bluuebunny/crossref_metadata_2025 huggingface dataset:
Nanosized graphene sheets enhanced photoelectric behavior of carbon film on p-silicon substrate
Authors: Yang Lei , Hu Gaijuan , Zhang Dongqing , Diao Dongfeng
Published: July 2016

We found that nanosized graphene sheets enhanced the photoelectric behavior of graphene sheets embedded carbon (GSEC) film on p-silicon substrate, which was deposited under low energy electron irradiation in electron cyclotron resonance plasma. The GSEC/p-Si photodiode exhibited good photoelectric performance with photoresponsivity of 206 mA/W, rise and fall time of 2.2, and 4.3 μs for near-infrared (850 nm) light. The origin of the strong photoelectric behavior of GSEC film was ascribed to the appearance of graphene nanosheets, which led to higher barrier height and photoexcited electron-collection efficiency. This finding indicates that GSEC film has the potential for photoelectric applications.
Microplasmas for direct, substrate-independent deposition of nanostructured metal oxides
Authors: Mackie Katherine E. , Pebley Andrew C. , Butala Megan M. , Zhang Jinping , Stucky Galen D. , Gordon Michael J.
Published: July 2016

A general, substrate-independent method for plasma deposition of nanostructured, crystalline metal oxides is presented. The technique uses a flow-through, micro-hollow cathode plasma discharge (supersonic microplasma jet) with a “remote” ring anode to deliver a highly directed flux of growth species to the substrate. A diverse range of nanostructured materials (e.g., CuO, α-Fe2O3, and NiO) can be deposited on any room temperature surface, e.g., conductors, insulators, plastics, fibers, and patterned surfaces, in a conformal fashion. The effects of deposition conditions, substrate type, and patterning on film morphology, nanostructure, and surface coverage are highlighted. The synthesis approach presented herein provides a general and tunable method to deposit a variety of functional and hierarchical metal oxide materials on many different surfaces. High surface area, conversion-type CuO electrodes for Li-ion batteries are demonstrated as a proof-of-concept example.
Giant exchange bias in Mn2FeGa with hexagonal structure
Authors: Liu Z. H. , Zhang Y. J. , Zhang H. G. , Zhang X. J. , Ma X. Q.
Published: July 2016

In this study, we present the experimental observation that polycrystalline Mn2+xFe1−xGa (x = −0.2, 0, 0.2, 0.4) compounds can be synthesized to be D019-type (Ni3Sn-type) hexagonal structure with space group P63/mmc. A giant exchange bias field up to 1.32 kOe was achieved in hexagonal Mn2FeGa alloy at 5 K. A cluster glass state is confirmed by ac susceptibility measurement under different driving frequencies. Interestingly, robust horizontal and vertical shifts in magnetic hysteresis loop were simultaneously observed at 5 K under high cooling field up to 90 kOe. The large exchange bias is originated from the large exchange anisotropy between cluster glass phase and ferrimagnetic matrix. The vertical shift is thought to be attributed to the incomplete reversal of frozen cluster spins.
Remote-sensing gas measurements with coherent Rayleigh-Brillouin scattering
Authors: Gerakis A. , Shneider M. N. , Stratton B. C.
Published: July 2016

We measure the coherent Rayleigh-Brillouin scattering (CRBS) signal integral as a function of the recorded gas pressure in He, Co2, SF6, and air, and we confirm the already established quadratic dependence of the signal on the gas density. We propose the use of CRBS as an effective diagnostic for the remote measurement of gas' density (pressure) and temperature, as well as polarizability, for gases of known composition.
Effects of exogenous nitric oxide on growth, proline accumulation and antioxidant capacity in Cakile maritima seedlings subjected to water deficit stress
Authors: Jday Asma , Ben Rejeb Kilani , Slama Ines , Saadallah Kaouthar , Bordenave Marianne , Planchais Séverine , Savouré Arnould , Abdelly Chedly
Published: July 2016

Nitric oxide (NO) – an endogenous signalling molecule in plants and animals – mediates responses to biotic and abiotic stresses. In the present study, we examined the role of exogenous application of NO in mediating stress responses in Cakile maritima Scop. seedlings under water deficit stress using sodium nitroprusside (SNP) as NO donor and as a pre-treatment before the application of stress. Water deficit stress was applied by withholding water for 14 days. Growth, leaf water content (LWC), osmotic potential (ψs), chlorophyll, malondialdehyde (MDA), electrolyte leakage (EL), proline and Δ1-pyrroline-5-carboxylate synthetase (P5CS) and proline dehydrogenase (ProDH) protein levels were determined. Enzyme activities involved in antioxidant activities (superoxide dismutase (SOD) and catalase (CAT)) were measured upon withholding water. The results showed that shoot biomass production was significantly decreased in plants subjected to water deficit stress alone. However, in water deficit stressed plants pre-treated with SNP, growth activity was improved and proline accumulation was significantly increased. Proline accumulation was concomitant with the stimulation of its biosynthesis as shown by the accumulation of P5CS proteins. Nevertheless, no significant change in ProDH protein levels was observed. Besides plants showed lower water deficit-induced lipid membrane degradation and oxidative stress after the pretreatment with 100 µM SNP. This behaviour was related to the increased activity of SOD and CAT. Thus, we concluded that NO increased C. maritima drought tolerance and mitigated damage associated with water deficit stress by the regulation of proline metabolism and the reduction of oxidative damage.
Nursery areas and connectivity of the adults anadromous catfish (Genidens barbus) revealed by otolith-core microchemistry in the south-western Atlantic Ocean
Authors: Avigliano Esteban , Carvalho Barbara , Velasco Gonzalo , Tripodi Pamela , Vianna Marcelo , Volpedo Alejandra Vanina
Published: July 2016

