bluuebunny/crossref_metadata_2025 huggingface dataset:
Using motional Stark splitting of Dα emission to constrain MHD equilibrium analysis in DIII-D plasmas
Authors: Burrell K. H. , Lao L. L. , Grierson B. A.
Published: August 2018

We report tests of an alternate technique for constraining MHD equilibrium analysis in tokamak plasmas using internal magnetic field measurements based on |B| measurements from the motional Stark splitting of Dα spectral lines emitted by a neutral heating beam (MSE-LS). We compare results using MSE-LS with those of the standard equilibrium analysis technique based on line polarization of the Dα emission (MSE-LP). An alternative to MSE-LP is needed in future devices such as ITER where MSE-LP will be difficult due to a plasma-induced coating of the first optical element. The tests utilized data from 10 DIII-D shots with 7 MSE-LS and 14 MSE-LP views covering a range of radii along the outer midplane of the plasma. Seven MSE-LS measurements can contribute significantly to the equilibrium reconstruction of pressure and q profiles using both synthetic and experimental DIII-D MSE-LS data. For example, 7 MSE-LS plus seven MSE-LP measurements give a fit quality that is as good as the same cases with 14 MSE-LP measurements. Analyzing synthetic data for 14 MSE-LS measurements shows significant improvement in fitting quality over the case with 7 MSE-LS locations.
A novel phase-shift-based amplitude detector for a high-speed atomic force microscope
Authors: Miyagi Atsushi , Scheuring Simon
Published: August 2018

In any atomic force microscope operated in amplitude modulation mode, aka “tapping mode” or “oscillating mode,” the most crucial operation is the detection of the cantilever oscillation amplitude. Indeed, it is the change in the cantilever oscillation amplitude that drives the feedback loop, and thus, the accuracy and speed of amplitude detection are of utmost importance for improved atomic force microscopy operation. This becomes even more crucial for the operation of a high-speed atomic force microscope (HS-AFM), where feedback operation on a single or a low number of cantilever oscillation cycles between 500 kHz and 1000 kHz oscillation frequency is desired. So far, the amplitude detection was performed by Fourier analysis of each oscillation, resulting in a single output amplitude value at the end of each oscillation cycle, i.e., 360° phase delay. Here, we present a novel analog amplitude detection circuit with theoretic continuous amplitude detection at 90° phase delay. In factual operation, when exposed to an abrupt amplitude change, our novel amplitude detector circuit reacted with a phase delay of ∼138° compared with the phase delay of ∼682° achieved by the Fourier analysis method. Integrated to a HS-AFM, the novel amplitude detector should allow faster image acquisition with lower invasiveness due to the faster and more accurate detection of cantilever oscillation amplitude change.
A combined molecular dynamics simulation and quantum mechanics study on the physisorption of biodegradable CBNAILs on h-BN nanosheets
Authors: Torkzadeh Mehrangiz , Moosavi Majid
Published: August 2018

The nanoscopic structure of biodegradable choline-based naphthenic acid ionic liquids near the hexagonal boron-nitride (h-BN) surface was analyzed using quantum mechanics calculations and molecular dynamics simulations. The effects of the type of the ring (aliphatic or aromatic) and the size of the ring in the anion counterpart of the aliphatic ionic liquids (ILs) on the configurations, binding energies, orbital energies, density of states, charge transfer, and thermochemistry of adsorption of ILs on the h-BN surface were investigated. Also the significance of non-covalent interactions on the adsorption of ILs was disclosed from the quantum theory of atoms in molecule. The results of radial distribution functions, number density, and also charge density profiles showed the existence of a solid-like bottom layer in the vicinity of the surface. Angular distribution functions revealed that while the most probable orientation in aromatic anions is parallel to the h-BN sheet, the most probable orientation in aliphatic rings apparently is perpendicular to the surface. The mobility of cations and anions in the studied ILs with respect to the h-BN sheet was analyzed using their mean square displacements. For all ions near the surface, dynamics in the parallel direction were faster than those in the z-direction due to the structuring of the solid-like layer of ILs near the h-BN surface. Altogether, this study provides new insights into the physisorption of this new class of biodegradable ILs on h-BN nanosheets at the molecular level.
Modulation of particle dynamics in dilute duct flows by electrostatic charges
Authors: Grosshans Holger
Published: August 2018

In manifold industries, the electric charging of powder while it is transported through pipes or ducts is a potential source of ignition and, therefore, a hazard to the operational safety of plants. For pure fluid flows, the relevance of the flow pattern for their charging has been highlighted previously. However, the modulation of particles’ trajectories by the rise of an electric field, i.e., the back-coupling of charges on the flow, has not been investigated yet. To this end, we performed large-eddy simulations to shed light on the question if electric effects modulate turbulent particle-laden flows to a significant extent. Specifically, a fully developed turbulent carrier gas of a Reynolds number of 10 000 in a generic computational domain representing a squared-shaped duct was solved. The flow was seeded by monodisperse particles at a solid-gas mass loading ratio of 0.01 to which a constant amount of charge was assigned, namely, 0 pC, 0.125 pC, or 0.25 pC. It was found that uncharged particles accumulate at the duct walls and, in particular, in its corners due to their turbophoretic drift. However, if charge of the same polarity is assigned to the particles, repelling forces arise in-between them which are especially important in regions where the average particle distance is low. These forces affect a migration in the wall-normal direction leading to a more homogeneous distribution. Furthermore, assigned charge stabilizes the particle trajectories and dampens their velocity fluctuations in most regions of the flow. These findings contribute to the understanding of the role of electrostatic forces in particle-laden flows and may facilitate the control of the flow pattern by adjusting their charge.
A synopsis of the bryocorine tribes (Heteroptera : Miridae : Bryocorinae): key, diagnoses, hosts and distributional patterns
Authors: Konstantinov Fedor V. , Namyatova Anna A. , Cassis Gerasimos
Published: August 2018

