bluuebunny/crossref_metadata_2025 huggingface dataset:
Two directional fast imaging of plasma plume in variable magnetic field: Structure and dynamics of the plume in diamagnetic and non-diamagnetic limits
Authors: Behera Narayan , Singh R. K. , Chaudhari V. , Kumar Ajai
Published: March 2017

A new experimental set-up which consists of a pulse magnetic field system has been developed to capture the different phases of expanding plasma plume across the transverse magnetic field, varying from 0 to 0.57 T. Two internally synchronized ICCD cameras mounted in the orthogonal direction have been used to record the two directional projections (across and along the magnetic field directions) of the plasma plume. The plume takes the conventional ellipsoidal shape in the absence of a magnetic field. Well-defined cavity-like structures have been observed in a plane perpendicular to the field direction, which are dominant at the early stage of the plasma and comparatively lower magnetic fields. As the time evolves, the cavity changes to jet/cone-like structures which in turn change to slab-like structures with a further increase in time delay. On the other hand, well separated intensity columns (striation-like structures) appeared in a plane parallel to the magnetic field direction, which are more apparent at a higher magnetic field. Based on the projections of plume images in two perpendicular planes, the three dimensional structure of the plasma plume is modeled as an elliptical cylinder-like structure. The time dependence of dynamics and geometry of the plasma plume in the presence of a magnetic field are correlated with the expansion in diamagnetic and non-diamagnetic regimes. The validity of plasma instability, which is responsible for observed striation-like structures, is also discussed.
Integrable reductions of the Bogoyavlenskij-Itoh Lotka-Volterra systems
Authors: Damianou P. A. , Evripidou C. A. , Kassotakis P. , Vanhaecke P.
Published: March 2017

Given a constant skew-symmetric matrix A, it is a difficult open problem whether the associated Lotka-Volterra system is integrable or not. We solve this problem in a special case when A is a Toeplitz matrix where all off-diagonal entries are plus or minus one. In this case, the associated Lotka-Volterra system turns out to be a reduction of Liouville integrable systems, whose integrability was shown by Bogoyavlenskij and Itoh. We prove that the reduced systems are also Liouville integrable and that they are also non-commutative integrable by constructing a set of independent first integrals, having the required involutive properties (with respect to the Poisson bracket). These first integrals fall into two categories. One set consists of polynomial functions that are restriction of the Bogoyavlenskij-Itoh integrals; their involutivity was already pointed out by Bogoyavlenskij. The other set consists of rational functions which are obtained through a Poisson map from the first integrals of some recently discovered superintegrable Lotka-Volterra systems. The fact that these polynomial and rational first integrals, combined, have the required properties for Liouville and non-commutative integrability is quite remarkable; the quite technical proof of functional independence of the first integrals is given in detail.
Design of low bias voltage Ge/SiGe multiple quantum wells electro-absorption modulator at 1550 nm
Authors: Gao Jianfeng , Zhou Heng , Jiang Jialin , Zhou Yang , Sun Junqiang
Published: March 2017

We design and simulate a Ge/SiGe multiple quantum wells (MQWs) modulator based on quantum confined Stark effect (QCSE) that operates at 1550 nm. By introducing a thick well and thin barrier in multiple quantum wells structure, the compressive strain of the Ge well is reduced and the absorption edge is shifted to the longer wavelength. An 8-band k⋅p model is employed to calculate the eigenstates and absorption spectra, and influences of quantum well parameters on the absorption property is analyzed and discussed. The numerical simulation indicates that the bias voltage is remarkably reduced to 0.5 V with 1 V voltage swing for 10 wells, while still maintaining over 5 dB absorption contrast ratio. The proposed Ge/SiGe modulator can be a potential approach compatible with traditional complementary metal-oxide-semiconductor (CMOS) technology and adoptable for integration with electronic components.
Bioaugmentation: an effective commercial technology for the removal of phenols from wastewater
Authors: Poi Gregory , Shahsavari Esmaeil , Aburto-Medina Arturo , Ball Andrew S
Published: March 2017

Phenol represents a huge problem in industrial wastewater effluents and needs to be removed due to its toxic and carcinogenic nature. The removal of phenol from the wastewater is often both expensive and time consuming; there is therefore a requirement for a more effective, sustainable solution for the removal of phenol from wastewaters. Bioaugmentation or the addition of phenol degrading microorganisms to contaminated effluents is one such sustainable approach being considered. Here, we describe how bioaugmentation has been applied for the biological treatment of phenol in industrial wastewaters.
Multispecies presence and connectivity around a designed artificial reef
Authors: Keller Krystle , Smith James A. , Lowry Michael B. , Taylor Matthew D. , Suthers Iain M.
Published: March 2017

