bluuebunny/crossref_metadata_2025 huggingface dataset:
Audition
Authors: Smith Leslie S.
Published: June 2018

Audition is the ability to sense and interpret pressure waves within a range of frequencies. The system tries to solve the what and where tasks: what is the sound source (interpretation), and where is it (location)? Auditory environments vary in the number and location of sound sources, their level and in the degree of reverberation, yet biological systems have robust techniques that work over a large range of conditions. We briefly review the auditory system, including the auditory brainstem and mid-brain major components, attempting to connect its structure with the problems to be solved: locating some sounds, and interpreting important ones. Systems using knowledge of animal auditory processing are discussed, including both CPU-based and Neuromorphic approaches, starting from the auditory filterbank, and including silicon cochleae: feature (auditory landmark) based systems are considered. The level of performance associated with animal auditory systems has not been achieved, and we discuss ways forward.
Electric sensing for underwater navigation
Authors: Boyer Frédéric , Lebastard Vincent
Published: June 2018

Underwater navigation in turbid water for exploration in catastrophic conditions or navigation in confined unstructured environments is still a challenge for robotics. In these conditions, neither vision nor sonar can be used. Pursuing a bio-inspired approach in robotics, one can seek solutions in nature to solve this difficult problem. Several hundred fish species in families Gymnotidae and Mormyridae have developed an original sense well adapted to this situation: the electric sense. Gnathonemus petersii first polarizes its body with respect to an electric organ discharge located at the base of its tail and generates a dipolar electric field in its near surroundings. Then, using many transcutaneous electro-receptors distributed along its body, the fish “measures” the distortion of the electric field and infers an image of its surroundings. Understanding and implementing this bio-inspired sense offers the opportunity to enhance the navigation abilities of our underwater robots in confined spaces bathed by turbid waters.
Capabilities
Authors: Verschure Paul F. M. J.
Published: June 2018

This chapter introduces the “Capabilities” section of the Handbook of Living Machines. Where the previous section considered building blocks, we recognize that components or modules do not automatically make systems. Hence, in the remainder of this handbook, the emphasis is toward the capabilities of living systems and their emulation in artifacts. Capabilities often arise from the integration of multiple components and thus sensitize us to the need to develop a system-level perspective on living machines. Here we summarize and consider the 14 contributions in this section which cover perception, action, cognition, communication, and emotion, and the integration of these through cognitive architectures into systems that can emulate the full gamut of integrated behaviors seen in animals including, potentially, our own capacity for consciousness.
Emotions and self-regulation
Authors: Vouloutsi Vasiliki , Verschure Paul F. M. J.
Published: June 2018

This chapter takes the view that emotions of living machines can be seen from the perspective of self-regulation and appraisal. We will first look at the pragmatic needs to endow machines with emotions and subsequently describe some of the historical background of the science of emotions and its different interpretations and links to affective neuroscience. Subsequently, we argue that emotions can be cast in terms of self-regulation where they provide for a descriptor of the state of the homeostatic processes that maintain the relationship between the agent and its internal and external environment. We augment the notion of homeostasis with that of allostasis which signifies a change from stability through a fixed equilibrium to stability through continuous change. The chapter shows how this view can be used to create complex living machines where emotions are anchored in the need fulfillment of the agent, in this case considering both utilitarian and epistemic needs.
The architecture of mind and brain
Authors: Verschure Paul F. M. J.
Published: June 2018

The components of a Living Machine must be integrated into a functioning whole, which requires a detailed understanding of the architecture of living machines. This chapter starts with a conceptual and historical analysis which from Plato brings us to nineteenth-century neuroscience and early concepts of the layered structure of nervous systems. These concepts were further captured in the cognitive behaviorism of Tolman and came to full fruition in the cognitive revolution of the second half of the twentieth century. Verschure subsequently describes the most relevant proposals of cognitive architectures followed by an overview of the few proposals stemming from modern neuroscience on the architecture of the brain. Subsequently, we will look at contemporary contenders that mediate between cognitive and brain architecture. An important challenge to any model of cognitive architectures is how to benchmark it. Verschure proposes the Unified Theories of Embodied Minds (UTEM) benchmark which advances from Newell’s classic Unified Theories of Cognition benchmark.
From slime molds to soft deformable robots
Authors: Ishiguro Akio , Umedachi Takuya
Published: June 2018

An autonomous decentralized control mechanism, where the coordination of simple individual components yields non-trivial macroscopic behavior or functionalities, is a key to understanding how animals orchestrate the large degrees of freedom of their bodies in response to different situations. However, a systematic design methodology is still missing. To alleviate this problem, we focus, in this chapter, on the plasmodium of a true slime mold (Physarum polycephalum), which is a primitive multinucleate single-cell organism. Despite its primitiveness, and lacking a brain and nervous system, the plasmodium exhibits surprisingly adaptive and versatile behavior (e.g. taxis, exploration). This ability has undoubtedly been honed by evolutionary selection pressure, and there likely exists an ingenious mechanism that underlies the animals’ adaptive behavior. We successfully extracted a design scheme for decentralized control and implemented it in an amoeboid robot with many degrees of freedom. The experimental results showed that adaptive behaviors emerge even in the absence of any centralized control architecture.
Principles and mechanisms learned from insects and applied to robotics
Authors: Quinn Roger D. , Ritzmann Roy E.
Published: June 2018

