bluuebunny/crossref_metadata_2025 huggingface dataset:
Note: Measuring instrument of singlet oxygen quantum yield in photodynamic effects
Authors: Li Zhongwei , Zhang Pengwei , Zang Lixin , Qin Feng , Zhang Zhiguo , Zhang Hongli
Published: June 2017

Using diphenylisobenzofuran (C20H14O) as a singlet oxygen (1O2) reporter, a comparison method, which can be used to measure the singlet oxygen quantum yield (ΦΔ) of the photosensitizer quantitatively, is presented in this paper. Based on this method, an automatic measuring instrument of singlet oxygen quantum yield is developed. The singlet oxygen quantum yield of the photosensitizer hermimether and aloe-emodin is measured. It is found that the measuring results are identical to the existing ones, which verifies the validity of the measuring instrument.
Temporal intermittency and the lifetime of chimera states in ensembles of nonlocally coupled chaotic oscillators
Authors: Semenova N. I. , Strelkova G. I. , Anishchenko V. S. , Zakharova A.
Published: June 2017

We describe numerical results for the dynamics of networks of nonlocally coupled chaotic maps. Switchings in time between amplitude and phase chimera states have been first established and studied. It has been shown that in autonomous ensembles, a nonstationary regime of switchings has a finite lifetime and represents a transient process towards a stationary regime of phase chimera. The lifetime of the nonstationary switching regime can be increased to infinity by applying short-term noise perturbations.
Characteristic measurement for femtosecond laser pulses using a GaAs PIN photodiode as a two-photon photovoltaic receiver
Authors: Chen Junbao , Xia Wei , Wang Ming
Published: June 2017

Photodiodes that exhibit a two-photon absorption effect within the spectral communication band region can be useful for building an ultra-compact autocorrelator for the characteristic inspection of optical pulses. In this work, we develop an autocorrelator for measuring the temporal profile of pulses at 1550 nm from an erbium-doped fiber laser based on the two-photon photovoltaic (TPP) effect in a GaAs PIN photodiode. The temporal envelope of the autocorrelation function contains two symmetrical temporal side lobes due to the third order dispersion of the laser pulses. Moreover, the joint time-frequency distribution of the dispersive pulses and the dissimilar two-photon response spectrum of GaAs and Si result in different delays for the appearance of the temporal side lobes. Compared with Si, GaAs displays a greater sensitivity for pulse shape reconstruction at 1550 nm, benefiting from the higher signal-to-noise ratio of the side lobes and the more centralized waveform of the autocorrelation trace. We also measure the pulse width using the GaAs PIN photodiode, and the resolution of the measured full width at half maximum of the TPP autocorrelation trace is 0.89 fs, which is consistent with a conventional second-harmonic generation crystal autocorrelator. The GaAs PIN photodiode is shown to be highly suitable for real-time second-order autocorrelation measurements of femtosecond optical pulses. It is used both for the generation and detection of the autocorrelation signal, allowing the construction of a compact and inexpensive intensity autocorrelator.
Optimization of AZO films for integrating optically transparent antennas with photovoltaics
Authors: Zamudio M. E. , Behzadirad M. , Christodoulou C. , Busani T.
Published: June 2017

The importance of having an optimal material for fabricating Optically Transparent Antennas (OTAs) is crucial for designing highly efficient antennas that can be integrated with photovoltaics. Transparent Conductor Oxides are promising for OTA fabrication due to their capability of being simultaneously transparent at optical frequencies and conductive within the radio frequency (RF) range. Here in this study, thin aluminum and zinc oxide layers were co-sputtered onto Si and a polycrystalline photovoltaic cell and then annealed between 350 °C and 450 °C for 24 and 48 h in a N2 ambient. The annealing process ensured the formation of Aluminum Zinc Oxide (AZO) with low resistivity ≈10−5 Ω cm and a transparency of 86% between 350 and 750 nm. The material was tested by performing RF characterization and by fabricating and testing two different OTAs. The results of the optimization process and characterization show that the AZO material is feasible for OTA fabrication.
Estimation of excitation temperature by duty ratio of observed period in non-equilibrium plasma
Authors: Yambe Kiyoyuki , Muraoka Sumihiro , Nihei Takashi , Abe Seiya
Published: June 2017

We investigated the excitation temperature of atmospheric-pressure non-equilibrium (cold) plasma using a line-pair method. An atmospheric cold plasma was intermittently generated using a quartz tube, a rare gas, and a foil electrode by applying high-voltage alternating current. Because the plasma occurred intermittently, an interval appeared between each generated plasma bullet. We assessed the time-averaged effective intensity from the observed intensity at each wavelength measured using a spectrometer. When the exposure time of the spectrometer is longer than the observed period of the plasma emission light, the time-averaged effective intensity at each wavelength decreases because it includes the interval with no plasma emission light. The difference in intensity between wavelengths changes with frequency, because changing the frequency changes the interval between plasma bullets. Consequently, even if the plasma electron temperature does not depend on the frequency of the applied voltage, the excitation temperature estimated from the difference in intensity changes with the frequency. The plasma electron temperature can be estimated from the duty ratio of the observed period of plasma emission light, and we estimated the electron temperature in the helium and argon cold plasmas to be 1.0 eV.
Kinetic simulations of gas breakdown in the dense plasma focus
Authors: Bennett N. , Blasco M. , Breeding K. , DiPuccio V. , Gall B. , Garcia M. , Gardner S. , Gatling J. , Hagen E. C. , Luttman A. , Meehan B. T. , Molnar S. , O'Brien R. , Ormond E. , Robbins L. , Savage M. , Sipe N. , Welch D. R.
Published: June 2017

