bluuebunny/crossref_metadata_2025 huggingface dataset:
Energy equipartition and fluctuation-dissipation theorems for damped flexible structures
Authors: Pearson Ronald K. , Johnson Timothy L.
Published: December 2016

Dynamics and control of flexible mechanical structures has been the topic of much recent research. Here, we examine the energy distribution in finite-dimensional flexible structure models of the type obtained through finite element analysis. Modeling external disturbance forces as zero-mean white noise, we establish that symmetry of the damping matrix is a sufficient condition for the equipartition of potential and kinetic energy in the structure. In addition, we develop upper and lower bounds on the total energy stored in symmetrically damped structures in terms of the strength of the stochastic driving term and the Euclidean norms of the damping matrix and its inverse. In two special cases, explicit solutions for the total energy are obtained and may be viewed as fluctuation-dissipation theorems for the structure models. Convergence conditions for modal expansions of distributed parameter flexible structure models are then developed from these finite-dimensional results. These conditions are interpreted physically as interrelations between assumed damping mechanisms and disturbance force actuator models that must exist in formulating well-posed stochastic distributed-parameter flexible structure models.
Complete solutions of a coupled system of partial differential equations arising in thermoelasticity
Authors: Chandrasekharaiah D. S.
Published: December 2016

Three general, complete solutions of a coupled hyperbolic or hyperbolic-parabolic system of two second-order linear partial differential equations are presented. The system includes among its particular cases the governing field equations of the conventional as well as generalized thermoelasticity theories. The solutions obtained are analogous to the Lamé, Papkovitch, and Galerkin solutions in classical elasticity. The interrelationships among the solutions are also exhibited. Some solutions obtained in earlier works are deduced as special cases of the unified solutions obtained here.
A linear Volterra integro-differential equation for viscoelastic rods and plates
Authors: Noren Richard D.
Published: December 2016

It is proved that the resolvent kernel of a certain Volterra integrodifferential equation in Hilbert space is absolutely integrable on

(

0
,
∞

)

\left ( {0,\infty } \right )

. Weaker assumptions on the convolution kernel appearing in the integral term are used than in existing results. The equation arises in the linear theory of isotropic viscoelastic rods and plates.
Relaxed elastic line on a curved surface
Authors: Manning Gerald S.
Published: December 2016

In an effort to begin to understand the mechanics of various forms of biologically packaged DNA, we develop the Euler—Lagrange equations for the equilibrium path of an elastic line constrained to a surface but otherwise relaxed. We find, in contrast to a statement by Hilbert and Cohn-Vossen [1], that whether or not the solutions are geodesic curves of the surface depends on the boundary conditions and on the surface. Not surprisingly, the relaxed elastic line on a plane or a sphere is always a geodesic (straight line and great circle, respectively). On a cylinder and a “pseudotorus,” however, the relaxed line is a geodesic only if both ends are free. For example, a relaxed line on a cylinder, with fixed initial point and oblique tangent, does not wind on the corresponding geodesic (helix).
A note on the Stokes paradox
Authors: Smith S. H.
Published: December 2016

A particular solution of the Stokes’ flow equations is presented which shows a nonuniformity of limits between the near and far flow fields which relates to the Stokes’ paradox.
Diffusion and convection of vorticity at low Reynolds numbers produced by a rotlet interior to a circular cylinder
Authors: Ranger K. B.
Published: December 2016

The diffusion and convection of vorticity produced by a rotlet inside a circular cylinder is discussed at low Reynolds numbers by considering a nonlinear approximation to a complex form of the steady two-dimensional Navier–Stokes equations. An expression is found for the boundary vorticity and the modifications to the separation of streamlines are discussed as a function of the Reynolds number.
Estimation of discontinuous coefficients and boundary parameters for hyperbolic systems
Authors: Lamm Patricia K. , Murphy Katherine A.
Published: December 2016

We consider the problem of estimating discontinuous coefficients, including locations of discontinuities, that occur in second-order hyperbolic systems typical of those arising in 1-D surface seismic problems. In addition, we treat the problem of identifying unknown parameters that appear in boundary conditions for the system. A spline-based approximation theory is presented, together with related convergence findings and representative numerical examples.
Bifurcations associated with a three-fold zero eigenvalue
Authors: Yu Pei , Huseyin K.
Published: December 2016

The bifurcation and instability behavior of a nonlinear autonomous system in the vicinity of a compound critical point is studied in detail. The critical point is characterized by a triple zero of index one eigenvalue, and the system is described by three independent parameters. The analysis is carried out via a unification technique, leading to a simple set of differential equations for the analysis of local behavior. Incipient and secondary bifurcations as well as bifurcations into invariant tori are discussed, and the explicit asymptotic results concerning periodic solutions are presented. Moreover, the criteria leading to a sequence of bifurcations into a family of two-dimensional tori are established. An electrical network is analyzed to illustrate the analytical results.
A variational-hemivariational inequality approach to the laminated plate theory under subdifferential boundary conditions
Authors: Panagiotopoulos P. D. , Stavroulakis G. E.
Published: December 2016

In this paper the delamination problem for laminated plates is studied. A nonmonotone multivalued law is introduced in order to describe the interlaminar bonding forces. This law is written as the generalized gradient in the sense of F. H. Clarke of an appropriately defined nonconvex superpotential. Moreover, monotone boundary conditions of the subdifferential type are assumed to hold. The problem is formulated as a variational-hemivariational inequality expressing the principle of virtual work in inequality form. By using compactness and monotonicity arguments, the existence and the approximation of the solution of this inequality are investigated.
An exact inverse method for subsonic flows
Authors: Daripa Prabir
Published: December 2016

