bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative study of Fisch-Boozer and Ohkawa current drive mechanisms for electron cyclotron waves
Authors: Zheng P. W. , Gong X. Y. , Lu X. Q. , Cao J. J. , He L. H. , Huang Q. H. , Deng S. , Lin J. F. , Zhong Y. J.
Published: July 2018

Localized current drive by electron cyclotron (EC) waves is of significant importance in the outer half region of tokamak plasmas. Using the coupled GENRAY/CQL3D suite codes, a systematic comparative study between Ohkawa current drive (OKCD) and electron cyclotron current drive (ECCD) is performed. The results show that OKCD has more advantages than ECCD for far off-axis localized current drive in tokamaks with large inverse aspect ratios, while ECCD is more efficient than OKCD in tokamaks with low inverse aspect ratios. The results of local current driving on the q = 2 rational surface show that both OKCD and ECCD are effective for control of the m = 2/n = 1 tearing mode or neoclassical tearing mode (NTM). It seems that efficient Ohkawa current can be driven in a specific far off-axis radial position as long as the local inverse aspect ratio is large enough. The effect of collisionality imposes a significant impact on OKCD and results in reduction of the net current driven by unit EC power. The dimensionless current drive efficiency of OKCD increases with increasing electron beta βe in a medium range. The results further confirm that OKCD can be a valuable alternative localized current drive method to replace ECCD in large inverse aspect ratio tokamaks or in the radial position where the local inverse aspect ratio is large enough.
Absolute fluorescence and absorption measurements over a dynamic range of 106 with cavity-enhanced laser-induced fluorescence
Authors: Sanders Scott E. , Willis Oliver R. , Nahler N. Hendrik , Wrede Eckart
Published: July 2018

We present a novel spectroscopic technique that exhibits high sensitivity and a large dynamic range for the measurement of absolute absorption coefficients. We perform a simultaneous and correlated laser-induced fluorescence and cavity ring-down measurement of the same sample in a single pulsed laser beam. The combined measurement offers a large dynamic range and a lower limit of detection than either technique on its own. The methodology, dubbed cavity-enhanced laser-induced fluorescence, is developed and rigorously tested against the electronic spectroscopy of 1,4-bis(phenylethynyl)benzene in a molecular beam and density measurements in a cell. We outline how the method can be used to determine absolute quantities, such as sample densities, absorption cross sections, and fluorescence quantum yields, particularly in spatially confined samples.
Treating linear molecule HCCH in calculations of rotation-vibration spectra
Authors: Chubb Katy L. , Yachmenev Andrey , Tennyson Jonathan , Yurchenko Sergei N.
Published: July 2018

Special treatment is required for ro-vibrational calculations involving polyatomic molecules of linear geometry in order to avoid singularities in the kinetic energy operator. Here we present a variational approach which allows calculations involving such configurations, with a set of 3N–5 linearized coordinates used to represent the vibrations. This approach has been implemented as part of the variational nuclear motion program TROVE (Theoretical ROVibrational Energies). A symmetry adapted basis set based on the Dnh symmetry point group is used. As an illustration of the 3N–5 model presented, TROVE has been used to compute an ab initio room temperature line list for C212H2 using symmetry-adapted ab initio potential energy (CCSD(T)-F12c/cc-pVQZ-F12) and dipole moment surfaces for the ground electronic state. Line positions and intensities (J ≤ 58, l < 8, covering the wavenumbers up to 10 000 cm−1) are compared against HITRAN-2016 and ASD-1000. Alternative methods for treating linear molecules and future work are discussed.
All polymer encapsulated, highly-sensitive MoS2 phototransistors on flexible PAR substrate
Authors: Ma Jiyeon , Choi Keun-Yeong , Kim So Hyeon , Lee Hojin , Yoo Geonwook
Published: July 2018

We have demonstrated electrically and optically enhanced MoS2 phototransistors on a flexible polyarylate substrate using poly(4-vinylphenol) (PVP) as a gate dielectric as well as an encapsulation layer. With the PVP encapsulation, the field-effect mobility (μFE) increases up to twofold, and the subthreshold slope as well as the on/off ratio (ION/IOFF) improves, which are desirable features for the photoresponsive characteristics. Consequently, both photoresponsivity and detectivity increase up to two orders of magnitude (×100) from visible to infrared spectrum. Such enhancement is associated with the n-doping effect of hydroxyl groups in PVP and reduced recombination centers by filling interface traps and surface states. Our results reveal that the transparent PVP polymer can be a promising encapsulation method in order to enhance the electrical and photoresponsive characteristics of MoS2-based flexible devices.
Entropic uncertainty relations under localizations on discrete quantum groups
Authors: Youn Sang-Gyun
Published: July 2018

The uncertainty principle has been established within the framework of locally compact quantum groups in recent years. This paper demonstrates that entropic uncertainty relations can be strengthened under localizations on discrete quantum groups, which is the case if the dual compact quantum group G is the free orthogonal quantum group ON+ with N ≥ 3 or if G admits an infinite Λ(p) set with p > 2. On the other hand, this paper explains the reason why such phenomena do not appear when G is one of the connected semisimple compact Lie groups, O2+, and the quantum SU(2) groups. Also, we discuss the divergence of entropic uncertainty relations together with some explicit explanations.
Direct observation of stacking fault shrinkage in 4H-SiC at high temperatures by in-situ X-ray topography using monochromatic synchrotron radiation
Authors: Fujie Fumihiro , Harada Shunta , Koizumi Haruhiko , Murayama Kenta , Hanada Kenji , Tagawa Miho , Ujihara Toru
Published: July 2018