The first fully kinetic, collisional, and electromagnetic simulations of the breakdown phase of a MA-scale dense plasma focus are described and shown to agree with measured electrical characteristics, including breakdown time. In the model, avalanche ionization is driven by cathode electron emission, and this results in incomplete gas breakdown along the insulator. This reinforces the importance of the conditioning process that creates a metallic layer on the insulator surface. The simulations, nonetheless, help explain the relationship between the gas pressure, the insulator length, and the coaxial gap width. Previously, researchers noted three breakdown patterns related to pressure. Simulation and analytical results show that at low pressures, long ionization path lengths lead to volumetric breakdown, while high pressures lead to breakdown across the relatively small coaxial electrode gap. In an intermediate pressure regime, ionization path lengths are comparable to the insulator length which promotes ideal breakdown along the insulator surface.
Simulation study of the photoemission effects in an electrostatic plasma sheath containing charged nanoparticles
Authors: Jalilpour P. , Foroutan G.
Published: June 2017

Numerical simulations of the multi-fluid equations are utilized to investigate the effects of a directed photon flux on the structure of an electrostatic plasma sheath in the presence of nano-sized dust grains. The results revealed that the sheath width decreases with an increase in the photon flux as well as the photoelectric efficiency, and that the effect is prominent at high plasma number densities. With the increase in the incident flux, the absolute dust charge decreases immediately until it changes sign and becomes positive at moderate fluxes and then increases quite slowly. The ion drag is also reduced by the photoemission, while the electric force is enhanced. The net effect is an enhancement of the total force on the dust grains towards the sheath edge, leading to a significantly reduced dust speed and consequently an increased dust number density throughout the sheath.
Exact solution to the steady-state dynamics of a periodically modulated resonator
Authors: Minkov Momchil , Shi Yu , Fan Shanhui
Published: June 2017

We provide an analytic solution to the coupled-mode equations describing the steady-state of a single periodically modulated optical resonator driven by a monochromatic input. The phenomenology of this system was qualitatively understood only in the adiabatic limit, i.e., for low modulation speed. However, both in and out of this regime, we find highly non-trivial effects for specific parameters of the modulation. For example, we show complete suppression of the transmission even with zero detuning between the input and the static resonator frequency. We also demonstrate the possibility for complete, lossless frequency conversion of the input into the sideband frequencies, as well as for optimizing the transmitted signal towards a given target temporal waveform. The analytic results are validated by first-principle simulations.
Graphene on silicon dioxide via carbon ion implantation in copper with PMMA-free transfer
Authors: Lehnert Jan , Spemann Daniel , Hamza Hatahet M. , Mändl Stephan , Mensing Michael , Finzel Annemarie , Varga Aron , Rauschenbach Bernd
Published: June 2017

In this work, a synthesis method for the growth of low-defect large-area graphene using carbon ion beam implantation into metallic Cu foils is presented. The Cu foils (1 cm2 in size) were pre-annealed in a vacuum at 950 °C for 2 h, implanted with 35 keV carbon ions at room temperature, and subsequently annealed at 850 °C for 2 h to form graphene layers with the layer number controlled by the implantation fluence. The graphene was then transferred to SiO2/Si substrates by a PMMA-free wet chemical etching process. The obtained regions of monolayer graphene are of ∼900 μm size. Raman spectroscopy, atomic force microscopy, scanning electron microscopy, and optical microscopy performed at room temperature demonstrated a good quality and homogeneity of the graphene layers, especially for monolayer graphene.
High performance photolithographically-patterned polymer thin-film transistors gated with an ionic liquid/poly(ionic liquid) blend ion gel
Authors: Thiburce Q. , Porcarelli L. , Mecerreyes D. , Campbell A. J.
Published: June 2017

We demonstrate the fabrication of polymer thin-film transistors gated with an ion gel electrolyte made of the blend of an ionic liquid and a polymerised ionic liquid. The ion gel exhibits a high stability and ionic conductivity, combined with facile processing by simple drop-casting from solution. In order to avoid parasitic effects such as high hysteresis, high off-currents, and slow switching, a fluorinated photoresist is employed in order to enable high-resolution orthogonal patterning of the polymer semiconductor over an area that precisely defines the transistor channel. The resulting devices exhibit excellent characteristics, with an on/off ratio of 106, low hysteresis, and a very large transconductance of 3 mS. We show that this high transconductance value is mostly the result of ions penetrating the polymer film and doping the entire volume of the semiconductor, yielding an effective capacitance per unit area of about 200 μF cm−2, one order of magnitude higher than the double layer capacitance of the ion gel. This results in channel currents larger than 1 mA at an applied gate bias of only –1 V. We also investigate the dynamic performance of the devices and obtain a switching time of 20 ms, which is mostly limited by the overlap capacitance between the ion gel and the source and drain contacts.
Gene silencing in Archaeplastida algae.
Authors: Ma XinRong Ma XinRong , Kim EunJeong Kim EunJeong , Cerutti H.
Published: June 2017

