bluuebunny/crossref_metadata_2025 huggingface dataset:
Conversion efficiency of a laser-plasma source based on a Xe jet in the vicinity of a wavelength of 11 nm
Authors: Chkhalo N. I. , Garakhin S. A. , Lopatin A. Ya. , Nechay A. N. , Pestov A. E. , Polkovnikov V. N. , Salashchenko N. N. , Tsybin N. N. , Zuev S. Yu.
Published: October 2018

We optimized the parameters of a laser-produced plasma source based on a solid-state Nd: YAG laser (λ = 1.06 nm, pulse duration 4 ns, energy per pulse up to 500 mJ, repetition rate 10 Hz, lens focus distance 45 mm, maximum power density of laser radiation in focus 9 × 1011 W/cm2) and a double-stream Xe/He gas jet to obtain a maximum of radiation intensity around 11 nm wavelength. It was shown that the key factor determining the ionization composition of the plasma is the jet density. With the decreased density, the ionization composition shifts toward a smaller degree of ionization, which leads to an increase in emission peak intensity around 11 nm. We attribute the dominant spectral feature centred near 11 nm originating from an unidentified 4d-4f transition array in Xe+10…+13 ions. The exact position of the peak and the bandwidth of the emission line were determined. We measured the dependence of the conversion efficiency of laser energy into an EUV in-band energy with a peak at 10.82 nm from the xenon pressure and the distance between the nozzle and the laser focus. The maximum conversion efficiency (CE) into the spectral band of 10–12 nm measured at a distance between the nozzle and the laser beam focus of 0.5 mm was CE = 4.25 ± 0.30%. The conversion efficiencies of the source in-bands of 5 and 12 mirror systems at two wavelengths of 10.8 and 11.2 nm have been evaluated; these efficiencies may be interesting for beyond extreme ultraviolet lithography.
Supersonic jet spectroscopy of parent hemiporphycene: Structural assignment and vibrational analysis for S and S1 electronic states
Authors: Peukert Sebastian , Kijak Michał , Ostapko Jakub , Sepioł Jerzy , Le Bris Catherine , Zehnacker-Rentien Anne , Gil Michał , Waluk Jacek
Published: October 2018

Hemiporphycene (HPc), a constitutional isomer of porphyrin, is studied under supersonic expansion conditions by means of laser-induced fluorescence, visible-visible hole-burning experiments, single vibronic level fluorescence techniques, and quantum chemical calculations. Only one trans form of jet-cooled HPc is observed, in contrast to solution studies that evidence a mixture of two trans tautomeric forms separated in energy by ∼1 kcal/mol. Reliable structural assignment is provided by simulating absorption and emission patterns at the density functional theory and time-dependent density functional theory levels of theory. The vibronic spectra are nicely reproduced for both electronic ground and lowest excited singlet states for the most stable trans form. In contrast to another porphyrin isomer, porphycene (Pc), no tunneling or photo-induced hydrogen transfer is detected. The lower symmetry of HPc compared with Pc and the concomitant non-equivalent positions of the inner-cavity nitrogen atoms result in a non-symmetric double minimum potential for tautomerization, larger energy barrier, and a longer tunneling distance, with the average intramolecular hydrogen bond length larger in HPc than in Pc. HPc readily forms hydrates that show red-shifted absorption relative to the bare molecule.
Ag-AgO nanostructures on glass substrates by solid-state dewetting: From extended to localized surface plasmons
Authors: Serrano A. , Llorca-Hernando O. , del Campo A. , Rubio-Marcos F. , Rodríguez de la Fuente O. , Fernández J. F. , García M. A.
Published: October 2018

We present here a study on the modification of morphological and plasmonic properties of Ag thin films deposited on glass substrates upon annealing in air at different temperatures. Initially, Ag films are continuous and exhibit extended surface plasmons with a resonant absorbance that depends on the film thickness. The dewetting process promotes the formation of nanoparticles with different sizes, shapes, and agglomerations states, besides a partial oxidation from Ag to AgO at surface level. The final Ag-AgO nanostructures are dependent on the annealing temperature and initial film thickness. The optical properties evolve from those typical of metallic films with high reflectivity and extended surface plasmon resonance toward localized surface plasmons characteristic of nanoparticles. The optical evolution and the final plasmonic response are evaluated according to the morphological and structural features of nanostructures.
Tunable metamaterial beam with shape memory alloy resonators: Theory and experiment
Authors: Candido de Sousa Vagner , Tan David , De Marqui Carlos , Erturk Alper
Published: October 2018

We investigate and experimentally validate the concept of bandgap tuning in a locally resonant metamaterial beam exploiting shape memory alloy (SMA) resonators. The underlying mechanism is based on the difference between the martensitic phase (low temperature) and austenitic phase (high temperature) elastic moduli of the resonators, enabling a significant shift of the bandgap for a sufficient temperature change. Experimental validations are presented for a base-excited locally resonant metamaterial beam with SMA resonators following a brief theoretical background. It is shown that the lower bound of the bandgap as well as the bandwidth can be increased by 15% as the temperature is increased from 25 °C to 45 °C for the specific SMAs used in this work for concept demonstration. The change in the bandgap lower bound frequency and its bandwidth is governed by the square root of the fully austenitic to fully martensitic elastic moduli ratio, and it could be as high as 70% or more for other SMAs reported in the literature.
DEM construction of binary hard sphere crystals and radical tessellation
Authors: Wang Defeng , An Xizhong , Gou Dazhao , Zhao Haiyang , Wang Lin , Huang Fei
Published: October 2018