The higher classification of the mirid subfamily Bryocorinae has received comparatively little attention. It is not highly species-rich in comparison with other mirid subfamilies but does exhibit extraordinary morphological heterogeneity. In this work we provide a synthesis of the subfamily on a global basis, providing a new key and updated diagnoses of supraspecific taxa. Five tribes are recognised: Bryocorini, Dicyphini, Eccritotarsini, Felisacini and Monaloniini. The genus Campyloneura Fieber is transferred from the tribe Dicyphini to the Eccritotarsini. Analysis of distributional patterns and a survey of host plant associations are provided. Available data on distribution of the main bryocorine lineages are summarised in tabular form and evaluated using UPGMA methods, and geographically structured patterns were detected. The synthesis will enable users to identify bryocorines to tribal level with confidence and provides a classificatory framework for future revisionary and phylogenetic studies.
Effects of heat stress on biochemical parameters and heat shock protein family A (Hsp70) member 5 (HSPA5) mRNA expression in rainbow trout (Oncorhynchus mykiss)
Authors: Xia Binpeng , Liu Zhe , Zhou Yanjing , Wang Yongjie , Huang Jinqiang , Li Yongjuan , Kang Yujun , Wang Jianfu , Liu Xiaoxia
Published: August 2018

Rainbow trout (Oncorhynchus mykiss) is a cold-water species of salmonid, and high temperatures are a significant threat to its aquaculture. In order to understand the degree of the heat stress response and the mechanisms involved, full-sibling inbred O. mykiss individuals were sampled at 18, 21, 23, 24, 25 and 26°C to investigate changes in some serum biochemical parameters, as well as in the mRNA expression of heat shock protein family A (Hsp70) member 5 (HSPA5; also known as glucose regulated protein 78 (GRP78)) in different tissues (liver, mid-kidney, heart, spleen and brain). At 21°C, there was a significant increase in the spleen macrophage respiratory burst and a significant decrease in superoxide dismutase activity compared with 18°C (P<0.05). Malondialdehyde peaked at 23°C, whereas alanine transaminase and aspartate aminotransferase activity were both twofold higher at 25 and 26°C compared with that at 18°C. The Ca2+, Mg2+, PO43– and glucose (Glu) content of serum declined significantly at 21°C relative to 18°C (P<0.05). The expression of HSPA5 mRNA responded in a temperature- and tissue-specific manner to heat stress. Except for in the spleen, HSPA5 mRNA expression was significantly higher in all tissues at 25 and 26°C than that at 18°C (P<0.05). These results indicate that heat stress causes oxidative damage, decreases the Ca2+, Mg2+, PO43– and Glu content of serum and induces HSPA5 mRNA expression.
Intestinal host defense outcome is dictated by PGE
2
production during efferocytosis of infected cells
Authors: Dejani Naiara Naiana , Orlando Allan Botinhon , Niño Victoria Eugenia , Penteado Letícia de Aquino , Verdan Felipe Fortino , Bazzano Júlia Miranda Ribeiro , Codo Ana Campos , Salina Ana Carolina Guerta , Saraiva Amanda Correia , Avelar Matheus Rossi , Spolidorio Luis Carlos , Serezani C. Henrique , Medeiros Alexandra Ivo
Published: August 2018

Significance

Citrobacter rodentium
infection, a murine colitis model to study human intestinal diseases, causes exacerbated apoptosis of intestinal epithelial cells and triggers Th17 immune responses. Here, we identified a heretofore unknown role for the bioactive lipid mediator prostaglandin E
2
(PGE
2
) in the inhibition of Th17 cell differentiation during intestinal
C. rodentium
infection. When the PGE
2
receptor EP4 was antagonized, we detected enhanced colonic Th17 cells, increased expression of antimicrobial peptides, and decreased bacterial numbers in the colon. These results suggest that pharmacological intervention of the PGE
2
signaling may be an important target to enhance Th17 actions and improve intestinal host defense.
Classification of prostate cancer using a protease activity nanosensor library
Authors: Dudani Jaideep S. , Ibrahim Maria , Kirkpatrick Jesse , Warren Andrew D. , Bhatia Sangeeta N.
Published: August 2018

Significance

Prostate cancer is the most common noncutaneous cancer in men, but there is a need for better biomarkers that can identify aggressive disease. Here, we describe a bottom-up approach to design nanosensors to detect and classify prostate cancer. We used transcriptomic and proteomic analysis to identify proteolytic enzymes that are dysregulated in human prostate cancer and built a library of nanosensors to measure their activity in vivo using multiplexed urinary readouts. In mouse models, we demonstrated that these nanosensors could classify aggressive prostate cancer and outperform a serum biomarker. This library could be deployed as a screening test to identify patients with higher-risk prostate cancer at the time of screening.
Tunable stacking fault energies by tailoring local chemical order in CrCoNi medium-entropy alloys
Authors: Ding Jun , Yu Qin , Asta Mark , Ritchie Robert O.
Published: August 2018

