bluuebunny/crossref_metadata_2025 huggingface dataset:
Sistema de vacío con bolsa de orina, variación técnica
Authors: Chávez Gárate Walter , Camba Gonzalez Eva , Couceiro Otero Jose
Published: August 2017

En el presente trabajo se propone un método simple, económico y eficiente para la aplicación de la terapia de presión negativa en el tratamiento de heridas en cirugía de la mano. El procedimiento consiste en abrir el extremo distal de una bolsa colectora de orina, cortar su válvula interna, realizar la cobertura de la herida con esponjas, colocar un drenaje a través del tubo de la bolsa, sellar la bolsa y aplicar la presión negativa habitual. Esa variación para la colocación de la terapia de vacío, permite el tratamiento de heridas grandes y complejas en la mano, sobre todo aquellas que involucran los dedos, en las que obtener un sellado que no pierda el vacío, con los plásticos habituales, es complejo. Como ventaja adicional, se puede controlar la vascularización local al ser una bolsa transparente. También es posible realizar movilización y/o rehabilitación tempranas incluso con la terapia funcionando. Las posibles complicaciones son principalmente el realizar vacío sobre piel sana y la rara pero posible reacción local alérgica. Esa es una modificación técnica muy útil y fácil de realizar para obtener un vacío adecuado en una localización compleja.
Retracción de los dedos y síndrome de túnel carpiano secundarios a infiltración gotosa de tendones flexores de la mano
Authors: Rodríguez Pérez E. , González Porto S. , Álvarez Jorge A.
Published: August 2017

Presentamos un caso de afectación gotosa de los tendones flexores de la mano a nivel de la zona IV flexora, en un paciente con clínica compresiva de nervio mediano y retracción de los dedos largos de la mano. Se realiza una revisión de la gota como etiología de síndrome de túnel del carpo secundario y retracción de los dedos largos, así como las distintas opciones de tratamiento tanto médico como quirúrgico.
Musculotendinous Disorders in the Lower Leg
Authors: Newman Joel
Published: August 2017

Musculotendinous injury in the lower leg is associated with a variety of athletic activities. Myotendinous strain is typically localized to the posterior calf muscles, with involvement of the medial head of gastrocnemius muscle most common. Nontraumatic soft tissue injuries of the lower leg, including muscle herniation, are less frequently imaged. Ruptured popliteal cysts and deep vein thrombosis are important differential considerations in the patient presenting with acute calf pain and swelling.
Musculotendinous Injuries: Sonographic-guided Interventions
Authors: Wood Jeffrey , Beaulieu Christopher
Published: August 2017

Musculotendinous injuries occur commonly in athletes of all levels and ages, leading to considerable missed game and practice time. Although most injuries heal well with conservative management, in appropriate circumstances, ultrasound-guided interventions are a safe, efficient, cost-effective, and readily available means of treatment that may help expedite return to play. This article describes the relevant anatomy and pathology of the musculotendinous unit and explains the decision-making process regarding percutaneous interventions. Through case examples, we discuss practical aspects of interventional techniques, sonographic approaches, and injectable materials including anti-inflammatory medications and platelet-rich plasma.
Musculotendinous Disorders in the Upper Extremity: Part 2. MRI of the Elbow, Forearm, Wrist, and Hand
Authors: Boutin Robert , Fritz Russell
Published: August 2017

Muscle and tendon injuries about the elbow and more distal aspect of the upper arm are commonly evaluated and characterized with magnetic resonance imaging. This article reviews our experience with muscle and tendon injury as well as denervation of muscles. We focus on abnormalities of the biceps and the triceps tendons about the elbow as well as abnormalities of the flexor and extensor tendons about the elbow, forearm, wrist, and hand. We also discuss and illustrate our experience with lacerations, crush injuries, and muscle hernias in the forearm.
Musculotendinous Disorders in the Upper Extremity: Part 1. MRI of the Shoulder and Upper Arm
Authors: Boutin Robert , Fritz Russell
Published: August 2017