A new inverse method for aerodynamic design of airfoils is presented for subcritical flows. The pressure distribution in this method can be prescribed in a natural way, i.e., as a function of arclength of the as yet unknown body. This inverse problem is shown to be mathematically equivalent to solving only one nonlinear boundary value problem subject to known Dirichlet data on the boundary. The solution to this nonlinear problem determines the airfoil, free stream Mach number

M
∞

{M_\infty }

and the upstream flow direction

θ
∞

{\theta _\infty }

. The existence of a solution to a given pressure distribution is discussed. The method is easy to implement and extremely efficient. We present a series of results for which comparisons are made with the known airfoils. This method will be extended to design supercritical airfoils in the future.
Nonlinear gravity-wave groups
Authors: Yih Chia-Shun
Published: December 2016

Groups of gravity waves of permanent form in deep water are investigated. The analysis provides a systematic procedure for determining the form of the group to any order of approximation, and a calculation is carried to the third order of the amplitude at least and, where it matters, to the fourth order. Closed formulas for the phase velocity

c
c

of the basic waves and the group velocity

c
g

{c_g}

are obtained. Inspection of the analytic procedure reveals that these formulas remain intact for all subsequent calculations to any order of approximation. These formulas are in terms of the group wavenumber

ε
\varepsilon

which, to the attained order of approximation, is found to be proportional to the amplitude

a
a

and the square of the basic wavenumber

k
k

, but is, for any assigned

k
k

, a power series in

a
a

. It is found that

c
c

increases and

c
g

{c_g}

decreases with

ε
\varepsilon

, in such a way that

2
c

c
g

=
g

/

k

2c{c_g} = g/k

, where

g
g

is the gravitational acceleration. The results are compared with the corresponding ones obtained by the cubic-Schrödinger-equation (CBE) approach, and wherever comparison is possible there is agreement. The CBE approach, however, does not give the variation of

c
g

{c_g}

with the amplitude.
Interaction of a plane compressional elastic wave with a rigid spheroidal inclusion
Authors: Datta Subhendu K.
Published: December 2016

In this paper we have considered the problem of diffraction of a plane compressional harmonic elastic wave by a rigid spheroidal inclusion embedded in a homogeneous isotropic medium. For simplicity we have confined our attention to the axisymmetric case when the incident wave propagates along the axis of symmetry of the spheroid. The inclusion is assumed to be movable. Since the exact solution to this problem is not obtainable analytically we have used a boundary perturbation technique that is applicable at any finite frequency. We have derived exact analytical expression for the amplitude of oscillation of the inclusion correct to first order in a shape correction factor

ϵ
\epsilon

. It is shown that the low-frequency expansion of the amplitude agrees with the expansion derived by other means correct to first order in frequency. We have also given a high-frequency expansion of the amplitude. Furthermore, we have derived the asymptotic expansion of the field in the illuminated zone and have shown that these are compatible with those obtained by an application of Keller’s ray theory.
Wave motion in an elastic solid due to a nonuniformly moving line load
Authors: Freund L. B.
Published: December 2016

The wave motion resulting from a line load moving through an unbounded elastic solid is considered. The line load suddenly appears in the body, and then moves in a fixed direction with nonuniform speed. Exact expressions are derived for the displacement potential functions for all places in the body, for all time, by Laplace transform methods. The wavefronts, particularly the Mach waves trailing the moving load, are determined by integrating the bicharacteristic equations. The details of the wavefront shapes are illustrated and discussed for a load accelerating or decelerating in a prescribed way. Finally, a sample first-motion calculation is carried out in which the mean normal stress is determined immediately behind the dilatational wavefront by asymptotic methods.
Rotational-translational addition theorems for spheroidal vector wave functions
Authors: Dalmas Jeannine , Deleuil Roger , MacPhie R. H.
Published: December 2016

Rotational-translational addition theorems for spherical and spheroidal vector wave functions are established. These theorems concern the vector wave functions

M
a

{M^a}

and

N
a

{N^a}

(with

a
=
r
,
x
,
y
,
z

a = r, x, y, z

) which can be obtained and used to treat various electromagnetic problems such as multiple scattering of a plane wave from prolate spheroids (with arbitrary spacings and orientations of their axes of symmetry) or radiation from thin-wire antennas. For sake of completeness, rotational-translational addition theorems for the vector wave function L are also established. This work is a natural extension of previous studies concerning simpler transformations of coordinate systems, such as rotation or translation. The two cases

r
≥
d

r \ge d

and

r
≤
d

r \le d

are distinguished, where

d
d

is the distance between the centers of the spheroids.
Elastic-plastic boundaries in the propagation of plane and cylindrical waves of combined stress
Authors: Ting T. C. T.
Published: December 2016

A general study is given of plane and cylindrical wave propagation of combined stress in an elastic-plastic medium. The coefficients of the governing differential equations, when written in matrix notation, are symmetric matrices and can be divided into submatrices each of which has a special form. The relations between the stresses on both sides of an elastic-plastic boundary are derived. Also presented are the restrictions on the speed of an elastic-plastic boundary.
Home: A Very Short Introduction
Authors: Fox Michael Allen
Published: December 2016