Significance

Our work has revealed the nature of local chemical order and has established its significant relationship to the intrinsic and extrinsic stacking fault energy in CrCoNi medium-entropy solid-solution alloys, whose combination of strength, ductility, and toughness properties approaches the best on record. These findings highlight the general need to discern how critical the role of local chemical ordering is in dictating the mechanical of properties of medium- and high-entropy alloys. Our results highlight the possibility of tuning order in disorder to ultimately achieve the science-based design and optimization of new high-entropy alloy systems with specifically desired combinations of macroscale mechanical properties.
Evolutionary history of humanPlasmodium vivaxrevealed by genome-wide analyses of related ape parasites
Authors: Loy Dorothy E. , Plenderleith Lindsey J. , Sundararaman Sesh A. , Liu Weimin , Gruszczyk Jakub , Chen Yi-Jun , Trimboli Stephanie , Learn Gerald H. , MacLean Oscar A. , Morgan Alex L. K. , Li Yingying , Avitto Alexa N. , Giles Jasmin , Calvignac-Spencer Sébastien , Sachse Andreas , Leendertz Fabian H. , Speede Sheri , Ayouba Ahidjo , Peeters Martine , Rayner Julian C. , Tham Wai-Hong , Sharp Paul M. , Hahn Beatrice H.
Published: August 2018

Significance

Chimpanzees, bonobos, and gorillas harbor close relatives of humanPlasmodium vivax, but current knowledge of these parasites is limited to a small number of gene fragments derived almost exclusively from mitochondrial DNA. We compared nearly full-length genomes of ape parasites with a global sample of humanP. vivaxand tested the function of human and apeP. vivaxproteins believed to be important for erythrocyte binding. The results showed that ape parasites are 10-fold more diverse than humanP. vivaxand exhibit no evidence of species specificity, whereas humanP. vivaxrepresents a bottlenecked lineage that emerged from within this parasite group. Thus, African apes represent a largeP. vivaxreservoir whose impact on human malaria eradication requires careful monitoring.
KIF1Bβ mutations detected in hereditary neuropathy impair IGF1R transport and axon growth
Authors: Xu Fang , Takahashi Hironori , Tanaka Yosuke , Ichinose Sotaro , Niwa Shinsuke , Wicklund Matthew P. , Hirokawa Nobutaka
Published: August 2018

KIF1Bβ is a kinesin-3 family anterograde motor protein essential for neuronal development, viability, and function. KIF1Bβ mutations have previously been reported in a limited number of pedigrees of Charcot-Marie-Tooth disease type 2A (CMT2A) neuropathy. However, the gene responsible for CMT2A is still controversial, and the mechanism of pathogenesis remains elusive. In this study, we show that the receptor tyrosine kinase IGF1R is a new direct binding partner of KIF1Bβ, and its binding and transport is specifically impaired by the Y1087C mutation of KIF1Bβ, which we detected in hereditary neuropathic patients. The axonal outgrowth and IGF-I signaling of Kif1b−/− neurons were significantly impaired, consistent with decreased surface IGF1R expression. The complementary capacity of KIF1Bβ-Y1087C of these phenotypes was significantly impaired, but the binding capacity to synaptic vesicle precursors was not affected. These data have supported the relevance of KIF1Bβ in IGF1R transport, which may give new clue to the neuropathic pathogenesis.
Diet Quality Indices and Risk of Type 2 Diabetes Mellitus
Authors: Chen Guo-Chong , Koh Woon-Puay , Neelakantan Nithya , Yuan Jian-Min , Qin Li-Qiang , van Dam Rob M
Published: August 2018

We aimed to test whether predefined dietary patterns that are inversely related to risk of type 2 diabetes (T2D) in Western populations were similarly associated with lower T2D risk in an Asian population. We included 45,411 middle-aged and older participants (ages 45–74 years) in the Singapore Chinese Health Study who were free of diabetes, cancer, and cardiovascular disease at baseline (1993–1998). Participants were followed up for T2D diagnosis through 2010. Dietary information was collected using a validated food frequency questionnaire. Dietary pattern scores were calculated for the alternate Mediterranean diet (aMED), Alternate Healthy Eating Index 2010 (AHEI-2010), the Dietary Approaches to Stop Hypertension (DASH) diet, an overall plant-based diet index, and a healthful plant-based diet index. During a median of 11.1 years of follow-up, 5,207 incident cases of T2D occurred. After adjustment for multiple potential confounders, the 5 dietary pattern scores were significantly associated with 16% (for aMED) to 29% (for DASH) lower risks of T2D when comparing the highest score quintiles with the lowest (all P-for-trend values < 0.001). These associations did not vary substantially by baseline age, sex, body mass index, or hypertension status but were limited to nonsmokers (aMED: P for interaction < 0.001; AHEI-2010: P for interaction = 0.03). Adherence to a high-quality diet, as reflected by several predefined diet quality indices derived in Western populations, was significantly associated with lower T2D risk in an Asian population.
Effect of Intentional Weight Loss on Mortality Biomarkers in Older Adults With Obesity
Authors: Shaver Lauren N , Beavers Daniel P , Kiel Jessica , Kritchevsky Stephen B , Beavers Kristen M
Published: August 2018

Background

Observational research has identified several mortality biomarkers; however, their responsiveness to change is unknown. We tested whether the Healthy Aging Index (HAI) and other mortality biomarkers were responsive to intentional weight loss (WL), which is associated with lower mortality risk in recent meta-analyses.