This chapter examines the existence of DNA cytosine methyltransferases and core components of the RNAi machinery, as well as briefly discusses the known or inferred biological role(s) of these mechanisms in microalgae. However, an added level of complexity is the evolutionary divergence of algal species, belonging to multiple eukaryotic supergroups, which complicates the recognition of shared mechanisms. For this reason, the analysis will be limited to microalgae in the Archaeplastida eukaryotic supergroup which includes the red algae (Rhodophyta), the green algae (Chlorophyta and Charophyta), a small group of unicellular microalgae called glaucophytes (Glaucophyta) and the land plants (Embryophyta). It is established that RNAi appears to be entirely absent from some microalgae and its biological role(s), in the species that possess core RNAi machinery components, is poorly understood. Limited evidence suggests that an siRNA pathway may operate as a defence mechanism against transposon mobilization and, possibly, in antiviral immunity. An miRNA pathway, when present, may contribute to endogenous gene regulation. However, the identification of genuine miRNA targets remains challenging and, to date, no specific metabolic or physiological process controlled or modulated by miRNAs has been clearly defined in microalgae.
Artificial small RNA-based strategies for effective and specific gene silencing in plants.
Authors: Carbonell A.
Published: June 2017

In plants, small RNAs (sRNAs) function in diverse RNA silencing pathways to regulate development, control genome integrity and protect against viruses. This chapter discusses various strategies to produce small artificial RNAs. Details of the biogenesis, action and application of both classes of plant artificial sRNAs (microRNAS and trans-acting siRNAs) are provided. In conclusion, the recent development of high-throughput cloning strategies and automated design tools for the generation of plant artificial sRNA constructs should accelerate gene function studies and crop improvement. However, a better knowledge of the rules governing the biogenesis, efficacy and mode of action (cleavage or translational repression) of endogenous sRNAs will undoubtedly help to further improve and refine plant artificial sRNA-based approaches.
Increasing nutritional value by RNA silencing.
Authors: Pons E. , Pena L.
Published: June 2017

Molecules in plants with dietary relevance can be grouped into four main sets: macronutrients (proteins, carbohydrates, lipids (oils), fibre), micronutrients (vitamins, minerals, functional metabolites), antinutrients (substances such as phytate that limit the bioavailability of nutrients) and allergens (intolerances and toxins); the levels of the first two would need to be increased and the latter two need to be reduced or removed. RNAi emerged as the most suitable strategy to enhance the nutritional composition of important crop plants. Moreover, RNAi can also be used to diminish the amount of antinutrients in the plant tissues by suppressing the expression of genes producing such compounds. This chapter does not intend to do an extensive review of all publications in the area but rather to illustrate with relevant examples how the nutritional and health value of plant foods can be improved by means of RNAi technology, resulting in products with either higher levels of nutrients or lower levels of antinutrients.
Gene silencing provides efficient protection against plant viruses.
Authors: Tavazza M. , Lucioli A. , Ilardi V.
Published: June 2017

In the early 1980s, the ability to transform and regenerate plants opened the way for developing biotechnological strategies to control virus infections. This chapter focuses on how knowledge of RNA silencing has been applied successfully to confer virus resistance in principal crops, i.e. sugarcane, maize, rice, potato, wheat, soyabean, cassava, sugarbeet, tomato and barley. It also illustrates how ongoing research in this field has allowed the development of new tools that, having been proved to be efficient in model systems, will be shortly applied to agriculture. However, extensive field trials are required to validate the effectiveness of these new tools in conferring stable and durable virus resistance. From the point of view of biosafety, transgenic plants expressing short sequences of foreign RNAs are undoubtedly safer and more acceptable than those expressing foreign proteins.
Propagation and nursery certification.
Authors: Nawaz M. A. , Liu YongZhong Liu YongZhong , Khan M. M. , Waqar Ahmed Waqar Ahmed
Published: June 2017

In limes (Rutaceae), propagation is more critical due to the presence of cross-pollination, cross-compatibility and polyembryony. Similarly the use of appropriate rootstocks is another unique aspect that must be considered during the process. This chapter summarizes the available information about propagation (sexual, asexual and in vitro through tissue culture), nursery management and certification, and registration systems for lime nurseries.
Plant protection: lime diseases and insect pests.
Authors: Al-Sadi A. M. , Queiroz R. B. , Donkersley P. , Nasehi A. , Elliot S. L.
Published: June 2017

This chapter is divided into two parts. The first part addresses some of the most common fungal, viral and prokaryotic diseases of acid lime [C. aurantiifolia]. Information is given about symptoms of each disease, causal agent(s) and management. The second part focuses on the main acid lime insect pests with their occurrence, biology and description, damage and some management strategies.
Traditional/commercial uses and future dynamics.
Authors: Hanif M. A. , Smitha Padmanabhan Smitha Padmanabhan , Waly M. , Al-Maskari A.
Published: June 2017

Citrus aurantifolia [C. aurantiifolia] (lime) tree is extensively cultivated in subtropical and tropical areas because of its edible fruits. The lime fruit and its juice are key ingredients in many drinks, confections, pickles and sauces. The flavour and bouquet of limeade and other lime-flavoured drinks are quite different from those prepared from lemons. Lime juice is largely used for citric acid production and is often used extensively for medicinal purposes with lemon juice. The most important quality of lime is its preservation ability. Lime essential oil is utilized for flavouring purposes, particularly in artificial lime juice cordials, which consist of mineral water and a sweetened solution of tartaric acid. This chapter discusses the chemical composition, uses (in food and medicine) and industrial products of lime.
SR proteins: To shuttle or not to shuttle, that is the question
Authors: Hammarskjold Marie-Louise , Rekosh David
Published: June 2017