In this paper, four binary hard sphere crystals were numerically constructed by discrete element method (DEM) through different packing modes under three-dimensional (3D) mechanical vibration. For each crystal, a modified Voronoi tessellation method (called radical tessellation) was utilized to quantitatively investigate the topological and metrical properties of radical polyhedra (RPs). The topological properties such as the number of faces, edges, vertices per RP and the number of edges per RP face as well as the metrical properties such as perimeter, surface area, volume, and relative pore size per RP were systematically characterized and compared. Meanwhile, the mechanism of the binary hard sphere crystallization was also investigated. The results show that the packing sequence and pattern of the large spheres can determine the structure of the binary hard sphere crystal. The RP structures and their metrical and topological properties of the four binary hard sphere crystals (even the packing density of the two crystals is the same) are quite different. Each property can clearly reflect the specific characteristics of the corresponding binary hard sphere crystalline structure. The obtained quantitative results would be useful for the deep understanding of the structure and resultant properties of binary hard sphere crystals.
The Effect of a Small Axial Pressure on the Growth of the Epicotyl of Vicia Faba Var. Minor Beck
Authors: Sedgley RH , Barley KP
Published: October 2018

Epicotyls of Vicia faba var. minor Beck, which had been subjected to an axial pressure of 0�5 atm for 48 hr, were 12% shorter than control epicotyls which had supported a negligible load. The state of stress produced in the epicotyl by the axial pressure led to a change in shape which was not accompanied by any change in volume. As the axial pressure of O� 5 atm is regarded as small compared with the point resistance which often has to be overcome by emerging shoots, it is likely that mechanical resistance is an important factor influencing seedling emergence in ordinary soils.
Diurnal-Nocturnal Changes in the Starch of Tobacco Leaves
Authors: Matheson NK , Wheatley JM
Published: October 2018

The quantitative changes in starch in tobacco leaves have been determined over diurnal-nocturnal periods for rapidly expanding, fully expanded, and yellow leaves. The daily increase in starch lessens as the leaves mature and senesee, and the amount of stureh not undergoing diurnal variation in fully expanded leaves is more than in rapidly expanding leaves.
Germination of Conidia of Peronospora Tabacina Adam II. Germination in Vivo
Authors: Shepherd CJ , Mandryk M
Published: October 2018

The percentage germination of conidia of Peronospora tabacina Adam on leaves and leaf disks of Nicotiana tabacurn L. cv. Virginia Gold ranged from less than 1 to 22% with a mean value of 1-7%. Addition of riboflavin-increased germination to a mean value of 44%. Prior washing of the leaf disks allowed 64% germination, which was increased to 95% on the addition of riboflavin, reaching a similar value to that recorded for conidia on agar. It is suggested that the degree of germination attained on N. labacum leaves is controlled by the amount of available riboflavin and by the presence of water-soluble compounds inhibitory to germination.
Environment and Sporulation in Phytopathogenic Fungi V. Monilinia Fruc'ticola (Wint.) Honey: Effect of Water Relations on Regeneration of Conidia in Vivo
Authors: Corbin JB , Cruickshank IAM
Published: October 2018

An investigation into the role of water relations in determining conidial regeneration of Monilinia f1"Ucticola (Wint.) Honey on infected leaves, peduncles, and mummified fruitlets of apricot (Prunus armeniaca L. cv. Trevatt) demonstrated the following points:
Studies on Phytoalexins VI. Pisatin: the Effect of Some Factors on its Formation in Pisum Sativum l., and the Signifioance of Pisatin in Disease Resistanoe
Authors: Cruickshank IAM , R Perrin Dawn
Published: October 2018

The effect of some biological, physical, and chemical factors on the formation of pis at in was studied by the chemical analysis aftha extracellular fluids (diffusates) from the endocarp tissues of pea pods. The following points were demonstrated
The Reducing Activity of Ram and Bull Spermatozoa
Authors: Blackshaw AW
Published: October 2018

Succinic and lactic dehydrogenase activities of ram and bull spermatozoa were measured by the reduction of 2-(p-iodophenyl)-3-(p-nitrophenyl)-5-phenyl tetrazolium chloride. The K11I values obtained were of the same order as those for other tissues.
The Conformation of a Soluble Wool Keratin Derivative
Authors: Harrap BS
Published: October 2018

The conformation of a low-sulphur soluble wool keratin derivative (SCMKA) has been studied by optical rotatory dispersion. On the assumption that the overall conformation consists of a mixture of a-helical and random-coil regions, this protein has a helical content of about 50% in aqueous solution at pH 9�1; this helical content does not vary with the degree of severity of the preparative procedure. The protein may be reversibly converted to the random-coil form by heating to 70�0, or by treatment with urea at concentrations exceeding 6r.r. An increase in pH to 12�5 causes very little change in conformation, such change as does occur being reversible. The maximum helical content which has been induced by solvents into the protein is about 62% in 2-chloroethanol. This probably represents the upper limit of the helical content of this protein as it occurs in the fibre. The changes in the conforma. tion of the protein which occur in several other solvents are briefly discussed.
The Isolation and Properties of Some Soluble Proteins From Wool VI. The Physicochemical Properties of Sgmkb2
Authors: Gillespie JM , Harrap BS
Published: October 2018