Methods

Older adults (70.3 ± 3.7 years) with obesity were randomized into a 6-month WL (n = 47) or weight stability (WS: ±5% baseline weight; n = 48) program. Baseline and 6-month HAI score (0–10) was calculated from component sum (each 0–2: systolic blood pressure, forced vital capacity [FVC], creatinine, fasting blood glucose [FBG], Montreal Cognitive Assessment), and gait speed, grip strength, Digit Symbol Substitution Test, FEV1, Interleukin-6, C-Reactive Protein, and Cystatin-C were assessed at baseline and 6 months.

Results

Mean baseline HAI was 3.2 ± 1.6. By 6 months, WL participants lost 8.87 (95% CI: −10.40, −7.34) kg, whereas WS participants remained weight stable. WL group reduced HAI score (WL: −0.75 [95% CI: −1.11, −0.39] vs WS: −0.22 [95% CI: −0.60, 0.15]; p = .04), and components changing the most were FBG (WL: −3.89 [95% CI: −7.78, 0.00] mg/dL vs WS: 1.45 [95% CI: −2.61, 5.50] mg/dL; p = .047) and FVC (WL: 0.11 [95% CI: −0.01, 0.23] L vs WS: −0.05 [95% CI: −0.17, 0.08] L; p = .06). Among other biomarkers, only Cystatin-C significantly changed (WL: −2.53 [95% CI: −4.38, −0.68] ng/mL vs WS: 0.07 [95% CI: −1.85, 1.98] ng/mL; p = .04). Combining treatment groups, 1 kg WL was associated with a 0.07 (95% CI: 0.03, 0.12) HAI reduction (p < .01).

Conclusion

Intentional WL via caloric restriction reduced HAI score by 0.53 points, largely attributable to metabolic and pulmonary improvements.
Reconciling the father tongue and mother tongue hypotheses in Indo-European populations
Authors: Zhang Menghan , Zheng Hong-Xiang , Yan Shi , Jin Li
Published: August 2018

In opposition to the mother tongue hypothesis, the father tongue hypothesis states that humans tend to speak their fathers’ language, based on a stronger correlation of languages to paternal lineages (Y-chromosome) than to maternal lineages (mitochondria). To reassess these two competing hypotheses, we conducted a genetic–linguistic study of 34 modern Indo-European (IE) populations. In this study, genetic histories of paternal and maternal migrations in these IE populations were elucidated using phylogenetic networks of Y-chromosomal and mitochondrial DNA haplogroups, respectively. Unlike previous studies, we quantitatively characterized the languages based on lexical and phonemic systems separately. We showed that genetic and linguistic distances are significantly correlated with each other and that both are correlated with geographical distances among these populations. However, when controlling for geographical factors, only the correlation between the distances of paternal and lexical characteristics, and between those of maternal and phonemic characteristics, remained. These unbalanced correlations reconciled the two seemingly conflicting hypotheses.
Bartonella Infectious Endocarditis Associated With Cryoglobulinemia and Multifocal Proliferative Glomerulonephritis
Authors: Babiker Ahmed , El Hag Mohammed I , Perez Christian
Published: August 2018

Bartonella sp. are a common cause of culture-negative infective endocarditis. Glomerulonephritis is a well-documented consequence of the immune activation associated with infective endocarditis. However, Cryoglobulinemia has not previously been reported in association with Bartonella infective endocarditis. Below we report a case of a 48-year-old male with Bartonella henselae infective endocarditis complicated by cryoglobulinemia and multifocal proliferative glomerulonephritis, highlighting a possible link between Bartonella sp. infection and type III cryoglobulinemia.
Postinvasive Bacterial Resistance Conferred by Open Stomata in Rice
Authors: Zhang Dandan , Tian Caijuan , Yin Kangquan , Wang Wenyi , Qiu Jin-Long
Published: August 2018

Stomata are leaf pores that regulate gas exchange and water transpiration in response to environmental cues. They also function in innate immunity by limiting pathogen entry through actively closing in so-called stomatal defense. However, roles of stomata in plant disease resistance are not fully elucidated, especially in monocots. Here, we report that non–race specific resistance of the rice abscisic acid-deficient mutant Osaba1 to Xanthomonas oryzae pv. oryzae is due to increased stomatal conductance. Reducing stomatal conductance in the Osaba1 mutant increases its susceptibility to X. oryzae pv. oryzae. Artificial opening of stomata in wild-type plants leads to enhanced resistance to X. oryzae pv. oryzae. The rice mutant es1-1 with constitutively higher stomatal conductance exhibits strong resistance to X. oryzae pv. oryzae. Additionally, Osaba1 and es1-1 are resistant to X. oryzae pv. oryzicola. The data support that open stomata confer postinvasive resistance against bacterial pathogens in rice, and such resistance probably results from decreased leaf water potential. Our findings reveal a novel role of stomata in plant immunity through modulation of leaf water status, which provides physiological insight into the interactions between plant, pathogen, and environment.
Role of allergen-specific T-follicular helper cells in immunotherapy
Authors: Yao Yin , Wang Zhi-Chao , Yu Di , Liu Zheng
Published: August 2018

Purpose of review

The discovery of novel T-cell subsets including follicular helper T (Tfh) cells has broadened our knowledge on the complex immune networks in allergic diseases. This review summarizes the evidence for Tfh cells in controlling immune responses to allergens with a particular focus on immunoglobulin E (IgE) production and discusses the implication of such regulation in allergen-specific immunotherapy.