Muscle and tendon injuries about the shoulder and upper arm are commonly evaluated and characterized with magnetic resonance imaging. This article reviews our experience with abnormalities of the rotator cuff tendons and muscles as well as the deltoid muscle in the shoulder. We discuss and illustrate abnormalities of the upper arm such as strain injuries of the pectoralis major, strain injuries of the teres major and latissimus dorsi, and contusion and crush injuries of the biceps and brachialis muscles in the upper arm.
Effectiveness of computer-aided diagnosis of colorectal lesions using novel software for magnifying narrow-band imaging: a pilot study
Authors: Tamai Naoto , Saito Yutaka , Sakamoto Taku , Nakajima Takeshi , Matsuda Takahisa , Sumiyama Kazuki , Tajiri Hisao , Koyama Ryosuke , Kido Shoji
Published: August 2017

Background and study aims Magnifying narrow-band imaging (M-NBI) enables detailed observation of microvascular architecture and can be used in endoscopic diagnosis of colorectal lesion. However, in clinical practice, differential diagnosis and estimation of invasion depth of colorectal lesions based on M-NBI findings require experience. Therefore, developing computer-aided diagnosis (CAD) for M-NBI would be beneficial for clinical practice. The aim of this study was to evaluate the effectiveness of software for CAD of colorectal lesions.

Materials and methods In collaboration with Yamaguchi University, we developed novel software that enables CAD of colorectal lesions using M-NBI images. This software for CAD further specifically divides original Sano’s colorectal M-NBI classification into 3 groups (group A, capillary pattern [CP] type I; group B, CP type II + CP type IIIA; group C, CP type IIIB), which describe hyperplastic polyps (HPs), adenoma/adenocarcinoma (intramucosal [IM] to submucosal [SM]-superficial) lesions, and SM-deep lesions, respectively. We retrospectively reviewed 121 lesions evaluated using M-NBI.

Results The 121 reviewed lesions included 21 HP, 80 adenoma/adenocarcinoma (IM to SM-superficial), and 20 SM-deep lesions. The concordance rate between the CAD and the diagnosis of the experienced endoscopists was 90.9 %. The sensitivity, specificity, positive and negative predictive values, and accuracy of the CAD for neoplastic lesions were 83.9 %, 82.6 %, 53.1 %, 95.6 %, and 82.8 %, respectively. The values for SM-deep lesions were 83.9 %, 82.6 %, 53.1 %, 95.6 %, and 82.8 %, respectively.

Conclusion Relatively high diagnostic values were obtained using CAD. This software for CAD could possibly lead to a wider use of M-NBI in the endoscopic diagnosis of colorectal lesions.
Interdisziplinäre Empfehlungen zur Behandlung des metastasierten Nierenzellkarzinoms
Authors: Miller Kurt , Bergmann Lothar , Doehn Christian , Gschwend Jürgen , Keilholz Ulrich
Published: August 2017

Die Prognose von Patienten mit einem metastasierten Nierenzellkarzinom (mRCC) hat sich dank zielgerichteter Substanzen deutlich verbessert. Überlebenszeiten von mehr als 2 Jahren sind realistisch. Die Fortschritte zeigen sich auch darin, dass zunehmend Therapieoptionen in Dritt- und weiteren Linien thematisiert werden.

Sunitinib, Pazopanib, die Kombination Bevacizumab+Interferon-alpha sowie Temsirolimus sind für die Erstlinie beim mRCC zugelassen. Sunitinib und Pazopanib haben eine Zulassung auch für die Zweitlinientherapie – für Pazopanib ist diese auf den Einsatz nach Zytokinen beschränkt. Everolimus (nach Therapie mit einem Tyrosinkinase-Inhibitor; TKI), Axitinib (nach Sunitinib- oder Zytokintherapie) sowie Sorafenib (nach Zytokintherapie) sind weitere Wirkstoffe für die Zweitlinien-Therapie.

