bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Informatics to Improve the Care of Patients Susceptible to Malignant Hyperthermia
Authors: Denholm Bonnie G.
Published: March 2016

Perioperative nurses and nurse leaders should understand how to apply a nursing informatics framework and informatics concepts to strengthen data interpretation, transitions in care, and engagement with patients susceptible to malignant hyperthermia (MH) and their family members. Patient outcomes can be improved when informatics solutions facilitate identifying risks, clinical decision making in a crisis situation, retrieving priority information during transitions of care, and involving patients in planning care. Incorporating informatics solutions into existing quality improvement processes can help evaluate knowledge and preparedness related to managing care for a patient in an MH crisis. Informatics solutions can also help enhance interoperability by evaluating workflow related to transitions in care. Perioperative nurses and nurse leaders should advocate for diligence in submitting reports of MH‐suspected events to databases. Improved data collection and data sharing enhance aggregated standardized data sets, which can advance research and increase the quality of evidence available with which to guide practice.
Clinical Issues‐April 2016
Authors: Fearon Mary C. , Ogg Mary J.
Published: March 2016

This Month

Creating a just culture

Key words:just culture, TeamSTEPPS, human error, briefing, huddle.

Circulating while administering moderate sedation/analgesia

Key words:moderate sedation/analgesia, RN circulator.

Monitoring RN leaving room during administration of moderate sedation

Key words:moderate sedation/analgesia, propofol.

Screening for obstructive sleep apnea before administering moderate sedation

Key words:moderate sedation/analgesia, obstructive sleep apnea, OSA.

Assessment for obstructive sleep apnea

Key words:moderate sedation/analgesia, obstructive sleep apnea, OSA, OSA questionnaires, OSA checklist.
Transthoracic Computed Tomography–Guided Lung Nodule Biopsy: Comparison of Core Needle and Fine Needle Aspiration Techniques
Authors: Sangha Bippan S. , Hague Cameron J. , Jessup Jennifer , O'Connor Robert , Mayo John R.
Published: March 2016

Purpose

To determine if there is a statistically significant difference in the computed tomography (CT)–guided trans-thoracic needle biopsy diagnostic rate, complication rate, and degree of pathologist confidence in diagnosis between core needle biopsy (CNB) and fine needle aspiration biopsy (FNAB).

Methods

A retrospective cohort design was used to compare the diagnostic biopsy rate, diagnostic confidence, and biopsy-related complications of pneumothorax, chest tube placement, pulmonary hemorrhage, hemoptysis, admission to hospital, and length of stay between 251 transthoracic needle biopsies obtained via CNB (126) or FNAB (125). Complication rates were assessed using imaging and clinical follow-up. Final diagnosis was confirmed via surgical pathology or clinical follow-up over a period of up to 10 years.

Results

CNB provided diagnostic samples in 91% and FNA in 80% of biopsies, which was statistically significant ( P < .05). The sensitivities for CNB and FNAB were 89% (85 of 95) and 95% (84 of 88), respectively. The specificity of CNB was 100% (21 of 21) and for FNAB was 81% (2 of 11) with 2 false positives in the FNAB group. The differences in complication rate was not statistically significant for pneumothorax (50% vs 46%; determined by routine postbiopsy CT), chest tube (2% vs 4%), hemoptysis (4% vs 6%), and pulmonary hemorrhage (38% vs 47%) between FNAB and CNB, respectively. Seven patients requiring chest tube were admitted to hospital, 2 in the FNAB cohort for an average of 2.5 days and 5 in the CNB cohort for an average of 4.6 days.

Conclusions

CNB provided more diagnostic samples with no statistical difference in complication rate.
Hydrochlorothiazide Potentiates Contractile Activity of Mouse Cavernosal Smooth Muscle
Authors: Gagliano-Jucá Thiago , Napolitano Mauro , Del Grossi Ferraz Carvalho Fernanda , Campos Rafael , Mónica Fabíola Zakia , Claudino Mário Angelo , Antunes Edson , Lopes Anibal Gil , De Nucci Gilberto
Published: March 2016

Introduction

Hydrochlorothiazide has a negative influence on penile erection but little is known about the mechanism(s) involved.

Aims

To characterize the effects of this diuretic on mouse corpus cavernosum (CC) smooth muscle in vitro and ex vivo.

Methods

CC strips of C57BL/6 mice (12–16 weeks old) were mounted in organ baths containing Krebs-Henseleit solution and tissue reactivity was evaluated. Expression of genes encoding diuretic targets and enzymes involved in penile erection were evaluated by polymerase chain reaction.

Main Outcome Measures

Stimulation-response curves to phenylephrine (10 nmol/L–100 μmol/L) or to electrical field stimulation (1–32 Hz) were constructed, with or without hydrochlorothiazide. Strips of CC from mice after long-term hydrochlorothiazide treatment (6 mg/kg/day for 4 weeks) with or without amiloride (0.6 mg/kg/day for 4 weeks) in vivo also were studied. Nitric oxide and Rho-kinase pathways were evaluated.

Results

Hydrochlorothiazide (100 μmol/L) increased the maximum response to phenylephrine by 64% in vitro. This effect was unaffected by the addition of indomethacin (5 μmol/L) but was abolished by N(ω)-nitro-L-arginine methyl ester (100 μmol/L). Hydrochlorothiazide (100 μmol/L) potentiated electrical field stimulation-induced contraction in vitro, but not ex vivo. Long-term treatment with hydrochlorothiazide increased the maximum response to phenylephrine by 60% and resulted in a plasma concentration of 500 ± 180 nmol/L. Amiloride (100μmol/L) caused rightward shifts in concentration-response curves to phenylephrine in vitro. Long-term treatment with hydrochlorothiazide plus amiloride did not significantly increase the maximum response to phenylephrine (+13%). Reverse transcriptase polymerase chain reaction did not detect the NaCl cotransporter in mouse CC. Hydrochlorothiazide did not change Rho-kinase activity, whereas amiloride decreased it in vitro and ex vivo (approximately 18% and 24% respectively). A 40% decrease in Rock1 expression also was observed after long-term treatment with hydrochlorothiazide plus amiloride.

