra, in the range from 0° to 180° with a 5° step, produced by bombarding a thick beryllium target with deuterons. The double-differential cross-sections (DDCSs) for the 9Be(d, xn) reaction are calculated using the TALYS-1.8 code. They are in agreement with the experimental data, and are much better than the PHITS-JQMD/GEM results at 15° , 30° , 45° and 60° neutron emission angles for deuteron energy of 10.0 MeV. In the TALYS-1.8 code, neutron contributions from direct reactions (break-up, stripping and knock-out reactions) are controlled by adjustable parameters, which describe the basic characteristics of typical direct reactions and control the relative intensity and the position of the ridgy hillock at the tail of DDCSs. It is found that the typical calculated wide-angle neutron spectra for different neutron emission angles and neutron angular distributions agree quite well with the experimental data for 13.5 MeV deuterons. The multi-layer computing model can reproduce the experimental data reasonably well by optimizing the adjustable parameters in the TALYS-1.8 code. Given the good agreement with the experimental data, the multi-layer computing model could provide better predictions of wide-angle neutron energy spectra, neutron angular distributions and neutron yields for the 9Be(d, xn) reaction neutron source.
Geometric anisotropy on biomaterials surface for vascular scaffold design: engineering and biological advances
Authors: Wang Zuyong , Zhang Wanqi , Xie Chao , Wen Feng , Ma Chao , Lin Nan , Thian Eng San , Wang Xianwei
Published: April 2019

Scaffold designs in combination with drug, growth factor and other bioactive chemicals account for lasting progress of vascular tissue engineering in the past decades. It is a great achievement to adjust tissue matrix composition and cell behaviour effectively. However, regenerating the innate physiologies of a blood vessel still needs its precise architecture to supply the vessel with structural basis for vascular functionality. Recent developments in biomaterial engineering have been explored in designing anisotropic surface geometries, and in turn to direct biological effects for recapitulating vascular tissue architecture. Here, we present current efforts, and propose future perspectives for the guidance on the architectural reconstruction and scaffold design of blood vessel.
Reading: A Very Short Introduction
Authors: Jack Belinda
Published: April 2019

Reading: A Very Short Introduction explores the fascinating history of literacy and the opportunities reading opens. For much of human history reading was the preserve of the elite, and most reading meant being read to. Innovations in printing, paper-making, and transport, combined with increased public education, brought a boom in worldwide literacy from the late 18th century. Established links between a nation’s levels of literacy and its economy led to the promotion of reading for political ends. Reading has also been associated with subversive ideas, leading to censorship. Telling the story of reading, its ambiguities and complexities, from the ancient world to digital reading and restrictions today, this VSI explores why it is such an important aspect of our society.
Comparative assessment of long-read error correction software applied to Nanopore RNA-sequencing data
Authors: Lima Leandro , Marchet Camille , Caboche Ségolène , Da Silva Corinne , Istace Benjamin , Aury Jean-Marc , Touzet Hélène , Chikhi Rayan
Published: April 2019

Motivation

Nanopore long-read sequencing technology offers promising alternatives to high-throughput short read sequencing, especially in the context of RNA-sequencing. However this technology is currently hindered by high error rates in the output data that affect analyses such as the identification of isoforms, exon boundaries, open reading frames and creation of gene catalogues. Due to the novelty of such data, computational methods are still actively being developed and options for the error correction of Nanopore RNA-sequencing long reads remain limited.

Results

In this article, we evaluate the extent to which existing long-read DNA error correction methods are capable of correcting cDNA Nanopore reads. We provide an automatic and extensive benchmark tool that not only reports classical error correction metrics but also the effect of correction on gene families, isoform diversity, bias toward the major isoform and splice site detection. We find that long read error correction tools that were originally developed for DNA are also suitable for the correction of Nanopore RNA-sequencing data, especially in terms of increasing base pair accuracy. Yet investigators should be warned that the correction process perturbs gene family sizes and isoform diversity. This work provides guidelines on which (or whether) error correction tools should be used, depending on the application type.