An in-situ X-ray topography system using monochromatic synchrotron radiation for the observation of the stacking faults in 4H-SiC during a high-temperature annealing process was developed. We demonstrated that the stacking faults in nitrogen-doped 4H-SiC not only expand but also shrink at high temperatures. Furthermore, it was confirmed that the types of the core structure of partial dislocations enclosing the stacking fault can be determined at high temperatures.
The role of oxygen vacancy over ZnCr-layered double oxide in enhancing solar light-driven photocatalytic degradation of bisphenol A
Authors: Chen Meiqing , Wu Pingxiao , Wei Qianqian , Zhu Yajie , Yang Shanshan , Ju Liting , Zhu Nengwu , Lin Zhang
Published: July 2018

Environmental contextAn important goal in attempts to degrade environmental organic pollutants is the development of a photocatalyst that is responsive to visible light. We report a facile method for preparing a zinc-based photocatalyst with oxygen vacancies that efficiently degrades bisphenol A under solar light irradiation. The study will stimulate further investigations into the efficacy of other metal oxide nanostructures for the photocatalytic degradation of organic pollutants.
AbstractTwo ZnCr-layered double oxides (ZnCr-LDO) were fabricated via different thermal treatment of the ZnCr-layered double hydroxide (ZnCr-LDH) precursor. ZnCr-V-700 and ZnCr-A-700 were obtained at 700 °C under vacuum and air, respectively. As X-ray diffraction revealed, both ZnCr-V-700 and ZnCr-A-700 were made up of ZnO and ZnCr2O4 spinel, and ZnCr-V-700 displayed a lower crystallinity and many uniform particles with oxygen vacancies. Scanning electron microscopy and transmission electron microscopy revealed that the particle size of ZnCr-V-700 was ~30 nm and its disordered crystallinity suggested the existence of oxygen vacancies. Notably, the ZnCr-LDO materials showed remarkably enhanced photocatalytic activity compared to the ZnCr-LDH precursor. ZnCr-V-700 was the most active material and more than 90 % of BPA was degraded after irradiation for 200 min with high mineralisation (up to 37 %). The results of Brunauer–Emmett–Teller surface area analysis, X-ray photoelectron spectroscopy, Raman and UV-vis spectroscopy and electron paramagnetic resonance spectroscopy showed that oxygen vacancies incorporated into ZnCr-V-700 played a key role in improving the photocatalytic performance by enhancing interfacial charge transfer and restricting the charge recombination. In addition, the uniform particle size, larger surface area and the coexistence of ZnO and ZnCr2O4 also played a synergistic role. In conclusion, this work not only provides a facile and low-cost method to prepare photocatalysts for treatment of wastewater containing BPA, but also supplies a new idea for improving the performance of photocatalysts.
Backbone-free duplex-stacked monomer nucleic acids exhibiting Watson–Crick selectivity
Authors: Smith Gregory P. , Fraccia Tommaso P. , Todisco Marco , Zanchetta Giuliano , Zhu Chenhui , Hayden Emily , Bellini Tommaso , Clark Noel A.
Published: July 2018

Significance

The columnar liquid crystal phases reported here are physical associations of the smallest molecular species to self-assemble into the duplex base-paired stacked columnar double-helical structures of nucleic acids. These assemblies of monomers can provide starting states capable of partitioning appropriate molecules from solution with a high degree of selectivity, acting as pathways for the prebiotic appearance of molecular selection, self-assembly, and, ultimately, of the sequence-directed assembly of polymers.
Serum exosomes mediate delivery of arginase 1 as a novel mechanism for endothelial dysfunction in diabetes
Authors: Zhang Huina , Liu Jian , Qu Dan , Wang Li , Wong Chi Ming , Lau Chi-Wai , Huang Yuhong , Wang Yi Fan , Huang Huihui , Xia Yin , Xiang Li , Cai Zongwei , Liu Pingsheng , Wei Yongxiang , Yao Xiaoqiang , Ma Ronald Ching Wan , Huang Yu
Published: July 2018

Significance

Endothelial dysfunction plays a crucial role in the development of diabetic vasculopathy, but the mechanisms are not fully understood. In this study, we have revealed a previously undefined importance of serum exosomes in regulating endothelial function and vascular homeostasis in diabetes. Through comparative proteomics analysis, arginase1 was found enriched in diabetic serum exosomes and can be transferred to endothelial cells to inhibit NO production, thus impairing endothelial function. This is a cell-to-cell communication mechanism first identified to contribute to vascular dysfunction in diabetes.
Reprogrammable Braille on an elastic shell
Authors: Chung Jun Young , Vaziri Ashkan , Mahadevan L.
Published: July 2018

Significance

Generically, memory requires a dynamical system that has multiple metastable states or in disordered systems, broken ergodicity. In living systems, memory is encoded biochemically, while in engineered systems, it is encoded electromagnetically. However, it can be realized using other means as well. We show how an otherwise featureless long cylindrical elastic plate can, when loaded appropriately, serve to store elastic bits, localized dimples and bumps that can be written and erased at will anywhere along it. Using experiments, theory, and computations, we determine the conditions under which we can write on such a linear device using a mechanical stylus and suggest that this might serve as the basis for small-scale mechanical memories.
Past role and future outlook of the Conservation Reserve Program for supporting honey bees in the Great Plains
Authors: Otto Clint R. V. , Zheng Haochi , Gallant Alisa L. , Iovanna Rich , Carlson Benjamin L. , Smart Matthew D. , Hyberg Skip
Published: July 2018