Serine- and arginine-rich proteins play important roles in splicing, nuclear export, and translation. In this issue, Botti et al. (2017. J. Cell Biol. https://doi.org/10.1083/jcb.201610051) show that SRSF2 and SRSF5, previously thought to be nuclear, shuttle with messenger RNA to the cytoplasm in pluripotent P19 cells, but not in differentiated cells.
Towards spatial management of fisheries in the Gulf: benthic diversity, habitat and fish distributions from Qatari waters
Authors: Walton Mark E M , Hayes Jamie , Al-Ansi Mohsin , Abdallah Mohamed , Al Maslamani Ibrahim , Al-Mohannadi Mohammed , Al-Shaikh Ismail , D’Urban Jackson Tim , Szostek Claire , Egerton Jack , Kaiser Michel J , Le Vay Lewis
Published: June 2017

As with many other regions in the world, more complete information on the distribution of marine habitats in the Gulf is required to inform environmental policy, and spatial management of fisheries resources will require better understanding of the relationships between habitat and fish communities. Towed cameras and sediment grabs were used to investigate benthic habitats and associated epifauna, infauna and fish communities in the central Gulf, offshore from the east coast of Qatar, in water depths of between 12 and 52 m. Six different habitats were identified: (i) soft sediment habitats of mud and (ii) sand, and structured habitats of (iii) macro-algal reef, (iv) coral reef, (v) mixed reef, and (vi) oyster bed. The epibenthic community assemblage of the mud habitat was significantly different to that of sand, which in turn differed from the structured habitats of coral reef, mixed reef and oyster bed, with the macroalgal assemblage having similarities to both sand and the other structured habitats. Fish assemblages derived from video data did not differ between habitats, although certain species were only associated with particular habitats. Epibenthic diversity indices were significantly lower in mud, sand and macro-algal habitats, with no differences recorded for fish diversity. Soft sediment grab samples indicated that mud habitats had the highest benthic diversity, with Shannon-Weiner values of >4, and were more diverse than sand with values of 3.3. The study demonstrates high biodiversity in benthic habitats in the central and southwestern Gulf, which may in part be due to the absence of trawling activity in Qatari waters. There is a strong influence of depth on benthic habitat type, so that depth can be used to predict habitat distribution with a high level of accuracy. The presence of outcrops of hard substrata creates a mosaic of patchy shallow structured benthic habitat across extensive areas of the offshore seabed. Such heterogeneity, and the association of commercially exploited fish species with specific habitats, indicates that this region is well suited to a spatial approach to fisheries management.
Epidural Fat and Its Association with Pain, Physical Function, and Disability Among Older Adults with Low Back Pain and Controls
Authors: Megan Sions Jaclyn , Angelica Rodriguez Christina , Todd Pohlig Ryan , Evan Hicks Gregory , Charles Coyle Peter
Published: June 2017

Objective

To examine epidural fat and its relationship to pain, physical function, and disability among older adults with chronic low back pain, chronic low back pain plus leg pain, and controls.

Design

Cross-sectional, comparative study.

Setting

Standardized examinations were conducted in a research laboratory, and magnetic resonance images were obtained.

Subjects

A total of 93 adults age 60 to 85 years (24 with chronic back pain, 25 with chronic back pain plus leg pain, and 44 controls).

Methods

Reliability for assessment of epidural fat diameter, averaged across spinal levels, was established (intraclass correlation coefficient = 0.95). Linear regression was used to explore how epidural fat diameter related to self-reported (Short Form-36 Health Survey: physical component summary score) and performance-based (stair climb performance) measures of physical function among adults with chronic back pain with and without leg pain, as compared with controls, while controlling for age, sex, and body mass index. Associations between epidural fat and pain intensity and low back pain–related disability were also explored (P ≤ 0.050).

Results

Epidural fat helped explain self-reported function (P < 0.001); adults with axial low back pain (LBP) may have a relationship between epidural fat and self-report function that is different from controls (P = 0.015). Relationships between epidural fat and stair performance were significantly different from controls for those with LBP (P = 0.000) but not for those with LBP plus leg pain (P = 0.366). Relationships between epidural fat and pain intensity and/or disability were not found.

Conclusions

Increased epidural fat may help explain better function among older adults with chronic axial back pain, but not among those who also report leg pain.
Strigolactones in the Rhizosphere: Friend or Foe?
Authors: De Cuyper Carolien , Goormachtig Sofie
Published: June 2017

Strigolactones are well-known endogenous plant hormones that play a major role in planta by influencing different physiological processes. Moreover, ex planta, strigolactones are important signaling molecules in root exudates and function as host detection cues to launch mutualistic interactions with arbuscular mycorrhizal fungi in the rhizosphere. However, parasitic plants belonging to the Orobanchaceae family hijacked this communication system to stimulate their seed germination when in close proximity to the roots of a suitable host. As a result, the secretion of strigolactones by the plant can have both favorable and detrimental outcomes. Here, we discuss these dual positive and negative effects of strigolactones and we provide a detailed overview on the role of these molecules in the complex dialogs between plants and different organisms in the rhizosphere.
Influence of Groundnut bud necrosis virus on the Life History Traits and Feeding Preference of Its Vector, Thrips palmi
Authors: Daimei Guisuibou , Raina Harpreet Singh , Devi Pukhrambam Pushpa , Saurav Gunjan Kumar , Renukadevi Perumal , Malathi Varagur Ganesan , Senthilraja Chinnaiah , Mandal Bikash , Rajagopal Raman
Published: June 2017