Benchmarking software

https://gitlab.com/leoisl/LR_EC_analyser
Multiple paternity and precocial breeding in wild Tasmanian devils, Sarcophilus harrisii (Marsupialia: Dasyuridae)
Authors: Russell Tracey , Lane Amanda , Clarke Judy , Hogg Carolyn , Morris Katrina , Keeley Tamara , Madsen Thomas , Ujvari Beata
Published: April 2019

Polyandry, a common reproductive strategy in various animal species, has potential female benefits, which include enhanced offspring fitness. Benefits can be direct, such as reduced risk of male infanticide of offspring, or indirect, such as increased genetic diversity of offspring and the acquisition of ‘good genes’. Multiple paternity of litters has been recorded in numerous marsupial species but has not been reported in Tasmanian devils, Sarcophilus harrisii (Boitard). We investigated whether multiple paternity occurred in litters within a wild population of Tasmanian devils. Using major histocompatibility complex-linked and neutral microsatellite markers, the paternity of nine litters was analysed. We found multiple paternity in four out of nine litters and that yearling (> 1, < 2 years old) male devils were siring offspring. This is the first record of multiple paternity and of male precocial breeding in wild Tasmanian devils. To date, there are no data relating to the subsequent survival of devils from single- vs. multiple-sired litters; therefore, we do not know whether multiple paternity increases offspring survival in the wild. These results have implications for the Tasmanian devil captive insurance programme, because group housing can lead to multiple-sired litters, making the maintenance of genetic diversity over time difficult to manage.
Use of Routine Complete Blood Count Results to Rule Out Anaplasmosis Without the Need for Specific Diagnostic Testing
Authors: Turbett Sarah E , Anahtar Melis N , Pattanayak Vikram , Azar Marwan M , Coffey K C , Eng George , Rudolf Joseph W , Lewandrowski Kent B , Baron Jason , Rosenberg Eric S , Branda John A
Published: April 2019

Background

Anaplasmosis presents with fever, headache, and laboratory abnormalities including leukopenia and thrombocytopenia. Polymerase chain reaction (PCR) is the preferred diagnostic but is overutilized. We determined if routine laboratory tests could exclude anaplasmosis, improving PCR utilization.

Methods

Anaplasma PCR results from a 3-year period, with associated complete blood count (CBC) and liver function test results, were retrospectively reviewed. PCR rejection criteria, based on white blood cell (WBC) and platelet (PLT) counts, were developed and prospectively applied in a mock stewardship program. If rejection criteria were met, a committee mock-refused PCR unless the patient was clinically unstable or immunocompromised.

Results

WBC and PLT counts were the most actionable routine tests for excluding anaplasmosis. Retrospective review demonstrated that rejection criteria of WBC ≥11 000 cells/µL or PLT ≥300 000 cells/µL would have led to PCR refusal in 428 of 1685 true-negative cases (25%) and 3 of 66 true-positive cases (5%) involving clinically unstable or immunocompromised patients. In the prospective phase, 155 of 663 PCR requests (23%) met rejection criteria and were reviewed by committee, which endorsed refusal in 110 of 155 cases (71%) and approval in 45 (29%), based on clinical criteria. PCR was negative in all 45 committee-approved cases. Only 1 of 110 mock-refused requests yielded a positive PCR result; this patient was already receiving doxycycline at the time of testing.

Conclusions

A CBC-based stewardship algorithm would reduce unnecessary Anaplasma PCR testing, without missing active cases. Although the prospectively evaluated screening approach involved medical record review, this was unnecessary to prevent errors and could be replaced by a rejection comment specifying clinical situations that might warrant overriding the algorithm.
Heartburn and dyspepsia symptom severity improves after treatment and correlates with histology in adults with eosinophilic esophagitis
Authors: Eluri Swathi , Perjar Irina , Betancourt Renee , Randall Cara , Raja Soha , Woosley John T , Shaheen Nicholas J , Dellon Evan S
Published: April 2019