Significance

Global pollinator declines have raised significant concern over food security, human health, and agricultural productivity. Our work highlights how the Conservation Reserve Program (CRP) has a direct influence on landscape suitability for supporting honey bee apiaries in a region harboring >1 million colonies. Our analysis revealed recent conversion of CRP grassland to annual crops in core areas of the commercial beekeeping industry, thereby reducing forage lands for honey bees at a time when the number of colonies in this region has never been greater. Our land-use scenario models provide policy makers with direct information on how future CRP acreage caps established by the US Congress will affect the environmental carrying capacity for supporting honey bees and the US beekeeping industry.
Opposite outcomes of coinfection at individual and population scales
Authors: Gorsich Erin E. , Etienne Rampal S. , Medlock Jan , Beechler Brianna R. , Spaan Johannie M. , Spaan Robert S. , Ezenwa Vanessa O. , Jolles Anna E.
Published: July 2018

Significance

Infection with multiple parasite species is common and the majority of coinfections involve at least one long-lasting infection. Our data-driven model of chronic coinfection dynamics shows that accurate prediction at the population level requires quantifying both the individual-level transmission and mortality consequences of coinfection. The infections characterized in this study compete at the population level. When one pathogen facilitates both the transmission and progression of the second pathogen, the prevalence of the first pathogen is reduced. This mechanism of competition is unique compared with previously described mechanisms and occurs without cross-immunity, resource competition within the host, or convalescence. We recommend assessing the generality of this mechanism, which could have important consequences for other chronic, immunosuppressive pathogens such as HIV or TB.
Anthropogenic and biogenic CO
2
fluxes in the Boston urban region
Authors: Sargent Maryann , Barrera Yanina , Nehrkorn Thomas , Hutyra Lucy R. , Gately Conor K. , Jones Taylor , McKain Kathryn , Sweeney Colm , Hegarty Jennifer , Hardiman Brady , Wang Jonathan A. , Wofsy Steven C.
Published: July 2018

Significance

Cities are taking a leading role in US efforts to reduce greenhouse gas emissions, and require traceable methods to assess the efficacy of their efforts. In this study, we developed an inverse model framework that quantified emissions in the Boston urban region over 16 months and is capable of detecting changes in emissions of greater than 18%. We show that a detailed representation of urban biological fluxes and knowledge of the spatial and temporal distribution of emissions are essential for accurate modeling of annual CO
2
emissions. Across the globe, it is possible to quantifiably assess the efficacy of mitigation efforts by developing frameworks similar to the one we present here for Boston.
Minor zygotic gene activation is essential for mouse preimplantation development
Authors: Abe Ken-ichiro , Funaya Satoshi , Tsukioka Dai , Kawamura Machika , Suzuki Yutaka , Suzuki Masataka G. , Schultz Richard M. , Aoki Fugaku
Published: July 2018

Significance

Results presented in this report demonstrate that minor zygotic gene activation (ZGA) must precede major ZGA to execute successfully the maternal-to-zygotic transition, and that the timely occurrence of minor ZGA is crucial for preimplantation development to continue beyond the two-cell stage. In addition, the results show that the gene-expression program proceeds in a step-by-step fashion, and at least initially, is not regulated by a “zygotic clock” (e.g., compaction) or cell cycle progression (e.g., major ZGA that occurs during the two-cell stage).
Feasting and the evolution of cooperative social organizations circa 2300 B.P. in Paracas culture, southern Peru
Authors: Stanish Charles , Tantaleán Henry , Knudson Kelly
Published: July 2018

Significance

A key process in cultural evolution is the development of cooperative organizations that confront the collective action problems inherent in human social interactions. We demonstrate that one classic ethnographic mechanism of cooperative social organization, the hosting of feasts, was used in an early complex, nonstate society in the south coast of Peru

∼

2300 B.P. We likewise demonstrate that the catchment zone of the people and goods that participated in the feast was extensive. These data support a cultural evolutionary model of early state formation as one of a network strategy. That is, key areas across a large landscape were initially integrated into a cooperative group as opposed to a strategy of local consolidation and subsequent aggregative growth.
Growth suppression of ice crystal basal face in the presence of a moderate ice-binding protein does not confer hyperactivity
Authors: Bayer-Giraldi Maddalena , Sazaki Gen , Nagashima Ken , Kipfstuhl Sepp , Vorontsov Dmitry A. , Furukawa Yoshinori
Published: July 2018

Significance

Ice-binding proteins (IBPs) can be considered a prominent example of macromolecules affecting ice growth kinetics. Until now, two groups of IBPs have been described based on their activity as ice growth inhibitors: moderate and hyperactive IBPs. The mechanism underlying these activity differences has not been clarified yet. Although it is commonly believed that hyperactivity is related to growth inhibition of the basal faces of ice crystals, we show that a moderate IBP can also attach to the basal faces and inhibit their growth. Our observations clearly indicate that this moderate IBP occupies a separate position in the classification of IBPs and contribute to our understanding of interaction between macromolecules and ice and more generally, between macromolecules and inorganic crystals.
Effects of gender and verbal aggression on perceptions of U.S. political speakers
Authors: Nau Charlotte , Stewart Craig O.
Published: July 2018