Recent findings

Tfh cells support the production of IgE in animal models for allergic diseases. Among Tfh cells, the type 2 subset (Tfh2) is considered as the major player that secretes IL-4 and promotes the isotype switching to IgE. In human inflammatory airway diseases, including allergic rhinitis, asthma, and nasal polyps, the increased frequencies of circulating or tissue Tfh2 cells have been reported. Notably, the frequencies of Dermatophagoides pteronyssinus group 1 (Der p 1)-specific IL-4+ Tfh cells in blood positively correlated with serum Der p-specific IgE levels in allergic rhinitis patients. After allergen immunotherapy (AIT), Der p 1-specific IL-4+ Tfh cells declined in allergic rhinitis patients, which associated with the remission of clinical symptoms.

Allergen-specific IL-4+ Tfh cells contribute to the production of allergen-specific IgE and correlate with clinical efficacy of AIT in allergic rhinitis patients, which suggest allergen-specific Tfh cells as a promising therapeutic target and biomarker for AIT in allergic rhinitis.
FGFR3 Antibodies in Neuropathy: What to Do With Them?
Authors: Samara Verena , Sampson Jacinda , Muppidi Srikanth
Published: August 2018

Objectives:

To describe the variability of fibroblast growth factor receptor 3 (FGFR3) antibody titers in a small series of patients.

Methods:

We performed a retrospective review of patients with neuropathy and positive FGFR3 antibodies.

Results:

We report 7 patients (3 women) with an age range 44–81 years. Symptoms were acute onset in 3 and subacute onset in 4 patients. Five had neuropathic pain. Examination revealed normal large fiber function to mild/moderate predominantly sensory neuropathy and ataxia in one patient. Electrodiagnostic studies revealed normal large fiber function (3), demyelinating neuropathy (1), and mild/moderate axonal neuropathy (3). Four patients had high and 3 patients had low FGFR3 titers. Repeat testing revealed absence of antibodies in 2 patients and a significant reduction in one patient without any intervening immunotherapy.

Conclusions:

Our case series highlights the variability and inconsistency in FGFR3 antibody titers through enzyme-linked immunosorbent assay testing. These antibody titers should always be interpreted with caution in clinical context.
Optimizing bone health in adolescents
Authors: Monge Maria C.
Published: August 2018

Purpose of review

The purpose is to provide a brief overview of factors that impact adolescent bone health and review special populations that deserve extra consideration of their bone health status.

Recent findings

Optimization of modifiable factors is critical for adolescents to reach peak bone mass. Binge drinking, tobacco use, and certain medications all have accumulating evidence showing detrimental impacts on adolescent bone health and certain populations are more at risk for poorer bone health outcomes because of the nature of their conditions. Furthermore, very recent evidence suggests that in certain patients who have a history of insufficient nutritional and hormone status, ‘catch-up’ bone acquisition may not occur, underscoring the importance of early attention to these modifiable factors.

Providers caring for adolescents should be aware of the many different populations at risk for poor bone health. Treatment that might further compromise bone health should be considered judiciously and providers should encourage optimization of any modifiable factor when possible.
Comparative Study of Ocular Pharmacokinetics of Gatifloxacin Between Continuous Lavage and Hourly Topical Instillation in Rabbits
Authors: Zhao Xin , Shen Xu , Zhang Xian , Chen Shichao , Lu Hong , Wang Mingwu
Published: August 2018

Purpose:

To investigate the ocular pharmacokinetics and distribution of gatifloxacin between continuous lavage through the Morgan lens and repeated topical drop instillation in rabbits.

Methods:

Thirty-six healthy rabbits were randomly divided into 2 groups, and 0.3% gatifloxacin ophthalmic solution was instilled by continuous lavage using the Morgan lens onto the left eyes at 15 mL/h (or 50 μL of the same solution repeatedly administered topically every hour). The animals were killed at 2, 4, 8, and 12 hours in the Morgan lens group or at 12 and 24 hours in the topical instillation group. Aqueous humor specimens were collected from the anterior chamber first, and other ocular tissues and plasma were collected subsequently. Pharmacokinetic and pharmacodynamic indices, other than the minimum inhibitory concentration (MIC), were used as therapeutic parameters in ocular tissues.

Results:

The highest concentration was found in the corneas in both groups. With continuous lavage, gatifloxacin reached an efficacious high concentration in 4 hours in the cornea, which is equivalent to about 23 times the concentration reached in the same tissue by hourly topical instillation for 12 to 24 hours. Using historic data as references, C/MIC90 was 105 (>10) and AUC0–t/MIC90 was 194 h (>125) in the cornea in the continuous lavage group at 4 hours, whereas these values were 5 and 73 hours for the topical hourly instillation group.

Conclusions:

Compared with hourly topical instillation, continuous lavage through the Morgan lens could achieve significantly higher concentrations in ocular tissues within a short period, especially in the cornea. Continuous lavage may be a much more efficient way to treat recalcitrant corneal infections.
The Relationship Between Eyebrow and Eyelid Position in Patients With Ptosis, Dermatochalasis and Controls
Authors: Sinha Kunal R. , Al Shaker Sara , Yeganeh Amir , Moreno Tyler , Rootman Daniel B.
Published: August 2018

Purpose:

The purpose of this study is to explore mechanical and co-innervational factors involved in both voluntary and involuntary brow elevation among people affected by ptosis and dermatochalasis.

Methods:

In this prospective cohort study of normal controls and eyelids with ptosis or dermatochalasis, marginal reflex distance (MRD1) and brow height were measured under the following conditions: neutral position, involuntary mechanical brow elevation, voluntary brow elevation, and maximal eyelid opening. The primary outcome measure was change in MRD1. Secondary outcome measures included brow height and coupling (mm brow height change per mm MRD1 change). Analysis of variance and t tests were performed for intra- and intercondition comparisons, respectively.