This chapter explores how insects have provided inspiration for robotic designs over recent decades as biologists have continued to learn more about these complex invertebrate systems. Initial legged robots typically mimicked insects only in terms of their basic six-legged (hexapod) designs and walking gaits. Since then robots have been developed that take advantage of insect leg and wing designs, compliant structures, movement behaviors, reflexes, and even local neural control systems identified in their central nervous systems. Future robots may be controlled with models of entire insect nervous systems including their brains.
Cooperation in collective systems
Authors: Nolfi Stefano
Published: June 2018

Cooperative collective systems, such as social insects, display amazing behaviors that combine efficiency, flexibility, and robustness. This chapter on cooperation in collective systems illustrates a fundamental property of natural organisms which operate only occasionally in isolation. The chapter discusses the methods that can be used to synthesize colonies or swarms of cooperating agents and some of the key principles that characterize such types of system such as coordination, generalization, and self-organization. It focuses in particular on collective evolutionary robotics approaches in which swarm of robots are evolved for the ability to solve problems that require cooperation.
From sensory substitution to perceptual supplementation
Authors: Lenay Charles , Tixier Matthieu
Published: June 2018

This chapter introduces the principle of sensory substitution and presents the main systems which currently exist, starting with the pioneering work of Paul Bach-y-Rita. Some research in this domain pursues the ideal of restoring an exact imitation of normal perceptual systems, but whenever there is a technical mediation, variations become possible and so there will always be possible novelties or augmentations. We highlight that these devices also open up the possibility of experimental studies of active perception within a minimalist framework, which lead to the conclusion that rather than “sensory substitution” one should more properly speak of “perceptual supplementation”. When we make prosthetic devices to assist persons with sensory disabilities, this creates possibilities of new forms of sensorimotor dynamics which open up new perceptual domains and augment the subjects’ capabilities. This raises new questions about the conditions of individual appropriation and social adoption of these innovations.
Neurorehabilitation
Authors: Ballester Belén Rubio
Published: June 2018

This chapter considers the ability of the damaged brain to reorganize following trauma and how this can be facilitated through interaction with virtual reality or robotic technologies. Stroke represents one of the main causes of adult disability and will be one of the main contributors to the burden of disease in by 2030. In this chapter we first review the main neuroscientific principles of recovery. Second, we explore the some of the latest technological approaches for neurorehabilitation, such as assistive exoskeletons and virtual reality systems. We describe a new virtual reality gaming system (RGS) that combines training scenarios with dedicated interface devices to optimize motor and cognitive training. RGS builds on theories of brain plasticity, thus we show how a living machines perspective can be used to create practical and useful systems that address a significant societal need. Finally, we comment on the broader advantages and potential applications of VR to maximize recovery.
Postcolonial Gothic
Authors: Turcotte Gerry
Published: June 2018

This chapter examines postcolonial Gothic in Australia, Canada, New Zealand, and the South Pacific and how its conventions as an imported British genre have been transformed in specific local contexts. Since the 1950s, Gothic in Australia has changed in a variety of ways: Christina Stead and Patrick White chart the suburban terror of the everyday, Joan Lindsay's Picnic at Hanging Rock (1967) and Kenneth Cook's Wake in Fright (1961) expand the possibilities for a modern uncanny that invokes an historic past and a frightening outback present, while women writers since the 1970s have employed Gothic to investigate the repressions of patriarchy. In the case of Canadian fiction, the Gothic voice has been present since the early nineteenth century, but realized its potential only from the 1970s onwards. The chapter discusses Gothic elements in Australian, Canadian, New Zealand, and Indigenous and South Pacific novels.
Popular Fiction
Authors: Weaver Roslyn
Published: June 2018

This chapter discusses the history of popular fiction in Australia. The question of place has always been central to Australian fiction, not only as a thematic element but also as a critical or political preoccupation. In part, this is because popular fiction writers, wanting to attract broad audiences, either exploited their Australian content to appeal to international readers or have excised the local to produce a generic and thus more readily accessible setting for outsiders. The chapter considers works by popular fiction writers who adopt a range of positions in relation to their focus on place, but often tackle many different aspects of Australian social and historical change. These novels cover various genres such as crime fiction, historical fiction and romance, science fiction and fantasy, and include Fergus Hume's The Mystery of a Hansom Cab (1886), Nevil Shute's On the Beach (1957), Damien Broderick's The Dreaming Dragons (1980), and Cecilia Dart-Thornton's The Ill-Made Mute (2001).
Major Authors: Robertson Davies, Margaret Atwood, Michael Ondaatje
Authors: Howells Coral Ann
Published: June 2018