Conclusion

Hydrochlorothiazide potentiates contraction of smooth muscle from mouse CC. These findings could explain why diuretics such as hydrochlorothiazide are associated with erectile dysfunction.
Normal values of nasal NO and exhaled NO in young Chinese people aged 9 – 22 years
Authors: You Shaohua , Zhang Jing , Bai Yin , Ji Lingchao , Wang Hongtian
Published: March 2016

Objective

To assess the normal levels of nasal nitric oxide (NNO) and fractional exhaled nitric oxide (FENO) in healthy Chinese young people, and to determine whether the obtained values were associated with age, sex, height, weight, BMI (body mass index) or BSA (body surface area).

Methods

One hundred and twenty healthy people were selected from a total of 436 Chinese young people based on their answers to a questionnaire. An electrochemical analyzer (NIOX MINO system) was used to measure NNO and FENO. The relationship between NNO, FENO and age, sex, height, weight, BMI, BSA was analyzed using SPSS software.

Results

The values of NNO were normal distributed (mean 273.5 ppb; SD 112.3). The values of FENO were non‐normally (Skewed) distributed (median: 14.00 ppb; interquartile range: 7.00 ppb). The obtained NNO values were independent of age, sex, height, weight, BMI and BSA, but were positively correlated to lnFENO (FENO log base e); lnFENO values were also independent of age, height, weight, BMI and BSA, but correlated with NNO and sex.

Conclusions

NNO values positively correlate with lnFENO in healthy people and the levels of each may be predicted by the other. The results of this study are expected to serve as a reference for future studies in China.
Comparing Planetary Climates to Investigate Climate Systems
Authors: Domagal-Goldman Shawn , Hollingsworth Jeffrey , Glaze Lori
Published: March 2016

Comparative Climates of Terrestrial Planets II (CCTP2 ): Understanding How Climate Systems Work; Moffett Field, California, 8–11 September 2015
Paraoxonase-1 overexpression prevents experimental abdominal aortic aneurysm progression
Authors: Burillo Elena , Tarin Carlos , Torres-Fonseca Monica-Maria , Fernandez-García Carlos-Ernesto , Martinez-Pinna Roxana , Martinez-Lopez Diego , Llamas-Granda Patricia , Camafeita Emilio , Lopez Juan Antonio , Vega de Ceniga Melina , Aviram Michael , Egido Jesus , Blanco-Colio Luis-Miguel , Martín-Ventura Jose-Luis
Published: March 2016

Abdominal aortic aneurysm (AAA) is a permanent dilation of the aorta due to excessive proteolytic, oxidative and inflammatory injury of the aortic wall. We aimed to identify novel mediators involved in AAA pathophysiology, which could lead to novel therapeutic approaches. For that purpose, plasma from four AAA patients and four controls were analysed by a label-free proteomic approach. Among identified proteins, paraoxonase-1 (PON1) was decreased in plasma of AAA patients compared with controls, which was further validated in a bigger cohort of samples by ELISA. The phenylesterase enzymatic activity of PON1 was also decreased in serum of AAA patients compared with controls. To address the potential role of PON1 as a mediator of AAA, experimental AAA was induced by aortic elastase perfusion in wild-type (WT) mice and human transgenic PON1 (HuTgPON1) mice. Similar to humans, PON1 activity was also decreased in serum of elastase-induced AAA mice compared with healthy mice. Interestingly, overexpression of PON1 was accompanied by smaller aortic dilation and higher elastin and vascular smooth muscle cell (VSMC) content in the AAA of HuTgPON1 compared with WT mice. Moreover, HuTgPON1 mice display decreased oxidative stress and apoptosis, as well as macrophage infiltration and monocyte chemoattractant protein-1 (MCP1) expression, in elastase-induced AAA. In conclusion, decreased circulating PON1 activity is associated with human and experimental AAA. PON1 overexpression in mice protects against AAA progression by reducing oxidative stress, apoptosis and inflammation, suggesting that strategies aimed at increasing PON1 activity could prevent AAA.
Prävalenz von Gastroschisis, Omphalozele, Spina bifida und orofazialen Spaltbildungen bei Neugeborenen im Zeitraum Januar 2000–Dezember 2010 in Leipzig, Sachsen, Sachsen-Anhalt und Deutschland
Authors: Bremer S. , Kiess W. , Thome U. , Knüpfer M. , Bühligen U. , Vogel M. , Friedrich A. , Janisch U. , Rißmann A.
Published: March 2016

Hintergrund: Zahlreiche Studien beschreiben weltweit eine Zunahme angeborener Fehlbildungen. Diese sind in Deutschland die häufigste Todesursache im frühen Kindesalter. Die hier vorliegende Studie untersuchte lokale und nationale Trends der Prävalenz von Gastroschisis, Omphalozele, Spina bifida und orofazialen Spaltbildungen von 2000 bis 2010.

Methoden: Die Prävalenz der 4 Fehlbildungen wurde im Zeitraum Januar 2000–Dezember 2010 mithilfe von 4 Datenquellen aus Leipzig, Sachsen, Sachsen-Anhalt und Deutschland untersucht.