Results:

Mechanical (involuntary) brow elevation significantly raised MRD1 in control eyelids and eyelids with dermatochalasis, but not in eyelids with ptosis. Voluntary brow elevation produced significantly greater brow height than maximal eyelid opening in controls and eyelids with dermatochalasis, but not in eyelids with ptosis. Maximal eyelid opening increased MRD1 greater than voluntary brow elevation significantly in control eyelids, but not in eyelids with dermatochalasis or ptosis. Coupling of the brow and eyelid margin during maximal eyelid opening was significantly greater in eyelids with ptosis relative to controls.

Conclusions:

In eyelids with ptosis, mechanical brow elevation does not change eyelid position; however, voluntary brow elevation raises eyelid position to a similar position as maximal eyelid opening. These results argue against the contention that the brow is elevated to mechanically lift the eyelid in ptosis and instead suggest that the brow elevation is driven by efforts to raise the eyelid, possibly via co-innervation.
Melancholic Symptoms in Bipolar II Depression and Responsiveness to Lamotrigine in an Exploratory Pilot Study
Authors: Peters Evyn M. , Bowen Rudy , Balbuena Lloyd
Published: August 2018

Background

In this exploratory pilot study we reanalyzed data from a previous randomized, double-blind, placebo-controlled trial of lamotrigine for bipolar II depression in which lamotrigine was not superior to placebo to determine if splitting the sample into melancholic and nonmelancholic subgroups revealed a significant treatment effect.

Methods

Adult outpatients (n = 150) in an acute bipolar II depressive episode completed 8 weeks of treatment with lamotrigine (titrated to 200 mg/d) or placebo. Depressive symptoms were assessed at baseline and weekly with the 17-item Hamilton Depression Rating Scale (HAMD-17) and the Montgomery-Åsberg Depression Rating Scale (MADRS). The presence of melancholic depression was determined by baseline responses to the HAMD-17 and MADRS according to the Diagnostic and Statistical Manual of Mental Disorders criteria. Cox regression models stratified by melancholic status were used to predict HAMD-17 and MADRS treatment response. Analysis-of-variance models were used to compare HAMD-17 and MADRS change scores between lamotrigine and placebo groups while testing for interactions by melancholic status.

Results

Lamotrigine was associated with higher odds of treatment response compared with placebo in the melancholic subgroup but not in the nonmelancholic subgroup. However, the melancholic subgroup-treatment interactions from the analysis-of-variance models were nonsignificant.

Conclusions

Further research is warranted to test the hypothesis that bipolar depression with melancholic symptoms is more responsive to lamotrigine over placebo than nonmelancholic bipolar depression.
Sequential Imaging in Patient With Suspected Menière's Disease Identifies Endolymphatic Sac Tumor
Authors: Kirsh Elliana R. , Kozin Elliott D. , Knoll Renata M. , Wong Kevin , Faquin William , Reinshagen Katherine L. , Kieff David , Rauch Steven D. , Jung David H.
Published: August 2018

Objective:

The standard evaluation of patients with suspected Menière's disease (MD) includes initial imaging to rule out tumors of the temporal bone. Few guidelines, however, advocate sequential imaging. We propose that sequential imaging may reveal other etiologies of auditory and vestibular symptoms as demonstrated in a patient with an endolymphatic sac tumor that was originally diagnosed Menière's after initial imaging.

Patients:

One patient with MD and initially unremarkable imaging. Repeat imaging several years after diagnosis after additional symptoms demonstrated interval development of an endolymphatic sac tumor (ELST).

Interventions:

Resection of endolymphatic sac tumor.

Main Outcome Measures:

1) Audiometry, 2) temporal bone imaging, and 3) otopathology

Results:

A 45-year-old man with diagnosis of asymmetric sensorineural hearing loss and intermittent vertigo underwent temporal bone magnetic resonance imaging that did not demonstrate any causative lesions. After an episode of sudden sensorineural hearing loss 4 years after initial presentation, repeat imaging was obtained. Magnetic resonance imaging and surgical resection confirmed diagnosis of ELST. The patient had no history of von Hippel-Lindau disease.

Conclusions:

A patient with a longstanding diagnosis of MD demonstrated interval development of an ELST. While ELSTs are rare, the study raises the question regarding whether interval imaging is indicated in patients with MD.
Primary Endoscopic Stapes Surgery: Audiologic and Surgical Outcomes
Authors: Nassiri Ashley M. , Yawn Robert J. , Dedmon Matthew M. , Tolisano Anthony M. , Hunter Jacob B. , Isaacson Brandon , Rivas Alejandro
Published: August 2018

Objective:

Evaluate outcomes following primary endoscopic stapes surgery.

Study Design:

Retrospective case series.

Setting:

Two tertiary otologic centers.

Patients:

Eighty-one ears with surgically confirmed stapes fixation.

Interventions:

Total endoscopic stapedotomy or stapedectomy.

Main Outcome Measures:

Surgical and audiologic outcomes.