In der Zweitlinientherapie gab es 3 Neuzulassungen: Nach Versagen einer gegen VEGF gerichteten Therapie können nun Nivolumab, Cabozantinib und Lenvatinib in Kombination mit Everolimus eingesetzt werden. Damit stehen zum ersten Mal eine zielgerichtete Immuntherapie und eine Kombination zielgerichteter Substanzen beim mRCC zur Verfügung.

Zur Frage nach der optimalen Sequenztherapie gibt es keine neuen Erkenntnisse. Bisher liegen Ergebnisse einer Phase-III-Studie vor, in der die geprüften Sequenzen Sorafenib-Sunitinib und Sequenz Sunitinib-Sorafenib gleichwertig waren.

Ziel eines interdisziplinären RCC-Expertengesprächs war es, gemeinsame Therapieempfehlungen auf Basis der aktuell publizierten Daten und der eigenen klinischen Erfahrung zu erarbeiten und für den Praxisalltag abzuleiten. Die Ergebnisse werden in dieser Publikation vorgestellt.
c-Met Onkogen bei Nierenzellkarzinomen
Authors: Erlmeier Franziska , Weichert W. , Autenrieth M. , Ivanyi P. , Hartmann A. , Steffens S.
Published: August 2017

c-Met spielt eine bedeutende Rolle in einer Vielzahl zellulärer Prozesse. Als Protoonkogen unterstützt die Tyrosinkinase aggressives Tumorverhalten, wie z. B. invasives Tumorwachstum und Metastasenbildung. Für einige Subtypen des Nierenzellkarzinoms (NZK) zeigt sich ein mehrfach belegter Zusammenhang zwischen der Höhe der c-Met Expression und dem Krankheitsverlauf bzw. der Prognose. c-Met stellt somit beim NZK einen prognostischen Marker dar.

Darüber hinaus wird c-Met in der Ära der personalisierten Medizin als möglicher Angriffspunkt gezielter Therapien eine bedeutende Rolle spielen. Vor allem beim klarzelligen NZK erlangt die duale VEGF und c-Met Tyrosinkinase-Hemmung bei metastasierten, therapierefraktären Tumoren zunehmend klinische Relevanz. Die Bedeutung von c-Met ist bis dato noch nicht gänzlich für alle Subtypen des NZK geklärt. Die Relevanz von c-Met bei den übrigen NZK gilt es noch abschließend zu klären.
Status quo: Immuntherapie in der Uroonkologie
Authors: Jentzmik Florian
Published: August 2017

Das Jahr 2016 markiert das Jahr der Immunonkologie bei urologischen Tumoren. Es wurde als erster Vertreter der Immuncheckpoint-Inhibitoren bei uroonkologischen Tumoren der PD-1-Antikörper Nivolumab beim fortgeschrittenen Nierenzellkarzinom in der zweiten Therapielinie (nach „Vortherapie“) zugelassen. Grundlage für die Zulassung von Nivolumab waren Daten der Phase-III-Studie CheckMate-025, in der Nivolumab im Vergleich zu Everolimus bei Patienten mit fortgeschrittenem klarzelligen Nierenzellkarzinom (RCC) nach Vortherapie mit einem Angiogeneseinhibitor untersucht wurde. Für den PD-1-Antikörper wurden eine höhere Remissionsrate (25 % vs. 5 %) und eine Verlängerung des Gesamtüberlebens um 5,4 Monate im Vergleich zu Everolimus analysiert.

In den USA wurde zudem der Anti-PD-1-Antikörper Atezolizumab beim metastasierten Urothelkarzinom nach platinbasierter Chemotherapie zugelassen. Ausschlaggebend dafür waren Phase-II-Daten der IMvigor-210-Studie, die eine Gesamtansprechrate von 15 % belegt. Das mediane Gesamtüberleben (mOS) betrug 7,9 Monate in der Gesamtpopulation.