The anadromous catfish, Genidens barbus, is a commercial and vulnerable species from South America. The aims of the present study were to assess whether the nursery areas can be discriminated by using microchemical signatures of lapillus otoliths, to assess the accuracy of classifying fish in relation to natal nursery area and to discuss the possibility of existence of homing behaviour. Thus, the otolith-core chemical signatures (barium (Ba):calcium (Ca), lithium (Li):Ca, magnesium (Mg):Ca, manganese (Mn):Ca, strontium (Sr):Ca, and zinc (Zn):Ca ratios) of adult fish were compared among different estuaries (De La Plata River in Argentina, and Patos Lagoon, Paranaguá Bay and Guanabara Bay in Brazil). PERMANOVA analysis showed significant differences in the multi-element signatures of the otolith core among sampling sites for all cohorts (2002, 2003, 2006 and 2007), indicating that the technique has considerable potential for use in future assessments of population connectivity and nursery areas of G. barbus. Via quadratic discriminant function analysis, fish were classified to natal nursery areas with 80–100% cross-validation classification accuracies. These results suggested that a high level of spatial segregation exists in adult catfish life and homing behaviour could not be ruled out on the basis of our data.
High-severity fire reduces early successional boreal larch forest aboveground productivity by shifting stand density in north-eastern China
Authors: Cai Wen H. , Yang Jian
Published: July 2016

Climate warming is predicted to increase fire activity across the Eurasian boreal larch forest in the 21st century, which could have serious consequences on carbon storage. Quantifying the effects of fire disturbance on forest structure and aboveground net primary productivity (ANPP) could aid in our ability to predict future carbon storage on a regional and biome level. In this study, we examined the spatial heterogeneity of forest structure and ANPP on sites of varying fire severity and topographic position in a recently burned landscape in the Great Xing’an Mountains, China. Results indicated that after 11 years of vegetation regrowth, fire severity significantly affected forest regeneration ANPP. Spatial heterogeneities in forest regeneration ANPP were explained by both tree sapling density and understorey vegetation abundance. Although understorey vegetation productivity on average contributed 50% of total ANPP after fire, the increase in understorey productivity with fire severity could not offset the decrease in tree productivity in severely burned stands where tree sapling density was limited. Our results suggest that high-severity fire can decrease forest regeneration ANPP by altering forest structure in the early post-fire successional stage and that this shift in forest structure may influence future forest productivity trajectories over an extended period.
Uncalculating cooperation is used to signal trustworthiness
Authors: Jordan Jillian J. , Hoffman Moshe , Nowak Martin A. , Rand David G.
Published: July 2016

Significance

Human prosociality presents an evolutionary puzzle, and reciprocity has emerged as a dominant explanation: cooperating today can bring benefits tomorrow. Reciprocity theories clearly predict that people should only cooperate when the benefits outweigh the costs, and thus that the decision to cooperate should always depend on a cost–benefit analysis. Yet human cooperation can be very uncalculating: good friends grant favors without asking questions, romantic love “blinds” us to the costs of devotion, and ethical principles make universal moral prescriptions. Here, we provide the first evidence, to our knowledge, that reputation effects drive uncalculating cooperation. We demonstrate, using economic game experiments, that people engage in uncalculating cooperation to signal that they can be relied upon to cooperate in the future.
Constituents and functional implications of the rat default mode network
Authors: Hsu Li-Ming , Liang Xia , Gu Hong , Brynildsen Julia K. , Stark Jennifer A. , Ash Jessica A. , Lin Ching-Po , Lu Hanbing , Rapp Peter R. , Stein Elliot A. , Yang Yihong
Published: July 2016

Significance

The default mode network (DMN) has been suggested to support a variety of internal-state functions in human. Because preclinical models can be used in translational studies of neuropsychiatric disorders, investigations of the DMN in these models may aid the understanding of both physiology and pathophysiology of the human DMN. To our knowledge, this is the first study to investigate the constituents and functional implications of the rat DMN. We provide empirical evidence that the rat DMN is composed of highly connected anatomical and functional subnetworks, which show differential modulation in association with age-related cognitive dysfunction. These findings provide a framework to further explore the physiological basis and behavioral significance of the rodent DMN.
Charge transport network dynamics in molecular aggregates
Authors: Jackson Nicholas E. , Chen Lin X. , Ratner Mark A.
Published: July 2016

Significance

Time-dependent network analysis is used to describe the structural dynamics underpinning electron transport in disordered aggregates of molecular materials, advancing understanding of how charges move through noncrystalline aggregates. Specifically, our methodology allows for the characterization of how collective, dynamic fluctuations in the 3N nuclear degrees of freedom of the disordered multimolecule aggregate impact the statistically averaged charge motion through that aggregate. Our results describe the characteristic timescales over which electron hopping competes with nuclear reorganization, providing insight into the fundamental timescales governing charge transport in disordered systems.
Speed-dependent chemotactic precision in marine bacteria
Authors: Son Kwangmin , Menolascina Filippo , Stocker Roman
Published: July 2016