Results:

Eighty-one subjects were included (60% women) with a median age of 47.6 years (range, 19.1–73.6 yr). Etiologies of hearing loss included otosclerosis (96.3%), stapedial ankylosis (2.5%), and congenital stapes fixation (1.2%). The median follow-up was 5.3 months (range, 1.2–50.4 mo). 74.1% required scutum removal, and the chorda tympani nerve was sacrificed in 7.4%. Two techniques were used: 51.9% underwent stapedectomy and 48.1% underwent stapedotomy (with use of laser, drill, or both in 74.4, 20.5, and 5.1% of cases, respectively). The median air-bone gap (ABG) improved from 31.3 dB preoperatively to 6.25 dB postoperatively at last follow-up (p < 0.0001). The ABG closed to less than 15 dB in 96.3% of patients and less than 10 dB in 84%. There were no instances of postoperative sensorineural hearing loss (defined as >15 dB change from baseline) or facial nerve injury. Postoperatively, 29.6% of patients reported dysgeusia, of which 8.3% was persistent at last follow-up. Postoperative disequilibrium was reported in 17.3% of cases, with 100% resolution at last follow-up. Comparison of the stapedotomy and stapedectomy groups revealed no significant differences in audiologic or surgical outcomes.

Conclusions:

Endoscopic stapedotomy and stapedectomy are effective techniques to manage stapes fixation resulting in a median postoperative ABG of 6.25 dB and ABG closure to within 10 dB in 84% of patients.
The Bone Mineral Density of the Lateral Skull Base and its Relation to Obesity and Spontaneous Cerebrospinal Fluid Leaks
Authors: Hatch Jonathan L. , Schopper Heather , Boersma Isabel M. , Rizk Habib G. , Nguyen Shaun A. , Lambert Paul R. , McRackan Theodore R. , Meyer Ted A.
Published: August 2018

Objectives:

Evaluate the bone mineral density (BMD) of the lateral skull base by thin sliced computed tomography (CT) scans.

Determine the BMD and its relation in patients who are obese or who have spontaneous cerebrospinal fluid (CSF) leaks.

Study Design:

Blinded retrospective case control series.

Setting:

Tertiary care university setting.

Patients:

A control group consisting of age and sex matched non-obese patients were compared with obese and CSF leak patients.

Interventions:

Three blinded reviewers measured the BMD at multiple locations along the lateral skull base using thin sliced high-resolution CT scans. Additional BMD measurements were obtained from the temporal bone squamosal and otic capsule. The BMD was compared between the groups.

Main Outcome Measure:

Lateral skull base BMD in patients who are obese or have CSF leaks as compared with non-obese controls.

Results:

Sixty-five (n = 65) patients were included in the study. The control group (n = 21) had a median density along the tegmen of 499.4 (178.8) HU, obese (n = 26) had an average HU of 559.5 (207.2), and CSF leak group (n = 18) had an average 472.9 (154.9), respectively (p = 0.35). The BMD in the temporal bone squamosa (p = 0.07) was not significantly different, however, the otic capsule was denser in the CSF leak group (p = 0.01) compared with the control group or the obese group. The intraclass correlation coefficient of the CT reviewers’ measurements were moderate to strong (k = 0.69–0.99).

Conclusion:

There appears to be no difference between the BMD of the lateral skull base as it relates to obesity or spontaneous CSF leaks compared with normal weight controls. These findings suggest the BMD does not have a significant role in the development of lateral skull base thinning or dehiscence leading to CSF leaks.
Analysing blood from intraosseous access: a systematic review
Authors: Jousi Milla , Laukkanen-Nevala Päivi , Nurmi Jouni
Published: August 2018

Intraosseous (IO) access is used widely as an optional vascular route for critically ill patients. It is still unclear whether the IO access can be used as a source for emergency blood samples. The aim of this study was to systematically review the existing literature on the usability of IO blood samples for analysing the parameters relevant to emergency care. We performed a data search from the Medline and Embase databases, the Cochrane Library and the Clinical trials registry. Animal studies and studies with healthy and ill adults and children were included in the search. The data were collected and reported following the PRISMA guidelines. The PROSPERO database registration number of this review is CRD42017064194. We found 27 studies comparing the blood samples from the IO space with arterial or venous samples, but only three of them followed the recommended guidelines for method comparison studies. The study populations were heterogeneous, and the sample sizes were relatively small (14, 17 and 20 individuals) in the three studies. The results of specific laboratory parameters were scarce and discordant. The evidence on the agreement between IO and arterial and venous samples is still weak. Existing studies with healthy volunteers and animal models provide important insight into the analyses of IO samples, but more evidence, especially from haemodynamically unstable patients, is needed for wider implementation of IO blood sampling in critically ill patients.
Narcissism and Interpersonal Problems Among Psychiatric Outpatients
Authors: Mielimaka Michal , Ogrodniczuk John S. , Kealy David , Cheek Joanna , Joyce Anthony S.
Published: August 2018

A growing body of evidence points to significant interpersonal problems associated with narcissism in clinical samples. Less well understood are the mechanisms by which narcissism negatively impacts one’s interpersonal functioning. The present study investigated defensive style as a possible mediator of the relationship between narcissism and interpersonal problems. A sample of 53 adult psychiatric outpatients completed measures of narcissism, defensive style, interpersonal problems, and current symptom distress. Mediation analysis was conducted, controlling for current symptom distress, using 95% bootstrapped confidence intervals to examine the indirect effect of narcissism on interpersonal problems via defensive style. Narcissism was significantly associated with immature and neurotic defensive styles. Although narcissism was not directly related to interpersonal problems, a significant indirect effect was observed for narcissism on interpersonal problems via neurotic defensive style. This finding suggests that narcissism contributes to the use of neurotic defenses, which in turn influence one’s interpersonal functioning.
Predictors of Sustained Employment Among Individuals With Serious Mental Illness
Authors: Russinova Zlatka , Bloch Philippe , Wewiorski Nancy , Shappell Heather , Rogers E. Sally
Published: August 2018