This chapter discusses the works of three Canadian novelists best known internationally: Robertson Davies, Margaret Atwood, and Michael Ondaatje. The careers of Davies, Atwood, and Ondaatje, although overlapping chronologically, represent distinctive stages in Canada's evolving cultural traditions and publishing practices since the 1950s. Davies's novels signal the first stage in a transition from colonial to postcolonial identity in post-war Canada. Atwood in the 1970s provided the script for a Canadian cultural and literary identity separate from British and American in what Carol Shields called ‘a period of explosive patriotism’. Ondaatje's novels and family memoir epitomize the ‘refocusing and defocusing’ of Canadian literature since the 1980s, coinciding with the nation's shifts into multiculturalism and transnationalism. The chapter first provides a background on Davies, Atwood, and Ondaatje's careers before considering some of their works, including the Deptford trilogy (Davies), The Handmaid's Tale (Atwood), and The English Patient (Ondaatje).
Major Authors: Janet Frame, Maurice Gee, Patricia Grace
Authors: Jones Lawrence
Published: June 2018

This chapter discusses the work of three New Zealand novelists: Janet Frame, Maurice Gee, and Patricia Grace. Frame began to publish in the late 1940s, Gee in the mid-1950s, and Grace in the early 1960s — they all started with short stories on ground that had been cleared by Frank Sargeson in his fiction of the 1930s and 1940s. All three writers have been, like Sargeson, critical of a conformist social pattern from a liberal humanist perspective, and sympathetic with its outsiders and victims. The chapter first provides a background on the careers of Frame, Gee, and Grace before considering some of their novels, including Frame's The Rainbirds (1968) and The Carpathians (1988), Gee's Plum trilogy (1978–83), and Grace's Maōri narratives Mutuwhenua: The Moon Sleeps (1978), Potiki (1986), and Tu (2004).
The Short Story in Aotearoa/New Zealand
Authors: Mcneill Dougal
Published: June 2018

This chapter discusses the history of the short story in Aotearoa/New Zealand, arguing that the genre's cultural centrality is, from 1950, displaced at the very moment its literary viability becomes assured. It considers how shifts in publishing practices and audience consumption patterns allowed all manner of literary writing, short fiction included, to flourish. The chapter examines the development of Pākehā short fiction during the periods 1950–1968 and it traces the parallel development of Maōri short fiction after 1950, and how the journal Te Ao Hou (1952–1976) promoted Maōri writing in English which has flourished since the 1970s. Finally, it shows how the New Zealand short story has fared in the 1980s and beyond.
Global Health Justice and Governance
Authors: Prah Ruger Jennifer
Published: June 2018

Critical and dangerous threats imperil global health. Serious health disparities, hazardous contagions that can circle our globalized planet in hours, a bewildering confusion of health actors and systems all combine in a kaleidoscopically fragmented, incoherent, and unjust global health enterprise. While a growing body of work in global justice and international relations explores moral issues and global governance, very little of it has linked principles of global health justice to governance to create a theory of global health. But the dangers confronting the world make a theoretical framework essential, to enable analysis of the current system and to ground proposals to reform it and align it with moral values. This book presents a global justice theory—provincial globalism (PG)—and links it with the theory of shared health governance (SHG) to offer an alternative to the prevailing modus operandi, which has manifestly failed to serve global health. The PG/SHG framework advances health capability, and specifically the capability to avoid premature death and preventable morbidity, as the proper goal of health systems and policy. This framework sees human flourishing as global society’s end goal and proposes an ethical demand for health equity as the criterion for evaluating global health policy and law. It examines the current actors in global health, assessing their strengths and weaknesses, and proposes assigning responsibilities to actors at all levels according to their functions and capabilities.
Contrasting Theories of Global Justice
Authors: Prah Ruger Jennifer
Published: June 2018

Theories of global justice fall into four main perspectives: realism, particularism, social contractarianism (society of states), and cosmopolitanism. But health justice remains largely unheeded in these justice theories. More recently, some theorists have turned to health; the perspective most frequently used to ground health obligations is the human rights view. Yet all these frameworks fall short of providing the necessary normative foundation for global health justice. Nor does global bioethics as a discipline address global health justice adequately. Health-sphere actors—global, state, and non-state—need to understand their interests more comprehensively. A more fully developed moral framework and ethical guidelines are essential if health-sphere actors are to tackle global health problems effectively.
Divergent Perspectives in Global Health Governance
Authors: Prah Ruger Jennifer
Published: June 2018

The global health governance (GHG) literature frames health variously as a matter of security and foreign policy, human rights, or global public good. Divergence among these perspectives has forestalled the development of a consensus vision for global health. Global health policy will differ according to the frame applied. Fundamentally, GHG today operates on a rational actor model, encompassing a continuum from the purely self-interest-maximizing position at one extreme to a more nuanced approach that takes others’ interests into account when making one’s own calculations. Even where humanitarian concerns are clearly and admirably at play, however, the problem of motivations remains. Often narrow self-interest is also at work, and actors obfuscate this behind altruistic motives.
Shared Health Governance at the Domestic Level
Authors: Prah Ruger Jennifer
Published: June 2018