Die Substanzgruppe der Immuncheckpoint-Inhibitoren zeichnet sich durch geringe Nebenwirkungen aus. Derzeit werden in zahlreichen Phase-III-Studien Immuncheckpoint-Inhibitoren geprüft, um bisherige Erstlinien-Standardtherapien bei metastasierten urologischen Tumoren abzulösen.
Herausforderungen für den Urologen in der Betreuung von Patienten mit Lynch-Syndrom am Beispiel eines Patienten mit Muir Torre-Syndrom als Unterform des Lynch-Syndroms
Authors: Löhmann C. , Kächele V. , Martinschek A. , Sparwasser C.
Published: August 2017

Das Muir-Torre Syndrom (MTS) stellt eine Variante des Lynch-Syndroms (LS) dar, die neben den typischen mit LS-assoziierten Malignomen zusätzlich mit Talgdrüsentumoren oder Keratoakanthomen einhergeht. Das MTS ist meist mit einer Mutation von MSH2 verknüpft. Vergleicht man die Mutationen der Gene MLH1, MSH6, PMS2 und MSH2 die im Zusammenhang mit dem Lynch-Syndrom beschrieben sind, zeigt sich vor allem bei MSH2 eine Häufung von urologischen Tumoren. Die Rolle des behandelnden Urologen beinhaltet die frühzeitige Detektion eines möglichen hereditären Hintergrunds bei jüngeren Patienten mit Tumoren der ableitenden Harnwege oder auffälliger Familienanamnese. Darüber hinaus ist der behandelnde Urologe involviert in die Überwachung von Mutationsträgern mit sehr hohem Risiko einer malignen Erkrankung der ableitenden Harnwege, hier vor allem Männern mit bekannter MSH2-Mutation.

Wir berichten über einen Patienten, der an einer Vielzahl von typischerweise mit Lynch-Syndrom assoziierten Tumoren sowie Tumoren mit unklarem Zusammenhang zum LS erkrankte und im Verlauf der Erkrankung an multifokalen Metastasen eines Urothelkarzinoms verstarb. Die Kasuistik zeigt exemplarisch die wichtige Bedeutung einer engen interdisziplinären Zusammenarbeit in der Betreuung von Patienten mit komplexen Erkrankungen.
Was ist ein Muss in der präoperativen Diagnostik vor elektiver Endoprothetik?
Authors: Haas Holger , Weber Christian
Published: August 2017

Hintergrund Im Vorfeld einer elektiven Endoprothesenimplantation sind diagnostische Maßnahmen erforderlich. Diese haben das Ziel, die patientenbezogene und eingriffsbezogene Risikokonstellation zu erfassen und durch die Einleitung geeigneter prä- und perioperativer Maßnahmen mögliche Komplikationen zu vermeiden bzw. deren Auftretenswahrscheinlichkeit zu reduzieren. Daneben dient die klinische und bildgebende Untersuchung des Patienten der Indikationsstellung zum Eingriff, die jedoch nicht Thema des vorliegenden Beitrags ist.

Ziel der Arbeit Die aktuelle Literatur zur präoperativen Diagnostik vor elektiven endoprothetischen Eingriffen wurde analysiert.

Methode Eine selektive Literaturrecherche wurde durchgeführt.

Ergebnisse Wir identifizierten studienbasierte Empfehlungen hinsichtlich (1) präoperativer Anämie, (2) Optimierung der Stoffwechsellage, (3) Gewichtskontrolle, (4) Schlafapnoesyndrom, (5) MRSA-Problematik und Hautdekontamination, (6) Harnwegsinfektion, (7) dentales Screening, (8) kardiologischer Diagnostik, (9) technisch-planerischen Vorbereitungen, insbesondere der Revisionsendoprothetik.