Ergebnisse: Die Prävalenz der Fehlbildungen betrug im Untersuchungszeitraum in Deutschland bzw. in Sachsen 1,97/2,12 (Gastroschisis), 1,63/1,48 (Omphalozele), 5,80/8,11 (orofaziale Spaltbildungen) und 2,92/2,50 (Spina bifida) je 10 000 Lebendgeborene. In Sachsen zeigte sich ein Trendanstieg, dessen Effektstärken jedoch sehr gering sind (OR/Jahr zwischen 1,01–1,09). Auch in Deutschland insgesamt wurde eine signifikante Zunahme der Fehlbildungen beobachtet (OR/Jahr zwischen 1,01–1,04), ausgenommen davon war die Lebendgeborenenprävalenz der Spina bifida, die abzunehmen schien (OR/Jahr 0,986 (0,97–1,0), p-korrigiert=0,04).

Schlussfolgerung: Ob ein tatsächlicher Anstieg der Prävalenzen besteht oder lediglich Artefakte einen Anstieg vortäuschen, ist unklar. Änderungen in der Erfassungs- und Verschlüsselungspraxis, Fehlcodierungen, Doppel- und/oder lückenhafte Erfassung der Fehlbildungen könnten die Daten verfälschen. Da nur in Sachsen-Anhalt und Rheinland-Pfalz das Auftreten von Fehlbildungen prospektiv erfasst wird, könnten im Übrigen auch nur in diesen Bundesländern zeitnah Veränderungen der Fehlbildungsprävalenz erkannt werden. Angesichts der anscheinenden oder scheinbaren Zunahme von Fehlbildungen und der offensichtlich fehlerhaften Datenlage ist ein bundesweites oder sind weitere regionale Register für eine bessere und zeitnahe Erkennung und Erfassung von Fehlbildungen in Deutschland notwendig.
Acoustic pulsation of a microbubble confined between elastic walls
Authors: Mekki-Berrada Flore , Thibault Pierre , Marmottant Philippe
Published: March 2016

This paper reports an experimental and theoretical study of the dynamics of microbubbles flattened between the two walls of a microfluidic channel. Using a micropit, a single bubble is trapped by capillarity at a specific position in the channel and its oscillation under ultrasound is observed by stroboscopy. It is shown that the bubble dynamics can be described by a two-dimensional Rayleigh-Plesset equation including the deformation of the walls of the channel and that the bubble behaves as a secondary source of Rayleigh waves at the wall interface. Above a critical pressure threshold, the bubble exhibits a two-dimensional shape oscillation around its periphery with a period doubling characteristic of a parametric instability. We report how each shape mode appears, varying the bubble radius and the amplitude of excitation, and demonstrate that the wall deformation has no significant effect on their dynamics.
First set of gated x-ray imaging diagnostics for the Laser Megajoule facility
Authors: Rosch R. , Trosseille C. , Caillaud T. , Allouche V. , Bourgade J. L. , Briat M. , Brunel P. , Burillo M. , Casner A. , Depierreux S. , Gontier D. , Jadaud J. P. , Le Breton J. P. , Llavador P. , Loupias B. , Miquel J. L. , Oudot G. , Perez S. , Raimbourg J. , Rousseau A. , Rousseaux C. , Rubbelynck C. , Stemmler P. , Troussel P. , Ulmer J. L. , Wrobel R. , Beauvais P. , Pallet M. , Prevot V.
Published: March 2016

The Laser Megajoule (LMJ) facility located at CEA/CESTA started to operate in the early 2014 with two quadruplets (20 kJ at 351 nm) focused on target for the first experimental campaign. We present here the first set of gated x-ray imaging (GXI) diagnostics implemented on LMJ since mid-2014. This set consists of two imaging diagnostics with spatial, temporal, and broadband spectral resolution. These diagnostics will give basic measurements, during the entire life of the facility, such as position, structure, and balance of beams, but they will also be used to characterize gas filled target implosion symmetry and timing, to study x-ray radiography and hydrodynamic instabilities. The design requires a vulnerability approach, because components will operate in a harsh environment induced by neutron fluxes, gamma rays, debris, and shrapnel. Grazing incidence x-ray microscopes are fielded as far as possible away from the target to minimize potential damage and signal noise due to these sources. These imaging diagnostics incorporate microscopes with large source-to-optic distance and large size gated microchannel plate detectors. Microscopes include optics with grazing incidence mirrors, pinholes, and refractive lenses. Spatial, temporal, and spectral performances have been measured on x-ray tubes and UV lasers at CEA-DIF and at Physikalisch-Technische Bundesanstalt BESSY II synchrotron prior to be set on LMJ. GXI-1 and GXI-2 designs, metrology, and first experiments on LMJ are presented here.
Active phase locking of thirty fiber channels using multilevel phase dithering method
Authors: Huang Zhimeng , Tang Xuan , Luo Yongquan , Liu Cangli , Li Jianfeng , Zhang Dayong , Wang Xiaojun , Chen Tunan , Han Mei
Published: March 2016

An active phase locking of a large-scale fiber array with thirty channels has been demonstrated experimentally. In the experiment, the first group of thirty phase controllers is used to compensate the phase noises between the elements and the second group of thirty phase modulators is used to impose additional phase disturbances to mimic the phase noises in the high power fiber amplifiers. A multi-level phase dithering algorithm using dual-level rectangular-wave phase modulation and time division multiplexing can achieve the same phase control as single/multi-frequency dithering technique, but without coherent demodulation circuit. The phase locking efficiency of 30 fiber channels is achieved about 98.68%, 97.82%, and 96.50% with no additional phase distortion, modulated phase distortion I (±1 rad), and phase distortion II (±2 rad), corresponding to the phase error of λ/54, λ/43, and λ/34 rms. The contrast of the coherent combined beam profile is about 89%. Experimental results reveal that the multi-level phase dithering technique has great potential in scaling to a large number of laser beams.
Time of flight spectrometer for background-free positron annihilation induced Auger electron spectroscopy
Authors: Mukherjee S. , Shastry K. , Anto C. V. , Joglekar P. V. , Nadesalingam M. P. , Xie S. , Jiang N. , Weiss A. H.
Published: March 2016