The effect of Groundnut bud necrosis virus (GBNV) infection on the life history traits of its vector, Thrips palmi, and its feeding preference on GBNV-infected plants were studied. A significant difference was observed in the developmental period (first instar to adult) between the GBNV-infected and healthy thrips, wherein the developmental period of GBNV-infected thrips was decreased. However, there was no effect on the other parameters such as preadult mortality, adult longevity, and fecundity. Further investigation on a settling and feeding choice assay of T. palmi to GBNV-infected and healthy plants showed that T. palmi preferred GBNV-infected cowpea plants more than the healthy cowpea plants. This preference was also noticed for leaf disks from GBNV-infected cowpea, groundnut, and tomato plants.
Left Lateral Table Tilt for Elective Cesarean Delivery under Spinal Anesthesia Has No Effect on Neonatal Acid–Base Status
Authors: Lee Allison J. , Landau Ruth , Mattingly James L. , Meenan Margaret M. , Corradini Beatriz , Wang Shuang , Goodman Stephanie R. , Smiley Richard M.
Published: June 2017

Background

Current recommendations for women undergoing cesarean delivery include 15° left tilt for uterine displacement to prevent aortocaval compression, although this degree of tilt is practically never achieved. We hypothesized that under contemporary clinical practice, including a crystalloid coload and phenylephrine infusion targeted at maintaining baseline systolic blood pressure, there would be no effect of maternal position on neonatal acid base status in women undergoing elective cesarean delivery with spinal anesthesia.

Methods

Healthy women undergoing elective cesarean delivery were randomized (nonblinded) to supine horizontal (supine, n = 50) or 15° left tilt of the surgical table (tilt, n = 50) after spinal anesthesia (hyperbaric bupivacaine 12 mg, fentanyl 15 μg, preservative-free morphine 150 μg). Lactated Ringer’s 10 ml/kg and a phenylephrine infusion titrated to 100% baseline systolic blood pressure were initiated with intrathecal injection. The primary outcome was umbilical artery base excess.

Results

There were no differences in umbilical artery base excess or pH between groups. The mean umbilical artery base excess (± SD) was −0.5 mM (± 1.6) in the supine group (n = 50) versus −0.6 mM (± 1.5) in the tilt group (n = 47) (P = 0.64). During 15 min after spinal anesthesia, mean phenylephrine requirement was greater (P = 0.002), and mean cardiac output was lower (P = 0.014) in the supine group.

Conclusions

Maternal supine position during elective cesarean delivery with spinal anesthesia in healthy term women does not impair neonatal acid–base status compared to 15° left tilt, when maternal systolic blood pressure is maintained with a coload and phenylephrine infusion. These findings may not be generalized to emergency situations or nonreassuring fetal status.
Does Additional Uncinate Resection Increase Pseudarthrosis Following Anterior Cervical Discectomy and Fusion?
Authors: Lee Dong-Ho , Cho Jae Hwan , Baik Jong-Min , Joo Youn-Suk , Park Sehan , Min Woo-Kie , Hwang Chang Ju , Lee Choon Sung
Published: June 2017

Study Design.

Retrospective comparative study.

Objective.

To investigate whether unilateral or bilateral uncinate resection (UR) combined with anterior cervical discectomy and fusion (ACDF) increases the risk of pseudarthrosis at long-term follow-up.

Summary of Background Data.

Uncoforaminotomy (or UR), performed along with ACDF, facilitates better and faster improvement of arm pain. As uncovertebral joints are important for maintaining stability, they may affect the fusion process by causing segmental instability if resected during ACDF.

Methods.

We retrospectively examined 167 patients (89 men, 78 women; mean age, 58.4 ± 10.5 yr) who consecutively underwent single- or double-level ACDF and were followed for >2 years. UR was not performed in 46 patients (N-UR group). UR of at least one foramen was performed in 121 patients (UR group), including unilateral UR in 89 patients (U-UR group) and bilateral UR in 32 patients (B-UR group). Demographic data, fusion rate, visual analog scale (VAS) scores for neck/arm pain, and neck disability index (NDI) scores were compared between the N-UR and UR groups. Moreover, the fusion rates after the single- and double-level procedures were compared among the groups.

Results.

There was no difference in sex, age, weight, height, body mass index (BMI), and smoking history between the N-UR and UR groups. The fusion rates after single-level ACDF were not significantly different among the N-UR, U-UR, and B-UR groups (91.4%, 97.8%, and 88.2%; P = 0.290). Solid fusion was achieved in all groups after double-level ACDF (72.7%, 95.5%, and 86.7%), although the rates did not significantly differ among the groups (P = 0.071). The improvement in the VAS score for arm pain was significantly better in the UR group than in the N-UR group at short-term follow-up (P < 0.001).

Conclusion.

Unilateral or bilateral UR does not affect the fusion rate after single- or double-level ACDF. Hence, if necessary, additional UR can be performed during ACDF without concern regarding nonunion.