Thoughts and feelings about home traditionally provided people of all cultures with a firm sense of where they belonged, and why. But the world is rapidly changing: populations are constantly on the move, seeking better opportunities and living conditions, or an escape from violence and war. Despite this, the concept of home remains a central organizing influence in human life. Home: A Very Short Introduction considers the complex meaning of home and the essential importance of place to human psychology. It considers what a dwelling is, the variety of dwellings, and also looks at the politics of the concept of ‘home’, homelessness, refugeeism and migration, and the future of home.
BclI Glucocorticoid Receptor Polymorphism in Relation to Arterial Stiffening and Cardiac Structure and Function: The Hoorn and CODAM Studies
Authors: van Moorsel Dirk , Henry Ronald M. , Schaper Nicolaas C. , van Greevenbroek Marleen M. , van Rossum Elisabeth F. , ‘t Hart Leen M. , Schalkwijk Casper G. , van der Kallen Carla J. , Dekker Jacqueline M. , Stehouwer Coen D. , Havekes Bas
Published: December 2016

BACKGROUND

Chronic glucocorticoid excess is associated with arterial stiffening and cardiac dysfunction. The BclI glucocorticoid receptor (GR) polymorphism increases GR sensitivity and is associated with a higher body mass index (BMI) and some proxies for cardiovascular disease (CVD). Whether BclI influences arterial stiffening and cardiac dysfunction is currently unknown. Therefore, the aim of the present study was to investigate the association of the BclI polymorphism with arterial stiffening and cardiac structure and function.

METHODS

We conducted an observational cohort study, combining 2 cohort studies designed to investigate genetic and metabolic determinants of CVD. We genotyped 1,124 individuals (age: 64.7 ± 8.5 years) from the Hoorn study and Cohort on Diabetes and Atherosclerosis Maastricht (CODAM) study for BclI. Several arterial stiffening indices of the carotid (Hoorn and CODAM study), brachial and femoral artery and the carotid-femoral pulse wave velocity (Hoorn study only) were determined. In addition, in the Hoorn study, we determined several variables of cardiac structure and function.

RESULTS

We identified 155 homozygous carriers (GG), 498 heterozygous carriers (CG), and 471 noncarriers (CC) of the BclI polymorphism. BclI genotypes did not display significant differences in variables of arterial stiffening (e.g., carotid distensibility coefficient (DC): 12.41 ± 5.37 vs. 12.87 ± 5.55 10−3/kPa [mean ± SD]; P = 0.38; homozygous vs. noncarriers). In addition, no clear differences in estimates of cardiac structure and function were found.

CONCLUSIONS

Even though BclI is associated with a higher BMI and some proxies of CVD, our results do not support the concept that BclI carrier status is associated with greater arterial stiffening or cardiac dysfunction.
Evaluating the impacts of fishing on sex-changing fish: a game-theoretic approach
Authors: Robinson Orin J. , Jensen Olaf P. , Provost Mikaela M. , Huang Shuochen , Fefferman Nina H. , Kebir Amira , Lockwood Julie L.
Published: December 2016

Sex change has been widely documented in many commercially and recreationally important fish species, yet the implications of this life history trait are not considered in most stock assessments. This omission can lead to poor estimates of parameters vital to understanding the health of sequentially hermaphroditic stocks. Here, we present a game theoretic approach to model the sex changing behaviour of a stock of protogynous (female first) hermaphroditic fish and produce estimates of maximum sustainable yield (MSY), equilibrium biomass at MSY (BMSY) and sex ratio, then compare these reference points to those from an otherwise identical gonochoristic (non-sex changing) stock. We tested each stock at varying levels of exploitation and with a range of assumptions about how sex ratio impacts fertilization rate. We show that a protogynous hermaphroditic stock with flexible timing of sex change produces similar MSY and slightly higher BMSY than a gonochoristic stock with otherwise identical vital rates. Sex changing stocks were also able to maintain a higher proportion of males in the population than did non-sex changing stocks as exploitation increased. Although sex changing stocks were able to maintain their sex ratio, the age at which females changed sex decreased with increased exploitation, suggesting smaller body size, and presumably lower fecundity, for females in heavily exploited sex changing stocks. Our game theoretic approach to evaluating hermaphroditic stocks can accommodate a wide variety of sex changing cues and behaviours and allows a flexible model for understanding the effects of exploitation on hermaphroditic stocks.
Bitter Melon Extract Promotes Granulation Tissue Growth and Angiogenesis in the Diabetic Wound
Authors: Singh Rekha , Garcia-Gomez Ignacio , Gudehithlu Krishnamurthy P. , Singh Ashok K.
Published: December 2016

OBJECTIVE:

Bitter melon is a plant fruit that has been shown to exert a hypoglycemic effect when used systemically in patients with diabetes. This study was designed to investigate the topical effect of bitter melon on diabetic wounds using the wound chamber model in rats.

DESIGN:

Two bilateral wound chambers were implanted subcutaneously in the thoracic-lumbar region of male Sprague-Dawley rats. Diabetes was induced with streptozotocin 7 days after implantation of wound chambers. After 24 hours of induction of diabetes, aqueous extract of bitter melon was injected into 1 wound chamber, and saline (0.9% sodium chloride solution) was injected into the contralateral chamber once daily for 3 days. Wound fluid was collected on day 4 for analysis, following which rats were euthanized. The granulation tissue encapsulating the wound chamber was removed and processed for histology. Controls included diabetic rats with wound chambers injected with saline (instead of bitter melon) and nondiabetic rats with wound chambers injected with bitter melon.