We describe a novel spectrometer designed for positron annihilation induced Auger electron spectroscopy employing a time-of-flight spectrometer. The spectrometer’s new configuration enables us to implant monoenergetic positrons with kinetic energies as low as 1.5 eV on the sample while simultaneously allowing for the detection of electrons emitted from the sample surface at kinetic energies ranging from ∼500 eV to 0 eV. The spectrometer’s unique characteristics made it possible to perform (a) first experiments demonstrating the direct transition of a positron from an unbound scattering state to a bound surface state and (b) the first experiments demonstrating that Auger electron spectra can be obtained down to 0 eV without the beam induced secondary electron background obscuring the low energy part of the spectra. Data are presented which show alternative means of estimating positron surface state binding energy and background-free Auger spectra.
Hydrodynamic structure of the boundary layers in a rotating cylindrical cavity with radial inflow
Authors: Herrmann-Priesnitz Benjamín , Calderón-Muñoz Williams R. , Salas Eduardo A. , Vargas-Uscategui Alejandro , Duarte-Mermoud Manuel A. , Torres Diego A.
Published: March 2016

A flow model is formulated to investigate the hydrodynamic structure of the boundary layers of incompressible fluid in a rotating cylindrical cavity with steady radial inflow. The model considers mass and momentum transfer coupled between boundary layers and an inviscid core region. Dimensionless equations of motion are solved using integral methods and a space-marching technique. As the fluid moves radially inward, entraining boundary layers develop which can either meet or become non-entraining. Pressure and wall shear stress distributions, as well as velocity profiles predicted by the model, are compared to numerical simulations using the software OpenFOAM. Hydrodynamic structure of the boundary layers is governed by a Reynolds number, Re, a Rossby number, Ro, and the dimensionless radial velocity component at the periphery of the cavity, Uo. Results show that boundary layers merge for Re < < 10 and Ro > > 0.1, and boundary layers become predominantly non-entraining for low Ro, low Re, and high Uo. Results may contribute to improve the design of technology, such as heat exchange devices, and turbomachinery.
Quantum tunneling splittings from path-integral molecular dynamics
Authors: Mátyus Edit , Wales David J. , Althorpe Stuart C.
Published: March 2016

We illustrate how path-integral molecular dynamics can be used to calculate ground-state tunnelling splittings in molecules or clusters. The method obtains the splittings from ratios of density matrix elements between the degenerate wells connected by the tunnelling. We propose a simple thermodynamic integration scheme for evaluating these elements. Numerical tests on fully dimensional malonaldehyde yield tunnelling splittings in good overall agreement with the results of diffusion Monte Carlo calculations.
Spin orientations of the spin-half Ir4+ ions in Sr3NiIrO6, Sr2IrO4, and Na2IrO3: Density functional, perturbation theory, and Madelung potential analyses
Authors: Gordon Elijah E. , Xiang Hongjun , Köhler Jürgen , Whangbo Myung-Hwan
Published: March 2016

The spins of the low-spin Ir4+ (S = 1/2, d5) ions at the octahedral sites of the oxides Sr3NiIrO6, Sr2IrO4, and Na2IrO3 exhibit preferred orientations with respect to their IrO6 octahedra. We evaluated the magnetic anisotropies of these S = 1/2 ions on the basis of density functional theory (DFT) calculations including spin-orbit coupling (SOC), and probed their origin by performing perturbation theory analyses with SOC as perturbation within the LS coupling scheme. The observed spin orientations of Sr3NiIrO6 and Sr2IrO4 are correctly predicted by DFT calculations, and are accounted for by the perturbation theory analysis. As for the spin orientation of Na2IrO3, both experimental studies and DFT calculations have not been unequivocal. Our analysis reveals that the Ir4+ spin orientation of Na2IrO3 should have nonzero components along the c- and a-axis directions. The spin orientations determined by DFT calculations are sensitive to the accuracy of the crystal structures employed, which is explained by perturbation theory analyses when interactions between adjacent Ir4+ ions are taken into consideration. There are indications implying that the 5d electrons of Na2IrO3 are less strongly localized compared with those of Sr3NiIrO6 and Sr2IrO4. This implication was confirmed by showing that the Madelung potentials of the Ir4+ ions are less negative in Na2IrO3 than in Sr3NiIrO6 and Sr2IrO4. Most transition-metal S = 1/2 ions do have magnetic anisotropies because the SOC induces interactions among their crystal-field split d-states, and the associated mixing of the states modifies only the orbital parts of the states. This finding cannot be mimicked by a spin Hamiltonian because this model Hamiltonian lacks the orbital degree of freedom, thereby leading to the spin-half syndrome. The spin-orbital entanglement for the 5d spin-half ions Ir4+ is not as strong as has been assumed.
Spectroscopic studies of the mechanism of reversible photodegradation of 1-substituted aminoanthraquinone-doped polymers
Authors: Hung Sheng-Ting , Bhuyan Ankita , Schademan Kyle , Steverlynck Joost , McCluskey Matthew D. , Koeckelberghs Guy , Clays Koen , Kuzyk Mark G.
Published: March 2016

The mechanism of reversible photodegradation of 1-substituted aminoanthraquinones doped into poly(methyl methacrylate) and polystyrene is investigated. Time-dependent density functional theory is employed to predict the transition energies and corresponding oscillator strengths of the proposed reversibly and irreversibly damaged dye species. Ultraviolet–visible and Fourier transform infrared (FTIR) spectroscopy are used to characterize which species are present. FTIR spectroscopy indicates that both dye and polymer undergo reversible photodegradation when irradiated with a visible laser. These findings suggest that photodegradation of 1-substituted aminoanthraquinones doped in polymers originates from interactions between dyes and photoinduced thermally degraded polymers, and the metastable product may recover or further degrade irreversibly.
Instability of thermocapillary liquid layers for Oldroyd-B fluid
Authors: Hu Kai-Xin , He Meng , Chen Qi-Sheng
Published: March 2016