The molecular weight of a high-sulphur protein (SCMKB2) from Merino wool has been determined by the Archibald technique and by light scattering, values of 22,600 and 22,100, respectively, being obtained. Optical rotatory dispersion data show that in aqueous solution the protein behaves as a random coil. This is consistent with the frictional properties of the molecule as deduced from its sedimentation coefficient and intrinsic viscosity. The protein appears to have one N-terminal arginyl end group; since it also contains two acyl groups per 22,000 molecular weight unit, the possibility of a multi�chain structure for the protein unit has been considered. However, no reduction in molecular weight could be achieved in any of several disaggregating solvents.
The Isolation and Properties of Some Soluble Proteins From Wool VII. The Heterogeneity of the High Sulphur Proteins
Authors: Gillespie JM
Published: October 2018

The heterogeneity of the S-carboxymethyl derivatives of high-sulphur proteins from Merino wool has been explored by means of moving boundary electrophoresis, ultracentrifugation, chromatography on DEAE-cellulose, and fractionation by use of solubility differences. Fractions isolated by chromatography and fractional precipitation have been analysed for their content of sulphur and amino acids. There are at least eight proteins present, which contain in common relatively large numbers of S-carboxymethyl cysteine, proline, serine, and threonine residues and small numbers of lysine, histidine, and aspartic acid residues. Apart from these similarities they show big differences in their overall amino acid content.The content of S-carboxymethyl cysteine nitrogen in the various components ranges from about 10�4 to 17�8% of total nitrogen and there is a linear relation between the content of this amino acid residue and the electrophoretic mobility at pH 4�5 of each protein component. There is also an increase in sedimentation coefficient with increasing sulphur content over the series.
Havens for threatened Australian mammals: the contributions of fenced areas and offshore islands to the protection of mammal species susceptible to introduced predators
Authors: Legge Sarah , Woinarski John C. Z. , Burbidge Andrew A. , Palmer Russell , Ringma Jeremy , Radford James Q. , Mitchell Nicola , Bode Michael , Wintle Brendan , Baseler Marcus , Bentley Joss , Copley Peter , Dexter Nicholas , Dickman Chris R. , Gillespie Graeme R. , Hill Brydie , Johnson Chris N. , Latch Peter , Letnic Mike , Manning Adrian , McCreless Erin E. , Menkhorst Peter , Morris Keith , Moseby Katherine , Page Manda , Pannell David , Tuft Katherine
Published: October 2018

Context Many Australian mammal species are highly susceptible to predation by introduced domestic cats (Felis catus) and European red foxes (Vulpes vulpes). These predators have caused many extinctions and have driven large distributional and population declines for many more species. The serendipitous occurrence of, and deliberate translocations of mammals to, ‘havens’ (cat- and fox-free offshore islands, and mainland fenced exclosures capable of excluding cats and foxes) has helped avoid further extinction. Aims The aim of this study was to conduct a stocktake of current island and fenced havens in Australia and assess the extent of their protection for threatened mammal taxa that are most susceptible to cat and fox predation. Methods Information was collated from diverse sources to document (1) the locations of havens and (2) the occurrence of populations of predator-susceptible threatened mammals (naturally occurring or translocated) in those havens. The list of predator-susceptible taxa (67 taxa, 52 species) was based on consensus opinion from >25 mammal experts. Key results Seventeen fenced and 101 island havens contain 188 populations of 38 predator-susceptible threatened mammal taxa (32 species). Island havens cover a larger cumulative area than fenced havens (2152km2 versus 346km2), and reach larger sizes (largest island 325km2, with another island of 628km2 becoming available from 2018; largest fence: 123km2). Islands and fenced havens contain similar numbers of taxa (27 each), because fenced havens usually contain more taxa per haven. Populations within fences are mostly translocated (43 of 49; 88%). Islands contain translocated populations (30 of 139; 22%); but also protect in situ (109) threatened mammal populations. Conclusions Havens are used increasingly to safeguard threatened predator-susceptible mammals. However, 15 such taxa occur in only one or two havens, and 29 such taxa (43%) are not represented in any havens. The taxon at greatest risk of extinction from predation, and in greatest need of a haven, is the central rock-rat (Zyzomys pedunculatus). Implications Future investment in havens should focus on locations that favour taxa with no (or low) existing haven representation. Although havens can be critical for avoiding extinctions in the short term, they cover a minute proportion of species’ former ranges. Improved options for controlling the impacts of cats and foxes at landscape scales must be developed and implemented.
Raf kinase inhibitor protein negatively regulates FcεRI-mediated mast cell activation and allergic response
Authors: Lin Wenlong , Su Fasheng , Gautam Rahul , Wang Ning , Zhang Yuanyuan , Wang Xiaojian
Published: October 2018

Significance

Mast cell activation contributes to multiple allergic disorders, such as asthma, rhinitis, and atopic dermatitis. Here, we demonstrate that the Raf kinase inhibitor protein (RKIP) functions as an inhibitor of mast cell activation. RKIP negatively regulates the pathogeneses of the mast cell-mediated anaphylactic response and allergic asthma in vivo. Furthermore, the expression of RKIP was significantly down-regulated in peripheral blood from asthma patients. Collectively, our findings not only suggest that RKIP plays an important role in controlling mast cell-mediated allergic responses but also provide insight into therapeutic targets for mast cell-related allergic diseases.
Convergent evolution of complex structures for ant–bacterial defensive symbiosis in fungus-farming ants
Authors: Li Hongjie , Sosa-Calvo Jeffrey , Horn Heidi A. , Pupo Mônica T. , Clardy Jon , Rabeling Christian , Schultz Ted R. , Currie Cameron R.
Published: October 2018