A goal of designed artificial reefs (ARs) is to enhance fish abundance, species diversity and fishing opportunities by providing food and refuge for fish. Quantifying the contribution of ARs to coastal ecosystems and fisheries productivity requires an understanding of fish presence at the structure and connectivity with surrounding habitats. In the present study, the movements and presence of 10 eastern fiddler rays (Trygonorrhina fasciata), 17 Port Jackson sharks (Heterodontus portusjacksoni) and 18 bluespotted flathead (Platycephalus caeruleopunctatus) were monitored using acoustic telemetry around a designed AR in 38-m depth near Sydney, Australia. Fiddler rays exhibited an average short-term presence of 43% at the AR, and 26% over the ~20-month monitoring period, which was significantly higher than the other two species. Fish tagged at the AR showed high affinity to the site at which they were tagged compared with fish tagged on natural reef. All three species moved frequently between the AR and the other reefs in the area, indicating that the AR may increase the connectivity between adjacent habitats and aid the dispersion of benthic species. The moderate presence at the AR suggests that these species may contribute to some biomass production at this AR by incorporating this reef in their natural range.
Is the Biodiversity Conservation Act 2016 (WA) fit for purpose?
Authors: Bateman Philip W. , Pearlman Patrick , Robertson Peter , Schultz Beth , Wardell-Johnson Grant
Published: March 2017

The Biodiversity Conservation Bill 2015 for Western Australia was criticised by scientists and conservation activists for its perceived flaws as it progressed from Bill through to Act. In this article, we summarise what we consider to be the major flaws in the Biodiversity Conservation Act 2016 (WA) and suggest future amendments that could make the Act fit for purpose. Such criticism is important as biodiversity conservation initiatives globally appear to be failing to prevent biodiversity losses. As we move further into the 21st Century we need to identify, enact and implement effective legislation that will produce successful conservation outcomes.
Exploring language choice and identity construction in ‘in-between’ sites
Authors: Rubino Antonia , Cruickshank Kenneth
Published: March 2017

Australian research on immigrant languages has paid little attention to interactional approaches to language alternation as identity construction, and sites other than the family and the mainstream school. We argue for the need of studies that take into account a wider range of sites, in particular ‘community’ sites, and adopt fine-grained approaches through micro-level data, to provide more linguistic evidence and support for findings identified using other strategies. Drawing on micro-sociolinguistic research conducted in Australia in the ethnic media and the community languages schools, we show how in these ‘in-between’ sites (Tsolidis & Kostogriz, 2008) language choice is often a matter of negotiation, and the issues of language use and identity tend to be foregrounded. We also address the questions of why these sites have been less researched and the value of findings from them in terms of language and identity research in multilingual contexts.
Integrating constructional semantics and conceptual metaphor
Authors: Sullivan Karen
Published: March 2017

Conceptual Metaphor Theory (CMT) aims to represent the conceptual structure of metaphors rather than the structure of metaphoric language. The theory does not explain which aspects of metaphoric language evoke which conceptual structures, for example. However, other theories within cognitive linguistics may be better suited to this task. These theories, once integrated, should make building a unified model of both the conceptual and linguistic aspects of metaphor possible. First, constructional approaches to syntax provide an explanation of how particular constructional slots are associated with different functions in evoking metaphor. Cognitive Grammar is especially effective in this regard. Second, Frame Semantics helps explain how the words or phrases that fill the relevant constructional slots evoke the source and target domains of metaphor. Though these theories do not yet integrate seamlessly, their combination already offers explanatory benefits, such as allowing generalizations across metaphoric and non-metaphoric language, and identifying the words that play a role in evoking metaphors, for example.
Cascades in metaphor and grammar
Authors: David Oana , Lakoff George , Stickles Elise
Published: March 2017

Public discourse on highly charged, complex social and political issues is extensive, with millions of sentences available for
analysis. It is also rife with metaphors that manifest vast numbers of novel metaphoric expressions. More and more, to understand
such issues, to see who is saying what and why, we require big data and statistically-based analysis of such corpora. However,
statistically-based data processing alone cannot do all the work. The MetaNet (MN) project has developed an analysis method that
formalizes existing insights about the conceptual metaphors underlying linguistic expressions into a computationally tractable
mechanism for automatically discovering new metaphoric expressions in texts. The ontology used for this computational method is
organized in terms of metaphor cascades, i.e. pre-existing packages of hierarchically organized primary and
general metaphors that occur together. The current paper describes the architecture of metaphor-to-metaphor relations built into
this system. MN’s methodology represents a proof of concept for a novel way of performing metaphor analysis. It does so by
applying the method to one particular domain of social interest, namely the gun debate in American political discourse. Though
well aware that such an approach cannot replace a thorough cognitive, sociological, and political analysis, this paper offers
examples that show how a cascade theory of metaphor and grammar helps automated data analysis in many ways.
Automatic metaphor detection using constructions and frames
Authors: Hong Jisup
Published: March 2017

This paper presents MetaNet’s automatic metaphor detection system that applies theoretical principles from construction grammar, frame semantics, and recent developments in conceptual metaphor theory, including the theory of cascades (Lakoff 2014). The system has achieved relative success in identifying metaphorical expressions for a range of target domains from large corpora and holds promise as a useful tool for corpus-based study of metaphor. The detection system relies on MetaNet’s conceptual network of frames and metaphors as a computational resource for its functionality, and improves automatically as the representations stored in the network are built up. In addition, because of its theoretically principled design the system’s level of accuracy at identifying metaphorical expressions provides feedback to linguists about the accuracy of the frame and metaphor analyses in the network.
À propos du corbeau dans la traduction des Vaticinia de summis pontificibus par Jean Miélot
Authors: Barale Elisabetta
Published: March 2017