Non-dysphagia symptoms, such as heartburn and dyspepsia, are poorly characterized in adults with eosinophilic esophagitis (EoE). It is unclear if treatment improves these symptoms. The aim of this paper was to assess (i) heartburn and dyspepsia symptom severity in adult EoE patients using validated symptom measures; (ii) change in symptoms after treatment; and (iii) symptom association with endoscopic and histologic features. In a prospective cohort of adult EoE patients who were not responsive to proton pump inhibitor therapy, non-dysphagia symptoms were assessed with heartburn items from the validated GERD-HRQL (gastroesophageal reflux disease health-related quality of life) and SODA (severity of dyspepsia assessment) instruments. Subjects completed the questionnaires at baseline and after treatment. Association of baseline symptoms with endoscopic and histologic features, and before and after treatment with diet or topical steroids, was assessed. Eighty-six EoE patients (mean age 39 years, 57% male, 95% white) completed a baseline questionnaire and 62 completed the follow-up questionnaire. The mean baseline GERD-HRQL score was 4.5 ± 6.5 and the mean total SODA score was 41.0 ± 12.6. At baseline, there was a weak but significant correlation between peak eosinophils and the SODA score (r = 0.28; p = 0.03) and no association between heartburn and SODA scores and endoscopic or other histologic findings. After treatment, there was a decrease in GERD-HRQL heartburn (4.3 vs. 2.6; p = 0.04) and SODA (49.5 vs. 35.5; p = 0.04) scores in histologic responders, but not in nonresponders. In a prospective cohort of EoE patients, baseline eosinophils positively correlated with dyspepsia severity. Heartburn and dyspepsia symptoms improved after treatment in histologic responders.
The other explanation for dyspnea: giant paraesophageal hiatal hernia repair routinely improves pulmonary function
Authors: Wirsching Andrea , Klevebro Fredrik , Boshier Piers R , Hubka Michal , Kuppusamy Madhan K , Kirtland Steve H , Low Donald E
Published: April 2019

Paraesophageal hiatal hernias (PEHs) are most commonly associated with gastrointestinal symptoms; less widely appreciated is their potentially important influence on respiratory function. We hypothesize that surgical repair of PEH will significantly improve not only gastrointestinal symptoms, but also preoperative dyspnea and spirometry scores. A prospective Institutional Review Board-approved database was used to review all patients undergoing PEH repair from 2000 to 2016. Patients with pre- and postoperative pulmonary function tests assessed by spirometry were included. Postoperative changes in spirometry measurements were compared to PEH size as reflected by the percentage of intrathoracic stomach observed on preoperative contrast studies. Patients were stratified according to improvement in forced expiratory volume in 1 second (FEV1). Patients with >12% (‘significant’) improvement in FEV1 after surgery were compared to the remaining patient population. In total, 299 patients met the inclusion criteria. Symptomatic improvement in respiratory function was noted in all patients after PEH repair. Age, gender, BMI, presenting symptoms, Charlson comorbidity index as well as preoperative comorbidities did not significantly impact the functional outcome. Spirometry results improved in 80% of the patients, 21% of whom showed an improvement of >20% compared to the preoperative level. ‘Significant’ improvement in respiratory function was seen in 122 of 299 (41%) patients. Patients presenting with moderate and severe preoperative pulmonary obstruction demonstrated ‘significant’ improvement in FEV1 in 48% and 40% of cases, respectively. Large PEHs, characterized by a percentage of intrathoracic stomach >75%, was strongly associated with ‘significant’ improvement in FEV1 (P = 0.001). PEHs can impact subjective and objective respiratory status and surgical repair can result in a significant improvement in dyspnea and pulmonary function score that is independent of preoperative pulmonary disease. Gastric herniation of more than 75% was associated with higher possibility for improvement of pulmonary function tests. Patients with persistent and unexplained dyspnea and coexistent PEH should be assessed by an experienced surgeon for consideration of elective repair.
WGS more accurately predicts susceptibility of Mycobacterium tuberculosis to first-line drugs than phenotypic testing
Authors: Jajou Rana , van der Laan Tridia , de Zwaan Rina , Kamst Miranda , Mulder Arnout , de Neeling Albert , Anthony Richard , van Soolingen Dick
Published: April 2019

Background

Drug-susceptibility testing (DST) of Mycobacterium tuberculosis complex (MTBC) isolates by the Mycobacteria Growth Indicator Tube (MGIT) approach is the most widely applied reference standard. However, the use of WGS is increasing in many developed countries to detect resistance and predict susceptibility. We investigated the reliability of WGS in predicting drug susceptibility, and analysed the discrepancies between WGS and MGIT against the first-line drugs rifampicin, isoniazid, ethambutol and pyrazinamide.

Methods

DST by MGIT and WGS was performed on MTBC isolates received in 2016/2017. Nine genes and/or their promotor regions were investigated for resistance-associated mutations: rpoB, katG, fabG1, ahpC, inhA, embA, embB, pncA and rpsA. Isolates that were discrepant in their MGIT/WGS results and a control group with concordant results were retested in the MGIT, at the critical concentration and a lower concentration, and incubated for up to 45 days after the control tube became positive in the MGIT.