The linear stability analysis of Oldroyd-B fluid for thermocapillary liquid layers is carried out. Results are presented for linear flow and return flow with Prandtl numbers of 0.02 and 100. Three kinds of instabilities are found: oblique wave, streamwise wave, and spanwise stationary mode, whose properties are all significantly affected by elasticity. For the first, the critical Marangoni number increases with elasticity. For the second, the work done by perturbation stress fluctuates in vertical direction. The last becomes the preferred mode when the elasticity is high enough and its perturbation energy comes from the Marangoni force caused by perturbation temperature while dissipates by perturbation stress. Their mechanisms are discussed and the comparisons are made with Newtonian fluid.
Charge carrier recombination dynamics in perovskite and polymer solar cells
Authors: Paulke Andreas , Stranks Samuel D. , Kniepert Juliane , Kurpiers Jona , Wolff Christian M. , Schön Natalie , Snaith Henry J. , Brenner Thomas J. K. , Neher Dieter
Published: March 2016

Time-delayed collection field experiments are applied to planar organometal halide perovskite (CH3NH3PbI3) based solar cells to investigate charge carrier recombination in a fully working solar cell at the nanosecond to microsecond time scale. Recombination of mobile (extractable) charges is shown to follow second-order recombination dynamics for all fluences and time scales tested. Most importantly, the bimolecular recombination coefficient is found to be time-dependent, with an initial value of ca. 10−9 cm3/s and a progressive reduction within the first tens of nanoseconds. Comparison to the prototypical organic bulk heterojunction device PTB7:PC71BM yields important differences with regard to the mechanism and time scale of free carrier recombination.
Multiferroic properties of uniaxially compressed orthorhombic HoMnO3 thin films
Authors: Shimamoto K. , Windsor Y. W. , Hu Y. , Ramakrishnan M. , Alberca A. , Bothschafter E. M. , Rettig L. , Lippert Th. , Staub U. , Schneider C. W.
Published: March 2016

Multiferroic properties of orthorhombic HoMnO3 (Pbnm space group) are significantly modified by epitaxial compressive strain along the a-axis. We are able to focus on the effect of strain solely along the a-axis by using an YAlO3 (010) substrate, which has only a small lattice mismatch with HoMnO3 along the other in-plane direction (the c-axis). Multiferroic properties of strained and relaxed HoMnO3 thin films are compared with those reported for bulk, and are found to differ widely. A relaxed film exhibits bulk-like properties such as ferroelectricity below 25 K and an incommensurate antiferromagnetic order below 39 K, with an ordering wave vector of (0 qb 0) with qb ≈ 0.41 at ∼10 K. A strained film becomes ferroelectric already at 37.5 K and has an incommensurate magnetic order with qb ≈ 0.49 at ∼10 K.
Investigation of temporal-resolved emission spectra of highly charged Al ions from laser-produced plasmas
Authors: Su M. G. , Cao S. Q. , Sun D. X. , Min Q. , Dong C. Z.
Published: March 2016

Temporal evolution of extreme ultraviolet emission from laser-produced aluminum (Al) plasma has been experimentally and theoretically investigated. Al plasmas have been measured by using the temporal-spatially resolved laser-produced plasma technique. The emission lines can be identified from 2p-3s, 3d, 4s, 4d, 5d transition lines from Al3+ to Al6+ ions. In order to quickly diagnose the plasma, the assumptions of a normalized Boltzmann distribution among the excited states and a steady-state collisional-radiative model are used to estimate the values of electron temperature and electron density in plasma. We succeeded in reproducing the simulated spectra related to the different time delays, which are in good agreement with experiments. Temporal evolution behavior of highly charged Al ions in plasma has been analyzed, and the exponential decay about electron temperature and electron density has been obtained. The results indicate that the temporal-spatially resolved measurement is essential for accurate understanding of evolution behavior of highly charged ions in laser-produced plasmas.
Structure and optical properties of aSiAl and aSiAlHx magnetron sputtered thin films
Authors: Thøgersen Annett , Stange Marit , Jensen Ingvild J. T. , Røyset Arne , Ulyashin Alexander , Diplas Spyros
Published: March 2016

Thin films of homogeneous mixture of amorphous silicon and aluminum were produced with magnetron sputtering using 2-phase Al–Si targets. The films exhibited variable compositions, with and without the presence of hydrogen, aSi1−xAlx and aSi1−xAlxHy. The structure and optical properties of the films were investigated using transmission electron microscopy, X-ray photoelectron spectroscopy, UV-VisNIR spectrometry, ellipsometry, and atomistic modeling. We studied the effect of alloying aSi with Al (within the range 0–25 at. %) on the optical band gap, refractive index, transmission, and absorption. Alloying aSi with Al resulted in a non-transparent film with a low band gap (<1 eV). Hydrogenation of the films increased the band gap to values >1 eV. Variations of the Al and hydrogen content allowed for tuning of the optoelectronic properties. The films are stable up to a temperature of 300 °C. At this temperature, we observed Al induced crystallization of the amorphous silicon and the presence of large Al particles in a crystalline Si matrix.
Dynamic strain enhanced abnormal percolative transport and colossal electroresistance in (011)-oriented La0.325Pr0.3Ca0.375MnO3/0.68Pb(Mg1/3Nb2/3)O3-0.32PbTiO3 heterostructure
Authors: Jiang Tao , Wang Xuemin , Shen Changle , Wang Xinming , Peng Liping , Fan Long , Wu Weidong
Published: March 2016