Two experiments tested whether male and female political speakers in the United States are judged differently when they use verbal attacks. Participants read eight short excerpts of political speeches, half of which contained character and competence attacks (the other half without such attacks), and half of which were attributed to a female speaker (the other half a male speaker), and rated these in terms of agreement with the message, and perceptions of credibility, appropriateness, and aggressiveness. In both experiments, messages containing verbally aggressive attacks resulted in less perceived credibility and appropriateness, and these negative effects were consistent regardless of the speaker’s gender. In Experiment 1, women tended to penalize aggressive speakers more so than did men, suggesting the men are less sensitive to verbal aggression in their evaluations of political speakers. However, women tended to perceive non-aggressive female speakers as more aggressive than male speakers. Most of these interaction effects were not replicated in Experiment 2.
Strategy of computational predictions for mechanical behaviour of additively manufactured materials
Authors: Zinovieva O. , Zinoviev A. , Ploshikhin V. , Romanova V. , Balokhonov R.
Published: June 2018

This paper presents a new computational framework to describe the evolution of grain structure during metal additive manufacturing and to simulate an inelastic deformation of the additively manufactured material, taking into account the grain structure explicitly. A combined effect of grain structure and loading conditions on the evolution of the stress–strain state in additively manufactured specimens is investigated. The results of the research highlight the need to account for the realistic microstructure, to properly describe the mechanical behaviour of additively manufactured specimens and parts.

This is part of a thematic issue on Small Scale Mechanics - EUROMAT.
Evolution of bonding interface during ultrasonic welding between steel and aluminium alloy
Authors: Lin Jhe-Yu , Nambu Shoichi , Koseki Toshihiko
Published: June 2018

Ultrasonic welding (USW), a solid-state bonding technique, was applied to join ultra-low carbon steel and Al5052 aluminium alloy. The evolution of bonding strength and microstructure at the bonding interface during ultrasonic welding was investigated with an emphasis on the early stage before the formation of intermetallic compound. Initially, adhesive wear starts when steel and Al alloy have sliding contact, and thereafter, a thin layer of Al is attached onto the surface of the steel while the wear of Al base metal is continued owing to the sliding. As the welding time increases, bonding sections are gradually formed with the increase of interfacial temperature owing to the sliding friction, whose process is illustrated in this article.
Circadian period of luciferase expression shortens with age in human mature adipocytes from obese patients
Authors: Kolbe Isa , Carrasco-Benso María Paz , Lόpez-Mínguez Jesús , Luján Juan , Scheer Frank A. J. L. , Oster Henrik , Garaulet Marta
Published: July 2018

Daily rhythms in physiology and behavior change with age. An unresolved question is to what extent such age‐related alterations in circadian organization are driven by the central clock in the suprachiasmatic nucleus (SCN), modifying timing signals to contributing peripheral tissue oscillators, and are mediated by underlying changes in the local cellular oscillators themselves. Using a bioluminescence reporter approach, we sought to determine whether circadian clock function in human adipocytes from subcutaneous (SAT) and visceral (VAT) adipose tissues changes with age. SAT and VAT biopsies were obtained from obese individuals during gastric bypass surgeries [n = 16; body mass index: 44.8 ± 11.4 kg/m2; age: 44 ± 9 yr (range: 30–58)]. Cells were isolated and transduced with a lentiviral circadian reporter construct [brain and muscle ary1 hydrocarbon receptor nuclear translocator‐like:luciferase (BMAL:LUC)], and bioluminescence was recorded over a period of 3 d. Human BMAL1:LUC adipocytes displayed a robust luminescence rhythm with comparable within‐individual periods in mature and preadipocytes (P > 0.05). With increasing age, the circadian period decreased in mature adipocytes (P = 0.005) (β = 4 min/yr; P < 0.05). Our ex vivo approach indicated that ageing changes the organization of endogenous circadian oscillators in human adipocytes, independent of SCN signaling.—Kolbe, I., Carrasco‐Benso, M. P., López‐Mínguez, J., Luján, J., Scheer, F. A. J. L., Oster, H., Garaulet, M. Circadian period of luciferase expression shortens with age in human mature adipocytes from obese patients. FASEB J. 33, 175–180 (2019). www.fasebj.org
A Radiologist's Guide to Breast Cancer Genomics
Authors: Kuzmiak Cherie M.
Published: July 2018

Breast cancer is the most common cancer among women in the world. According to World Health Organization data, in 2012 there were approximately 1.7 million new cases diagnosed and nearly half a million deaths from breast cancer worldwide.1 The highest incidence of the disease is in North America and Europe; however, the highest mortality rates are in South America, Africa, and Asia.2 The increased rate of breast cancer mortality in those regions of the world may be due partially to lack of health care access and advanced therapies. Nevertheless, breast cancer is one of the most lethal cancers, along with lung and colon cancer, in women worldwide.1
The new Israeli PA
Authors: Berkowitz Oren , Gelbshtein Udi , Segal Idit , Jacobson Eyal
Published: June 2018

Israel launched its new physician assistant profession with its first class of students, who were graduated in October 2017. The program is run by the Ministry of Health's Training and Development Department. This first course was focused on emergency medicine and the plan is to expand to anesthesiology and pathology in the near future.
Seeing—and Nursing—Our Power
Authors: Kennedy Maureen Shawn
Published: June 2018

By standing up for patients, we stand up for ourselves.
Ireland Proposes Promising Model for Nurse Staffing
Authors: Sofer Dalia
Published: June 2018

In pilot studies, the framework reduced adverse events and absenteeism.
Can You Be Fired for Taking a Sick Day?
Authors: Nelson Roxanne
Published: June 2018

Know your rights and responsibilities when it comes to sick time.
Promoting Drug Safety in Older Adults
Authors: Aschenbrenner Diane S.
Published: June 2018

The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults is an evidence-based list of medications generally considered inappropriate for use in older patients.