Results

In total, 1136 isolates were included, of which 1121 were routine MTBC isolates from the Netherlands. The negative predictive value of WGS was ≥99.3% for all four first-line antibiotics. The majority of discrepancies for isoniazid and ethambutol were explained by growth at the lower concentrations, and for rifampicin by prolonged incubation in the MGIT, both indicating low-level resistance.

Conclusions

Applying WGS in a country like the Netherlands, with a low TB incidence and low prevalence of resistance, can reduce the need for phenotypic DST for ∼90% of isolates and accurately detect mutations associated with low-level resistance, often missed in conventional DST.
The Importance of the Arms Trade Treaty for the Implementation of the Sustainable Development Goals
Authors: Nave Eva
Published: April 2019

The availability, propagation and excessive accumulation of arms are a serious impediment to countries’ achievement of Sustainable Development Goals (SDGs). Irresponsible arms trade leads to permanent insecurity, which forces people to leave their homes and impacts on the diversion of funds from inter alia health, education, social–economic stability and peace-building processes to defence and the military. Goal 16 of the SDGs sets out, noting its indicator 16.4, that the significant reduction of illicit arms flows is a way to promote just, peaceful and inclusive societies. This is a target to be met by 2030. The Arms Trade Treaty (ATT), aiming at preventing and eradicating the unregulated arms flows by laying down criteria to be assessed before authorising arms transfers, is a crucial international legally binding instrument in that quest. This study advocates that, applying an integrative approach to the ATT, the potentially negative impact in the recipient country’s achievement of the SDGs is to be considered when pondering upon arms transfers.
Information of valence charge of 3d transition metal elements observed in L-emission spectra
Authors: Terauchi Masami
Published: April 2019

L-emission spectra of 3d transition metal elements from Sc to Zn and some oxides were measured to examine the relation between L-emission intensities of Lα, Lβ, Lℓ, and Lη and valences of those elements by using a soft X-ray emission spectrometer attached to a scanning electron microscope. Lα,β emission intensity due to transitions from valence bands to core 2p levels compared with Lℓ,η emission intensity due to transitions from core 3 s to deeper 2p levels, Lα,β/Lℓ,η was found to be a key parameter. A linear relation was found between the number of 3d electrons and the intensity ratio of Lα,β/(Lα,β+ Lℓ,η) from Sc to Ni, except for Cr. It takes into account not only a change in N3d but also a change of transition probability due to a change in N3d In the case of 3d metal oxides, the evaluation based on the equation showed an overestimation of the calculated number of 3d electrons, which could be due to a charge transfer from ligand oxygen atoms to the transition metal element, resulting from a core-hole effect in the intermediate state.
Integration or Isolation? Refugees’ Social Connections and Wellbeing
Authors: Strang Alison B. , Quinn Neil
Published: April 2019

The Indicators of Integration framework—a conceptual framework defining core domains of refugee integration—has had a significant impact on the discourse surrounding refugee integration and a major role in shaping policy, practice and academic debate. Drawing on an innovative participatory mapping approach, this study examined the social connections of isolated single refugee men from Iran and Afghanistan (highlighted as particularly marginalized) and the implications for their mental health and wellbeing. Findings indicated very low levels of contact with family, local friends or local services, difficulties establishing trust and few opportunities for reciprocal relationships. The article makes an important contribution to the field of refugee integration in a number of ways. It suggests that the role of trust should be made explicit within the Indicators of Integration framework and be included as a ‘Facilitator’ of integration. It challenges Putnam’s simple binary distinction between bonding and bridging relationships and suggests a new conceptualization based on a continuum between bonds and bridges. It offers theoretical innovation by bringing together the concept of reciprocity with Hobfoll’s resource-conservation model to offer new insights into the way domains of the Framework interact. Its important contribution is in critiquing Putnam’s reliance on the idealization of community solidarity and suggesting conceptualizations of integration must be informed by the impact of intersecting but differentiated communities. Two key priorities emerge for policy and practice: enabling asylum seekers and refugees to develop sufficient close bonding relationships and finding more effective ways of building knowledge and trust of relevant resources and services.
OsMADS18, a membrane-bound MADS-box transcription factor, modulates plant architecture and the abscisic acid response in rice
Authors: Yin Xiaoming , Liu Xiong , Xu Buxian , Lu Piaoyin , Dong Tian , Yang Di , Ye Tiantian , Feng Yu-Qi , Wu Yan
Published: April 2019