Les analyses pionnières de H. Grundmann et les contributions essentielles de R. Lerner, M. Reeves, H. Millet et D. Rigaux ont éclairci quelques aspects des Vaticinia de summis pontificibus dans leur complexité, mais la fortune de l’opuscule en langue vernaculaire n’a pas encore été suffisamment étudiée. Cet article porte sur une traduction en français rédigée par Jean Miélot au XVe siècle et transmise par le manuscrit unique Giessen, Universitätsbibliothek, Hs 633a. Il se focalise sur quatre prophéties dans lesquelles le corbeau figure parmi les éléments symboliques demandant à être interprétés afin de décrypter le sens du vaticinium ; l’analyse de ces textes devrait permettre de préciser le rôle joué par les animaux dans la construction du sens allégorique des prophéties et d’exemplifier quelques-uns des problèmes philologiques posés par la mise en français de Miélot.
Langue et parole de la serpente dans La Faula de Guillem de Torroella
Authors: Compagna Anna Maria
Published: March 2017

Vers 1375, le Majorquin Guillem de Torroella écrivit un roman de 1265 vers en langue occitano-catalane. Il s’agit de La Faula, le récit d’un voyage du narrateur à dos de baleine, jusqu’à l’Île enchantée. Là, après une conversation en français avec une serpente, il rencontre Morgane et le roi Arthur. Cette serpente parle français comme Arthur et Morgane. Notre analyse portera notamment sur le discours de la serpente: un animal qui parle… La langue, donc, est le français, mais un français improbable: un français “catalanisé,” qui est non seulement celui de la serpente mais aussi celui d’Arthur et de sa sœur. Une fois de plus, c’est donc dans le merveilleux, et plus particulièrement derrière les références à une culture zoomorphe, que la signification politique possible du texte se trouverait camouflée. Est-il possible qu'un texte comme celui-ci ne dispose que d'une signification didactique et morale sans toute portée politique? Y a-t-il des textes littéraires dépourvus sens politique? Les merveilles et les références à une culture zoomorphe permettent de camoufler l'importance politique, déjà suggérée par l'analyse du contexte historique que semble évoquer l’œuvre (Espadaler), de même que par l'examen de sa tradition textuelle: les lacunes que comportent trois  des quatre témoins manuscrits ne paraissent pas fortuites, mais intentionnelles, résultat d’une sorte de censure, que la circulation de l'œuvre a dû subir (Compagna). Ce camouflage n'aurait ainsi pas réussi à convaincre le parti victorieux, opposé à celui de Guillem de Torroella, perdant, qui s’est alors réfugié dans le monde de la littérature…
Renart et les escoufles, l’intertextualité de l’univers animal médiéval dans le Chevalier Silence de Jacques Roubaud
Authors: Ding Leticia
Published: March 2017

Le Chevalier Silence (1997) est l’œuvre de l’oulipien Jacques Roubaud. Ce texte se présente comme une réécriture du Roman de Silence d’Heldris de Cornouailles (XIIIe siècle), mais rapidement, au fil de la lecture, on se rend compte que le récit roubaldien emprunte un grand nombre de passages à d’autres textes médiévaux. Parmi ceux-ci, Roubaud réactualise le Roman de Renart et L’Escoufle de Jean Renart. La manière dont il remet au goût du jour ces deux œuvres passe par un jeu intertextuel et un entrelacement des textes, où les personnages des deux récits se retrouvent dans un même système diégétique. Par ce mécanisme d’écriture, Roubaud veut, d’une part, faire découvrir ou redécouvrir la littérature médiévale à un jeune public et à un lecteur moderne, en l’amusant. D’autre part, il s’adresse également aux médiévistes, car le jeu intertextuel, fruit d’une grande érudition, propose des énigmes au sujet des sources et des références empruntées.
Un animal très ambigu
Authors: Leclercq-Marx Jacqueline
Published: March 2017

À la fois vivipare et dotée d’ailes lui permettant de voler, la chauve-souris occupe une place ambiguë dans la classification zoologique d’Aristote, tandis qu’Ésope et Phèdre ont tiré argument de cette forme d’hybridité pour construire des fables à la morale par ailleurs contradictoire. Par contre, Pline en fit un oiseau. On verra ici comment cet héritage complexe fut transmis au Moyen Âge et intégré dans la littérature savante – d’abord les écrits des Pères de l’Église, puis essentiellement la littérature didactique (bestiaires et encyclopédies) et succinctement, les fables. On constatera ainsi que l’interprétation symbolique dont elle fut l’objet dans ce cadre atteste d’une double valorisation, à la fois positive et négative. Il appert toutefois d’après certains indices – notamment iconographiques – que dans les faits, la chauve-souris fut diabolisée et pourchassée par le peuple. Face à ces divergences en termes de perception, on tentera de comprendre les raisons qui ont fait que ce drôle d’oiseau a occupé une place à ce point particulière dans l’imaginaire médiéval.
Is action video gaming related to sustained attention of adolescents?
Authors: Trisolini Daniela Carmen , Petilli Marco Alessandro , Daini Roberta
Published: March 2017