The list can be used in any health care setting and for all patients except those in hospice or palliative care.

Nurses should consult the Beers criteria as a starting point when evaluating the appropriateness of a patient's drug therapy. Some patients may need treatment with a medication despite its presence on the list.
New HIV Drug Treats Patients Unresponsive to Other Therapies
Authors: Aschenbrenner Diane S.
Published: June 2018

Ibalizumab-uiyk (Trogarzo) is a new CD4-directed postattachment HIV-1 inhibitor approved for use in adults with multidrug resistant HIV-1 who have previously received multiple HIV medications and in whom current therapy is now failing.

Ibalizumab-uiyk is administered as an IV infusion. It should never be given as an IV push or bolus.
New Medical Residents and Patient Mortality—Does the ‘Nurse Effect’ Lessen the ‘July Effect’?
Authors: Kennedy Maureen Shawn
Published: June 2018

Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely—and often more personal—perspectives on professional, policy, and clinical issues. Best of the Blog will be a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com.
Nursing Instructor Incivility Toward Students
Authors: Koharchik Linda
Published: June 2018

This article is one in a series on the roles of adjunct clinical faculty and preceptors, who teach nursing students and new graduates to apply knowledge in clinical settings. In this article, the author discusses instructor incivility toward students, the possible reasons for this behavior, the outcomes of instructor incivility, and suggestions for remediation.
Patients with Dementia have Better Surgical Outcomes in Hospitals with Better-Educated Nurses
Authors: Rosenberg Karen
Published: June 2018

According to this study:

Patients treated in a hospital with better-educated nurses are less likely to die after surgery than those in a hospital with less-well-educated nurses.

The benefit is particularly pronounced in patients with dementia.
New Screening Tool Useful in Nurse Recruitment
Authors: Rosenberg Karen
Published: June 2018

According to this study:

A 16-item scale created from identified characteristics of high-performing nurses is useful in recruiting nurses who best fit an organization's nursing culture.
We Remember Them, Too
Authors: Spruit Jessica L.
Published: June 2018

A nurse's open letter to families who have lost a child.
Association between Performance in a Maintenance of Certification Program and Disciplinary Actions against the Medical Licenses of Anesthesiologists
Authors: Zhou Yan , Sun Huaping , Macario Alex , Keegan Mark T. , Patterson Andrew J. , Minhaj Mohammed M. , Wang Ting , Harman Ann E. , Warner David O.
Published: June 2018

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

In 2000, the American Board of Anesthesiology (Raleigh, North Carolina) began issuing time-limited certificates requiring renewal every 10 yr through a maintenance of certification program. This study investigated the association between performance in this program and disciplinary actions against medical licenses.

Methods

The incidence of postcertification prejudicial license actions was compared (1) between anesthesiologists certified between 1994 and 1999 (non–time-limited certificates not requiring maintenance of certification) and those certified between 2000 and 2005 (time-limited certificates requiring maintenance of certification); (2) within the non–time-limited cohort, between those who did and did not voluntarily participate in maintenance of certification; and (3) within the time-limited cohort, between those who did and did not complete maintenance of certification requirements within 10 yr.

Results

The cumulative incidence of license actions was 3.8% (587 of 15,486). The incidence did not significantly differ after time-limited certificates were introduced (hazard ratio = 1.15; 95% CI, 0.95 to 1.39; for non–time-limited cohort compared with time-limited cohort). In the non–time-limited cohort, 10% (n = 953) voluntarily participated in maintenance of certification. Maintenance of certification participation was associated with a lower incidence of license actions (hazard ratio = 0.60; 95% CI, 0.38 to 0.94). In the time-limited cohort, 90% (n = 5,329) completed maintenance of certification requirements within 10 yr of certificate issuance. Not completing maintenance of certification requirements (n = 588) was associated with a higher incidence of license actions (hazard ratio = 4.61; 95% CI, 3.27 to 6.51).

Conclusions

These findings suggest that meeting maintenance of certification requirements is associated with a lower likelihood of being disciplined by a state licensing agency. The introduction of time-limited certificates in 2000 was not associated with a significant change in the rate of license actions.
Incidence of congenital idiopathic clubfoot in the Netherlands
Authors: Besselaar Arnold T. , Kamp Maud C. , Reijman Max , van der Steen Marieke
Published: June 2018