Abnormal percolative transport properties have been studied in (011)-oriented La0.325Pr0.3Ca0.375MnO3 (LPCMO)/0.68Pb(Mg1/3Nb2/3)O3-0.32PbTiO3 (PMN-PT) heterostructure. By introducing a dynamic electric field-induced in-plane anisotropic strain-field in phase separated LPCMO film, we observed a significant promotion of the thermal hysteresis (∼68 K) and a positive colossal electroresistance (∼8450%). Such abnormal hysteresis is believed to be associated with anisotropic strain induced strong pinning effect in the material. This work unambiguously evidenced the importance of the anisotropic strain on the abnormal transport and meanwhile provides alternative opportunity for well understanding the percolation mechanism in inhomogeneous systems.
Wide temperature window of magnetostructural transition achieved in Mn0.4Fe0.6NiSi1−xGax by a two-step isostructural alloying process
Authors: Chen J. , Zhang H. G. , Liu E. K. , Yue M. , Lu Q. M. , Wang W. H. , Wu G. H. , Zhang J. X.
Published: March 2016

A new approach has been proposed in this work, which provides an effective way for tuning the structural transition in MM’X systems with relatively high transition temperature. With this method, a temperature window as wide as 275 K for the magnetostructural transition has been achieved in the MnNiSi alloy system. The maximum magnetic entropy change of the system is as high as 13.3 J/kgK, which, together with the large temperature window, enables the Mn0.4Fe0.6NiSi1−xGax system to be a promising candidate for magnetic refrigerant applications.
Formation of high electrical-resistivity thin surface layer on carbonyl-iron powder (CIP) and thermal stability of nanocrystalline structure and vortex magnetic structure of CIP
Authors: Sugimura K. , Miyajima Y. , Sonehara M. , Sato T. , Hayashi F. , Zettsu N. , Teshima K. , Mizusaki H.
Published: March 2016

This study focuses on the carbonyl-iron powder (CIP) used in the metal composite bulk magnetic core for high-efficient/light-weight SiC/GaN power device MHz switching dc-dc converter, where the fine CIP with a mean diameter of 1.1 μm is used to suppress the MHz band eddy current inside the CIP body. When applying the CIP to composite core together with the resin matrix, high electrical resistivity layer must be formed on the CIP-surface in order to suppress the overlapped eddy current between adjacent CIPs. In this study, tens nm thick silica (SiO2) was successfully deposited on the CIP-surface by using hydrolysis of TEOS (Si(OC2H5)4). Also tens nm thick oxidized layer of the CIP-surface was successfully formed by using CIP annealing in dry air. The SiC/GaN power device can operate at ambient temperature over 200 degree-C, and the composite magnetic core is required to operate at such ambient temperature. The as-made CIP had small coercivity below 800 A/m (10 Oe) due to its nanocrystalline-structure and had a single vortex magnetic structure. From the experimental results, both nanocrystalline and single vortex magnetic structure were maintained after heat-exposure of 250 degree-C, and the powder coercivity after same heat-exposure was nearly same as that of the as-made CIP. Therefore, the CIP with thermally stable nanocrystalline-structure and vortex magnetic state was considered to be heat-resistant magnetic powder used in the iron-based composite core for SiC/GaN power electronics.
Ambulatory Blood Pressure Parameters and Heart Failure With Reduced or
Preserved Ejection Fraction in Elderly Treated Hypertensive Patients
Authors: Pierdomenico Sante D. , Pierdomenico Anna M. , Coccina Francesca , Lapenna Domenico , Porreca Ettore
Published: March 2016

BACKGROUND

The association between ambulatory blood pressure (BP) and future risk of heart failure (HF) is unclear. We investigated the association between ambulatory BP parameters and risk of HF with reduced ejection fraction (HFREF) or preserved ejection fraction (HFPEF) in elderly treated hypertensive patients.

METHODS

The occurrence of HFREF and HFPEF was evaluated in 1,191 elderly treated hypertensive patients who underwent clinical and instrumental evaluation, including ambulatory BP monitoring to evaluate daytime, nighttime, and 24-hour BP, dipping status, and morning surge (MS) of BP.

RESULTS

During the follow-up (9.1±4.9 years, range 0.4–20 years), 123 patients developed HF, of whom 56 had HFREF and 67 had HFPEF. After adjustment for other covariates, Cox regression analysis showed that 24-hour systolic BP, but not clinic BP, was independently associated with risk of both HFREF (hazard ratio (HR): 1.36, 95% confidence interval (CI): 1.14–1.63, per 10mm Hg increment) and HFPEF (HR: 1.35, 95% CI: 1.13–1.61, per 10mm Hg increment); moreover, high MS of BP (>23mm Hg) in dippers was independently associated with risk of HFREF (HR: 2.27, 95% CI: 1.00–5.15) and nondipping was independently associated with risk of HFPEF (HR: 2.78, 95% CI: 1.38–5.63).