Over the past few years, an increasing number of studies have shown that playing action video games can have positive effects on tasks that involve attention and visuo-spatial cognition (e.g., visual search, enumeration tasks, tracking multiple objects). Although playing action video games can improve several cognitive functions, the intensive interaction with the exciting, challenging, intrinsically stimulating and perceptually appealing game environments may adversely affect other functions, including the ability to maintain attention when the level of stimulation is not as intense. This study investigated whether a relationship existed between action video gaming and sustained attention performance in a sample of 45 Italian teenagers. After completing a questionnaire about their video game habits, participants were divided into Action Video Game Player (AVGP) and Non–Action Video Game Player (NAVGP) groups and underwent cognitive tests. The results confirm previous findings of studies of AVGPs as they had significantly enhanced performance for instantly enumerating a set of items. Nevertheless, we found that the drop in performance over time, typical of a sustained attention task, was significantly greater in the AVGP compared with the NAVGP group. This result is consistent with our hypothesis and demonstrates a negative effect of playing action video games.
Grammatical-gender effects in noun–noun compound production: Evidence from German
Authors: Lorenz Antje , Mädebach Andreas , Jescheniak Jörg D
Published: March 2017

We examined how noun–noun compounds and their syntactic properties are lexically stored and processed in speech production. Using gender-marked determiner primes ( dermasc, diefem, dasneut [the]) in a picture naming task, we tested for specific effects from determiners congruent with either the modifier or the head of the compound target (e.g., Teemasckannefem [teapot]) to examine whether the constituents are processed independently at the syntactic level. Experiment 1 assessed effects of auditory gender-marked determiner primes in bare noun picture naming, and Experiment 2 assessed effects of visual gender-marked determiner primes in determiner–noun picture naming. Three prime conditions were implemented: (a) head-congruent determiner (e.g., diefem), (b) modifier-congruent determiner (e.g., dermasc), and (c) incongruent determiner (e.g., dasneuter). We observed a facilitation effect of head congruency but no effect of modifier congruency. In Experiment 3, participants produced novel noun–noun compounds in response to two pictures, demanding independent processing of head and modifier at the syntactic level. Now, head and modifier congruency effects were obtained, demonstrating the general sensitivity of our task. Our data support the notion of a single-lemma representation of lexically stored compound nouns in the German production lexicon.
Memory demands in linguistic compensation
Authors: Medimorec Srdan , Mander Chandeep , Risko Evan F
Published: March 2017

Individuals often modify speech characteristics to accommodate their listeners. In the present study, we investigate how speakers modify their speech in a dictation task and what this says about their beliefs with respect to the listener’s information processing limitations. To do so, we asked participants to either read a set of numbers aloud, or dictate numbers so that another person could write them down. Our results suggest that speech modification in this task was not related to individual differences in working memory capacity, and could represent speakers’ attempt to minimize working memory demands of the listener. This account is similar to minimal memory strategies, whereby individuals often try to minimize memory demands in cognitive tasks.
The Employed Neurosurgeon: Essential Lessons
Authors: Benzil Deborah L. , Zusman Edie E.
Published: March 2017

Neurosurgeons are highly specialized surgeons whose pride is mastery of the complexity of form and function that is the nervous system and then knowing when and how these require surgical intervention. Following years of arduous postgraduate education, neurosurgeons enter the world of practice that is not only daunting in its intricacies of regulations, mandates, and unknown business practices, but also changing at a meteoric pace. Overwhelmingly, graduating residents and fellows are choosing to practice as employed physicians, a trend that is new in its magnitude and also changed because of the rapid evolution of large health systems. Case studies of challenges other employed surgical specialists have faced can provide critical and important education for any neurosurgeon in this arena. As with the lessons of all case studies, the teachings are remarkably universal, but how those lessons apply to an individual's specific situation will require personalized adaptation.
Creating Leverage to Counter Threats to Neurosurgical Practice
Authors: Dyer E. Hunter
Published: March 2017

This article describes guiding principles utilized in practice. It is descriptive of the evolution of one of the largest neurosurgical practices in the United States. The objective is to identify and effectively create leverage in neurosurgical practice and to describe principles instrumental in the growth of this practice.

Methods included data collection, responsiveness, recruitment, and innovation. Results demonstrate important strategies for creating and maintaining leverage, as well as principles that have enabled the practice to remain independent and continue to provide high-quality care.

In conclusion, it is important to stay focused on potential sources of leverage, to gain advantage for the future, and maintain stability as healthcare changes occur. Quality data and outcomes will allow practice to continue to grow strategically.
A Direct Experience in a New Accountable Care Organization: Results, Challenges, and the Role of the Neurosurgeon
Authors: Kim Dong H. , Lloyd Christopher , Fernandez Douglas K. , Spielman Amanda , Bradshaw David
Published: March 2017

The passage of the Affordable Care Act saw the creation of Accountable Care Organizations (ACOs), a new approach to healthcare delivery moving from fee-for-service toward population health. This paper presents a case study of the Memorial Hermann ACO (MHACO), launched in response to the Medicare Shared Savings Program, with goals to align physician and hospital incentives, practice evidence-based medicine, develop care coordination, and increase efficiency. Building blocks included an affiliated primary care network, a clinical integration program (involving shared electronic medical record platforms and quality data reporting), and significant investments in information technology. Presented is the approach taken to form MHACO; the management structure, technology developed, and a 2-year experience. Incorporated in July 2012, the MHACO involved 22 000 Medicare patients. In 2015, Centers for Medicare and Medicaid Services released data showing a composite quality score between 80 and 85 (from a maximum 100) and nearly $53 million in total savings (or 11% of expected expenditure), making MHACO one of the most successful nationally.
1
In fewer than 5 years, almost 500 ACOs have developed, and by some estimates, a quarter of Medicare patients are currently enrolled in an ACO. Although ACOs to date have focused on primary care, the future will increasingly involve specialists. At Memorial Hermann, neurosurgeons took an early role in forming collaborative partnerships with the hospital, and started programs that served as precursors to the ACO model. This paper ends with an overview of ACO development, likely changes going forward, and a discussion of the role of specialists in general, and of neurosurgeons in particular.
Expandable vs Static Cages in Transforaminal Lumbar Interbody Fusion: Radiographic Comparison of Segmental and Lumbar Sagittal Angles
Authors: Yee Timothy J. , Joseph Jacob R. , Terman Samuel W. , Park Paul
Published: March 2017