The incidence of clubfoot patients is an important factor for centralization of care. Medical records of 21 accredited clubfoot centers were selected using the diagnosis treatment codes and checked to confirm diagnosis. All idiopathic clubfoot cases born during 2013–2014 were analyzed with respect to sex, affected foot, regional distribution, and seasonal variation. Among the 346 522 live births, 377 idiopathic clubfoot cases were registered. The incidence of the congenital idiopathic clubfoot in the Netherlands during 2013 and 2014 was 1.09 per 1000 live births, indicating that every year, ~200 children with one or two clubfeet are born in the Netherlands. On the basis of this finding, we can start to refine clubfoot care.
Diagnostic Ultrasound and Microbubbles Treatment Improves Outcomes of Coronary No-Reflow in Canine Models by Sonothrombolysis
Authors: Li Hairui , Lu Yongkang , Sun Yili , Chen Gangbin , Wang Junfen , Wang Shifei , Huang Chixiong , Zhong Lintao , Si Xiaoyun , Liao Wangjun , Liao Yulin , Cao Shiping , Bin Jianping
Published: June 2018

Objectives:

Effective treatment for microvascular thrombosis-induced coronary no-reflow remains an unmet clinical need. This study sought to evaluate whether diagnostic ultrasound and microbubbles treatment could improve outcomes of coronary no-reflow by dissolving platelet- and erythrocyte-rich microthrombi.

Design:

Randomized controlled laboratory investigation.

Setting:

Research laboratory.

Subjects:

Mongrel dogs.

Interventions:

Coronary no-reflow models induced by platelet- or erythrocyte-rich microthrombi were established and randomly assigned to control, ultrasound, recombinant tissue-type plasminogen activator, ultrasound + microbubbles, or ultrasound + microbubbles + recombinant tissue-type plasminogen activator group. All treatments lasted for 30 minutes.

Measurements and Main Results:

Percentage of microemboli-obstructed coronary arterioles was lower in ultrasound + microbubbles group than that in control group for platelet- (> 50% obstruction: 10.20% ± 3.56% vs 31.80% ± 3.96%; < 50% obstruction: 14.80% ± 4.15% vs 28.20% ± 3.56%) and erythrocyte-rich microthrombi (> 50% obstruction: 8.20% ± 3.11% vs 30.60% ± 4.83%; < 50% obstruction: 12.80% ± 4.15% vs 25.80% ± 3.70%) (p < 0.001). Percentage change of myocardial blood flow in left anterior descending artery-dominated region, left ventricular ejection fraction, fractional shortening, and ST-segment resolution were higher, whereas infarcted area, troponin I, and creatine kinase MB isoenzyme were lower in ultrasound + microbubbles group than that in control group for both types of microthrombi (p < 0.001). Percentage change of myocardial blood flow, ejection fraction, fractional shortening, and ST-segment resolution were higher, whereas infarcted area, troponin I, and creatine kinase MB isoenzyme were lower in ultrasound + microbubbles and ultrasound + microbubbles + recombinant tissue-type plasminogen activator groups than that in recombinant tissue-type plasminogen activator group for platelet-rich microthrombi (p < 0.05).

Conclusions:

Ultrasound + microbubbles treatment could dissolve platelet- and erythrocyte-rich microthrombi, thereby improving outcomes of coronary no-reflow, making it a promising supplement to current reperfusion therapy for acute ST-segment elevation myocardial infarction.
Autoimmune Myocarditis Caused by Immune Checkpoint Inhibitors Treated With Antithymocyte Globulin
Authors: Jain Varun , Mohebtash Mahsa , Rodrigo Maria E. , Ruiz George , Atkins Michael B. , Barac Ana
Published: June 2018

The immune checkpoint inhibitors have brought about a paradigm shift in the treatment of many cancers and are being used as the first line therapy in increasing number of aggressive malignancies, including metastatic melanoma. Their adverse effects, mostly mediated by an uncontrolled overactivation of the immune system, may compromise the therapeutic benefit. Combination immune checkpoint therapies in particular, have higher therapeutic efficacy, but have also been associated with a higher incidence of severe immune-related adverse effects including autoimmune lymphocytic myocarditis. Recent clinical reports of this rare and life threatening condition indicated rapid progression of severe hemodynamic and electrical instability, with or without acute decompensated heart failure, reduced ejection fraction and shock, pointing to the need for early recognition, diagnosis and prompt management. Current guidelines for management of other immune-related adverse effects recommend high-dose glucocorticoids, with consideration of immunomodulators, such as infliximab in patients with severe colitis. However, knowledge about the treatment approaches in immune-related myocarditis remains extremely scarce. Here we report a case of severe, steroid refractory, lymphocytic myocarditis that occurred after the first cycle of combination immunotherapy with the programmed cell death protein-1 inhibitor, nivolumab, and the cytotoxic T-lymphocyte-associated protein 4 blocker, ipilimumab, for metastatic melanoma. We discuss treatment approaches including the role for transvenous pacemaker, advanced heart failure support, and interdisciplinary decision making.
Composition of Exfoliation Material
Authors: Challa Pratap , Johnson William M.
Published: June 2018

Exfoliation glaucoma (XFG) is the most common identifiable cause of open-angle glaucoma worldwide, and results from the accumulation of extracellular fibrillary material (XFM) within the trabecular meshwork and the Schlemm canal leading to increased intraocular pressure and potential blindness. Immunohistochemical and mass spectrometry analyses have revealed that XFM is a highly glycosylated proteinaceous complex that is extremely resistant to degradation both within the body and under experimental conditions. The protein core contains a wide variety of proteins, including basement membrane proteins, elastic fiber proteins, latent TGFβ proteins, metalloproteinases, chaperone proteins, complement proteins, lysyl oxidase-like 1 (LOXL1), and apolipoprotein E (ApoE). This supplemental section identifies the advances in knowledge and current understanding of the components within XFM with a specific focus on the most recent work defining proteins within XFM and to pose several biological questions that remain unanswered.
Clinical and Laboratory Biomarkers for Pseudoexfoliation Syndrome
Authors: Kamel Khalid , Bourke Liam , O’Brien Colm
Published: June 2018