CONCLUSIONS

In elderly treated hypertensive patients, 24-hour systolic BP is independently associated with future risk of both HFREF and HFPEF, whereas high MS is independently associated with risk of HFREF and nondipping is independently associated with risk of HFPEF.
Improving Ecological Inference by Predicting Individual Ethnicity from Voter Registration Records
Authors: Imai Kosuke , Khanna Kabir
Published: March 2016

In both political behavior research and voting rights litigation, turnout and vote choice for different racial groups are often inferred using aggregate election results and racial composition. Over the past several decades, many statistical methods have been proposed to address this ecological inference problem. We propose an alternative method to reduce aggregation bias by predicting individual-level ethnicity from voter registration records. Building on the existing methodological literature, we use Bayes's rule to combine the Census Bureau's Surname List with various information from geocoded voter registration records. We evaluate the performance of the proposed methodology using approximately nine million voter registration records from Florida, where self-reported ethnicity is available. We find that it is possible to reduce the false positive rate among Black and Latino voters to 6% and 3%, respectively, while maintaining the true positive rate above 80%. Moreover, we use our predictions to estimate turnout by race and find that our estimates yields substantially less amounts of bias and root mean squared error than standard ecological inference estimates. We provide open-source software to implement the proposed methodology.
A Chronic Disease Management Student–Faculty Collaborative Practice: Educating Students on Innovation in Health Care Delivery
Authors: Remus Kristin E. , Honigberg Michael , Tummalapalli Sri Lekha , Cohen Laura P. , Fazio Sara , Weinstein Amy R.
Published: March 2016

Problem

In the current transformative health care landscape, it is imperative that clinician educators inspire future clinicians to practice primary care in a dynamic environment. A focus on patient-centered, goal-oriented care for patients with chronic conditions is critical.

Approach

In 2009, Harvard Medical School founded the Crimson Care Collaborative, a student–faculty collaborative practice (SFCP) network. With the aim of expanding clinical and educational opportunities for medical students and improving patient control of chronic disease (i.e., hypertension, obesity, and diabetes) in an innovative learning environment, in 2012, the authors developed a novel SFCP at their hospital-based academic primary care practice. In this SFCP, students learn to explore patient priorities, provide focused counseling and education, and assist patients with self-management goals during clinical visits.

Outcomes

From 2012 to 2014, 250 student volunteers participated in the SFCP as clinicians, innovators, educators, and leaders, with between 80 and 95 medical students engaging each semester. Between January 2012 and March 2014, there were 476 urgent care or chronic disease management visits. Patients with chronic diseases were seen at least twice on average, and by 2014, chronic disease management visits accounted for approximately 74% of visits.

Next Steps

Work is under way to create assessment tools to evaluate the practice’s educa tional impact and student understanding of the current health care system, develop interdisciplinary care teams, expand efforts in registry management and broaden the patient recruitment scope, further emphasize patient engage ment and retention, and evaluate chronic disease management and patient satisfaction effectiveness.
Recognizing Patients’ Emotions: Teaching Health Care Providers to Interpret Facial Expressions
Authors: Ragsdale John W. , Van Deusen Reed , Rubio Doris , Spagnoletti Carla
Published: March 2016

Purpose

Facial expressions are an important clue to a patient’s emotions. The authors developed a 90-minute workshop in May 2011 to teach physicians and physicians-in-training to interpret facial expressions and to use that skill in the context of patient care.

Method

The workshop included a didactic presentation in which facial expression features were taught using progressively more difficult examples, followed by three interactive exercises. The authors presented the workshop at six separate venues in the United States in 2011 and 2012. To test the effectiveness of this workshop, the authors designed a comprehensive pre- and postworkshop evaluation which assessed participants’ skill, knowledge, attitude (toward importance), and confidence.

Results

A total of 156 health care providers participated in the workshop and completed pre- and postworkshop evaluations. Participants showed substantial improvement in skill and knowledge (fact- and case-based) scores, as well as modest improvement in importance and confidence ratings. Faculty and medical students demonstrated similar baseline measures of skill, knowledge, and importance, though faculty reported a slightly higher confidence in their skills. No correlation was found between baseline ratings of confidence in abilities and any baseline measure of performance.

Conclusions

Given the similar baseline performance of faculty and medical students, the ability to interpret facial expressions does not appear to be learned through routine clinical practice, highlighting the need for dedicated facial expression training. The authors were able to demonstrate that physicians and physicians-in-training could effectively learn to recognize emotion by interpreting facial expressions through a short workshop.
Cerebrospinal Fluid Oxaliplatin Contributes to the Acute Pain Induced by Systemic Administration of Oxaliplatin
Authors: Huang Zhen-Zhen , Li Dai , Ou-Yang Han-Dong , Liu Cui-Cui , Liu Xian-Guo , Ma Chao , Wei Jia-You , Liu Yong , Xin Wen-Jun
Published: March 2016

AbstractAbstract

The administration of oxaliplatin to rats leads to nociceptive sensitization and the accumulation of the drug in cerebrospinal fluid. Oxaliplatin may support sensitization of spinal cord neurons through an epigenetic mechanism resulting in the up-regulation of CX3CL1.

Background

Systemic administration of oxaliplatin has no effect on the tumors in the central nervous system (CNS) due to the limited concentration of oxaliplatin in the cerebrospinal fluid (CSF), while it was clinically reported that oxaliplatin can induce acute encephalopathy. Currently, the impairment of neuronal functions in the CNS after systemic administration of oxaliplatin remains uninvestigated.

Methods

The von Frey test and the plantar test were performed to evaluate neuropathic pain behavior after a single intraperitoneal administration of oxaliplatin (4 mg/kg) in rats. Inductively coupled plasma–mass spectrometry, electrophysiologic recording, real-time quantitative reverse transcription polymerase chain reaction, chromatin immunoprecipitation, Western blot, immunohistochemistry, and small interfering RNA were applied to understand the mechanisms.

Results

Concentration of oxaliplatin in CSF showed a time-dependent increase after a single administration of oxaliplatin. Spinal application of oxaliplatin at the detected concentration (6.6 nM) significantly increased the field potentials in the dorsal horn, induced acute mechanical allodynia (n = 12 each) and thermal hyperalgesia (n = 12 each), and enhanced the evoked excitatory postsynaptic currents and spontaneous excitatory postsynaptic currents in the projection neurokinin 1 receptor–expressing lamina I to II neurons. The authors further found that oxaliplatin significantly increased the nuclear factor-κB p65 binding and histone H4 acetylation in cx3cl1 promoter region. Thus, the upregulated spinal CX3CL1 markedly mediated the induction of central sensitization and acute pain behavior after oxaliplatin administration.