BACKGROUND: One criticism of transforaminal lumbar interbody fusion (TLIF) is the inability to increase segmental lordosis (SL). Expandable interbody cages are a relatively new innovation theorized to allow improvement in SL.

OBJECTIVE: To compare changes in SL and lumbar lordosis (LL) after TLIF with nonexpandable vs expandable cages.

METHODS: We performed a retrospective cohort study of patients who were ≥18 years old and underwent single-level TLIF between 2011 and 2014. Patients were categorized by cage type (static vs expandable). Primary outcome of interest was change in SL and LL from preoperative values to those at 1 month and 1 year postoperatively.

RESULTS: A total of 89 patients were studied (48 nonexpandable group, 41 expandable group). Groups had similar baseline characteristics. For SL, median (interquartile range) improvement was 3° for nonexpandable and 2° for expandable (unadjusted, P = .09; adjusted, P = .68) at 1 month postoperatively, and 3° for nonexpandable and 1° for expandable (unadjusted, P = .41; adjusted, P = .28) at 1 year postoperatively. For LL, median improvement was 1° for nonexpandable and 2° for expandable (unadjusted, P = .20; adjusted, P = .21), and 2° for nonexpandable and 5° for expandable (unadjusted, P = .15; adjusted, P = .51) at 1 year postoperatively. After excluding parallel expandable cages, there was still no difference in SL or LL improvement at 1 month or 1 year postoperatively between static and expandable cages (both unadjusted and adjusted, P > .05).

CONCLUSION: Patients undergoing single-level TLIF experienced similar improvements in SL and LL regardless of whether nonexpandable or expandable cages were placed.
Infections in Hematopoietic Cell Transplant Recipients: Results From the Organ Transplant Infection Project, a Multicenter, Prospective, Cohort Study
Authors: Schuster Mindy G. , Cleveland Angela A. , Dubberke Erik R. , Kauffman Carol A. , Avery Robin K. , Husain Shahid , Paterson David L. , Silveira Fernanda P. , Chiller Tom M. , Benedict Kaitlin , Murphy Kathleen , Pappas Peter G.
Published: March 2017

Background

Infection is a major cause of morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT). Our object was to better define the epidemiology and outcomes of infections after HCT.

Methods

This was a prospective, multicenter cohort study of HCT recipients and conducted from 2006 to 2011.

The study included 4 US transplant centers and 444 HCT recipients. Data were prospectively collected for up to 30 months after HCT using a standardized data collection tool.

Results

The median age was 53 years, and median follow up was 413 (range, 5–980) days. The most common reason for HCT was hematologic malignancy (87%). The overall crude mortality was 52%. Death was due to underlying disease in 44% cases and infection in 21%. Bacteremia occurred in 231 (52%) cases and occurred early posttransplant (median day 48). Gram-negative bloodstream infections were less frequent than Gram-positive, but it was associated with higher mortality (45% vs 13%, P = .02). Clostridium difficile infection developed in 148 patients (33%) at a median of 27 days post-HCT. There were 53 invasive fungal infections (IFIs) among 48 patients (11%). The median time to IFI was 142 days. Of 155 patients with cytomegalovirus (CMV) infection, 4% had CMV organ involvement. Varicella zoster infection (VZV) occurred in 13 (4%) cases and was disseminated in 2. Infection with respiratory viruses was seen in 49 patients. Pneumocystis jirovecii pneumonia was rare (1%), and there were no documented cases of nocardiosis, toxoplasmosis, endemic mycoses, or mycobacterial infection. This study lacked standardized antifungal and antiviral prophylactic strategies.

Conclusions

Infection remains a significant cause of morbidity and mortality after HCT. Bacteremias and C difficile infection are frequent, particularly in the early posttransplant period. The rate of IFI is approximately 10%. Organ involvement with CMV is infrequent, as are serious infections with VZV and herpes simplex virus, likely reflecting improved prevention strategies.
Reduced Meloidogyne ethiopica Parasitism in Vitis vinifera Grafted on Six Resistant Rootstocks Under Field and Greenhouse Conditions
Authors: Magunacelaya J. C. , Mancilla R. , González-Bernal S.
Published: March 2017