RESULTS:

In rats with diabetes, wound granulation tissue treated with bitter melon was well formed, with distinct cellular layers, whereas the saline-treated granulation tissue showed a severe loss of tissue organization and blood vessels. Moreover, the bitter melon treatment increased angiogenesis in the diabetic granulation tissue, marked by abundant microvessels and large blood vessels. In nondiabetic rats, no differences in wound granulation tissues were observed between saline- and bitter melon-treated groups. Bitter melon treatment had no effect on systemic blood glucose levels or insulin receptor substrate 1, suggesting that its stimulatory effect on diabetic granulation tissue was not due to alteration of systemic blood glucose levels.

CONCLUSIONS:

When applied locally to diabetic wounds, bitter melon extract prevents regression of granulation tissue and blood vessels, thus accelerating and improving wound healing.
Polyethylene Glycol 3350 and Docusate Sodium Compared With Docusate Sodium Alone After Urogynecologic Surgery: A Randomized Controlled Trial
Authors: Edenfield Autumn L. , Siddiqui Nazema Y. , Wu Jennifer M. , Dieter Alexis A. , Garrett Melissa A. , Visco Anthony G.
Published: December 2016

(Abstracted from Obstet Gynecol 2016;128:543–549)

Patients who undergo pelvic reconstruction are at high risk of constipation following surgery due to use of narcotics, anesthesia, mechanical bowel preparations, and anatomic manipulation. Few rigorous studies have compared the efficacy of medications for the management of postoperative constipation after urogynecologic surgery.
Metabolic Screening in Patients With Polycystic Ovary Syndrome Is Largely Underutilized Among Obstetrician-Gynecologists
Authors: Dhesi Amy S. , Murtough Katie L. , Lim Jonathan K. , Schulkin Jay , McGovern Peter G. , Power Michael L. , Morelli Sara S.
Published: December 2016

(Abstracted from Am J Obstet Gynecol 2016;215:579.e1–579.e5)

Women with polycystic ovary syndrome (PCOS) are at significantly increased risk of several metabolic abnormalities (insulin resistance, impaired glucose tolerance, type 2 diabetes, dyslipidemia, and metabolic syndrome) and have substantially higher rates of these abnormalities compared with women without PCOS. Published guidelines issued by the American College of Obstetricians and Gynecologists (ACOG) and Endocrine Society recommend that all women with PCOS undergo screening for impaired glucose tolerance and dyslipidemia (with a 2-hour, 75-g oral glucose tolerance test [OGTT] and fasting lipid profile upon diagnosis) and undergo repeat screening every 2 to 5 years and every 2 years, respectively.
Evaluation of Smartphone Menstrual Cycle Tracking Applications Using an Adapted APPLICATIONS Scoring System
Authors: Moglia Michelle L. , Nguyen Henry V. , Chyjek Kathy , Chen Katherine T. , Castaño Paula M.
Published: December 2016

(Abstracted from Obstet Gynecol 2016;127:1153–1160)

Tracking of menstrual cycles is a form of self-monitoring that promotes patient empowerment and informed decision making. Tracking is useful in women for self-understanding and achieving fertility goals.
Post–Policy Implementation Review of Rapid Fetal Fibronectin (fFN) Testing for Preterm Labour in Alberta
Authors: Chuck Anderson W. , Thanh Nguyen X. , Chari Radha S. , Wilson Robert Douglas , Janes-Kelley Selikke , Wesenberg James C.
Published: December 2016

(Abstracted from J Obstet Gynaecol Can 2016;38(7):659–666)

Research indicates that worldwide an estimated 13 million infants are born prematurely each year. Preterm delivery, a leading cause of neonatal mortality and morbidity, can be defined as birth prior to 37 weeks’ gestation and has accounted for 60% to 80% of perinatal deaths in infants without congenital anomalies and up to 75% of neonatal morbidity.
Modeled Fetal Risk of Genetic Diseases Identified by Expanded Carrier Screening
Authors: Haque Imran S. , Lazarin Gabriel A. , Peter Kang H. , Evans Eric A. , Goldberg James D. , Wapner Ronald J.
Published: December 2016

(Abstracted from JAMA 2016;316(7):734–742)

As part of routine obstetrical practice, many prospective parents undergo genetic testing to detect carriers of specific inherited recessive diseases. There are recommendations provided by professional organizations to test for a limited number of individual diseases that are in part based on self-reported racial/ethnic backgrounds.
Outcome After Tibial Plateau Fracture: How Important Is Restoration of Articular Congruity?
Authors: Singleton Neal , Sahakian Vahe , Muir Dawson
Published: December 2016

Objectives:

Does restoration of articular congruity have any effect on long-term outcome following tibial plateau fracture?

Design:

Cohort study.

Setting:

A secondary hospital in New Zealand, which services a population of 150,000.

Patients:

All patients with a depressed tibial plateau fracture seen over a 6 year period were invited to participate in the study. There were 41 patients (average age 54 years) recruited from an eligible population of 97. Average follow-up was 3.9 years after injury.

Intervention:

Patients had either been treated operatively or nonoperatively after depressed tibial plateau fracture.

Main Outcome Measurements:

The primary outcome analyzed was residual articular depression (as measured on coronal plane tomogram) and its effect on clinical outcome [Oxford Knee Score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), Iowa knee score, and a visual analogue satisfaction score] and functional outcome (knee range of motion) at a minimum of 12 months after fracture. Patients were divided into 3 groups based on the amount of articular depression: <2.5, 2.5–5.0, and ≥5.0 mm. The secondary outcome analyzed was mechanical axis (as measured on weightbearing long leg alignment radiographs) and its effect on clinical and functional outcomes.