The APETALA1 (AP1)/FRUITFULL (FUL)-like transcription factor OsMADS18 plays diverse functions in rice development, but the underlying molecular mechanisms are far from fully understood. Here, we report that down-regulation of OsMADS18 expression in RNAi lines caused a delay in seed germination and young seedling growth, whereas the overexpression of OsMADS18 produced plants with fewer tillers. In targeted OsMADS18 genome-edited mutants (osmads18-cas9), an increased number of tillers, altered panicle size, and reduced seed setting were observed. The EYFP-OsMADS18 (full-length) protein was localized to the nucleus and plasma membrane but the EYFP-OsMADS18-N (N-terminus) protein mainly localized to the nucleus. The expression of OsMADS18 could be stimulated by abscisic acid (ABA), and ABA stimulation triggered the cleavage of HA-OsMADS18 and the translocation of OsMADS18 from the plasma membrane to the nucleus. The inhibitory effect of ABA on seedling growth was less effective in the OsMADS18-overexpressing plants. The expression of a set of ABA-responsive genes was significantly reduced in the overexpressing plants. The phenotypes of transgenic plants expressing EYFP-OsMADS18-N resembled those observed in the osmads18-cas9 mutants. Analysis of the interaction of OsMADS18 with OsMADS14, OsMADS15, and OsMADS57 strongly suggests an essential role for OsMADS18 in rice development.
A Primer on Psychotherapy Integration
Authors: Norcross John C. , Alexander Erin F.
Published: April 2019

This opening chapter explicates the broad context of psychotherapy integration and sets the stage for the subsequent chapters in the volume. As the chapter title indicates, the authors offer a primer on integration in the dual sense of a primer (soft i) as a small introduction to the subject and of a primer (hard i) as a basecoat or undercoat for the following applications. The authors describe the converging reasons for the growth of psychotherapy integration and then the four primary routes to integration. This segues into the varieties of integration, which includes summaries of recent studies on the prevalence, subtypes, and practices of integrative therapists. The chapter concludes with a discussion of recurrent obstacles to psychotherapy integration.
Integrating Research and Practice
Authors: Castonguay Louis G. , Constantino Michael J. , Xiao Henry
Published: April 2019

This chapter reviews efforts to integrate psychotherapy research and practice through collaboration and information-sharing within naturalistic clinical settings. Specifically, the chapter focuses on three types of practice-oriented research that capitalize on the bidirectional partnership between researchers and practitioners: (1) patient-focused, (2) practice-based, and (3) practice-research networks. The authors provide examples of each type of integration, highlighting the ways in which the research is different, yet complementary to more traditional studies conducted in controlled settings. They submit that the researcher–practitioner partnership in an ecologically valid treatment context represents an optimal means to reduce the pervasive research–practice chasm and to promote genuine integration for enhancing the effectiveness and personalization of psychotherapy. The chapter also discusses future directions in this vein.
MFEprimer-3.0: quality control for PCR primers
Authors: Wang Kun , Li Haiwei , Xu Yue , Shao Qianzhi , Yi Jianming , Wang Ruichao , Cai Wanshi , Hang Xingyi , Zhang Chenggang , Cai Haoyang , Qu Wubin
Published: April 2019

Quality control (QC) for lab-designed primers is crucial for the success of a polymerase chain reaction (PCR). Here, we present MFEprimer-3.0, a functional primer quality control program for checking non-specific amplicons, dimers, hairpins and other parameters. The new features of the current version include: (i) more sensitive binding site search using the updated k-mer algorithm that allows mismatches within the k-mer, except for the first base at the 3′ end. The binding sites of each primer with a stable 3′ end are listed in the output; (ii) new algorithms for rapidly identifying self-dimers, cross-dimers and hairpins; (iii) the command-line version, which has an added option of JSON output to enhance the versatility of MFEprimer by acting as a QC step in the ‘primer design → quality control → redesign’ pipeline; (iv) a function for checking whether the binding sites contain single nucleotide polymorphisms (SNPs), which will affect the consistency of binding efficiency among different samples. In summary, MFEprimer-3.0 is updated with the well-tested PCR primer QC program and it can be integrated into various PCR primer design applications as a QC module. The MFEprimer-3.0 server is freely accessible without any login requirement at: https://mfeprimer3.igenetech.com/ and https://www.mfeprimer.com/. The source code for the command-line version is available upon request.