Meloidogyne ethiopica, an aggressive nematode, causes significant economic losses to Vitis crops. Rootstocks can successfully manage phytoparasitic nematodes. However, no studies exist on M. ethiopica-resistant rootstocks under field conditions. This study assessed the resistance of six Vitis rootstocks to M. ethiopica under field and greenhouse conditions. The number of galls and eggs in vine roots, quantity of second stage juveniles and males in 250 ml of soil, root weight, and shoot weight were determined for the Harmony, SO4, 101-14 MG, 110R, 3309C, and Kober 5BB rootstocks, and the own-root Chardonnay variety as a control. In the field, Harmony, SO4, 101-14 MG, Kober 5BB, and 110R were highly resistant to nematode parasitism and reproduction. In turn, 3309C was the least resistant rootstock. In the greenhouse, all rootstocks similarly limited M. ethiopica attack and reproduction. In both conditions, Chardonnay was the most susceptible vine to nematode attack, with high quantities of galls, eggs, and nematode reproduction. In conclusion, most of the evaluated rootstocks reduced M. ethiopica parasitism. Harmony, SO4, 101-14 MG, 110R, and Kober 5BB rootstocks are options for vineyard use, with final selection dependent on winegrower requirements.
Functional Outcomes Post Lisfranc Injury—Transarticular Screws, Dorsal Bridge Plating or Combination Treatment?
Authors: Lau Simon , Guest Catherine , Hall Marcus , Tacey Mark , Joseph Samuel , Oppy Andrew
Published: March 2017

Objective:

To identify whether transarticular screws, dorsal bridging plates or a combination of the 2 result in the best functional outcome after Lisfranc injury.

Design:

Case series.

Setting:

Level one trauma center.

Patients:

Fifty patients who underwent surgical fixation of Lisfranc injuries over a 6-year period were retrospectively reviewed.

Intervention:

One of 3 treatment arms: transarticular screw fixation alone, dorsal bridge plating alone or a combination of dorsal bridge and transarticular screw fixation.

Main Outcome Measures:

The primary outcome measures were 1 of 2 midfoot scores—the American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Score and the Foot Function Index (FFI) Score. Secondary results included postoperative complications.

Results:

Quality anatomical reduction is the best predictor of functional outcomes (FFI—P = 0.008, AOFAS—P = 0.02). Functional outcomes with both FFI and AOFAS scores were not significantly associated with any of the fixation groups (FFI—P = 0.495, AOFAS—P = 0.654) on univariate analysis. Injury type by Myerson classification systems or open versus closed status was also not significantly associated with any fixation group. Open exposures were more likely to result in soft-tissue complications, but there was no significant difference in metalware failure or need for removal.

Conclusion:

Functional outcomes after Lisfranc fractures are most dependant on the quality of anatomical reduction and not the choice of fixation implant used.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
A Preliminary Report: Radical Surgery and Stem Cell Transplantation for the Treatment of Patients With Pancreatic Cancer
Authors: Omazic Brigitta , Ayoglu Burcu , Löhr Matthias , Segersvärd Ralf , Verbeke Caroline , Magalhaes Isabelle , Potacova Zuzana , Mattsson Jonas , Terman Alexei , Ghazi Sam , Albiin Nils , Kartalis Nikolaos , Nilsson Peter , Poiret Thomas , Zhenjiang Liu , Heuchel Rainer , Schwenk Jochen M. , Permert Johan , Maeurer Markus J. , Ringden Olle
Published: March 2017

We examined the immunologic effects of allogeneic hematopoietic stem cell transplantation (HSCT) in the treatment of pancreatic ductal adenocarcinoma, a deadly disease with a median survival of 24 months for resected tumors and a 5-year survival rate of 6%. After adjuvant chemotherapy, 2 patients with resected pancreatic ductal adenocarcinoma underwent HSCT with HLA-identical sibling donors. Comparable patients who underwent radical surgery, but did not have a donor, served as controls (n=6). Both patients developed humoral and cellular (ie, HLA-A*01:01-restricted) immune responses directed against 2 novel tumor-associated antigens (TAAs), INO80E and UCLH3 after HSCT. Both TAAs were highly expressed in the original tumor tissue suggesting that HSCT promoted a clinically relevant, long-lasting cellular immune response. In contrast to untreated controls, who succumbed to progressive disease, both patients are tumor-free 9 years after diagnosis. Radical surgery combined with HSCT may cure pancreatic adenocarcinoma and change the cellular immune repertoire capable of responding to clinically and biologically relevant TAAs.
Clinical Use and Optimal Cutoff Value of Ca15-3 in Evaluation of Adnexal Mass
Authors: Sagi-Dain Lena , Lavie Ofer , Auslander Ron , Sagi Shlomi
Published: March 2017

Objective:

To estimate the diagnostic performance and reference values of serum cancer antigen (Ca)15-3 levels in the triage of adnexal masses.

Materials and Methods:

This retrospective cohort study was carried out in 481 patients referred to the Gynecology Department at Carmel Medical Center due to adnexal mass between years 2005 and 2012. All patients underwent surgery with histopathologically confirmed diagnosis and routine preoperative measurements of serum Ca125 and Ca15-3.

Results:

Combination of Ca125 with Ca15-3 elevated the sensitivity of Ca125 alone (from 86.9% to 93.2%; P=0.029), along with reduction of its specificity (from 80.5% to 69.5%; P=0.005) in differentiation between malignant and benign cases. According to receiver operating characteristic curve, Ca15-3 level of 21 U/mL was shown to be the optimal reference value for malignancy detection. All cases with Ca15-3 levels above 44.5 U/mL were malignant, mostly of primary ovarian source.