Results:

Statistical analysis found that patients with <2.5 mm of articular depression had significantly smaller losses in knee range of motion (P = 0.000), better Oxford (P = 0.006), Iowa (P = 0.003), and KOOS symptom (P = 0.011) and pain (P = 0.001) scores. We found that there was no significant relationship between restoration of mechanical axis and loss in range of motion (P = 0.126), Oxford (P = 0.584), WOMAC (P = 0.101), IOWA (P = 0.418), Visual Analogue Score (VAS) (P = 0.466) or any subgroup within the KOOS survey other than activities of daily living (P = 0.029).

Conclusions:

This study found that patients with smaller amounts of residual articular depression at a minimum of 12 months after tibial plateau fracture had significantly smaller losses in knee range of motion and better functional outcomes than those with greater amounts of articular depression.

Level of Evidence:

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Family Functioning Predicts Body Mass Index and Biochemical Levels of Youths with Nonalcoholic Fatty Liver Disease
Authors: Smith Justin D. , Montaño Zorash , Maynard Andrew , Miloh Tamir
Published: December 2016

Family functioning is associated with obesity-related chronic illnesses and impedes effective treatment of weight-related conditions, such as nonalcoholic fatty liver disease (NAFLD).

Objectives:

Evaluate the utility of a brief screening measure of family functioning among youth aged 8 to 18 years being treated in a specialty care clinic for NAFLD.

Methods:

Thirty-nine youths and their caregivers participated. Relations between family functioning and anthropometric and biochemical variables assessed 3 to 6 months later were evaluated using regression analyses, controlling for child age, gender, and ethnicity.

Results:

Family functioning was related to significantly higher body mass index (BMI) and levels of cholesterol, HbA1c, and glucose, but not serum alanine aminotransferase (ALT)—a marker of NAFLD—controlling for baseline levels. The magnitudes of effects were medium for models of BMI (Cohen's f
2 = 0.29), cholesterol (0.32), and blood glucose (0.30) and small to medium for HbA1c (0.23) and ALT (0.10).

Conclusion:

This is the first study to examine the role of family functioning in youth with NALFD. Treatment programs might consider screening for family functioning to identify families that could benefit from a family-centered behavioral intervention.
Inhibition of glycogen synthase kinase-3 by SB 216763 affects acquisition at lower doses than expression of amphetamine-conditioned place preference in rats
Authors: Wickens Rebekah H. , Quartarone Susan E. , Beninger Richard J.
Published: December 2016

Dopamine (DA) drives incentive learning, whereby neutral stimuli acquire the ability to elicit responses. DA influences the signaling molecule glycogen synthase kinase-3 (GSK3). Inhibition of GSK3 attenuates the development of behavioral sensitization to stimulant drugs and conditioned place preference (CPP), a measure of incentive learning. We examined the role of GSK3 in the nucleus accumbens (NAc) of rats in CPP produced by amphetamine (1.5 mg/kg, i.p. or 20.0 μg/0.5 μl/side intra-NAc) by administering the inhibitor SB 216763 (1.0, 2.0, and 2.5 mg/kg, i.p. or 0.03, 0.30, 3.00, and 5.00 μg/0.5 μl/side intra-NAc) during acquisition or expression. We hypothesized a dose-dependent effect of SB 216763 and that acquisition would be affected by smaller doses than expression. For the systemic groups, 1.0 mg/kg of SB 216763 did not block CPP; 2.0 mg/kg administered in acquisition but not expression blocked CPP; and 2.5 mg/kg administered in either phase blocked CPP. For the central groups, 0.03 μg/0.5 μl/side of SB 216763 prevented acquisition but not expression, whereas larger doses administered in either phase blocked CPP. Thus, systemic or NAc inhibition of GSK3 by SB 216763 during acquisition or expression blocks amphetamine-produced CPP and acquisition is sensitive to lower doses than expression.
Genomic profiling of gynecologic cancers and implications for clinical practice
Authors: Prendergast Emily N. , Elvin Julia A.
Published: December 2016

Purpose of review

This article summarizes advances in the application of next-generation sequencing (NGS) to the personalized treatment of gynecologic malignancies.

Recent findings

Many recurrent genomic alterations (GA) in gynecologic malignancies have been identified by studies applying NGS to tumor tissue, which can provide insights into tumor biology, diagnostic or prognostic information, and potential targeted therapy options. NGS can be used to assay single genes, portions of multiple genes (“hot-spot” panels), or the complete coding sequence of a broad range of cancer-associated genes [i.e. comprehensive genomic profiling (CGP)]. CGP of a patient's tumor reveals to practitioners clinically relevant GA (CRGA) and associated biomarker-matched treatments, with a goal of improving therapeutic response while limiting cumulative chemotherapeutic toxicities. Although the use of precision medicine for gynecologic cancers holds much promise, the data detailing impact on survival and quality of life is still accumulating, lagging behind other areas of oncology. Enrolling gynecologic oncology patients in genotype-matched trials remains challenging and highlights the need for more molecular-based basket trials for reproductive tract malignancies.