While no society can guarantee good health, societies can, if they will, create the conditions—effective institutions, social systems, and practices—to support all members as they seek to achieve central health capabilities. The SHG model sets out allocations of responsibility, resources, and sovereignty to state and non-state actors and institutions, NGOs, the private sector, communities, families, and individuals themselves. The primary responsibility for efficiently preventing and reducing shortfall inequalities in central health capabilities falls to the state, because national governments have the authority and resources to create health system infrastructures, including health care, public health, and other systems affecting health. State duties include developing and maintaining a national health care and public health policy and system and guaranteeing a universal comprehensive benefits package of medically necessary and appropriate goods and services as well as ensuring the social determinants of health.
The Life Story, Domains of Identity, and Personality Development in Emerging Adulthood
Authors: Pratt Michael W. , Matsuba M. Kyle
Published: June 2018

This book is about the life story and its integration into the wider personality in development, as depicted in Erikson’s theory of personality stages. The authors focus on how this personal identity narrative develops in emerging adulthood, the transition period from adolescence to young adulthood. They utilize a framework proposed by McAdams, which treats personality development as composed of three levels acquired across the life course: behavioral traits; personal values and motives; and finally, the life story, which provides some sense of a coherent personal identity. The life story and identity development are examined through the lens of different identity domains, including ideological domains such as religion, morality, and vocation, and various relational domains, including family, close peer and romantic relationships, and wider civic concerns. In a series of chapters the authors review personality development in each of these domains following McAdams’s three-part model, and describe the growth of the life story in each. All these chapters review the empirical personality research literature and then discuss findings from the authors’ ongoing longitudinal, mixed methods study following a sample of young Canadians across emerging adulthood, drawing on the individual narrative voices of the sample to illustrate this life story development. The authors also present case studies of the emerging adulthood of well-known public figures at the end of each chapter. The final chapter ties together these various lines of evidence around some general issues concerning the role of the life story in the study of the emerging adult personality.
Peer and Romantic Relationships in Emerging Adulthood
Authors: Pratt Michael W. , Matsuba M. Kyle
Published: June 2018

Chapter 8 focuses on the development of peer and romantic relationships. The authors draw on Erikson’s theory as focused around the key period of intimacy development in emerging adulthood, and also discuss attachment theory models on this topic. They review the longitudinal research evidence on links between the three components of personality in the McAdams and Pals model and intimacy development. Turning to the evidence from our Futures Study sample, the authors analyze stories told at ages 26 and 32 about friends and about romantic partners, and how these two domains of relationships are linked with personality development. Finally, to illustrate key topics, the chapter ends with a case study on the complex and stressful romantic relationship of an iconic Canadian political couple from the 1970s, Prime Minister Pierre Trudeau and his emerging adult-aged wife, Margaret Sinclair.
Using a Poverty Simulation Exercise in Mental Health Nursing
Authors: Link Kimberly A. , Haughtigan Kara S. , Garrett-Wright Dawn
Published: June 2018

Simulation exercises can be used to provide poverty-related content that might be lacking in traditional clinical settings. A descriptive qualitative study design was used to examine the use of a poverty simulation in mental health nursing. Thematic analysis of reflective journals indicated students viewed the poverty simulation as a positive, realistic, and informative learning experience; had a better understanding of how poverty impacts health; and expressed changes in attitudes toward providing care. Results from this study suggest poverty simulations can be used to illustrate key concepts taught in mental health nursing, including empathy, advocacy, and refrainment from judging patients.
Spinal Injuries in Suicidal Jumpers
Authors: Kano Hiroki , Matsuo Yohei , Kubo Noriaki , Fujimi Satoshi , Nishii Takashi
Published: June 2018

Study Design.

This was a retrospective case series at a single institution.

Objective.

The study was performed to investigate the characteristics of spinal injuries in survivors of suicidal jumping.

Summary of Background Data.

Spinal fracture/dislocation is associated with high-energy trauma such as that induced by motor vehicle accidents. Survivors of suicidal jumping sometimes sustain spinal injuries. However, the characteristics of such spinal injuries are unclear.

Methods.

We identified 87 survivors of suicidal jumping who sustained spinal injuries from 2007 to 2016 in our institution. We compared the demographic data, radiological findings, neurological status, associated injuries, treatments, and mental health conditions between these 87 survivors and 204 non-suicidal patients with spinal injury.

Results.

Suicidal jumpers were predominantly female (67%) and 10 years younger than non-suicidal patients. Mental health problems, mainly schizophrenia and depression, were diagnosed in 77% of suicidal jumpers. Neurological damage from spinal trauma was generally less severe in suicidal jumpers than in non-suicidal patients. Most spinal injuries in suicidal jumpers were located in the thoracic or lumbar spine region (85%). Among comorbid injuries, extremity injuries were highly associated with spine injury in suicidal jumpers. Nearly 70% of suicidal jumpers exhibited extremity injury in contrast to 33% of non-suicidal patients. Approximately, 25% of suicidal jumpers underwent surgical treatment. Surgical treatment was similarly performed on suicidal jumpers and non-suicidal patients regardless of the discrepancy in neurological damage between these two groups.

Conclusion.