Significance

Our understanding of bacterial chemotaxis, a fundamental nutrient-seeking strategy in the microbial world, mainly derives from
Escherichia coli.
However, it has become clear that marine bacteria evolved fundamentally different chemotaxis adaptations, often allowing them to accumulate at resource peaks more tightly and rapidly than
E. coli
. We studied the origin of this high chemotactic precision and found that it lies in an unexpected dependence of chemotaxis on swimming speed: faster cells have substantially higher precision, counter to all known models of chemotaxis. We elucidate this finding through a combination of single-cell tracking of thousands of marine bacteria in microfluidic gradients and a mathematical model of chemotaxis that explicitly accounts for swimming speed in the chemotaxis pathway.
Bunyamwera orthobunyavirus glycoprotein precursor is processed by cellular signal peptidase and signal peptide peptidase
Authors: Shi Xiaohong , Botting Catherine H. , Li Ping , Niglas Mark , Brennan Benjamin , Shirran Sally L. , Szemiel Agnieszka M. , Elliott Richard M.
Published: July 2016

Significance

Bunyamwera virus (BUNV) is the prototype of the
Orthobunyavirus
genus and
Bunyaviridae
family that contains important human and animal pathogens. The cleavage mechanism of orthobunyavirus glycoprotein precursor (GPC) and the host proteases involved have not been clarified. Here we found that NSm and Gc contain their own internal signal peptides, which mediate the GPC cleavage by host signal peptidase and signal peptide peptidase (SPP). Furthermore, the NSm domain-I plays an important postcleavage role in cell fusion. Our data clarified the implication of host proteases in the processing of the orthobunyavirus GPC. This work identifies SPP as a potential intervention target, and the knowledge we gained will benefit preventive strategies against other orthobunyavirus infections.
Conformational selectivity in cytochrome P450 redox partner interactions
Authors: Hollingsworth Scott A. , Batabyal Dipanwita , Nguyen Brian D. , Poulos Thomas L.
Published: July 2016

Significance

Cytochrome P450 activates molecular oxygen to hydroxylate various molecules. This process requires the transfer of electrons from a redox partner, which further requires formation of a specific protein–protein complex. A question of increasing importance is whether or not the interaction between the P450 and its redox partner results in functionally important structural changes required for activity. The present work addresses the question of whether the redox partner favors binding to a specific conformer. This question is critically important in understanding how P450s activate molecular oxygen.
Spatial organization of the Ran pathway by microtubules in mitosis
Authors: Oh Doogie , Yu Che-Hang , Needleman Daniel J.
Published: July 2016

Significance

How nanometer-sized proteins produce micron-scale subcellular organization is poorly understood. Here we study the spatial organization of the ras-related nuclear protein (Ran) pathway in mitosis. Our results reveal that whereas the upstream components of this pathway are well described as a reaction-diffusion system the downstream components exhibit more complex behaviors in which their association with microtubules causes them to be enriched in the spindle region. Because the Ran pathway influences the nucleation of microtubules, this suggests the presence of feedback based on spatial localization, in which the Ran pathway generates the microtubules that localize it. We argue that such feedback between soluble signaling pathways and the cytoskeleton have functional consequences with general implications for subcellular organization.
Dual-Task Interference Effects on Cross-Modal Numerical Order and Sound Intensity Judgments: The More the Louder?
Authors: Alards-Tomalin Doug , Walker Alexander C. , Nepon Hillary , Leboe-McGowan Launa C.
Published: July 2016

In the current study, cross-task interactions between number order and sound intensity judgments were assessed using a dual-task paradigm. Participants first categorized numerical sequences composed of Arabic digits as either ordered (ascending, descending) or non-ordered. Following each number sequence, participants then had to judge the intensity level of a target sound. Experiment 1 emphasized processing the two tasks independently ( serial processing), while Experiments 2 and 3 emphasized processing the two tasks simultaneously ( parallel processing). Cross-task interference occurred only when the task required parallel processing and was specific to ascending numerical sequences, which led to a higher proportion of louder sound intensity judgments. In Experiment 4 we examined whether this unidirectional interaction was the result of participants misattributing enhanced processing fluency experienced on ascending sequences as indicating a louder target sound. The unidirectional finding could not be entirely attributed to misattributed processing fluency, and may also be connected to experientially derived conceptual associations between ascending number sequences and greater magnitude, consistent with conceptual mapping theory.
Numerical and experimental study of the redistribution of energetic and impurity ions by sawteeth in ASDEX Upgrade
Authors: Jaulmes F. , Geiger B. , Odstrčil T. , Weiland M. , Salewski M. , Jacobsen A.S. , Rasmussen J. , Stejner M. , Nielsen S.K. , Westerhof E.
Published: July 2016