Identification of molecular subsets with distinct clinical attributes, prognostic significance, and targeted therapy directed options is now feasible in clinical gynecologic oncology practice.
Understanding How to Prevent and Treat Adverse Events of Fillers and Neuromodulators
Authors: Ablon Glynis
Published: December 2016

Experience teaches cosmetic surgeons to become good, but avoiding and treating adverse events make them great. In no area is this more true than in cosmetic procedures involving fillers and neuromodulators. By utilizing knowledge of materials and anatomy involved, specialists seek to avoid complications. A well-trained physician is able to reduce the sequelae from an adverse event by acting promptly using algorithms and a methodical approach to treatments. In this article I discuss the difference between perceived and true complications from fillers and neuromodulators, how to avoid, what to look for and how to treat to provide patients with the best possible outcomes, and make the physicians life less stressful.
Review of 3-dimensional Facial Anatomy: Injecting Fillers and Neuromodulators
Authors: Sieber David A. , Scheuer Jack F. , Villanueva Nathaniel L. , Pezeshk Ronnie A. , Rohrich Rod J.
Published: December 2016

To achieve consistent results utilizing facial injectables, practitioners must understand the pertinent anatomy of the forehead, temple, cheek, nose, and perioral areas. A detailed understanding of facial blood vessels, nerves, and musculature is essential for safe and effective placement of fillers and neuromodulators.
CAPILLARY NONPERFUSION AND PHOTORECEPTOR LOSS IN BRANCH RETINAL VEIN OCCLUSION
Authors: Kanakis Menelaos G. , Giannouli Konstantina , Andreanos Konstantinos , Papaconstantinou Dimitrios , Koutsandrea Chrysanthi , Ladas Ioannis , Georgalas Ilias , Petrou Petros , Kotsolis Athanasios I.
Published: December 2016

Purpose:

To evaluate the photoreceptor layer in eyes with branch retinal vein occlusion associated with macular ischemia, using a method of en face optical coherence tomography (OCT) representation of the ellipsoid zone.

Methods:

Customized macular OCT scans of 9 patients (10 eyes) with branch retinal vein occlusion and macular ischemia were exported and subsequently postprocessed (removal of vascular and cystic spaces' shadows, segmentation, and alignment to the retinal pigment epithelium). The ellipsoid band was then isolated, aligned, and used to produce an en face OCT image. Areas with photoreceptor loss (hyporeflective ellipsoid) were compared with ischemic areas as identified in an early-phase fluorescein angiography.

Results:

The areas of capillary nonperfusion (as detected in fluorescein angiography) were closely associated with disruption of the ellipsoid zone (depicted as areas of low reflectance in the en face reconstruction of the OCT images). The ellipsoid zone disruption had a patchy appearance and either sharp or fuzzy borders, depending on the grade of the loss of reflectance.

Conclusion:

En face OCT reconstruction and subsequent representation of ellipsoid zone revealed a close association between capillary nonperfusion and photoreceptor disruption in eyes with branch retinal vein occlusion. It seems that the deep capillary plexus plays an important role on the metabolic demands of outer retina and, consequently, an ischemia at the level of deep capillary plexus has significant impact on the integrity of the photoreceptors.
LONG-TERM ANATOMICAL AND FUNCTIONAL OUTCOMES FOLLOWING VITRECTOMY FOR ADVANCED COATS DISEASE
Authors: Karacorlu Murat , Hocaoglu Mumin , Sayman Muslubas Isil , Arf Serra
Published: December 2016

Purpose:

To assess the long-term anatomical and functional results of vitreoretinal surgery in patients with advanced Coats disease.

Methods:

Retrospective analysis of 23 patients who underwent 23-gauge pars plana vitrectomy combined with transscleral cryotherapy, laser photocoagulation, and intraocular tamponade between 2005 and 2014 and had a follow-up of at least 1 year. The primary outcomes were mean visual acuity and anatomical success.

Results:

The average age at the time of surgery was 8.7 ± 1.3 years (range, 2–18 years). The mean follow-up period was 55.2 ± 31 months (range, 12–120 months). In 16 eyes (70%), further treatment was not necessary. In the remaining 7 patients (30%), revision surgery with silicone oil tamponade was required. In 20 eyes (87%), the retina was reattached. At the final visit, 8 eyes (35%) had improved mean Snellen visual acuity from 20/1,000 at initial presentation to 20/160, 3 eyes (13%) showed stabilization, and 6 eyes (26%) had decline in visual acuity. No enucleation was necessary, and no progression to neovascular glaucoma was observed.

Conclusion:

Pars plana vitrectomy combined with cryotherapy, laser photocoagulation, and intraocular tamponade could be an effective treatment option for advanced Coats disease. Despite surgery, disease-related complications remained high, but the main aim of management in these young patients is functional and anatomical stability.
EFFICACY OF DEXAMETHASONE INTRAVITREAL IMPLANT FOR REFRACTORY MACULAR EDEMA CAUSED BY RETINAL VEIN OCCLUSION
Authors: Hussain Rehan M. , Ciulla Thomas A. , Ciulla Lauren M. , Sink Bethany , Harris Alon
Published: December 2016

Purpose:

To investigate efficacy of dexamethasone intravitreal (DEX) implant in treating refractory macular edema caused by retinal vein occlusion.

Methods:

Retrospective chart review.

Results:

Twenty-two eyes with refractory macular edema caused by retinal vein occlusion were treated with a mean of 2.2 DEX over 12 months. Patient had previously received a mean of 7 treatments (laser, bevacizumab, and/or triamcinolone) for macular edema present for at least 4 months duration (mean 20.8 ± 17.6 months, range 4–72 months) before starting DEX. Mean baseline visual acuity was 20/91, and mean central subfield thickness was 506 μm. DEX improved mean best-corrected visual acuity to 20/75 and 20/66 at 7 weeks and 6 months follow-up, although it worsened to 20/132 at 12 months. Mean central subfield thickness improved to 292, 352, and 356 μm at 7 weeks, 6 months, and 12 months follow-up, respectively. There was a statistically significant association between number of DEX treatments and central subfield thickness (P = 3.28 × 10−9). There was a statistically significant association between number of days followed and best-corrected visual acuity (P = 0.006). Six of 12 (50%) phakic patients developed visually significant cataract requiring surgery. Five of 22 (23%) patients developed ocular hypertension (intraocular pressure > 30) and consequently did not undergo further treatment with DEX.