Spinal injuries in suicidal jumpers differed from spinal injuries in non-suicidal patients with regard to sex, age, mental health condition, injury location, neurologic damage, and associated injuries. Most survivors of suicidal jumping were young female patients with mental health problems. They tended to have thoracic and lumbar spine trauma rather than cervical trauma with less severe neurological deficits and a higher incidence of accompanying limb injury.

Level of Evidence: 3
Effects of the INSIGHT Obesity Preventive Intervention on Reported and Observed Infant Temperament
Authors: Anzman-Frasca Stephanie , Paul Ian M. , Moding Kameron J. , Savage Jennifer S. , Hohman Emily E. , Birch Leann L.
Published: June 2018

Objective:

Infants higher on negative reactivity and lower on regulation, aspects of temperament, have increased obesity risk. Responsive parenting (RP) has been shown to impact the expression of temperament, including the developing ability to regulate negative emotions. The aim of this analysis was to test the effects of the INSIGHT study's RP intervention designed for the primary prevention of obesity on reported and observed infant negativity and regulation.

Methods:

The sample included 240 mother-infant dyads randomized 2 weeks after birth to the RP intervention or a safety control intervention. Both groups received 4 home visits during the infant's first year. In the RP group, nurses delivered RP guidance in domains of sleep, feeding, soothing, and interactive play. At 1 year, mother-reported temperament was measured by a survey, and a frustration task was used to observe temperament in the laboratory. Effects of the RP intervention were tested using general linear models.

Results:

The RP intervention reduced overall reported infant negativity, driven by lower distress to limitations (p < 0.05) and faster recovery from distress (p < 0.01) in the RP group versus controls. There were no intervention effects on reported regulation or observed negativity. The intervention did increase observed regulation, particularly the use of self-comforting strategies (p < 0.05) during the frustration task.

Discussion:

An RP intervention designed for early obesity prevention affected reported infant negativity and observed regulation, outcomes that have been linked with subsequent healthy development. Interventions grounded in an RP framework have the potential for widespread effects on child health and well-being.
Comprehensive Review of Tissue Adhesives
Authors: Jenkins Lauren E. , Davis Loretta S.
Published: June 2018

BACKGROUND

Cyanoacrylates, also known as tissue adhesives or skin glues, are commonly used as sealants for lacerations and incisions and have found utility in excisional and cosmetic surgeries in both outpatient and operating room settings.

OBJECTIVE

To review the surgical literature on the utilities, advantages, disadvantages, and special uses of cyanoacrylates applicable to dermatology.

MATERIALS AND METHODS

PubMed was reviewed for relevant articles related to cyanoacrylates and their use in skin closures. Articles unrelated to cutaneous closures were excluded.

RESULTS

Tissue adhesives polymerize to a water resistant, pliable film after application to approximated wound edges and have antibacterial properties. Adhesives slowly slough off as the wound heals, typically after 5 days. Compared with 5-0 nonabsorbable suture, adhesives provide similar tensile strength and similar patient and surgeon satisfaction. Although slightly more expensive than sutures, tissue adhesives obviate the need for wound dressings and suture removal. They do not perform as well as sutures for wounds under higher tension or in the setting of moisture and inadequate hemostasis.

CONCLUSION

Cyanoacrylates serve as a safe and effective suture alternative in appropriate dermatologic surgeries and procedures.
IMPROVED DETECTION AND DIAGNOSIS OF POLYPOIDAL CHOROIDAL VASCULOPATHY USING A COMBINATION OF OPTICAL COHERENCE TOMOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY
Authors: Cheung Chui Ming Gemmy , Yanagi Yasuo , Akiba Masahiro , Tan Anna , Mathur Ranjana , Chan Choi Mun , Yeo Ian , Wong Tien Y.
Published: June 2018

Purpose:

To assess the ability of optical coherence tomography (OCT) alone and in combination with OCT angiography (OCTA) to differentiate polypoidal choroidal vasculopathy (PCV) from neovascular age-related macular degeneration, as compared to fluorescein angiography and indocyanine green angiography.

Methods:

This is a cross-sectional study. All participants had a standardized history, clinical examination including measurement of best-corrected visual acuity, slit-lamp biomicroscopy, and indirect fundus examination, and underwent standardized imaging (color photography, fluorescein and indocyanine green angiography, OCT, and OCTA) after predefined protocols. We used a 2-step approach (Step 1: spectral domain OCT; Step 2: addition of OCTA) combining structural OCT and OCTA to differentiate 50 treatment-naive eyes with PCV, choroidal neovascularization, and retinal angiomatous proliferation and compared with the diagnosis based on fluorescein angiography and indocyanine green angiography. Spectral domain OCT signs used to diagnose PCV included presence of two out of three of any retinal pigment epithelium detachment (pigment epithelial detachment/double-layer sign), notched or narrow-peaked pigment epithelial detachment, or round subretinal pigment epithelium structure. Optical coherence tomography angiography signs used to diagnose PCV included presence of a localized subretinal pigment epithelium hyperflow signal in the cross-sectional OCTA and/or presence of a focal hyperflow sign in en face OCTA based on outer retina slab.