In this review, we present an update on biomarkers (both clinical and laboratory) on the basis of recent peer-reviewed publications relating to pseudoexfoliation syndrome and pseudoexfoliation glaucoma.
Inner and Outer Retinal Contributions to Pupillary Light Response: Correlation to Functional and Morphologic Parameters in Glaucoma
Authors: Duque-Chica Gloria L. , Gracitelli Carolina P.B. , Moura Ana L.A. , Nagy Balázs V. , Vidal Kallene S. , Paranhos Augusto , Ventura Dora F.
Published: June 2018

Purpose:

To evaluate in patients with primary open-angle glaucoma (POAG) the contribution of the inner and outer retinal photoreceptors to the pupillary light responses (PLRs) correlated with both functional (color vision and visual field perimetry) and morphologic (optical coherence tomography) parameters.

Methods:

In total, 45 patients with POAG and 25 healthy control participants were evaluated. The PLR was measured as pupil diameter with an eye tracker; stimuli were presented in a Ganzfeld. Pupil responses were measured monocularly, to 1 second blue (470 nm) and red (640 nm) flashes with −3, −2, −1, 0, 1, 2, and 2.4 log cd/m2 luminance levels. Color vision was evaluated with the Cambridge Color Test, visual field was measured by standard automatic perimetry, and retinal nerve fiber layer thickness was evaluated by optical coherence tomography.

Results:

Patients with moderate and severe POAG have a significantly decreased PLR that depends on the severity of POAG, for both the 470 and 640 nm stimuli, revealing the reduction of the contributions of the rods, cones, and intrinsically photosensitive retinal ganglion cells to PLR. A significant loss of color discrimination along the blue-yellow axis was observed in all stages of POAG. Correlations among standard automatic perimetry, retinal nerve fiber layer thickness, Cambridge Color Test, PLR, and melanopsin parameters were found.

Conclusions:

The results provide evidence that in moderate and severe stages of POAG, both the inner and outer retinal contributions to PLR are affected. Also, a worsening in color vision was correlated with reduced PLR responses at high-intensity stimuli. These findings may enhance the clinical management of POAG patients.
A Standardized Approach to Electronic Fetal Monitoring in Critical Care Obstetrics
Authors: Cypher Rebecca L.
Published: June 2018

From the periphery, pregnancy is a common event in women of childbearing age. Normal anatomic and physiologic adaptations occur and, in most cases, will result in ideal maternal-fetal outcomes. Yet, every day, obstetric clinicians are facing complex pregnancies with complicated life-threatening conditions or coexisting medical and surgical problems that not only alter maternal physiology but also impact fetal survival. A challenge in this population is individualizing maternal-fetal care in critical care women while integrating medical-surgical specialties in creating an interdisciplinary team with similar management goals. Questions frequently arise concerning admission criteria, location of care, as well as type and mix of personnel. Furthermore, how to simultaneously manage a critically ill parturient while monitoring a viable fetus is often obscured. This article focuses on crucial fetal monitoring concepts using a standardized approach to interpretation and management in pregnancies managed in an intensive care environment. Application of fetal monitoring during surgical procedures, during perimortem cesarean birth, and in women who have irreversible loss of brain function is included.
Interpersonal Relationships Among Black Couples and Depressive Symptoms During Pregnancy
Authors: Caldwell Cleopatra Howard , Misra Dawn P. , Rogers William B. , Young Alford , Giurgescu Carmen
Published: June 2018

Objective:

The purpose of this study was to examine associations of the mother–father relationship and social support with depressive symptoms during pregnancy among Black mothers and fathers.

Methods:

Fifty Black mother–father dyads from the Midwest completed a packet of questionnaires that included conflict with partner, social support, depressive symptoms, and sociodemographic characteristics.

Results:

Twenty-four percent of mothers and 16% of fathers had Center for Epidemiological Studies-Depression scores ≥23, which have been correlated with a major depression diagnosis. There were no differences in depressive symptoms between mothers and fathers. Fathers reporting high depressive symptoms were not more likely to be partnered with mothers reporting high depressive symptoms. Controlling for age, higher levels of conflict with partner, and lower levels of social support predicted higher levels of depressive symptoms for both mothers and fathers.

Clinical Implications:

Black expectant mothers and fathers may be at risk for clinical depression. Fathers experienced comparable levels of depressive symptoms with mothers, indicating the need to consider fathers' psychological adjustment during pregnancy. Higher levels of conflict with partner and lower levels of social support predicted higher levels of depressive symptoms for both parents. Maternal–child nurses should assess for mothers' as well as fathers' experiences of depressive symptoms and the mother–father relationship when providing prenatal care.
Ethics in Plastic Surgery: Applying the Four Common Principles to Practice
Authors: Gallo Lucas , Baxter Charmaine , Murphy Jessica , Schwartz Lisa , Thoma Achilleas
Published: June 2018