Conclusion:

DEX resulted in sustained anatomical reduction of retinal vein occlusion–associated refractory macular edema, although this did not translate into long-term best-corrected visual acuity improvement in either phakic or pseudophakic patients, possibly related to chronic structural alterations in the retina despite reduction of edema.
Upper Eyelid Response to Topical 0.5% Apraclonidine
Authors: Kirkpatrick Christopher A. , Shriver Erin M. , Clark Thomas J. E. , Kardon Randy H.
Published: December 2016

Purpose:

To describe the change in upper eyelid position in a self-reportedly normal population after the administration of topical 0.5% apraclonidine in each eye.

Methods:

One hundred self-reportedly normal subjects received a 1-time administration of topical 0.5% apraclonidine in each eye. Digital photographs were taken at baseline and then 30 and 45 minutes following apraclonidine instillation. Marginal reflex distance 1 was determined via image analysis of acquired digital photographs (image-derived measurements are given the prefix “i” in this study). The horizontal corneal diameter was used as a constant measurement scale in each photograph.

Results:

The mean increase in i-marginal reflex distance 1 post-administration of 0.5% apraclonidine was +0.70 ± 0.60 mm (range, −0.94 to +2.66 mm) after 30 minutes and +0.68 ± 0.59 mm (range, −0.69 to +2.54 mm) after 45 minutes. Of the 200 total eyelids in 100 subjects, 181 (90.5%) had an increase in i-marginal reflex distance 1 at 30 minutes. Of the 100 subjects, 85 (85%) had a bilateral increase in i-marginal reflex distance 1, 4 (4%) had a bilateral decrease, and 11 (11%) had a unilateral increase with a contralateral decrease.

Conclusions:

Given its predominant small-amplitude upper eyelid elevating effect, topical apraclonidine may be a useful off-label alternative treatment for mild upper eyelid ptosis and in eyelid asymmetry due to eyelid retraction through use in the contralateral eye.
Low‐impedance Baseline Values Predict Severe Esophagitis
Authors: Cohen Sabban Judith , Bertoldi Gabriela D. , Ussher Federico , Christiansen Silvia , Lifschitz Carlos , Orsi Marina
Published: December 2016

Objectives:

The aim of the study was to determine whether esophageal baseline impedance (BI) values in children could be predictive of esophagitis.

Materials and Methods:

Multichannel intraluminal impedance (MII) tracings of children 3 to 17 years of age suspected of having gastroesophageal reflux and esophagitis, who had also undergone upper endoscopy with multiple esophageal biopsies, were reviewed. Patients with eosinophilic esophagitis were excluded. Esophagitis was assessed by macroscopic and microscopic parameters. Esophageal histology was reported by 2 blinded independent pathologists unaware of the MII results. Mean BI was automatically calculated in the different MII channels (ch) by the specific software without removing any episode of increased/decreased BI. BI results were plotted against macroscopic and histological scores for each channel.

Results:

Tracings of 87 children, 53 boys, were evaluated. Mean age was 7.4 years: 45 had histologic esophagitis, 8 macroscopic. Histologic mild esophagitis (grade 1) was observed in 30, and 15 had moderate to severe esophagitis (grade 2–3). Ten had grade 3 esophagitis. Eight had macroscopic esophagitis as well. Results: in channel 6 of the MII, all 10 patients with grade 3 esophagitis and the 8 with macroscopic esophagitis had a BI <900 Ω/s (positive predictive value 100% and negative predictive value 100%), whereas none of those having a biopsy score of 0 to 2 or no endoscopic evidence of esophagitis had a mean BI below 2000 Ω/s.

Conclusions:

The evaluation of the BI measured in channel 6 gave us 100% prediction of grade 3 and macroscopic esophagitis. BI on channel 6 may be useful to predict severe esophageal mucosa inflammation and could potentially be used for follow‐up evaluation, rather than repeating an upper endoscopy. In addition, it would seem that grade 3 esophagitis even in the absence of macroscopic esophagitis affects the integrity of the esophageal epithelium.
Trends in Use and Outcomes of Women Undergoing Hysterectomy With Electric Power Morcellation
Authors: Wright Jason D. , Chen Ling , Burke William M. , Hou June Y. , Tergas Ana I. , Ananth Cande V. , Hershman Dawn L.
Published: December 2016

(Abstracted from JAMA 2016;316:877–878)

Over several years, there has been increasing concern that use of electric power morcellation during hysterectomy for benign conditions may result in the spread of undetected malignancies. This concern led the US Food and Drug Administration (FDA) to issue a safety communication in April 2014 discouraging use of morcellation and, in November 2014, to recommend against use of this procedure in perimenopausal and postmenopausal women.
Adverse Fetal and Neonatal Outcome and an Abnormal Vertebral Pattern: A Systematic Review
Authors: Schut Pauline Christine , Cohen-Overbeek Titia E. , Galis Frietson , Ten Broek Clara M. A. , Steegers Eric A. , Eggink Alex J.
Published: December 2016

Importance

The human vertebral column has a stable number of vertebrae and ribs, which is presumably the result of evolutionary selection. An association between an abnormal vertebral pattern, especially in the cervical region, and congenital anomalies or adverse fetal outcome has been reported.