Results:

Based on fluorescein angiography and indocyanine green angiography, the diagnosis was choroidal neovascularization in 24 eyes, PCV in 23 eyes, and retinal angiomatous proliferation in 3 eyes. Based on spectral domain OCT signs, PCV was diagnosed in 19/23 (82.6%) eyes; however, specificity of OCT was only 51.9%. Cross-sectional OCTA showed a diffuse hyperflow signal in all 24 (100.0%) eyes with choroidal neovascularization, whereas a localized subretinal pigment epithelium hyperflow signal was detected in 19/23 (82.6%) eyes with PCV. En face OCTA only detected a nodular hyperflow signal in 10/23 eyes (43.5%) with PCV. Combination of OCT and OCTA achieved 82.6% sensitivity and 100.0% specificity for differentiating PCV from choroidal neovascularization/retinal angiomatous proliferation.

Conclusion:

Cross-sectional OCTA is more sensitive than en face OCTA in detecting flow signal in polyps. Combination of structural OCT and OCTA can be used to screen for PCV with a high level of sensitivity and specificity.
Cultures of Proximal and Distal Segments of Silicone Tubes After Dacryocystorhinostomy
Authors: Becker Bruce B.
Published: June 2018

Purpose:

To compare the results of cultures of the proximal and distal segments of silicone tubes after dacryocystorhinostomy.

Methods:

The medical records of patients undergoing a dacryocystorhinostomy and silicone intubation were reviewed. The inclusion criteria were cultures of both distal and proximal stent segments after removal, dye testing, evaluation of the tear meniscus, and notation of the presence or absence of discharge before and after removal. The exclusion criteria included the use of systemic or topical antibiotics within 1 month before tube removal.

Results:

Forty-six lacrimal systems in 40 patients were included, with 6 patients having bilateral dacryocystorhinostomies. There were no cases of dacryocystitis at the time of or after tube removal. Four (9%) of the dacryocystorhinostomies failed. Forty-one (89%) of the distal tube segments had positive cultures. The distal tube cultures grew 17 (36%) gram-positive bacteria, 21 (45%) gram-negative bacteria, 7 (15%) skin flora, and 2 (4%) fungi (6 distal segments had mixed cultures). Thirteen (28%) of the proximal tube segments had positive cultures. The proximal tube cultures were 5 (38%) gram-negative bacteria, 4 (31%) gram-positive bacteria, 3 (23%) skin flora, and 1 (8%) acid-fast bacteria. Four (31%) of the proximal tubes with positive cultures grew the same organism as the distal tube segment. Nine (69%) of the proximal tubes with positive cultures grew different organisms than the distal segment. Forty-two (91%) of all the proximal tube cultures were either negative or grew different organisms than the distal segment cultures.

Conclusions:

The proximal segment of a silicone tube after a dacryocystorhinostomy may be a “privileged” area. There is usually a lack of growth or the growth of different organisms than those present on the distal tube segments. This may be explained by the protective nature of the tear film. The findings may also help to explain the low incidence of dacryocystitis in spite of the growth of virulent organisms on the distal tube segment after a dacryocystorhinostomy.
Dupilumab
Authors: Sung Calvin T. , Jacob Sharon E.
Published: June 2018

Drugs are broadly defined as any chemical substance that can elicit a physiological effect on the body. Medication is a subgroup of drugs utilized by healthcare providers to diagnose, treat, or prevent diseases from occurring. Therapeutic monoclonal antibodies are immunotherapies that have gained commercial interest over the past 30 years within the biopharmaceutical sector. In addition to cancer and rheumatology diseases, common dermatological pathologies traditionally limited to topical steroid therapies through immunotherapies can now be targeted with specific immunomodulatory drugs.

This pharmacological column aims to draw attention to the first targeted monoclonal antibody therapy approved by the Food and Drug Administration for the treatment of moderate-to-severe atopic dermatitis, dupilumab (Dupixent). The purpose of this article is to review dupilumab within the context of atopic dermatitis immunology, standard treatments, indications, mechanisms of action, adverse reactions, and upcoming applications for asthma with relevance to the growing biopharmaceutical sector. As the popularity of immunotherapies has grown, so has the need for nurse practitioners and educators to continue expanding their knowledge base in drug delivery, adverse reaction management, and therapeutic opportunities to advance care.
Platelet Transfusions in the PICU: Does Disease Severity Matter?*
Authors: Saini Arun , West Alina N. , Harrell Camden , Jones Tamekia L. , Nellis Marianne E. , Joshi Ashwini D. , Cowan Krista M. , Gatewood Connor W. , Ryder Alex B. , Reiss Ulrike M.
Published: June 2018

Objectives:

Pediatric intensivists frequently prescribe platelet transfusions to critically ill children, but there are limited data on platelet transfusion practice and platelet transfusion–related outcomes in the PICU. In this study, we evaluated the current platelet transfusion practice and platelet transfusion–related outcomes in the PICU.

Design:

Institutional review board–approved, retrospective cohort study from January 2010 to March 2016.

Setting:

Tertiary-level PICU.

Patients:

Children less than 19 years old who received platelet transfusions in the PICU.

Interventions:

None.