Level of Evidence: 4
The impact of under-reporting of cases on the estimates of childhood cancer incidence and survival in Estonia
Authors: Paapsi Keiu , Mägi Margit , Mikkel Sirje , Saks Kadri , Aareleid Tiiu , Innos Kaire
Published: June 2017

About 35 new childhood cancer cases are diagnosed in Estonia (population 1.3 million in 2011) every year. Despite continuous improvements in the healthcare system and available cancer treatment options, the survival rates for childhood cancers have appeared to remain lower than the European average. These observations and the accompanying decrease in incidence led us to hypothesize that some nonfatal cases might be missing from the Estonian Cancer Registry (ECR). The aim of this study was to evaluate the completeness of reporting of childhood cancer cases to the ECR and its impact on the estimates of cancer incidence and survival. All cases of benign and malignant tumours, diagnosed in 2000–2011 among children aged 0–17 years and eligible for registration in the ECR, were included in the study. Completeness of reporting was evaluated for cases aged 0–17 years, and incidence and survival were analysed for cases aged 0–14 for international comparisons. The total number of new cancer cases increased from 459 to 515. Overall completeness of case ascertainment was estimated to be 89.5%. After adding the missing cases, the overall incidence rate increased from 12.9 to 14.9/100 000 (from 3.4 to 4.7 for leukaemias). The 2010–2014 period estimate of the 5-year survival increased from 70 to 76% for all sites combined and from 71 to 82% for leukaemias. In conclusion, the under-reporting of nonfatal childhood cancer cases to the ECR had an important impact on incidence and survival rates, causing a considerable underestimation of both.
Clinical Nurse Specialist Perceptions' of Spiritual Care
Authors: Saunders Mitzi M. , Harris Karen , Hale Deborah L.
Published: June 2017

The clinical nurse specialist (CNS) is positioned to influence spiritual care at three levels of practice: patient, nurse, and system. This study, the first to explore CNS spiritual care, reports on CNSs' perceptions in providing spiritual care. Four themes were extracted from interview data: 1) Providing direct spiritual support for patients, 2) Nurses need support in providing spiritual care, 3) Using existing resources, and 4) Spiritual care falls short. Not one CNS mentioned barriers to their direct provision of spiritual care. Results support that CNSs can improve spiritual care delivery.
Abstinence-Only Sex Education Fails African American Youth
Authors: Breunig Michelle
Published: June 2017

Sexually transmitted infections (STIs) disproportionately affect U.S. African American (AA) youth. In AA faith communities, cultural practices have contributed to increased STI rates because abstinence-only-until-marriage education programs do not teach the use of condoms or birth control for preventing STIs or pregnancy. Comprehensive sex education or abstinence-plus programs have been reported to increase STI knowledge and reduce risk-taking behaviors in adolescents and young adults. Evidence supports computerized education to increase STI knowledge and decrease risky sexual behaviors of AA churchgoing youth.
Transverse Split Sternotomy
Authors: Garg Pankaj , Kumar Bishnoi Arvind , Patel Kartik , Annanthnarayan Chandrashekaran , Patel Jigar , Talsariya Malkesh , Shah Komal , Patel Sanjay
Published: June 2017

Objective

In this article, we aim to review our mini-invasive technique of transverse sternal split (TSS) with or without cervical cannulation for cardiopulmonary bypass (CPB), its usefulness, and efficiency for repair of congenital cardiac defects.

Methods

Between January 2013 and June 2015, 34 infants and small children were operated through TSS in third or fourth intercostal space [Tetralogy of Fallot 11, perventricular ventricular septal defect (VSD) device closure 23]. Cardiopulmonary bypass was established through cervical (common carotid artery [CCA] and internal juglar vein [IJV]) and inferior vena cava cannulation. In patients operated on CPB, near-infrared spectroscopy was monitored during surgery for cerebral oxygenation and Doppler ultrasonography was performed postoperatively for patency of CCA and IJV. Patients were followed up after discharge with physical examination and transthoracic echocardiography (TTE).

Results

Surgical site exposure through TSS was adequate in all patients. There was no significant morbidity, postoperatively or during follow-up except three patients with VSD device closure who required prolonged mechanical ventilation. Cervical cannulation was sufficient for arterial inflow in all patients operated on CPB. There was one mortality and three procedure failures in VSD device closure group. There was no incidence of neurological complication. Both CCA and IJV were patent in all patients operated on CPB. No significant residual defect was found in either group on postoperative transthoracic echocardiography.

Conclusions

Transverse sternal split with or without cervical cannulation is a feasible technique for repair of tetralogy of Fallot and perventricular device closure in selected group of infants and small children without compromising the exposure or quality of repair.
Early Hemodynamic Results in Patients with Small Aortic Annulus after Aortic Valve Replacement
Authors: Olivier Dionne Pierre , Poulin Frédéric , Bouchard Denis , Généreux Philippe , Ibrahim Reda , Cartier Raymond , Lamarche Yoan , Demers Philippe
Published: June 2017

Objective

Patients with a small aortic annulus (≤21 mm) have an increased risk of patient-prosthesis mismatch after valve replacement. The aim of this study was to compare the early hemodynamic performance of the balloon-expandable transaortic valve implantation Edwards system (SAPIEN) and the sutureless Perceval prostheses.