In the non-linear phase of a sawtooth, the complete reconnection of field lines around the q  =  1 flux surface often occurs resulting in a radial displacement of the plasma core. A complete time-dependent electromagnetic model of this type of reconnection has been developed and implemented in the EBdyna_go code. This contribution aims at studying the behaviour of ions, both impurity and fast particles, in the pattern of reconnecting field lines during sawtoothing plasma experiments in the ASDEX Upgrade tokamak by using the newly developed numerical framework. Simulations of full reconnection with tungsten impurity that include the centrifugal force are achieved and recover the soft x-ray measurements. Based on this full-reconnection description of the sawtooth, a simple tool dedicated to estimate the duration of the reconnection is introduced. This work then studies the redistribution of fast ions during several experimentally observed sawteeth. In some cases of sawteeth at ASDEX Upgrade, full reconnection is not always observed or expected so the code gives an upper estimate of the actual experimental redistribution. The results of detailed simulations of the crashes are compared with measurements from various diagnostics such as collective Thomson scattering and fast-ion D-alpha (FIDA) spectroscopy, including FIDA tomography. A convincing qualitative agreement is found in different parts of velocity space.
TSSC1 is novel component of the endosomal retrieval machinery
Authors: Gershlick David C. , Schindler Christina , Chen Yu , Bonifacino Juan S.
Published: July 2016

Endosomes function as a hub for multiple protein-sorting events, including retrograde transport to the trans-Golgi network (TGN) and recycling to the plasma membrane. These processes are mediated by tubular-vesicular carriers that bud from early endosomes and fuse with a corresponding acceptor compartment. Two tethering complexes named GARP (composed of ANG2, VPS52, VPS53, and VPS54 subunits) and EARP (composed of ANG2, VPS52, VPS53, and Syndetin subunits) were previously shown to participate in SNARE-dependent fusion of endosome-derived carriers with the TGN and recycling endosomes, respectively. Little is known, however, about other proteins that function with GARP and EARP in these processes. Here we identify a protein named TSSC1 as a specific interactor of both GARP and EARP and as a novel component of the endosomal retrieval machinery. TSSC1 is a predicted WD40/β-propeller protein that coisolates with both GARP and EARP in affinity purification, immunoprecipitation, and gel filtration analyses. Confocal fluorescence microscopy shows colocalization of TSSC1 with both GARP and EARP. Silencing of TSSC1 impairs transport of internalized Shiga toxin B subunit to the TGN, as well as recycling of internalized transferrin to the plasma membrane. Fluorescence recovery after photobleaching shows that TSSC1 is required for efficient recruitment of GARP to the TGN. These studies thus demonstrate that TSSC1 plays a critical role in endosomal retrieval pathways as a regulator of both GARP and EARP function.
Centrosome centering and decentering by microtubule network rearrangement
Authors: Letort Gaëlle , Nedelec Francois , Blanchoin Laurent , Théry Manuel
Published: July 2016

The centrosome is positioned at the cell center by pushing and pulling forces transmitted by microtubules (MTs). Centrosome decentering is often considered to result from asymmetric, cortical pulling forces exerted in particular by molecular motors on MTs and controlled by external cues affecting the cell cortex locally. Here we used numerical simulations to investigate the possibility that it could equally result from the redistribution of pushing forces due to a reorientation of MTs. We first showed that MT gliding along cell edges and pivoting around the centrosome regulate MT rearrangement and thereby direct the spatial distribution of pushing forces, whereas the number, dynamics, and stiffness of MTs determine the magnitude of these forces. By modulating these parameters, we identified different regimes, involving both pushing and pulling forces, characterized by robust centrosome centering, robust off-centering, or “reactive” positioning. In the last-named conditions, weak asymmetric cues can induce a misbalance of pushing and pulling forces, resulting in an abrupt transition from a centered to an off-centered position. Taken together, these results point to the central role played by the configuration of the MTs on the distribution of pushing forces that position the centrosome. We suggest that asymmetric external cues should not be seen as direct driver of centrosome decentering and cell polarization but instead as inducers of an effective reorganization of the MT network, fostering centrosome motion to the cell periphery.
Measuring Political Positions from Legislative Speech
Authors: Lauderdale Benjamin E. , Herzog Alexander
Published: July 2016

Existing approaches to measuring political disagreement from text data perform poorly except when applied to narrowly selected texts discussing the same issues and written in the same style. We demonstrate the first viable approach for estimating legislator-specific scores from the entire speech corpus of a legislature, while also producing extensive information about the evolution of speech polarization and politically loaded language. In the Irish Dáil, we show that the dominant dimension of speech variation is government–opposition, with ministers more extreme on this dimension than backbenchers, and a second dimension distinguishing between the establishment and anti-establishment opposition parties. In the U. S. Senate, we estimate a dimension that has moderate within-party correlations with scales based on roll-call votes and campaign donation patterns; however, we observe greater overlap across parties in speech positions than roll-call positions and partisan polarization in speeches varies more clearly in response to major political events.
Techniques for First Metatarsophalangeal Joint Salvage Associated With Failed Hallux Valgus Surgery
Authors: Daws Snow B. , Dunaway Linda , Lundeen Gregory A.
Published: July 2016

The surgical correction of hallux valgus (HV) is one of the most common procedures performed by orthopedic foot and ankle surgeons. There are >100 different operations described in the literature for the management of HV, yet patient dissatisfaction following HV surgery can occur in 4% to 41% of cases. The most common outcomes leading to patient complaints include recurrence of HV, hallux varus, malunion, nonunion, osteonecrosis of the first metatarsal head, first metatarsophalangeal joint stiffness, and pain. This manuscript will present and discuss 4 cases of failed HV treated with joint-sparing secondary procedures. The goal is to use these cases as examples of treatment options available in the management of revision surgery related to previous HV reconstruction. The evaluation of patients with failed HV surgery is discussed, and an overview of the various joint-sparing surgical treatment options is presented.

Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Protection of Brain Injury by Amniotic Mesenchymal Stromal Cell-Secreted Metabolites
Authors: Pischiutta Francesca , Brunelli Laura , Romele Pietro , Silini Antonietta , Sammali Eliana , Paracchini Lara , Marchini Sergio , Talamini Laura , Bigini Paolo , Boncoraglio Giorgio B. , Pastorelli Roberta , De Simoni Maria-Grazia , Parolini Ornella , Zanier Elisa R.
Published: July 2016

Objectives:

To define the features of human amniotic mesenchymal stromal cell secretome and its protective properties in experimental models of acute brain injury.

Design:

Prospective experimental study.

Setting:

Laboratory research.

Subjects:

C57Bl/6 mice.

Interventions:

Mice subjected to sham or traumatic brain injury by controlled cortical impact received human amniotic mesenchymal stromal cells or phosphate-buffered saline infused intracerebroventricularly or intravenously 24 hours after injury. Organotypic cortical brain slices exposed to ischemic injury by oxygen-glucose deprivation were treated with human amniotic mesenchymal stromal cells or with their secretome (conditioned medium) in a transwell system.

Measurements and Main Results:

Traumatic brain injured mice receiving human amniotic mesenchymal stromal cells intravenously or intracerebroventricularly showed early and lasting functional and anatomical brain protection. cortical slices injured by oxigen-glucose deprivation and treated with human amniotic mesenchymal stromal cells or conditioned medium showed comparable protective effects (neuronal rescue, promotion of M2 microglia polarization, induction of trophic factors) indicating that the exposure of human amniotic mesenchymal stromal cells to the injured tissue is not necessary for the release of bioactive factors. Using sequential size-exclusion and gel-filtration chromatography, we identified a conditioned medium subfraction, which specifically displays these highly protective properties and we found that this fraction was rich in bioactive molecules with molecular weight smaller than 700 Da. Quantitative RNA analysis and mass spectrometry-based peptidomics showed that the active factors are not proteins or RNAs. The metabolomic profiling of six metabolic classes identified a list of molecules whose abundance was selectively elevated in the active conditioned medium fraction.

Conclusions:

Human amniotic mesenchymal stromal cell-secreted factors protect the brain after acute injury. Importantly, a fraction rich in metabolites, and containing neither proteic nor ribonucleic molecules was protective. This study indicates the profiling of protective factors that could be useful in cell-free therapeutic approaches for acute brain injury.
Patient and Organizational Factors Associated With Delays in Antimicrobial Therapy for Septic Shock*
Authors: Amaral Andre C. K. B. , Fowler Robert A. , Pinto Ruxandra , Rubenfeld Gordon D. , Ellis Paul , Bookatz Brian , Marshall John C. , Martinka Greg , Keenan Sean , Laporta Denny , Roberts Daniel , Kumar Anand
Published: July 2016

Objectives:

To identify clinical and organizational factors associated with delays in antimicrobial therapy for septic shock.

Design:

In a retrospective cohort of critically ill patients with septic shock.

Setting:

Twenty-four ICUs.

Patients:

A total of 6,720 patients with septic shock.

Interventions:

None.

Measurements and Main Results:

Higher Acute Physiology Score (+24 min per 5 Acute Physiology Score points; p < 0.0001); older age (+16 min per 10 yr; p < 0.0001); presence of comorbidities (+35 min; p < 0.0001); hospital length of stay before hypotension: less than 3 days (+50 min; p < 0.0001), between 3 and 7 days (+121 min; p < 0.0001), and longer than 7 days (+130 min; p < 0.0001); and a diagnosis of pneumonia (+45 min; p < 0.01) were associated with longer times to antimicrobial therapy. Two variables were associated with shorter times to antimicrobial therapy: community-acquired infections (–53 min; p < 0.001) and higher temperature (–15 min per 1°C; p < 0.0001). After adjusting for confounders, admissions to academic hospitals (+52 min; p< 0.05), and transfers from medical wards (medical vs surgical ward admission; +39 min; p < 0.05) had longer times to antimicrobial therapy. Admissions from the emergency department (emergency department vs surgical ward admission, –47 min; p< 0.001) had shorter times to antimicrobial therapy.

Conclusions:

We identified clinical and organizational factors that can serve as evidence-based targets for future quality-improvement initiatives on antimicrobial timing. The observation that academic hospitals are more likely to delay antimicrobials should be further explored in future trials.
Electroencephalographic Response to Sodium Nitrite May Predict Delayed Cerebral Ischemia After Severe Subarachnoid Hemorrhage
Authors: Garry Payashi S. , Rowland Matthew J. , Ezra Martyn , Herigstad Mari , Hayen Anja , Sleigh Jamie W. , Westbrook Jon , Warnaby Catherine E. , Pattinson Kyle T. S.
Published: July 2016

Objectives:

Aneurysmal subarachnoid hemorrhage often leads to death and poor clinical outcome. Injury occurring during the first 72 hours is termed “early brain injury,” with disruption of the nitric oxide pathway playing an important pathophysiologic role in its development. Quantitative electroencephalographic variables, such as α/δ frequency ratio, are surrogate markers of cerebral ischemia. This study assessed the quantitative electroencephalographic response to a cerebral nitric oxide donor (intravenous sodium nitrite) to explore whether this correlates with the eventual development of delayed cerebral ischemia.

Design:

Unblinded pilot study testing response to drug intervention.