Conclusions:

As Ca15-3 assessment allowed detection of significantly more malignancy cases, we believe that measurement of this marker in combination with Ca125 is worthwhile in patients presenting with adnexal masses. The cutoff of 21 U/mL seems to be the optimal value in this specific population. High Ca15-3 levels (above 44.5 U/mL) strongly direct to a diagnosis of malignancy, mostly of primary ovarian tumors rather than breast malignancy.
Ethnicity, lipids and cardiovascular disease
Authors: Gazzola Katia , Reeskamp Laurens , van den Born Bert-Jan
Published: March 2017

Purpose of review

The prevalence of cardiovascular disease differs among ethnic groups and along geographic boundaries. At present, most of the projected increase in mortality from cardiovascular disease occurs in sub-Saharan African, Chinese and Southeast Asian populations. Ethnic disparities in the prevalence of cardiovascular disease coincide with quantitative and qualitative differences in risk factors for cardiovascular disease. High plasma cholesterol is one of the most important preventable causes of ischemic heart disease.

Recent findings

The current review summarizes recent evidence on ethnic differences in ischemic heart disease and its correlates with genetic and acquired differences in plasma lipid and lipoprotein levels. The nature of ethnic differences in plasma lipid levels, apolipoprotein L1 en lipoprotein(a) [Lp(a)] is outlined, and the effects of lipid-lowering therapy and future efforts and challenges regarding implementation are discussed.

Ethnic differences in HDL-cholesterol (HDL-C), triglyceride levels and Lp(a) may impact ethnic differences in cardiovascular disease and result in higher residual risk during lipid-lowering therapy. Further efforts should be made to stimulate the use of statins in both high-income and low-income countries and study their effects in individuals with different ethnic backgrounds.
Developments in intestinal cholesterol transport and triglyceride absorption
Authors: Paalvast Yared , de Boer Jan Freark , Groen Albert K.
Published: March 2017

Purpose of review

To discuss recent advances in research focused on intestinal lipid handling.

Recent findings

An important strategy in reducing atherosclerosis and risk of cardiovascular events is to increase the rate of reverse cholesterol transport, including its final step; cholesterol excretion from the body. The rate of removal is determined by a complex interplay between the factors involved in regulation of intestinal cholesterol absorption. One of these factors is a process known as transintestinal cholesterol excretion. This pathway comprises transport of cholesterol directly from the blood, through the enterocyte, into the intestinal lumen. In humans, this pathway accounts for 35% of cholesterol excretion in the feces. Mechanistic studies in mice revealed that, activation of the bile acid receptor farnesoid X receptor increases cholesterol removal via the transintestinal cholesterol excretion pathway as well as decreases plasma cholesterol and triglyceride providing an interesting target for treatment of dyslipidemia in humans. The physical chemical properties of bile acids are under control of farnesoid X receptor and determine intestinal cholesterol and triglyceride solubilization as well as absorption, providing a direct link between these two important factors in the pathogenesis of cardiovascular disease. Besides bile acids, intestinal phospholipids are important for luminal lipid solubilization. Interestingly, phospholipid remodeling through LPCAT3 was shown to be pivotal for uptake of fatty acids by enterocytes, which may provide a mechanistic handle for therapeutic intervention.

The importance of the intestine in control of cholesterol and triglyceride homeostasis is increasingly recognized. Recently, novel factors involved in regulation of cholesterol excretion and intestinal triglyceride and fatty acid uptake have been reported and are discussed in this short review.
Selection of promising strain of Lactobacillus for treating vaginal infections
Authors: Mogha Kanchan V. , Prajapati Jashbhai B.
Published: March 2017

Lactobacilli have been known to inhibit in-vitro growth of many organisms and have been used as probiotic to treat eclectic range of gastrointestinal and/or vaginal disorders. Four Lactobacillus strains, namely, Lactobacillus helveticus MTCC (Microbial Type Culture Collection) 5463, Lactobacillus rhamnosus MTCC 5462, L. rhamnosus (NS6) MTCC 5946, Lactobacillus fermentum (PD2) belonging to different species were analysed based on their properties, such as hydrophobicity, arginine deiminase assay, inhibitory effect of lactobacilli to some of the pathogenic microorganism indicator of bacterial vaginosis, ability to produce H2O2, lactic acid production, antibiotic susceptibility of lactobacilli against various antibiotics used for treating bacterial vaginosis, and reduction in pH of artificial vaginal fluid.
Nursing Interruptions in a Trauma Intensive Care Unit
Authors: Craker Nicole C. , Myers Robert A. , Eid Jessy , Parikh Priti , McCarthy Mary C. , Zink Kathy , Parikh Pratik J.
Published: March 2017

OBJECTIVE

The aims of this study were to identify and analyze elements that affect duration of an interruption and likelihood of activity switch as experienced by nurses in an ICU.

BACKGROUND

Although interruptions in the ICU impact patient safety, little is known regarding the complex situations that drive them.

METHODS

RNs were observed in a 23-bed surgical ICU. We observed 206 interruptions, and analyzed for duration and activity switch.

RESULTS

RNs were interrupted on the average every 21.8 minutes. Attending physicians/residents caused fewer, but longer, interruptions to the RN. Longer interruptions were more likely to result in an activity switch. During complex situations such as when an RN is documenting, interruptions by a physician led to longer durations. Interruptions by a device led to higher switches.

CONCLUSIONS

A deeper understanding of individual factors and their complex interactions related to interruptions experienced by ICU RNs are vital to understanding the clinical significance of these interruptions and intervention design.
Characteristics of Nurse Directors That Contribute to Registered Nurse Satisfaction
Authors: Burke Debra , Flanagan Jane , Ditomassi Marianne , Hickey Patricia A.
Published: March 2017

OBJECTIVE

The aim of this study was to explore RNs and nurse directors' (NDs') perceptions of leadership on units with high RN satisfaction scores.