Methods

Fifty patients underwent transcatheter aortic valve implantation, and 113 patients underwent sutureless aortic valve replacement. Mean ± SD aortic annulus diameter was 19.7 ± 1 mm, with no significant difference between groups. SAPIEN valve size was 23 mm in 40 patients (80%) and 26 mm in 10 patients (20%). Perceval valve size was small in 45 patients (40%), medium in 62 patients (55%), and large in 6 patients (5%). Transthoracic Doppler echocardiographic images were collected at baseline and before discharge.

Results

There were no significant difference in predischarge effective orifice area (SAPIEN: 1.5 ± 0.5 cm2 and Perceval: 1.48 ± 0.34 cm2, P = 0.58) and indexed effective orifice areas (SAPIEN: 0.93 ± 0.32 cm2/m2 and Perceval: 0.88 ± 0.22 cm2/m2, P = 0.42). Predischarge mean ± SD transaortic gradient was lower with the SAPIEN than with Perceval valves (12 ± 6 and 17 ± 6 mm Hg, respectively, P < 0.001). Rates of moderate and severe prosthesis-patient mismatch were similar (SAPIEN: 44% and 10% and Perceval: 50% and 14%, P = 0.53 and 0.75, respectively). There were no moderate-severe paravalvular leaks.

Conclusions

Although indexed effective orifice areas were similar, transcatheter aortic valve implantation with the balloon-expandable SAPIEN system yielded lower predischarge transaortic mean gradients than the surgically implanted Perceval, in patients with a small annulus.
HVAD Waveform Analysis as a Noninvasive Marker of Pulmonary Capillary Wedge Pressure: A First Step Toward the Development of a Smart Left Ventricular Assist Device Pump
Authors: Grinstein Jonathan , Rodgers Daniel , Kalantari Sara , Sayer Gabriel , Kim Gene H. , Sarswat Nitasha , Adatya Sirtaz , Ota Takeyoshi , Jeevanandam Valluvan , Burkhoff Daniel , Uriel Nir
Published: June 2017

Flow waveforms are an important feature of the HVAD left ventricular assist device (LVAD) that provides information about HVAD function and patient hemodynamics. We assessed the properties of one specific aspect of the waveform, the slope of the ventricular filling phase (VFP), and its correlation with pulmonary capillary wedge pressure (PCWP). A total of 101 screenshots from the HVAD monitor and simultaneous hemodynamic measurements were obtained simultaneously during sequential stages of invasive hemodynamic ramp studies. Each screenshot was digitized (IGOR Pro, WaveMetrics Inc., Oswego, OR) and properties of the flow waveforms including instantaneous flow and rate of change of flow were analyzed. Ventricular filling phase slope (VFPS) was calculated for each screenshot and correlated to PCWP. Ventricular filling phase slope was significantly higher in patients with PCWP ≥ 18 mm Hg than in patients with PCWP < 18 mm Hg [6.25 (5.84–7.37) L/min/s vs. 3.27 (2.00–4.69) L/min/s, p ≤ 0.0001]. A VFPS threshold of 5.8 L/min/s predicted a PCWP ≥ 18 mm Hg with a sensitivity of 87% and specificity of 95% (AUC 0.95). Ventricular filling phase slope of the HVAD flow waveform is a novel noninvasive parameter that correlates with PCWP and can discriminate elevated versus normal or low PCWP. Automated reporting of this parameter may help clinical assessment and management of patients supported by an HVAD and may serve as the basis of a smart LVAD pump that can adapt in response to changes in a patient’s physiology.
Latest advances in the management of facial synkinesis
Authors: Markey Jeffrey D. , Loyo Myriam
Published: June 2017

Purpose of review

To provide an overview of the treatment options for nonflaccid facial paralysis including physical rehabilitation, botulinum toxin injection and surgical intervention. To also describe recent technique advances regarding facial synkinesis in each zone of facial movement.

Recent findings

Physical therapy and neuromodulation with botulinum toxin continues to be the main treatment strategy for facial synkinesis. Treating the orbicularis oculi, mentalis and platysma muscles with neurotoxin has been well described. A symmetric smile can also be improved with ipsilateral depressor anguli oris and the contralateral depressor labi inferioris weakening. Novel surgical techniques to selectively ablate specific facial muscles have also been recently described.

Nonflaccid facial paralysis is a spectrum of hypokinetic and hyperkinetic movement following facial nerve injury that is best treated in a patient-tailored graduated fashion. Novel techniques are evolving to maximize patient function while minimizing morbidity.
Early Antibiotic Exposure in Low‐resource Settings Is Associated With Increased Weight in the First Two Years of Life
Authors: Rogawski Elizabeth T. , Platts‐Mills James A. , Seidman Jessica C. , John Sushil , Mahfuz Mustafa , Ulak Manjeswori , Shrestha Sanjaya , Soofi Sajid B. , Yori Pablo Penataro , Mduma Estomih , Svensen Erling , Ahmed Tahmeed , Lima Aldo A.M. , Bhutta Zulfiqar , Kosek Margaret , Lang Dennis , Gottlieb Michael , Zaidi Anita , Kang Gagandeep , Bessong Pascal , Houpt Eric R. , Guerrant Richard L. ,   MAL‐ED Network Investigators
Published: June 2017

Objectives:

The potential growth‐promoting effects of antibiotics are not well understood among undernourished children in environments with high pathogen exposure. We aimed to assess whether early antibiotic exposure duration and class were associated with growth to 2 years of age across 8 low‐resource sites in the MAL‐ED birth cohort study.