Setting:

Neuroscience ICU, John Radcliffe Hospital, Oxford, United Kingdom.

Patients:

Fourteen World Federation of Neurosurgeons grades 3, 4, and 5 patients (mean age, 52.8 yr [range, 41–69 yr]; 11 women).

Interventions:

IV sodium nitrite (10 μg/kg/min) for 1 hour.

Measurements and Main Results:

Continuous electroencephalographic recording for 2 hours. The alpha/delta frequency ratio was measured before and during IV sodium nitrite infusion. Seven of 14 patients developed delayed cerebral ischemia. There was a +30% to +118% (range) increase in the alpha/delta frequency ratio in patients who did not develop delayed cerebral ischemia (p < 0.0001) but an overall decrease in the alpha/delta frequency ratio in those patients who did develop delayed cerebral ischemia (range, +11% to –31%) (p = 0.006, multivariate analysis accounting for major confounds).

Conclusions:

Administration of sodium nitrite after severe subarachnoid hemorrhage differentially influences quantitative electroencephalographic variables depending on the patient’s susceptibility to development of delayed cerebral ischemia. With further validation in a larger sample size, this response may be developed as a tool for risk stratification after aneurysmal subarachnoid hemorrhage.
Regional hyperthermia for high-risk soft tissue sarcoma treatment: present status and next questions
Authors: Issels Rolf , Lindner Lars H.
Published: July 2016

Purpose of review

Recent developments of neo-adjuvant chemotherapy treatment strategies for high-risk soft tissue sarcoma (STS) with special emphasis on regional hyperthermia (RHT) are reviewed.

Recent findings

Attempts to improve outcomes using up-front strategies in addition to surgery have essentially focused on neo-adjuvant and adjuvant chemotherapy or preoperative radiochemotherapy. Unfortunately, the results are either confounded by retrospective analyses of nonrandomized studies with small sample size or are negative showing no substantial clinical benefit in the few randomized trials. RHT targets the region of tumor burden by heat. The pleotropic effects on malignant cells and tumor stroma to counteract tumor growth and progression have been recently summarized as hallmarks of hyperthermia. An updated analysis of a completed EORTC-ESHO Intergroup randomized phase 3 trial for the most common types of high-risk STS demonstrates a significantly improved long-term overall survival for patients receiving RHT in combination with neo-adjuvant chemotherapy added to standard surgery and postoperative radiation.

By comparison with other strategies, RHT combined with preoperative and postoperative chemotherapy improves overall survival and adds an important but underused standard for high-risk STS.
Obstructive anomalies of the gynecologic tract
Authors: Patel Vrunda , Gomez-Lobo Veronica
Published: July 2016

Purpose of review

This review discusses current diagnosis, management and outcomes of obstructive anomalies of the gynecologic tract.

Recent findings

In this review, we will discuss the clinical presentation of obstructive anomalies, surgical management and reproductive outcomes following surgical intervention.

Identification of obstructive anomalies of the gynecologic tract is crucial when evaluating patients presenting with or without menses and cyclical pain. Surgical management is often the preferred modality for treatment, although menstrual suppression is recommended in certain circumstances.
Four steps to preserving adolescent confidentiality in an electronic health environment
Authors: Williams Rebekah L. , Taylor Julia F.
Published: July 2016

Purpose of review

Best practices in adolescent care require the ability to provide confidential services, particularly for reproductive health care. As systems implement electronic health records and patients use health portals to access information and communicate with their healthcare team, special attention should be paid to protection of adolescent confidentiality in the electronic environment.

Recent findings

Professional organizations have issued guidance for electronic health records and portal use, but implementation has varied widely between systems, with multiple risks for breaches of confidentiality. Despite interest from patients and families, adolescent health portal use remains low.

Understanding the legal and electronic environments in which we care for adolescent patients allows us to educate, advocate, and implement our electronic tools in a way that respects our adolescent patients’ need for confidential care, the importance of their caregivers in promoting their health, and the legal rights of both.
Multidisciplinary Oncoplastic Approach Reduces Infection in Chest Wall Resection and Reconstruction for Malignant Chest Wall Tumors
Authors: Khalil Haitham H. , Malahias Marco N. , Balasubramanian Balapathiran , Djearaman Madava G. , Naidu Babu , Grainger Melvin F. , Kalkat Maninder
Published: July 2016

Background:

Management of complex thoracic defects post tumor extipiration is challenging because of the nature of pathology, the radical approach, and the insertion of prosthetic material required for biomechanical stability. Wound complications pose a significant problem that can have detrimental effect on patient outcome. The authors outline an institutional experience of a multidisciplinary thoracic oncoplastic approach to improve outcomes.

Methods:

Prospectively collected data from 71 consecutive patients treated with chest wall resection and reconstruction were analyzed (2009–2015). The demographic data, comorbidities, operative details, and outcomes with special focus on wound infection were recorded. All patients were managed in a multidisciplinary approach to optimize perioperative surgical planning.

Results:

Pathology included sarcoma (78%), locally advanced breast cancer (15%), and desmoids (6%), with age ranging from 17 to 82 years (median, 42 years) and preponderance of female patients (n = 44). Chest wall defects were located anterior and anterolateral (77.5%), posterior (8.4%), and apical axillary (10%) with skeletal defect size ranging from 56 to 600 cm2 (mean, 154 cm2). Bony reconstruction was performed using polyprolene mesh, methyl methacrylate prosthesis, and titanium plates. Soft tissue reconstructions depended on size, location, and flap availability and were achieved using regional, distant, and free tissue flaps. The postoperative follow-up ranged from 5 to 70 months (median, 32 months). All flaps survived with good functional and aesthetic outcome, whereas 2 patients experienced surgical site infection (2.8%).