Measurements and Main Results:

Thirty-six percent (1,547/4,339) of platelet transfusions in the institution were given to 2.4% of PICU patients (232/9,659). The patients who received a platelet transfusion (platelet transfusions, n = 232) compared with those who did not receive platelets (no platelet transfusions, n = 9,427) were younger, had similar gender distribution, had a higher median Pediatric Risk of Mortality-3 score, and stayed longer in the PICU. Fifty percent of platelet transfusions were prescribed prophylactically for thrombocytopenia to patients without extracorporeal membrane oxygenation support. The mortality was higher for platelet transfusions group (30% vs 2.3%) with an 18 times increased unadjusted odds of mortality when compared with no platelet transfusion group (odds ratio, 18.2; 95% CI, 13.3–24.8; p < 0.0001). In a multiple logistic regression analysis, the predicted probability of dying for platelet transfusion group compared with no platelet transfusion group depended on the median Pediatric Risk of Mortality-3 score. Patients who received platelet transfusion versus no platelet transfusion have increased odds of dying at lower median Pediatric Risk of Mortality-3 scores, but decreased odds of dying at higher median Pediatric Risk of Mortality-3 scores.

Conclusions:

This PICU cohort demonstrates that the odds or predicted probability of dying change in patients who received platelet transfusions based on underlying disease severity measured by Pediatric Risk of Mortality-3 score compared with patients who did not receive platelet transfusions. A large, prospective trial is required to confirm this association and determine whether to consider underlying disease severity in estimating risks and benefits of prophylactic platelet transfusions in critically ill children.
Refining Post–Orthognathic Surgery Facial Contour with Computer-Designed/Computer-Manufactured Alloplastic Implants
Authors: Lee Jeffrey H. , Kaban Leonard B. , Yaremchuk Michael J.
Published: June 2018

Background:

Le Fort I maxillary osteotomies and sagittal split mandibular osteotomies are performed to correct significant dentofacial deformities. The multidimensional skeletal movements, particularly those of large magnitude, may result in contour irregularities and facial imbalances.

Methods:

Three-dimensional images were reconstructed from computed tomographic scans in patients unhappy with their appearances after Le Fort I advancement and/or bilateral sagittal split osteotomies. The data from these scans were used to produce alloplastic implants using computer-aided design/computer-aided manufacturing for surgical correction of contour irregularities and imbalances. These implants were surgically placed through intraoral and submental incisions and fixed using titanium screws.

Results:

A total of 21 patients underwent implant placement with implants produced using computer-design/computer manufacturing. One patient required removal of implants secondary to infection. All other patients were satisfied with their result.

Conclusion:

The use and surgical placement of implants produced by means of computer-aided design/computer-aided manufacturing has been shown to be effective in refining appearance in 21 patients over a 7-year period with minimal morbidity.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Tardive Myoclonic Dyskinesia Responsive to Sodium Oxybate
Authors: D'Arrigo Andrea Maria , Campiglio Laura , Casellato Chiara , Gambini Chiara , Belvedere Daniela , Secchi Manuela , Rosci Chiara , Priori Alberto
Published: June 2018

Hyperkinetic movement disorders may be difficult to treat, but cases where patients respond to alcohol and/or drugs with similar effects have been described. We report the case of a 64-year-old man with tardive dyskinesia characterized by severe uncontrolled dystonic and myoclonic jerks of the face, shoulders, and arm and forearm muscles, which improved with oral sodium oxybate. Our case suggests the possibility to test sodium oxybate in patients with severe, drug-resistant hyperkinetic syndromes, especially when they are known to improve with alcohol.
Kif17 phosphorylation regulates its ciliary localization and photoreceptor outer segment turnover
Authors: Lewis Tylor R. , Kundinger Sean R. , Link Brian A. , Insinna Christine , Besharse Joseph C.
Published: June 2018

Background

KIF17, a kinesin-2 motor that functions in intraflagellar transport, can regulate the onset of photoreceptor outer segment development. However, the function of KIF17 in a mature photoreceptor remains unclear. Additionally, the ciliary localization of KIF17 is regulated by a C-terminal consensus sequence (KRKK) that is immediately adjacent to a conserved residue (mouse S1029/zebrafish S815) previously shown to be phosphorylated by CaMKII. Yet, whether this phosphorylation can regulate the localization, and thus function, of KIF17 in ciliary photoreceptors remains unknown.

Results

Using transgenic expression in both mammalian cells and zebrafish photoreceptors, we show that phospho-mimetic KIF17 has enhanced localization to cilia. Importantly, expression of phospho-mimetic KIF17 is associated with greatly enhanced turnover of the photoreceptor outer segment through disc shedding in a cell-autonomous manner, while genetic mutants of kif17 in zebrafish and mice have diminished disc shedding. Lastly, cone expression of constitutively active tCaMKII leads to a kif17-dependent increase in disc shedding.