Objective

The aim of this study was to review the current literature concerning an abnormal vertebral pattern and prevalence of cervical ribs in healthy subjects and in subjects with adverse outcome.

Evidence Acquisition

Scientific databases were searched systematically. Studies assessing the number of vertebrae and/or ribs were included, and data concerning anomalies and outcome were extracted.

Results

Thirty-nine studies including 75,018 healthy subjects and 6130 subjects with structural or chromosomal anomalies or adverse outcome were selected. The majority of these studies focused on the prevalence of cervical ribs. The prevalence of cervical ribs was considerably higher in fetuses with adverse outcome, including aneuploidies, compared with healthy individuals in the vast majority of studies. Studies suggest an association between cervical ribs and other structural anomalies.

Conclusions

These results demonstrate that detailed assessment of the fetal vertebral column, especially of the cervicothoracic region, could provide valuable information regarding fetal and neonatal prognosis. Based on the available evidence, the application of 3-dimensional (3D) ultrasound to assess the vertebral column and ribs, in particular the cervical region, warrants further research.

Relevance

Prenatal assessment of the ribs and vertebral pattern by 3D ultrasound, which is currently not routinely performed, might be useful in the assessment of the fetus, because this can predict fetal and neonatal outcome in some cases.

Target Audience

Obstetricians and gynecologists, family physicians.

Learning Objectives

After completing this activity, the learner should be better able to be aware of the possible relation between a disturbed pattern of the vertebral column and adverse fetal outcome; discuss why changes in the pattern of the vertebral column, especially at the cervical level, should be more deleterious than those at the caudal part of the vertebral column; determine whether an abnormal vertebral pattern is more common in fetuses and neonates with adverse outcome than in healthy subjects; and have insight into the usefulness of detailed assessment of the fetal vertebral column by 3D ultrasound.
Self-Organization of the Human Embryo in the Absence of Maternal Tissues
Authors: Shahbazi Marta N. , Jedrusik Agnieszka , Vuoristo Sanna , Recher Gaelle , Hupalowska Anna , Bolton Virginia , Fogarty Norah M. E. , Campbell Alison , Devito Liani G. , Ilic Dusko , Khalaf Yakoub , Niakan Kathy K. , Fishel Simon , Zernicka-Goetz Magdalena
Published: December 2016

(Abstracted from Nat Cell Biol 2016;18:700–708)

The failure of an embryo to implant into the womb is a major cause of early pregnancy loss. The human embryo must implant into the uterus on the seventh day of development to survive and to develop further.
Use of the APTIMA Combo 2 Assay and a Secondary Algorithm to Detect and Confirm Chlamydia trachomatis in Rectal-Only Infections
Authors: Pabbaraju Kanti , Wong Sallene , Gill Kara , Severini Alberto , Roy Felicia , Gratrix Jennifer , Singh Ameeta E. , Naidu Prenilla , Read Ron , Drews Steven J.
Published: December 2016

We sought to confirm the results of 81 rectal specimens positive for Chlamydia trachomatis by the APTIMA Combo 2 assay among patients with concurrently collected negative genitourinary specimens. A total of 79 (97.5%) samples were confirmed by the APTIMA single target assay and/or sequencing of the C. trachomatis ompA gene.
Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture To Nucleic Acid Amplification Testing
Authors: Cornelisse Vincent J. , Chow Eric P.F. , Huffam Sarah , Fairley Christopher K. , Bissessor Melanie , De Petra Vesna , Howden Benjamin P. , Denham Ian , Bradshaw Catriona S. , Williamson Deborah , Chen Marcus Y.
Published: December 2016

Background

This before-and-after study measured the impact of a change in testing methods from culture to nucleic acid amplification testing (NAAT) on the detection of pharyngeal and rectal gonorrhea in men who have sex with men (MSM) on a sexual health service level, including the effect on subgroups anticipated to have higher rates of gonorrhea.

Methods

In March 2015, Melbourne Sexual Health Centre changed its laboratory method for gonococcal testing from culture to NAAT using the Aptima Combo 2 and Aptima GC tests. We compared the proportion of tests positive for rectal and pharyngeal gonorrhea in MSM using culture in 2014 with those using NAAT in 2015.

Results

The proportion of tests positive for rectal gonorrhea by NAAT was double that obtained by culture (8% vs 3.9%; prevalence ratio [PR], 2.0; 95% confidence interval [CI], 1.8–2.4) and 5-fold for pharyngeal gonorrhea (8.3% vs 1.6%; PR, 5.2; 95% CI, 4.2–6.4). Similar increases in test positivity were observed in human immunodeficiency virus (HIV)-positive and HIV-negative men. By NAAT, test positivity for rectal gonorrhea was higher in HIV-positive compared with HIV-negative men (15.4% vs 7.3%; PR, 2.1; 95% CI, 1.7–2.6). Culture and NAAT had similar test positivity for rectal gonorrhea among men who reported contact with gonorrhea (24.9% vs 25.3%, PR 1.0, 95% CI 0.8–1.4) and men who presented with symptoms of proctitis (22.2% vs 27.9%, PR 1.3, 95% CI 0.8–2.0).

Conclusions

A switch from culture to Aptima Combo 2 testing for extragenital gonorrhea in MSM increased detection and was most marked for pharyngeal infections.