Schlussfolgerung Auch wenn nicht zu allen präoperativen diagnostischen Maßnahmen belastbare evidenzbasierte Empfehlungen vorliegen, bestehen bereits klare Anforderungen an die präoperative Diagnostik elektiver Patienten vor endoprothetischen Eingriffen. Die zunehmende Fokussierung auf erweiterte Maßnahmen im Rahmen des perioperativen Managements wird den Umfang notwendiger Untersuchungen im Vorfeld dieser Operationen erhöhen.
Low-temperature magnetoresistance of GaSb whiskers
Authors: Druzhinin A. , Ostrovskii I. , Khoverko Yu. , Liakh-Kaguy N.
Published: August 2017

Transverse and longitudinal magnetoresistancies in n-type GaSb whiskers with different doping concentration (Te) in the vicinity to the metal-insulator transition (MIT) from metal side of the transition were studied in the temperature range 1.5–60 K and magnetic field 0–14 T. Shubnikov-de Haas oscillations in GaSb whiskers at low temperatures were revealed in magnetic field range 2–12 T. The oscillation period 0.025T−1 was found at various doping concentration in GaSb whiskers. The effective mass of electrons mc = 0.041m0 and Dingle temperature of about 7.5 K were found in GaSb whiskers with impurity concentration in the vicinity to MIT. The presence of negative magnetoresistance in GaSb whiskers with the impurity concentration in the nearest approximation to MIT with resistivity ρ300 K = 0.0053 Ω cm was observed and associated with weak localization. Besides for the whiskers a resistance minimum was observed at temperature about 16 K that is connected with Kondo effect. Magnetoresistance studies of n-type conductivity for GaSb whiskers revealed the crossover from weak localization to antilocalization in the temperature range of 1.4–4.2 K and magnetic fields below 1 T.
Variable range hopping in thin film with large dielectric constant
Authors: Shklovskii B. I.
Published: August 2017

In a film with large dielectric constant κ the electric field of an electron spreads inside the film before exiting the film at large distances of order of κd (d is the film width). This leads to the logarithmic Coulomb repulsion between electrons and modifies the shape of the Coulomb gap in the density of localized states in a doped film. As a result the variable range hopping conductivity in such a film has a peculiar temperature dependence, where the domain of the ln σ(T) ∝ (T0/T)p dependence, with the index p ≃ 0.7, is sandwiched between the two domains with p = 1/2.
Influence of freezing down to 77.15 K on structure and antioxidant power of some proteins
Authors: Rozanova S. L. , Narozhnyi S. V. , Nardid O. A.
Published: August 2017

The purpose of the present work was to investigate influence of different freeze-thawing protocols on structure and antioxidant properties of isolated proteins. In our experiments we have studied human serum albumin, human hemoglobin and cytochrome C derived from equine heart frozen down to 77.15 K with 1–2 deg/min and 300 deg/min rate with following thawing on a water bath at 293.15 K. Native proteins were assumed as a control. Influence of freeze-thawing protocols on protein structure was investigated using spectrophotometric and fluorescent assays. Antioxidant activities of isolated proteins were estimated by their ability to reduce ABTS+ radical. It has been established that unfolding derived from freeze-thawing exposure leads to protein antioxidant activity increasing while decreasing of such an activity may be connected with macromolecule aggregation. Character of freeze-thawing influence on antioxidant activity of proteins depends on molecule structure peculiarities and freezing protocols.
The study of chromium borate CrBO3 by optical and IR spectroscopy
Authors: Molchanova A. D. , Dobretsova E. A. , Kuzmin N. N. , Boldyrev K. N.
Published: August 2017

A complex study of the CrBO3 single crystal has been performed by optical and IR spectroscopy methods over a broad temperature range. Factor-group and correlation analyses of the phonon modes are presented. All IR active phonons and their frequencies are experimentally identified by way of attenuated total reflectance. A magnetic phase transition at a temperature of 6 K is detected. In the magnetically ordered state, an anisotropy of the optical spectrum was observed during polarization studies in the isotropic ab-plane of the crystal. A study of the temperature dependences of the phonon spectrum did not show any anomalies over the course of magnetic ordering, which indicates that there is an absence of an appreciable spin-lattice interaction in CrBO3.
The electric response in the wave of second sound: Hardware aspect
Authors: Rybalko A. S. , Chagovets T. V. , Korolev A. M.
Published: August 2017