Conclusions

Taken together, our data support a model in which phosphorylation of KIF17 promotes its ciliary localization. In cone photoreceptor outer segments, this promotes disc shedding, a process essential for photoreceptor maintenance and homeostasis. While disc shedding has been predominantly studied in the context of the mechanisms underlying phagocytosis of outer segments by the retinal pigment epithelium, this work implicates photoreceptor-derived signaling in the underlying mechanisms of disc shedding.
Evolution of correlated complexity in the radically different courtship signals of birds-of-paradise
Authors: Ligon Russell A. , Diaz Christopher D. , Morano Janelle L. , Troscianko Jolyon , Stevens Martin , Moskeland Annalyse , Laman Timothy G. , Scholes Edwin
Published: June 2018

Ornaments used in courtship often vary wildly among species, reflecting the evolutionary interplay between mate preference functions and the constraints imposed by natural selection. Consequently, understanding the evolutionary dynamics responsible for ornament diversification has been a longstanding challenge in evolutionary biology. However, comparing radically different ornaments across species, as well as different classes of ornaments within species, is a profound challenge to understanding diversification of sexual signals. Using novel methods and a unique natural history dataset, we explore evolutionary patterns of ornament evolution in a group - the birds-of-paradise - exhibiting dramatic phenotypic diversification widely assumed to be driven by sexual selection. Rather than the tradeoff between ornament types originally envisioned by Darwin and Wallace, we found positive correlations among cross-modal (visual/acoustic) signals indicating functional integration of ornamental traits into a composite unit - thecourtship phenotype.Furthermore, given the broad theoretical and empirical support for the idea that systemic robustness - functional overlap and interdependency - promotes evolutionary innovation, we posit that birds-of-paradise have radiated extensively through ornamental phenotype space as a consequence of the robustness in the courtship phenotype that we document at a phylogenetic scale. We suggest that the degree of robustness in courtship phenotypes among taxa can provide new insights into the relative influence of sexual and natural selection on phenotypic radiations.

Author Summary

Animals frequently vary widely in ornamentation, even among closely related species. Understanding the patterns that underlie this variation is a significant challenge, requiring comparisons among drastically different traits - like comparing apples to oranges. Here, we use novel analytical approaches to quantify variation in ornamental diversity and richness across the wildly divergent birds-of-paradise, a textbook example of how sexual selection can profoundly shape organismal phenotypes. We find that color and acoustic complexity, along with behavior and acoustic complexity, are positively correlated across evolutionary time-scales. Positive covariation among ornament classes suggests that selection is acting on correlated suites of traits - a composite courtship phenotype - and that this integration may be partially responsible for the extreme variation we see in birds-of-paradise.
Ancestry of the two subgenomes of maize
Authors: McKain Michael R. , Estep Matt C. , Pasquet Rémy , Layton Daniel J. , Vela Díaz Dilys M. , Zhong Jinshun , Hodge John G. , Malcomber Simon T. , Chipabika Gilson , Pallangyo Beatrice , Kellogg Elizabeth A.
Published: June 2018

Maize (Zea maysssp.mays) is not only one of the world’s most important crops, but it also is a powerful tool for studies of genetics, genomics, and cytology. The genome of maize shows the unmistakable signature of an ancient hybridization event followed by whole genome duplication (allopolyploidy), but the parents of this event have been a mystery for over a century, since studies of maize cytogenetics began. Here we show that the whole genome duplication event preceded the divergence of the entire genusZeaand its sister genusTripsacum. One genome was donated, in whole or in part, by a plant related to the modern African generaUrelytrumandVossia, although genomic rearrangement has been extensive. The other genome donor is less well-supported, but may have been related to the modernRottboellia-Hemarthriaclade, which is also African. ThusZeaandTripsacumtogether represent a New World radiation derived from African ancestors.
BFA1has multiple positive roles in directing late mitotic events inS. cerevisiae
Authors: Whalen J , Sniffen C , Gartland S , Vannini M , Seshan A
Published: June 2018

The proper regulation of cell cycle transitions is paramount to the maintenance of cellular genome integrity. In budding yeast, the mitotic exit network (MEN) is a Ras-like signaling cascade that effects the transition from M phase to G1 during the cell division cycle in budding yeast. MEN activation is tightly regulated. It occurs during anaphase and is coupled to mitotic spindle position by the spindle position checkpoint (SPoC). Bfa1 is a key component of the SPoC and functions as part of a two-component GAP complex along with Bub2. The GAP activity of Bfa1-Bub2 keeps the MEN GTPase Tem1 inactive in cells with mispositioned spindles, thereby preventing inappropriate mitotic exit and preserving genome integrity. Interestingly, a GAP-independent role for Bfa1 in mitotic exit regulation has been previously identified. However the nature of this Bub2-independent role and its biological significance are not understood. Here we show that Bfa1 also activates the MEN by promoting the localization of Tem1 primarily to the daughter spindle pole body (dSPB). We demonstrate that the overexpression ofBFA1is lethal due to defects in Tem1 localization, which is required for its activity. In addition, our studies demonstrate a Tem1-independent role for Bfa1 in promoting proper cytokinesis. Cells lackingTEM1, in which the essential mitotic exit function is bypassed, exhibit cytokinesis defects. These defects are suppressed by the overexpression ofBFA1. We conclude that Bfa1 functions to both inhibit and activate late mitotic events.