Conclusions

The findings of this study suggested that oxaliplatin in CSF may directly impair the normal function of central neurons and contribute to the rapid development of CNS-related side effects during chemotherapy. This provides novel targets to prevent oxaliplatin-induced acute painful neuropathy and encephalopathy.
How compelling are the data for Epstein–Barr virus being a trigger for systemic lupus and other autoimmune diseases?
Authors: Draborg Anette , Izarzugaza Jose M.G. , Houen Gunnar
Published: March 2016

Purpose of review

Systemic lupus erythematosus (SLE) is caused by a combination of genetic and acquired immunodeficiencies and environmental factors including infections. An association with Epstein–Barr virus (EBV) has been established by numerous studies over the past decades. Here, we review recent experimental studies on EBV, and present our integrated theory of SLE development.

Recent findings

SLE patients have dysfunctional control of EBV infection resulting in frequent reactivations and disease progression. These comprise impaired functions of EBV-specific T-cells with an inverse correlation to disease activity and elevated serum levels of antibodies against lytic cycle EBV antigens. The presence of EBV proteins in renal tissue from SLE patients with nephritis suggests direct involvement of EBV in SLE development. As expected for patients with immunodeficiencies, studies reveal that SLE patients show dysfunctional responses to other viruses as well. An association with EBV infection has also been demonstrated for other autoimmune diseases, including Sjögren's syndrome, rheumatoid arthritis, and multiple sclerosis.

Collectively, the interplay between an impaired immune system and the cumulative effects of EBV and other viruses results in frequent reactivation of EBV and enhanced cell death, causing development of SLE and concomitant autoreactivities.
Outcomes Over a Decade After Surgery for Unstable Ankle Fracture: Functional Recovery Seen 1 Year Postoperatively Does Not Decay With Time
Authors: Regan Deirdre K. , Gould Stephen , Manoli Arthur , Egol Kenneth A.
Published: March 2016

Objectives:

To evaluate long-term clinical and radiographic outcomes after surgical fixation of unstable ankle fractures.

Design:

Prospective follow-up study.

Setting:

Academic medical center with 2 Level-I trauma centers and a tertiary care center.

Patients:

One hundred forty-one patients who underwent surgical repair of an unstable ankle fracture.

Intervention:

Open reduction internal fixation of an unstable ankle fracture.

Main Outcome Measurements:

Short Musculoskeletal Function Assessment (SMFA) scores and radiographic outcomes based on the van Dijk criteria at a mean of 11.6 years follow-up.

Results:

Of the 281 patients meeting the inclusion criteria for this study, follow-up data were obtained from 141 patients (50%), at a mean of 11.6 years after surgery. Overall, mean long-term SMFA scores were improved when compared with scores at 1 year. The American Society of Anesthesiologists class 1 or 2 was found to be a significant predictor of recovery based on SMFA scores. Sixty-three percent of follow-up radiographs demonstrated evidence of radiographic arthritis, including 31% with mild osteoarthritis, 22% with moderate osteoarthritis, and 10% with severe osteoarthritis. Fracture dislocation at injury was found to be a significant predictor of radiographic posttraumatic osteoarthritis at latest follow-up. One patient (0.7%) underwent a tibiotalar fusion secondary to symptomatic posttraumatic arthrosis. One patient (0.7%) underwent total ankle replacement due to severe osteoarthritis.

Conclusions:

Our data indicate that over a decade after ankle fracture fixation, most of the patients are doing well. Despite the presence of radiographic arthritis in 63% of patients, few experience pain or have restrictions in function, and mean long-term functional outcome scores are improved when compared with scores at 1 year. Patients undergoing operative fixation of unstable ankle fractures can anticipate functional outcomes that are maintained over time.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Fibrous tether of the distal femur produced unilateral genu valgus with subsequent patellar dislocation: case report and review of the literature
Authors: Thanacharoenpanich Songkiat , Kulkrittaya Somchai , Pakpianpairoj Charoenchai , Liupolvanich Prasert , Chiarapattanakom Pariyut
Published: March 2016

Fibrous tether at the distal femur is a rare condition that causes angular deformity of the lower extremity; only 18 cases have been reported previously. We report the case of a 2-year-old boy presenting with unilateral genu valgus. The patient had a subsequent lateral patellar dislocation, 1 year after surgical correction. A second surgery was performed to correct this patellar dislocation. Intraoperative finding indicated contracted lateral patellar retinaculum. To the best of our knowledge, this is the first report of such a finding. The natural history is still not understood. At the 6-month-follow-up visit, the patient still has good results without recurrent patellar dislocation or angular deformity. We also review the literature in terms of proper treatment and results of treatment.
Distal tibial derotational osteotomy with external fixation to treat torsional deformities: a review of 71 cases
Authors: Erschbamer Matthias , Gerhard Pascal , Klima Harry , Ellenrieder Birte , Zdenek-Lehnen Katja , Giesinger Karlmeinrad
Published: March 2016

We retrospectively reviewed the safety and efficacy of operative treatment of torsional malalignment of the tibia in 44 children, on whom we performed 71 derotational osteotomies of the distal tibia to treat tibial torsion. We placed four pins using an alignment jig, performed a percutaneous osteotomy, and applied an external fixator after derotation. Postoperative radiographs showed accurate tibial derotation and pin placement in all patients. Nine patients developed superficial pin-tract infections that resolved with antibiotic treatment. Two developed fractures after removal of the external fixator, which healed in a plaster cast. Operative treatment of these cases with an external fixator is safe, effective, and well tolerated.