Evolutionary adaptations for maintaining beneficial microbes are hallmarks of mutualistic evolution. Fungus-farming “attine” ant species have complex cuticular modifications and specialized glands that house and nourish antibiotic-producing Actinobacteria symbionts, which in turn protect their hosts’ fungus gardens from pathogens. Here we reconstruct ant–Actinobacteria evolutionary history across the full range of variation within subtribe Attina by combining dated phylogenomic and ultramorphological analyses. Ancestral-state analyses indicate the ant–Actinobacteria symbiosis arose early in attine-ant evolution, a conclusion consistent with direct observations of Actinobacteria on fossil ants in Oligo-Miocene amber. qPCR indicates that the dominant ant-associated Actinobacteria belong to the genusPseudonocardia. Tracing the evolutionary trajectories ofPseudonocardia-maintaining mechanisms across attine ants reveals a continuum of adaptations. InMyrmicocryptaspecies, which retain many ancestral morphological and behavioral traits,Pseudonocardiaoccur in specific locations on the legs and antennae, unassociated with any specialized structures. In contrast, specialized cuticular structures, including crypts and tubercles, evolved at least three times in derived attine-ant lineages. Conspicuous caste differences inPseudonocardia-maintaining structures, in which specialized structures are present in worker ants and queens but reduced or lost in males, are consistent with verticalPseudonocardiatransmission. Although the majority of attine ants are associated withPseudonocardia, there have been multiple losses of bacterial symbionts and bacteria-maintaining structures in different lineages over evolutionary time. The early origin of ant–Pseudonocardiamutualism and the multiple evolutionary convergences on strikingly similar anatomical adaptations for maintaining bacterial symbionts indicate thatPseudonocardiahave played a critical role in the evolution of ant fungiculture.
The ReFRAME library as a comprehensive drug repurposing library and its application to the treatment of cryptosporidiosis
Authors: Janes Jeff , Young Megan E. , Chen Emily , Rogers Nicole H. , Burgstaller-Muehlbacher Sebastian , Hughes Laura D. , Love Melissa S. , Hull Mitchell V. , Kuhen Kelli L. , Woods Ashley K. , Joseph Sean B. , Petrassi H. Michael , McNamara Case W. , Tremblay Matthew S. , Su Andrew I. , Schultz Peter G. , Chatterjee Arnab K.
Published: October 2018

Significance

The ReFRAME collection of 12,000 compounds is a best-in-class drug repurposing library containing nearly all small molecules that have reached clinical development or undergone significant preclinical profiling. The purpose of such a screening collection is to enable rapid testing of compounds with demonstrated safety profiles in new indications, such as neglected or rare diseases, where there is less commercial motivation for expensive research and development. Providing the academic and nonprofit research community access to a high-value compound collection and related screening data in an open-access platform should provide new tool compounds for biomedical research, as well as accelerate drug-discovery and/or development programs aimed at developing new therapies for diverse unmet medical needs.
Left/right asymmetric collective migration of parapineal cells is mediated by focal FGF signaling activity in leading cells
Authors: Roussigné Myriam , Wei Lu , Tsingos Erika , Kuchling Franz , Alkobtawi Mansour , Tsalavouta Matina , Wittbrodt Joachim , Carl Matthias , Blader Patrick , Wilson Stephen W.
Published: October 2018

Significance

The ability of cells to migrate collectively underlies many biological processes. The parapineal is a small group of cells that requires Fgf8 to migrate from the midline to the left side of the zebrafish forebrain. Studying the dynamics of FGF pathway activation reveals that FGF activity is restricted to a few left-sided parapineal cells. Global activation of the FGF pathway interferes with parapineal migration in wild-type embryos, while focal activation in few parapineal cells can restore migration in
fgf8
−/−
mutants, indicating that FGF pathway activation in leading cells is required for collective migration. We show that focal FGF activity is influenced by left-sided Nodal signaling. Our findings may apply to other contexts of FGF-dependent cell migration during development or metastasis.
On the linearity of lattices in affine buildings and ergodicity of the singular Cartan flow
Authors: Bader Uri , Caprace Pierre-Emmanuel , Lécureux Jean
Published: October 2018

Let

X
X

be a locally finite irreducible affine building of dimension 

≥
2

\geq 2

, and let

Γ
≤
Aut
⁡
(
X
)

\Gamma \leq \operatorname {Aut}(X)

be a discrete group acting cocompactly. The goal of this paper is to address the following question: When is

Γ
\Gamma

linear? More generally, when does

Γ
\Gamma

admit a finite-dimensional representation with infinite image over a commutative unital ring? If

X
X

is the Bruhat–Tits building of a simple algebraic group over a local field and if

Γ
\Gamma

is an arithmetic lattice, then

Γ
\Gamma

is clearly linear. We prove that if

X
X

is of type

A
~

2

\widetilde {A}_2

, then the converse holds. In particular, cocompact lattices in exotic

A
~

2

\widetilde {A}_2

-buildings are nonlinear. As an application, we obtain the first infinite family of lattices in exotic