The topic of ethics in plastic surgery remains underrepresented in the literature. By applying the four principles of biomedical ethics—respect for autonomy, beneficence, nonmaleficence, and justice—as described by Beauchamp and Childress to proposed ethical scenarios, this article attempts to provide plastic surgeons with a systematic approach to recognize and address ethical dilemmas as they present in day-to-day practice. Through the perspective of an experienced plastic surgeon and medical ethicist, this article is intended to spark discussion, reflection, and debate on ethical challenges in plastic surgery.
Lymph Flow Restoration after Tissue Replantation and Transfer: Importance of Lymph Axiality and Possibility of Lymph Flow Reconstruction without Lymph Node Transfer or Lymphatic Anastomosis
Authors: Yamamoto Takumi , Iida Takuya , Yoshimatsu Hidehiko , Fuse Yuma , Hayashi Akitatsu , Yamamoto Nana
Published: June 2018

Background:

The lymph system plays important roles in maintaining fluid balances, the immune system, and lipid metabolism. After tissue replantation or transfer, some cases suffer long-lasting edema or lymphedema caused by interruption of main lymph flows; however, this mechanism has yet to be clarified.

Methods:

The medical charts of 38 patients who underwent indocyanine green lymphography after tissue replantation or free flap transfer were reviewed to obtain data regarding clinical demographics, intraoperative findings, and postoperative indocyanine green lymphographic findings. Postoperative lymph flow restoration based on indocyanine green lymphographic findings was evaluated according to intraoperative findings, including raw surface in lymph axiality and compatible lymph axiality.

Results:

Lymph flow restoration was observed in 24 cases (63 percent). There were significant differences in positive lymph flow restoration with regard to sex (male, 78 percent; female, 40 percent; p = 0.017), cause of defect (trauma, 83 percent; others, 33 percent; p = 0.002), type of operation (replantation, 94 percent; free flap, 41 percent; p = 0.001), and compatible lymph axiality (positive, 96 percent; negative, 0 percent; p < 0.001). Based on lymph axiality, the raw surface in lymph axiality–negative and compatible lymph axiality–positive condition was completely matched with lymph flow restoration positivity; 100 percent accuracy to predict postoperative lymph flow restoration was observed.

Conclusions:

Lymph flow can be restored after tissue replantation or free flap transfer without lymph node or supermicrosurgical lymphatic anastomosis. The raw surface in lymph axiality–negative and compatible lymph axiality–positive condition is considered a key for restoring lymph flows after surgery affecting the main lymph pathway.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Genome-wide association analysis with a 50K transcribed gene SNP-chip identifies QTL affecting muscle yield in rainbow trout
Authors: Salem Mohamed , Al-Tobasei Rafet , Ali Ali , Lourenco Daniela , Gao Guangtu , Palti Yniv , Kenney Brett , Leeds Timothy D.
Published: June 2018

Detection of coding/functional SNPs that change the biological function of a gene may lead to identification of putative causative alleles within QTL regions and discovery of genetic markers with large effects on phenotypes. Two bioinformatics pipelines, GATK and SAMtools, were used to identify ~21K transcribed SNPs with allelic imbalances associated with important aquaculture production traits including body weight, muscle yield, muscle fat content, shear force, and whiteness in addition to resistance/susceptibility to bacterial cold-water disease (BCWD). SNPs were identified from pooled RNA-Seq data collected from ~620 fish, representing 98 families from growth- and 54 families from BCWD-selected lines with divergent phenotypes. In addition, ~29K transcribed SNPs without allelic-imbalances were strategically added to build a 50K Affymetrix SNP-chip. SNPs selected included two SNPs per gene from 14K genes and ~5K non-synonymous SNPs. The SNP-chip was used to genotype 1728 fish. The average SNP calling-rate for samples passing quality control (QC; 1,641 fish) was ≥ 98.5%. Genome-wide association (GWA) study on 878 fish (representing 197 families from 2 consecutive generations) with muscle yield phenotypes and genotyped for 35K polymorphic markers (passing QC) identified several QTL regions explaining together up to 28.40% of the additive genetic variance for muscle yield in this rainbow trout population. The most significant QTLs were on chromosomes 14 and 16 with 12.71% and 10.49% of the genetic variance, respectively. Many of the annotated genes in the QTL regions were previously reported as important regulators of muscle development and cell signaling. No major QTLs were identified in a previous GWA study using a 57K genomic SNP chip on the same fish population. These results indicate improved detection power of the transcribed gene SNP-chip in the target trait and population, allowing identification of large-effect QTLs for important traits in rainbow trout.
Proxi: a Python package for proximity network inference from metagenomic data
Authors: EL-Manzalawy Yasser
Published: June 2018

Summary: Recent technological advances in high-throughput metagenomic sequencing have provided unique opportunities for studying the diversity and dynamics of microbial communities under different health or environmental conditions. Graph-based representation of metagenomic data is a promising direction not only for analyzing microbial interactions but also for a broad range of machine learning tasks including feature selection, classification, clustering, anomaly detection, and dimensionality reduction. We present Proxi, an open source Python package for learning different types of proximity graphs from metagenomic data. Currently, three types of proximity graphs are supported: k-nearest neighbor (k-NN) graphs; radius-nearest neighbor (r-NN) graphs; and perturbed k-nearest neighbor (pk-NN) graphs.

Availability: Proxi Python source code is freely available at https://bitbucket.org/idsrlab/proxi/.

Contact:yme2@psu.edu

Supplementary information: Tutorials and online documentation are available at https://proxi.readthedocs.io