Conclusions:

Multidisciplinary thoracic oncoplastic maximizes outcome for patients with large resection of chest wall tumors with reduction in surgical site infection and wound complications particularly in association with rigid skeletal chest wall reconstruction.
Infant Mandibular Distraction for Upper Airway Obstruction: A Clinical Audit
Authors: Adhikari Ashim N. , Heggie Andrew A.C. , Shand Jocelyn M. , Bordbar Patrishia , Pellicano Anastasia , Kilpatrick Nicky
Published: July 2016

Background:

Mandibular distraction osteogenesis (MDO) is an effective method of treating upper airway obstruction (UAO) in micrognathic infants. The short-term outcomes include relief of UAO, avoidance of tracheostomy, and prompt discharge from hospital. However, it is a significant surgical procedure with potential associated morbidities. This study describes a cohort of infants managed using MDO over a twelve-year period.

Methods:

A retrospective chart review was undertaken for children who had MDO before the age of 5 years between 2000 and 2012. This was followed by a clinical review of the same cohort specifically looking for dental anomalies, nerve injuries, and scar cosmesis.

Results:

Seventy-three children underwent MDO at a mean age of 2 months [interquartile range (IQR), 1.7–4.2] for nonsyndromic infants and 3.3 months (IQR, 2.1–7.4) for those with syndromes. Infants were discharged from hospital, on average, 15 days after procedure. After MDO, of the 9 who were previously tracheostomy dependent, 5 (56%) were decannulated within 12 months and none of the nontracheostomy-dependent children required further airway assistance. The majority of children required supplemental feeding preoperatively but, 12 months postoperatively, 97% of the nonsyndromic infants fed orally. Thirty-nine children (53%) were reviewed clinically [median age, 5.1 y (IQR, 3.9–6.5)] with 18 being syndromic. Many of the mandibular first permanent and second primary molars had developmental defects, but there was a low rate of neurosensory deficit and good scar cosmesis.

Conclusions:

This study contributes further to the evidence base underpinning the management of micrognathic infants with UAO.
Risk Factors for Institutionalization After Traumatic Brain Injury Inpatient Rehabilitation
Authors: Eum Regina S. , Brown Allen W. , Watanabe Thomas K. , Zasler Nathan D. , Goldstein Richard , Seel Ronald T. , Roth Elliot J. , Zafonte Ross D. , Glenn Mel B.
Published: July 2016

Objective:

To create a profile of individuals with traumatic brain injury (TBI) who received inpatient rehabilitation and were discharged to an institutional setting using characteristics measured at rehabilitation discharge.

Methods:

The Traumatic Brain Injury Model Systems National Database is a prospective, multicenter, longitudinal database for people with moderate to severe TBI. We analyzed data for participants enrolled from January 2002 to June 2012 who had lived in a private residence before TBI. This cross-sectional study used logistic regression analyses to identify sociodemographic factors, lengths of stay, and cognitive and physical functioning levels that differentiated patients discharged to institutional versus private settings.

Results:

Older age, living alone before TBI, and lower levels of function at rehabilitation discharge (independence in locomotion, bladder management, comprehension, and social interaction) were significantly associated with higher institutionalization rates and provided the best models identifying factors associated with institutionalization. Institutionalization was also associated with decreased independence in bed-chair-wheelchair transfers and increased duration of posttraumatic amnesia.

Conclusions:

Individuals institutionalized after inpatient rehabilitation for TBI were older, lived alone before injury, had longer posttraumatic amnesia durations, and were less independent in specific functional characteristics. Research evaluating the effect of increasing postdischarge support and improving treatment effectiveness in these functional areas is recommended.
Genome-wide association analysis of pain severity in dysmenorrhea identifies association at chromosome 1p13.2, near the nerve growth factor locus
Authors: Jones Amy V. , Hockley James R.F. , Hyde Craig , Gorman Donal , Sredic-Rhodes Ana , Bilsland James , McMurray Gordon , Furlotte Nicholas A. , Hu Youna , Hinds David A. , Cox Peter J. , Scollen Serena
Published: July 2016

Dysmenorrhea is a common chronic pelvic pain syndrome affecting women of childbearing potential. Family studies suggest that genetic background influences the severity of dysmenorrhea, but genetic predisposition and molecular mechanisms underlying dysmenorrhea are not understood. In this study, we conduct the first genome-wide association study to identify genetic factors associated with dysmenorrhea pain severity. A cohort of females of European descent (n = 11,891) aged 18 to 45 years rated their average dysmenorrhea pain severity. We used a linear regression model adjusting for age and body mass index, identifying one genome-wide significant (P < 5 × 10−8) association (rs7523086, P = 4.1 × 10−14, effect size 0.1 [95% confidence interval, 0.074–0.126]). This single nucleotide polymorphism is colocalising with NGF, encoding nerve growth factor. The presence of one risk allele corresponds to a predicted 0.1-point increase in pain intensity on a 4-point ordinal pain scale. The putative effects on NGF function and/or expression remain unknown. However, genetic variation colocalises with active epigenetic marks in fat and ovary tissues, and expression levels in aorta tissue of a noncoding RNA flanking NGF correlate. Participants reporting extreme dysmenorrhea pain were more likely to report being positive for endometriosis, polycystic ovarian syndrome, depression, and other psychiatric disorders. Our results indicate that dysmenorrhea pain severity is partly genetically determined. NGF already has an established role in chronic pain disorders, and our findings suggest that NGF may be an important mediator for gynaecological/pelvic pain in the viscera.
Light Transmission Aggregometry Does Not Correlate With the Severity of δ-Granule Platelet Storage Pool Deficiency
Authors: Woods Gary M. , Kudron Elizabeth L. , Davis Kyle , Stanek Joseph , Kerlin Bryce A. , O’Brien Sarah H.
Published: July 2016