A
~

2

\widetilde {A}_2

-buildings of arbitrarily large thickness, providing a partial answer to a question of W. Kantor from 1986. We also show that if

X
X

is Bruhat–Tits of arbitrary type, then the linearity of

Γ
\Gamma

implies that

Γ
\Gamma

is virtually contained in the linear part of the automorphism group of

X
X

; in particular,

Γ
\Gamma

is an arithmetic lattice. The proofs are based on the machinery of algebraic representations of ergodic systems recently developed by U. Bader and A. Furman. The implementation of that tool in the present context requires the geometric construction of a suitable ergodic

Γ
\Gamma

-space attached to the the building

X
X

, which we call the singular Cartan flow.
Top-Down Policy Implementation and Social Workers as Institutional Entrepreneurs: The Case of an Electronic Information System in Belgium
Authors: De Corte Joris , Devlieghere Jochen , Roets Griet , Roose Rudi
Published: October 2018

In this article, we focus on how social workers use their agency when implementing top-down policy measures as street-level bureaucrats. We report on findings of a case study that was conducted in Flanders, the Dutch-speaking region of Belgium, about the top-down introduction of an electronic information system (IS) in the field of Child Welfare and Protection (CWP). Starting from insights derived from neo-institutional theory, we explore how social workers perform a role as so-called ‘institutional entrepreneurs’ by initiating critical reflections about policy rationales. In our contribution, we show that, despite social workers’ awareness of being embedded in their own field or service area, they use their field-level expertise and day-to-day experiences to disengage from this context as well. Besides unravelling the lack of coherence informing the IS’s initial ambitions of transparency and efficiency, they constantly (re)frame their views and explain their alternative ideas with the aim of convincing other social workers and managers. In this vein, we conclude by highlighting the importance of ‘distributed’ forms of agency that involve a gradual process, which is co-produced by social workers as street-level bureaucrats in close collaboration with service users, other professionals, other organisations and policy makers.
Cultural variation in the gray matter volume of the prefrontal cortex is moderated by the dopamine D4 receptor gene (DRD4)
Authors: Yu Qinggang , Abe Nobuhito , King Anthony , Yoon Carolyn , Liberzon Israel , Kitayama Shinobu
Published: October 2018

Recent evidence suggests a systematic cultural difference in the volume/thickness of prefrontal regions of the brain. However, origins of this difference remain unclear. Here, we addressed this gap by adopting a unique genetic approach. People who carry the 7- or 2-repeat (7/2-R) allele of the dopamine D4 receptor gene (DRD4) are more sensitive to environmental influences, including cultural influences. Therefore, if the difference in brain structure is due to cultural influences, it should be moderated by DRD4. We recruited 132 young adults (both European Americans and Asian-born East Asians). Voxel-based morphometry showed that gray matter (GM) volume of the medial prefrontal cortex and the orbitofrontal cortex was significantly greater among European Americans than among East Asians. Moreover, the difference in GM volume was significantly more pronounced among carriers of the 7/2-R allele of DRD4 than among non-carriers. This pattern was robust in an alternative measure assessing cortical thickness. A further exploratory analysis showed that among East Asian carriers, the number of years spent in the U.S. predicted increased GM volume in the orbitofrontal cortex. The present evidence is consistent with a view that culture shapes the brain by mobilizing epigenetic pathways that are gradually established through socialization and enculturation.
Epidemiology of Carbapenem-Resistant Enterobacteriaceae at a Long-term Acute Care Hospital
Authors: Chopra Teena , Rivard Christopher , Awali Reda A , Krishna Amar , Bonomo Robert A , Perez Federico , Kaye Keith S
Published: October 2018

Background

Residents of long-term acute care hospitals (LTACHs) are considered important reservoirs of multidrug-resistant organisms, including Carbapenem-resistant Enterobacteriaceae (CRE). We conducted this study to define the characteristics of CRE-infected/colonized patients admitted to an LTACH and the molecular characteristics of the CRE isolates.

Methods

This retrospective study was conducted to collect information on demographic and comorbid conditions in CRE-colonized/infected patients admitted to a 77-bed LTACH in Detroit between January 2011 and July 2012. Data pertaining to hospital-related exposures were collected for 30 days before positive CRE culture. Polymerase chain reaction (PCR) gene amplification, repetitive sequence–based PCR, and multilocus sequence typing (MLST) were performed on 8 of the CRE isolates.

Results

The study cohort included 30 patients with CRE-positive cultures, 24 (80%) with infections, and 6 (20%) with colonization. The mean age of cohort was 69 ±12.41 years; 19 (63%) patients were ventilator-dependent, and 20 (67%) were treated with at least 1 antibiotic. Twenty-three (77%) patients had CRE detected following LTACH admission, and the median days from admission to CRE detection in these patients (interquartile range) was 25 (11–43). Seven more patients were already positive for CRE at the time of LTACH admission. Molecular genotyping and MLST of 8 CRE isolates demonstrated that all isolates belonged to the same strain type (ST258) and contained the blaKPC-3 sequence.