BACKGROUND

Identifying the characteristics of NDs that contribute to RN satisfaction is important in the recruitment and retention of RNs and in the selection and role development of NDs.

METHODS

This study used a qualitative design using appreciative inquiry–guided data collection.

RESULTS

Nine RNs and 9 NDs met the inclusion criteria. Each group identified 4 themes.

CONCLUSIONS

Registered nurse and ND participants identified similar themes representative of leadership attributes and behaviors that contribute to RN satisfaction.
Differential Diagnosis in Neuroendocrine Neoplasms of the Larynx
Authors: Hunt Jennifer L. , Ferlito Alfio , Hellquist Henrik , Rinaldo Alessandra , Skálová Alena , Slootweg Pieter J. , Willems Stefan M. , Cardesa Antonio
Published: March 2017

The differential diagnosis of neuroendocrine neoplasms of the larynx is broad and includes lesions of epithelial, mesenchymal, and neuroectodermal origin. These lesions have overlapping clinical and pathologic aspects and must be carefully considered in the differential diagnosis of laryngeal neoplasms. The prognosis and treatment are also different among these tumor types, which necessitates making these distinctions clinically. The current literature was reviewed to provide updated information regarding the epithelial-derived tumors, including carcinoid, atypical carcinoid, small cell neuroendocrine carcinomas, large cell neuroendocrine carcinoma, and squamous cell carcinoma with neuroendocrine component. These tumors are compared and contrasted with non–epithelial-derived tumors such as paraganglioma and nonmucosal tumors, such as medullary thyroid carcinoma. The morphologic and cytologic features are discussed, along with helpful immunohistochemical and ancillary investigations.
Congenital cytomegalovirus infection: management update
Authors: Khalil Asma , Jones Chrissie , Ville Yves
Published: March 2017

Purpose of review

Until recently, management options in congenital cytomegalovirus (cCMV) infection have been either conservative or termination of pregnancy. However, medical therapies aimed at reducing the risk of infection and/or its severity have recently been investigated.

Recent findings

In a phase 2 open label, nonrandomized trial, valaciclovir (ValACV) was given to women carrying a CMV-infected fetus. ValACV was associated with a greater proportion of asymptomatic neonates when compared with a historical cohort (82 vs. 43%). However, the study design and the small number of treated women limit its applicability. Even though initial observational data suggested that hyperimmune globulin (HIG) therapy in pregnancy was associated with a significantly lower risk of cCMV, its efficacy has not been borne out in a subsequent phase 2 randomized, placebo controlled, double-blind study [cCMV 30% in the HIG group, 44% in the placebo group (P = 0.13)]. Furthermore, 11% of fetuses in the HIG group had transient or permanent abnormalities, compared with 16% in the placebo group.

ValACV might have a promising role in the antenatal treatment of cCMV infection, but definitive recommendations require further research. The use of HIG should currently be limited to the research setting.

Video abstract http://links.lww.com/COID/A18.
Dual-energy Computed Tomography for the Evaluation of Enhancement of Pulmonary Nodules≤3 cm in Size
Authors: Reiter Michael J. , Winkler Weston T. , Kagy Kenton E. , Schwope Ryan B. , Lisanti Christopher J.
Published: March 2017

Purpose:

The aim of the study was to compare the accuracies of 4 different methods of assessing pulmonary nodule enhancement to distinguish benign from malignant solid pulmonary nodules using nondynamic contrast-enhanced dual-energy computed tomography.

Materials and Methods:

Seventy-two patients (mean age, 62 y) underwent dual-energy chest computed tomography 3 minutes after intravenous contrast administration. Each of 118 pulmonary nodules (9±5.9 mm) were evaluated for enhancement by 4 methods: visual assessment, 3-dimensional automated postprocessing measurement tool, manually drawn region of interest with calculated iodine-related attenuation, and measurement of iodine concentration. The optimal cutoff for enhancement was defined as having the largest specificity among all cutoffs while maintaining 100% sensitivity. Accuracy of the methods was assessed with receiver operating characteristic curves.

Results:

Ninety-three of 118 pulmonary nodules were benign (79%). Visual assessment of enhancement had sensitivity and specificity of 100% and 44%, respectively. For the automated 3-dimensional measurement tool, 20 HU was found to be the optimal threshold for defining enhancement, resulting in a specificity of 71% and a sensitivity of 100%, as well as an area under the curve (AUC) of 0.87 (95% confidence interval [CI], 0.82-0.92). The AUC was 0.79 (95% CI, 0.73-0.85) for the measured enhancement using a manually drawn region of interest. When a threshold of 21 HU was used for defining enhancement, maximum specificity was obtained (56%) while maintaining 100% sensitivity. The AUC for measured iodine concentration was 0.79 (95% CI, 0.77-0.85). At a cutoff iodine concentration of 0.6 mg/mL, the sensitivity was 100% with a specificity of 57%.

Conclusions:

Although use of automated postprocessing had the highest specificity while maintaining 100% sensitivity, there were only minor clinically relevant differences between measurement techniques given that no single technique misclassified a malignant nodule as nonenhancing.