Delta-granule platelet storage pool deficiency (δ-PSPD) is a poorly studied bleeding diathesis resulting from either decreased granule content or decreased average number of platelet δ-granules. Light transmission aggregometry (LTA) is commonly used to evaluate for δ-PSPD and platelet electron microscopy (EM) is used to confirm the diagnosis. Currently, little data exist examining the relationship between the likelihood of abnormal platelet aggregation findings, severity of δ-granule deficiency on platelet EM, and severity of bleeding symptoms in patients with δ-PSPD. Patients diagnosed with δ-PSPD by platelet EM who also underwent LTA testing were identified at a single institution for correlation between severity of bleeding, average number of platelet δ-granules, and number of agonist abnormalities on LTA. No statistically significant association was identified between the average number of δ-granules per platelet and likelihood of an abnormal LTA. LTA abnormalities were quite varied and only 50% diagnosed with δ-PSPD on EM had abnormal aggregation testing. Also, no correlation was seen between the number of clinical bleeding symptoms, number of average δ-granules per platelet, and the number of LTA agonist abnormalities. Our findings highlight the difficulties inherent in the laboratory evaluation of platelet function.
Reference Values of Reticulocyte Hemoglobin Content and Their Relation With Other Indicators of Iron Status in Healthy Children
Authors: López-Ruzafa Encarnación , Vázquez-López Maria A. , Lendinez-Molinos Francisco , Poveda-González Juan , Galera-Martínez Rafael , Bonillo-Perales Antonio , Martín-González Manuel
Published: July 2016

Reticulocyte hemoglobin content (CHr) is considered an indicator of functional iron deficiency, but is understudied in children. The goals of this study are to determine the reference intervals for CHr in healthy children, and their relation with iron parameters, erythropoiesis, and individual conditions. A total of 902 children without iron deficiency, aged 1 to 11 years were analyzed in a cross-sectional study. Besides a physical examination of the subjects and a questionnaire completed by their parents, the complete blood count, serum transferrin receptor, ferritin, transferrin saturation, erythrocyte protoporphyrin, serum erythropoietin, C-reactive protein, and CHr levels were measured. Changes in CHr, iron status, and erythropoiesis at different age intervals were analyzed and linear multiple regression was used to identify the factors that determine CHr variability. Mean value obtained for CHr was 30.9±1.8 pg (P2.5-P97.5: 26.9 to 34.3 pg), but the influence of age on CHr (the values increased with age) and on the iron parameters justified the establishment of different reference ranges. In addition to age, nutritional status, hematologic measurements, reticulocytes, transferrin saturation, and erythrocyte protoporphyrin accounted for 39% of CHr variability.
A Rare Case of Primary Myelofibrosis in a 14-Year-Old Patient With Congenital Asplenia
Authors: Khan Maliha , Yin Cheng C. , Yates Amber , Newberry Kate J. , Verstovsek Srdan
Published: July 2016

Primary myelofibrosis (PMF) is rarely diagnosed in children, and in most cases in children younger than 3 years old. Pediatric PMF generally follows a benign course and is usually managed supportively with blood transfusions and prophylactic antibiotics for infections. We present a case of a 17-year-old girl diagnosed with PMF at the age of 14 years. A computed tomography scan performed at the time of an appendectomy showed congenital asplenism. To our knowledge, this is only the third case of myelofibrosis and congenital asplenism to be reported in the literature. Whether asplenism contributed to the development of myelofibrosis is not known.
Structure in the variability of the basic reproductive number (R0) for Zika epidemics in the Pacific islands
Authors: Champagne Clara , Salthouse David Georges , Paul Richard , Cao-Lormeau Van-Mai , Roche Benjamin , Cazelles Bernard
Published: July 2016

Before the outbreak that reached the Americas in 2015, Zika virus (ZIKV) circulated in Asia and the Pacific: these past epidemics can be highly informative on the key parameters driving virus transmission, such as the basic reproduction number (R0). We compare two compartmental models with different mosquito representations, using surveillance and seroprevalence data for several ZIKV outbreaks in Pacific islands (Yap, Micronesia 2007, Tahiti and Moorea, French Polynesia 2013-2014, New Caledonia 2014). Models are estimated in a stochastic framework with state-of-the-art Bayesian techniques.R0for the Pacific ZIKV epidemics is estimated between 1.5 and 4.1, the smallest islands displaying higher and more variable values. This relatively low range ofR0suggests that intervention strategies developed for other flaviviruses should enable as, if not more effective control of ZIKV. Our study also highlights the importance of seroprevalence data for precise quantitative analysis of pathogen propagation, to design prevention and control strategies.