Despite decades of research, understanding of the employment trajectories of individuals with serious mental illnesses remains elusive. We conducted a 5-year prospective, longitudinal study using a geographically broad sample of individuals who met established criteria for sustained competitive employment (N = 529). We collected data on an annual basis with a specifically designed survey instrument. Despite stable employment at study entry, more than half of the participants experienced work interruptions during the 5-year follow-up period. Predictors of sustained employment included the absence of a trauma diagnosis, Social Security disability income, psychiatric hospitalizations, and difficulties with daily functioning. The presence of a higher quality of life, workplace supports, and a flexible job were also predictive. Results dispel the myth that people with serious mental illnesses cannot be employed for prolonged periods. Interruptions in work trajectories, however, suggest that longer-term supports may increase individuals' capacity to maintain stable employment.
Long-Term Effects of Experimental Human Endotoxemia on Immune Cell Function: Similarities and Differences With Sepsis
Authors: Rodriguez-Rosales Yessica Alina , Kox Matthijs , van Rijssen Esther , van Cranenbroek Bram , van Welie Marina , Pickkers Peter , Joosten Irma , Koenen Hans J.P.M.
Published: August 2018

Sepsis is the cause of more than 5.3 million deaths per year, and novel immunotherapeutic strategies are highly warranted. Human models that mirror sepsis immunology are instrumental to this aim. The response to endotoxin in humans during the first 24 h captures many hallmarks of the inflammatory response observed in sepsis. However, the long-term immunologic effects of human experimental endotoxemia have been sparsely studied and could be determinant for the use of this model in sepsis therapy research. In the present work, we studied the immune-composition of healthy subjects challenged with endotoxin (1 ng/kg) 4 h, 2 days, and 20 days post administration by flow cytometry to study the effects on innate and adaptive immune system, and compared it with the immune-composition in patients during the first 9 days after onset of septic shock. We found several differences and similarities between these groups. Experimental endotoxemia resulted in an increase in absolute numbers of intermediate monocytes, which also displayed lower human leucocyte antigen expression 20 days post endotoxin. These changes differed with those observed in septic shock patients. Another long-term effect of experimental endotoxemia was elevated numbers of effector CD8+ cells and an increased percentage of proliferating and cytokine expressing CD8+ cells, and these phenomena were also present in sepsis patients. In conclusion, despite considerable differences, experimental endotoxemia captures several long-term aspects of sepsis immunology, specifically the behavior of CD8+ T cells, which may eventually aid the development of new therapies for sepsis patients.
Surgical Risk Is Not Linear: Derivation and Validation of a Novel, User-friendly, and Machine-learning-based Predictive OpTimal Trees in Emergency Surgery Risk (POTTER) Calculator
Authors: Bertsimas Dimitris , Dunn Jack , Velmahos George C. , Kaafarani Haytham M. A.
Published: August 2018

Introduction:

Most risk assessment tools assume that the impact of risk factors is linear and cumulative. Using novel machine-learning techniques, we sought to design an interactive, nonlinear risk calculator for Emergency Surgery (ES).

Methods:

All ES patients in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) 2007 to 2013 database were included (derivation cohort). Optimal Classification Trees (OCT) were leveraged to train machine-learning algorithms to predict postoperative mortality, morbidity, and 18 specific complications (eg, sepsis, surgical site infection). Unlike classic heuristics (eg, logistic regression), OCT is adaptive and reboots itself with each variable, thus accounting for nonlinear interactions among variables. An application [Predictive OpTimal Trees in Emergency Surgery Risk (POTTER)] was then designed as the algorithms’ interactive and user-friendly interface. POTTER performance was measured (c-statistic) using the 2014 ACS-NSQIP database (validation cohort) and compared with the American Society of Anesthesiologists (ASA), Emergency Surgery Score (ESS), and ACS-NSQIP calculators’ performance.

Results:

Based on 382,960 ES patients, comprehensive decision-making algorithms were derived, and POTTER was created where the provider's answer to a question interactively dictates the subsequent question. For any specific patient, the number of questions needed to predict mortality ranged from 4 to 11. The mortality c-statistic was 0.9162, higher than ASA (0.8743), ESS (0.8910), and ACS (0.8975). The morbidity c-statistics was similarly the highest (0.8414).

Conclusion:

POTTER is a highly accurate and user-friendly ES risk calculator with the potential to continuously improve accuracy with ongoing machine-learning. POTTER might prove useful as a tool for bedside preoperative counseling of ES patients and families.
Fluctuations in Arctic sea-ice extent: comparing observations and climate models
Authors: Agarwal Sahil , Wettlaufer John S.
Published: August 2018

The fluctuation statistics of the observed sea-ice extent during the satellite era are compared with model output from CMIP5 models using a multifractal time series method. The two robust features of the observations are that on annual to biannual time scales the ice extent exhibits white noise structure, and there is a decadal scale trend associated with the decay of the ice cover. It is shown that (i) there is a large inter-model variability in the time scales extracted from the models, (ii) none of the models exhibits the decadal time scales found in the satellite observations, (iii) five of the 21 models examined exhibit the observed white noise structure, and (iv) the multi-model ensemble mean exhibits neither the observed white noise structure nor the observed decadal trend. It is proposed that the observed fluctuation statistics produced by this method serve as an appropriate test bed for modelling studies.

This article is part of the theme issue ‘Modelling of sea-ice phenomena’.