Conclusions

The majority of patients with CRE presented several days to weeks after LTACH admission, indicating possible organism acquisition in the LTACH itself. The genetic similarity of the CRE isolates tested could further indicate the occurrence of horizontal transmission in the LTACH or simply be representative of the regionally dominant strain.
‘Taking Back Control’, the UK’s Constitutional Narrative and Schrodinger’s Devolution
Authors: Sandford Mark , Gormley-Heenan Cathy
Published: October 2018

The UK’s decision to leave the European Union in 2016 threatens to open up a range of territorial management issues that have long remained unexplored. Since 1999, the UK’s devolution settlements have allowed divergent constitutional narratives to develop and to co-exist. This ‘constructive ambiguity’ has led UK territorial governance to take the form of ‘Schrodinger’s devolution’, where Scotland, Wales and Northern Ireland have and have not experienced fundamental constitutional change. However, the technical requirements of Brexit will mandate the need for exact decisions where ‘constructive ambiguity’ has existed up to now. The UK’s unwritten constitution, limited intergovernmental relations and a lack of shared rule mechanisms mean that these technical decisions have the potential to lead to ongoing political instability.
Preoperative Quadriceps Muscle Strength and Functional Ability Predict Performance-Based Outcomes 6 Months After Total Knee Arthroplasty: A Systematic Review
Authors: Devasenapathy Niveditha , Maddison Ralph , Malhotra Rajesh , Zodepy Sanjay , Sharma Saket , Belavy Daniel L
Published: October 2018

Background

One-third of individuals report limitations in activities of daily living even 6 months after total knee arthroplasty (TKA). Moderate-quality evidence exists for several sociodemographic and clinical predictors of patient-reported outcome measures of perceived functionality. Objectively measured performance-based measures (PBMs) provide a less subjective approach to informing patient treatment after TKA; however, information about predictors of functionally relevant PBMs is scarce.

Purpose

This systematic review synthesized the available research on preoperative predictors of PBMs after primary TKA for osteoarthritis.

Data Sources

In June 2016 and January 2017, MEDLINE, EMBASE, and PsycINFO databases were searched.

Study Selection

Cohort studies exploring preoperative predictors of stair climbing, walking speed, and gait speed measured ≥6 months after primary TKA were included. Screening of abstracts and selection of full texts were undertaken by 2 independent reviewers.

Data Extraction

Information on study design, patient characteristics, analysis, and results was extracted using pilot-tested forms. Two independent reviewers assessed risk of bias using modified Quality in Prognostic Studies criteria.

Data Synthesis

Of the eligible 12 studies involving 6 prospective cohorts, 10 studies reported information on baseline predictors. Meta-analysis of predictors was not possible because of missing information on effect size or standard errors. Narrative synthesis of evidence of predictors was therefore performed.

Limitations

The quality of evidence was low because of the risk of bias and heterogeneity of included studies as well as nonreporting of measures of effect.

Conclusions

Low-quality evidence exists for an association of preoperative functional ability and quadriceps muscle strength with functionality at 6 months after TKA. Improved reporting of predictor analyses is needed to enable evidence generation for clinical management.
Program-Level Factors Influencing Positive Graduate Outcomes of Physical Therapy Residency Programs
Authors: Hartley Gregory W , Roach Kathryn E , Harrington Kendra L , McNally Stephanie
Published: October 2018

Background

Physical therapist clinical residency programs vary widely in administrative structure, instructional characteristics, and program design. The impact of program-level factors on resident outcomes such as graduation and board certification is unknown.

Objective

The objective of this study was to examine the influence of program-level factors on participant outcomes of physical therapist residency programs.

Design

This was a retrospective cohort study using data from accredited programs from 2010 to 2013.

Methods

Data were collected on program characteristics such as administrative structure, size, salary, tuition, full- or part-time options, didactic format, and clinical-site structure. The odds ratios were calculated to examine the impact of program characteristics on graduation, board certification, and passing the exam. A logistic regression analysis to determine the combined contribution of these characteristics on the 3 outcomes was performed.

Results

Data from 183 residency programs and 1589 residents were analyzed. Participants attending programs that were single site or multifacility, provided live didactic instruction, did not charge tuition, and paid residents ≥ 70% full-time equivalent salary were 9.8 times more likely to graduate, 5.1 times more likely to become board certified, and 3.2 times more likely to pass the specialty board examination.

Limitations

This study did not examine the impact of program location, resident attributes, or resident exposure to patient diagnostic volume and variety.

Conclusions

This study has identified some program-level factors that appear to influence the odds of graduating, becoming board-certified, and passing the specialty board examination. This information could inform existing and developing residency programs, as well as applicants, on program-level factors that might influence participant outcomes.
Factors Influencing Nurses’ Perceptions of the Baccalaureate Degree in Nursing as Minimum Requirement for Professional Practice
Authors: Thielmann Bethany , Parker Kelly K. , Post Jill M. , Abraham Samuel P.
Published: October 2018

AIM

The purpose of this study was to determine factors influencing nurses’ perceptions of the baccalaureate degree in nursing as the minimum requirement for professional practice.

BACKGROUND

The associate degree nursing program was created in response to a nursing shortage in the early 1950s. In 1965, the American Nurses Association recommended that the BSN be the minimum to practice professionally as a nurse.

METHOD

A quantitative method with a descriptive design was used. An online, Likert-type survey collected data from 61 nurses in southern Michigan and northern Indiana. Two open-ended questions were included to gain perceptions in nurses’ own words.