Methods:

We followed 1954 children twice per week from birth to 2 years to record maternally reported antibiotic exposures and measure anthropometry monthly. We estimated the associations between antibiotic exposure before 6 months of age and weight‐for‐age and length‐for‐age (LAZ) z scores to 2 years. We assessed the impact of class‐specific exposures and duration, and compared these results to effects of antibiotic exposures after 6 months of age.

Results:

Antibiotic use before 6 months of age was associated with increased weight from 6 months to 2 years, whereas associations with length were less consistent across sites and antibiotic classes. Compared to unexposed children, 2 or more courses of metronidazole, macrolides, and cephalosporins were associated with adjusted increases in weight‐for‐age of 0.24 (95% confidence interval (CI): 0.04, 0.43), 0.23 (95% CI: 0.05, 0.42), and 0.19 (95% CI: 0.04, 0.35) from 6 months to 2 years, respectively.

Conclusions:

Antibiotic use in low‐resource settings was most associated with the ponderal growth of children who had multiple exposures to antibiotics with broad spectrum and anaerobic activity in early infancy. Opportunities for rational and targeted antibiotic therapy in low resource settings may also promote short‐term weight gain in children, although longer‐term physical growth and metabolic impacts are unknown.
Novel Pressure‐Impedance Parameters for Evaluating Esophageal Function in Pediatric Achalasia
Authors: Singendonk Maartje M.J. , Omari Taher I. , Rommel Nathalie , van Wijk Michiel P. , Benninga Marc A. , Rosen Rachel , Nurko Samuel
Published: June 2017

Objective:

In achalasia, absent peristalsis and reduced esophagogastric junction (EGJ) relaxation and compliance underlie dysphagia symptoms. Novel high‐resolution impedance manometry variables, that is, bolus presence time (BPT) and trans‐EGJ‐bolus flow time (BFT) have been developed to estimate the duration of EGJ opening and trans‐EGJ bolus flow. The aim of this study was to evaluate esophageal motor function and bolus flow in children diagnosed with achalasia using these variables.

Methods:

High‐resolution impedance manometry recordings from 20 children who fulfilled the Chicago Classification (V3) criteria for achalasia were compared with recordings of 15 children with normal esophageal high‐resolution manometry findings and no other evidence suggestive of achalasia. Matlab‐based analysis software was used to calculate BPT and BFT.

Results:

Both BPT and BFT were significantly reduced in achalasia patients compared with children with normal esophageal motility (BPT 3.3 s vs 5.1 s P < 0.01; BFT 1.4 s vs 4.3 s P < 0.001). BFT was significantly lower than BPT (achalasia difference 1.9 s ± 1.3 s, P = 0.001 and normal difference 0.9 ± 0.3 s, P = 0.001). Overall, there was a significant correlation between BPT and BFT (r = 0.825, P < 0.001). We observed a 2‐way differentiation of achalasia patients; those in whom the BPT and BFT were proportional, but significantly lower than in patients with normal peristalsis, and those in whom BFT was disproportionately lower than BPT.

Conclusions:

Calculation of BPT and BFT may help determine whether esophageal bolus transport to the EGJ and/or esophageal emptying through the EGJ are aberrant. For achalasia, this may detect flow resistance at the EGJ, potentially improving both diagnosis and objective assessment of therapeutic effects.
Incidence and Risk Factors for Perianal Disease in Pediatric Crohn Disease Patients Followed in CEDATA‐GPGE Registry
Authors: Brückner Annecarin , Werkstetter Katharina J. , de Laffolie Jan , Wendt Claudia , Prell Christine , Weidenhausen Tanja , Zimmer Klaus P. , Koletzko Sibylle ,   CEDATA‐GPGE study group
Published: June 2017

Objectives:

Perianal disease (PD) with fistula and/or abscess formation is a severe complication in Crohn disease (CD). We examined prevalence, incidence, and risk factors for PD development in a pediatric CD cohort.

Methods:

Patients with CD from the prospective, multicenter registry for inflammatory bowel disease from Germany and Austria (CEDATA‐GPGE) were included if diagnosed at the age of 18 years or younger, registered within 3 months after diagnosis, and having at least 2 follow‐up visits within the first year of registration. We examined potential risk factors for PD with Kaplan‐Meier analysis and a final Cox model considering sex, family history of inflammatory bowel disease, extraintestinal manifestations, disease location, and induction therapy (corticosteroids or nutritional therapy).

Results:

Of 2406 patients with CD, 742 fulfilled inclusion criteria (59% boys, mean age at diagnosis 12.4 ± 3.4 years). PD was present at diagnosis in 41 patients (5.5%; 80.9% boys), whereas 32 patients (4.3%, 81.3% male) developed PD during follow‐up (mean 2.0 ± 1.6 years). The cumulative incidence of PD at 12 and 36 months after diagnosis was 3.5% and 7.5%, respectively. Potential risk factors for PD development during follow‐up were male sex (hazard ratio = 3.2, [95%; confidence interval 1.2–7.8]) and induction therapy with corticosteroids (hazard ratio = 2.5 [1.1–5.5]). Diagnostic evaluation at PD diagnosis was incomplete in 40% of affected subjects. PD resolved within 1 year in 50% of cases.

Conclusions:

Approximately 10% of CD patients in our cohort suffered from PD within the first 3 years of their disease. Male sex and initial corticosteroid therapy were associated with an increased risk to develop PD after diagnosis.