RESULTS

Higher education was noted as positive for nurses, but not necessary for becoming an expert nurse. The most common factors influencing advancing education were time and money, followed by career advancement.

CONCLUSION

The study supports the idea that if nurses are able, they will continue their education.
Type 2 diabetes management
Authors: GC Kajal , Cadet Myriam Jean , Hirani Shabeena , Thomas Tisha
Published: October 2018

Type 2 diabetes mellitus (T2DM) is an endocrine and metabolic disorder that requires ongoing medical management. If T2DM is not adequately assessed and managed, a wide spectrum of clinical manifestations and complications may occur. This article provides clinical guidance to NPs on the management of T2DM in primary care settings.
Variable clinical presentations of babesiosis
Authors: Paparone Pamela , Paparone Philip W.
Published: October 2018

Human babesiosis continues to spread in multiple regions of the US. It is transmitted by Ixodes species ticks, as are Lyme disease and anaplasmosis. Its variable clinical presentations, together with serologic detection limitations, require that a high index of clinical suspicion be present for prompt diagnosis. This article discusses case examples showing the wide range of symptoms and presentations that are possible with babesiosis.
Patient Satisfaction after Aesthetic Chondrolaryngoplasty
Authors: Cohen Michael B. , Insalaco Louis F. , Tonn Christopher R. , Spiegel Jeffrey H.
Published: October 2018

Background:

Patient’s pursuing aesthetic surgery often inquire about the success of the procedure. Having objective data for these patients improves preoperative counseling. To assess patient satisfaction after aesthetic chondrolaryngoplasty using specifically developed outcomes assessment instrument and to evaluate the anatomy of the vocalis insertion on the thyroid cartilage and its effect on the extent of surgical resection.

Methods:

Retrospective survey of patients who underwent chondrolaryngoplasty from 2006 to 2012. Patients answered 6 questions on a 5-point Likert scale assessing satisfaction from a physical, emotional, and social quality of life perspective. We separately undertook cadaveric dissection to examine the ligamentous attachment of the vocal fold to the thyroid cartilage.

All patient were seen in a private practice affiliated with a university medical center.

One hundred ninety-eight patients underwent chondrolaryngoplasty during the study period; we were able to contact 112.

The main outcome measure is patient satisfaction using a 5-point Likert Scale.

Results:

Sixty percentage of patients were either “very” or “completely” satisfied with the appearance of their neck and Adam’s apple. Only 13% still reported that their neck/Adam’s apple still appeared unsatisfactorily prominent or masculine. No patients had permanent voice change, and greater than 90% of patients had no significant voice change of any duration; any voice change was temporary. The most frequent comments from less satisfied patients were the amount of remaining prominence and the size or location of the scar.

Conclusions:

Aesthetic chondrolaryngoplasty is a safe and effective surgery to reduce the prominence of the thyroid cartilage. Patients should be aware that because of the need to preserve voice it may not be 100% effective from an aesthetic perspective.
Greater Sleep Fragmentation Is Associated With Less Physical Activity in Adults With Cystic Fibrosis
Authors: Cox Narelle S. , Pepin Véronique , Holland Anne E.
Published: October 2018

Background:

Sleep quality in people with cystic fibrosis (CF) is known to be poor, whereas participating in regular physical activity is associated with less decline in lung function (forced expiratory volume in 1 sec [FEV1]). The relationship between sleep quality and physical activity in people with CF is unknown.

Methods:

Secondary analysis of sleep and activity data collected via actigraphy. Adults with CF in stable health, participating in a study of physical activity (including assessment of exercise capacity), completed 7 d of activity and sleep assessment (SenseWear Armband [SWA]; BodyMedia). Sleep characteristics were derived from accelerometer positional data and registration of sleep state by the SWA, determined by energy expenditure.

Results:

Sleep and activity data were available for 47 participants [n = 28 male; mean ± standard deviation age = 29 ± 8 yr; median (IQR) FEV1 = 60 (50, 82) % predicted]. More fragmented sleep was associated with poorer exercise capacity (r
s = −0.303, P = .04), less time spent in moderate-vigorous physical activity (r
s = −0.337, P = .020), and poorer FEV1 (r
s = −0.344, P = .018). Regression analysis showed that less fragmented sleep was an independent predictor of more total daily activity time (β = −1.0, standard error [SE] of β = .4, P = .02) and trended toward significance for more moderate-vigorous physical activity (β = −.3, SE of β = −.26, P = .08). Greater total sleep time and sleep efficiency were related to better exercise capacity and lung function (P < .05).

Conclusion:

This secondary analysis demonstrated a modest relationship between sleep parameters and physical activity and exercise capacity in adults with CF. Future studies of interventions to promote physical activity participation in this group should consider the relationship between sleep and activity performance.
Sex- and Gender-Related Factors Associated With Cardiac Rehabilitation Enrollment
Authors: Cossette Sylvie , Maheu-Cadotte Marc-André , Mailhot Tanya , Fontaine Guillaume , Cournoyer Alexis , Cournoyer Catherine , Guertin Marie-Claude , Juneau Martin
Published: October 2018

Purpose:

To assess sex- and gender-related factors associated with cardiac rehabilitation (CR) enrollment following acute coronary syndrome among systematically referred patients.

Methods:

This secondary analysis of a randomized controlled trial used an exploratory approach to examine the TRANSITion process for patients between the coronary care unit and CR (TRANSIT-UC). The present analysis examined the relationship between sex- and gender-related factors and CR enrollment in systematically referred women (n = 35) and men (n = 207). We performed χ2 and logistic regression analyses to identify statistically significant results. Using the Bonferroni method, a P value of .002 or less was considered a significant statistical result. A raw difference of 15% or more between enrolled and nonenrolled participants was considered a difference worthy of further investigation.

Results:

Men who were regularly engaged in physical activity prior to their hospitalization and who lived near the CR center showed a statistically higher CR enrollment rate. In women and men, a radial entry site for percutaneous coronary intervention resulted in a clinically significant difference in favor of CR enrollment. In women, 3 sex-related and 9 gender-related variables were associated with a difference of 15% or more between enrolled and nonenrolled participants.

Conclusion:

Factors related to CR enrollment in women and men are suggested. As women keep showing a lower rate of CR enrolment, the investigation of these factors in a larger sample of patients may hold valuable insights to improve CR enrolment.
Antibiotic Resistance Among Pediatric-Sourced Ocular Pathogens: 8-Year Findings From the Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) Surveillance Study
Authors: Alter Sherman J. , Sanfilippo Christine M. , Asbell Penny A. , DeCory Heleen H.
Published: October 2018

Background:

The Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) study is a nationwide longitudinal antibiotic resistance surveillance program specific to bacterial pathogens commonly encountered in ocular infections. We evaluated in vitro resistance rates and trends among isolates obtained from pediatric patients (≤17 years of age).

Methods:

Clinical centers across the United States were invited to submit ocular isolates ofStaphylococcus aureus, coagulase-negative staphylococci (CoNS),Streptococcus pneumoniae,Haemophilus influenzaeandPseudomonas aeruginosato a central laboratory. Minimum inhibitory concentrations for various antibiotic classes were determined by broth microdilution per Clinical and Laboratory Standards Institute guidelines and interpreted as susceptible, intermediate or resistant based on available breakpoints. Longitudinal trends were analyzed using a Cochran-Armitage test for linear trends in a proportion.

Results:

Of 4829 isolates collected from January 2009 to December 2016, 995 isolates, sourced primarily from hospitals and referral centers, were obtained from pediatric patients (n = 286H.influenzae, n = 284S.aureus, n = 213 CoNS, n = 150S. pneumoniaeand n = 62P. aeruginosa). With few exceptions,P. aeruginosaandH. influenzaewere generally susceptible to the antibiotics tested. OfS. aureusand CoNS isolates, respectively, 56% and 72% were resistant to azithromycin and 24% and 47% were methicillin-resistant (MR); concurrent resistance to other drug classes and multidrug resistance (≥3 drug classes) were prevalent among MR staphylococci. OfS. pneumoniaeisolates, 38% and 35% demonstrated resistance to azithromycin and penicillin, respectively. Besifloxacin had the lowest minimum inhibitory concentration against the Gram-positive isolates.

Conclusions:

These in vitro data suggest antibiotic resistance is common among staphylococcal and pneumococcal isolates collected from pediatric patients with ocular infections. Methicillin resistance was prevalent among staphylococci with many strains demonstrating multidrug resistance. These findings may not be representative of resistance trends in community-based practices.
Nasal and Lacrimal Sac Histopathology in Patients With Systemic Sarcoidosis Undergoing External Lacrimal Drainage Surgery
Authors: Stewart Christopher M. , Luthert Philip J. , Rose Geoffrey E.
Published: October 2018

Purpose:

To review the histological findings in the lacrimal sac and nasal mucosa from patients with sarcoidosis undergoing external lacrimal drainage surgery.

Methods:

All patients undergoing external dacryocystorhinostomy at Moorfields Eye Hospital with a known history of sarcoidosis had biopsies taken from the lacrimal sac and/or nasal mucosa during surgery. These patients were identified from databases at Moorfields Eye Hospital and the Institute of Ophthalmology, and their clinical notes were reviewed retrospectively for intraoperative findings with a view to identifying common trends. The histological findings of each biopsy were reviewed and classified as showing granulomas, nongranulomatous inflammation, or nonspecific fibrosis.

Results:

Forty patients (29 females; 72%) were known to have systemic sarcoidosis prior to surgery, and they underwent 60 external dacryocystorhinostomies. Paired histological samples were available from 49/60 (82%) procedures, nasal biopsies alone in 3 dacryocystorhinostomies (5%), and solely lacrimal sac biopsies in 8 (13%). The main site of systemic sarcoidosis was pulmonary involvement (19 patients; 48%). Recorded operative findings included 9 large lacrimal sac mucoceles (29%), a “thick” (26%) or “inflamed” (9.7%) lacrimal sac mucosa, and “thick” (36%) or “friable” (32%) nasal mucosa. Noncaseating granulomas were identified in 34/57 (60%) sacs, and 45/52 (87%) nasal tissues—this being in 31/49 (63%) of paired tissues. Chronic inflammation, without granulomas, was present in 20/57 (35%) lacrimal sacs but only in 5/52 (9.6%) of nasal biopsies.

Conclusions:

In patients with sarcoidosis undergoing external dacryocystorhinostomy, the characteristic histological feature—noncaseating granulomas—is present in most patients’ lacrimal sac mucosa and in almost all of their nasal mucosae. The lacrimal sac and nasal mucosa often appears abnormal—thickened or friable—during surgery.