A detailed description of the standard measuring techniques and original technical solutions used by the authors while studying the recently discovered phenomenon of electric response in the second sound wave. The most successful amplifier circuits used for precision low-temperature measurements are presented, as well as a sensitivity analysis of the different measuring systems. The main goal of the study is to substantiate the reliability of the electrical activity effect occurring in a resonator with He II when a second sound wave is excited. It is shown that the observed electric response signal is not associated with external interference or internal pick-ups, and is also not the result of either direct acoustoelectric conversion or thermal contact potentials. An analysis and comparison of new experimental data obtained by two scientific groups is also presented.
Negative ions in cryogenic media (Review Article)
Authors: Shikin V. , Nazin S.
Published: August 2017

We discuss localization of free electrons embedded in cryogenic media. These electrons do not bind to gas atoms within the confinement length of the order of the Bohr radius, but can participate in formation of “condensons”—many-particle complexes first introduced and studied by Lifshitz. The formalism is based on the construction of the interaction energy, W(a0, ng), between the electron and the gas medium. The functional form of W(a0, ng) is generally non-linear in the gas density ng and the details of the interaction between the electron and a single atom in the gas approximation are determined from the characteristic scattering length a0, which determines both the sign and strength of W(a0, ng). An explicit expression for W(a0, ng), allows for a uniform description of various effects based on formation of “condensons” of electronic origin observed in cryogenic media. These include formation of bubbles (“bubble effect”) for a0 > 0 and possibly alternative, charged gas density enhancement domains for a0 < 0, where electron plays a collectivizing role. The formalism is in qualitative agreement with direct measurements of the minimal energy Vinject (generally non-linear in ng) required to inject an electron into cryogenic media, as well as other experimental observations.
Embedded soliton dynamics in the asymmetric array of Josephson junctions
Authors: Starodub Ivan O. , Zolotaryuk Yaroslav
Published: August 2017

The dc-biased annular array of three-junction asymmetric superconducting quantum interference devices (SQUIDs) is investigated. The existence of embedded solitons (solitons that exist despite the resonance with the linear waves) is demonstrated both in the unbiased Hamiltonian limit and in the dc-biased and damped case on the current-voltage characteristics (CVCs) of the array. The existence diagram on the parameter plane is constructed. The signatures of the embedded solitons manifest themselves as inaccessible voltage intervals on the CVCs. The upper boundary of these intervals is proportional to the embedded soliton velocity.
First and second sounds in a degenerate Bose gas
Authors: Dmytruk I. , Svidzynskiy A. , Shygorin P.
Published: August 2017

In this work the propagation of sound waves in a degenerate quantum gas is considered. We modify the Wang Chang and Uhlenbeck method for description of the sounds in a Maxwell gas for the case of a degenerate quantum gas. Using this approach, we constructed a dispersion relation for sound waves in a condensed Bose gas at finite temperatures, and calculate the velocities of first and second sounds in the first approximation. The possibility of the theoretical investigation for sound damping is discussed.
Effect of the magnetic topology of a tokamak divertor on the power exhaust properties
Authors: Pericoli Ridolfini V. , Ambrosino R. , Calabrò G. , Crisanti F. , Lombroni R. , Mastrostefano S. , Rubino G. , Zagórski R.
Published: August 2017

The peculiarities of various advanced divertor magnetic configurations that could be adopted for a tokamak reactor are investigated with the 2D edge code TECXY applied to the different divertor options of the projected tokamak DTT (Divertor Test Tokamak). The analysis highlights very interesting features for those configurations that realize a wide region with significantly depressed poloidal field in between the main X point and the target. Here, the energy cross-field diffusion can become so fast to extend up to ≈10 times the width of the power flow channel, in terms of the poloidal flux coordinates. This can spread the power over a long length and then drop the peak heat load below the technologically safe value, even with no help from impurities. Furthermore, the strongly enlarged effective divertor volume can favour the dissipative processes and lead to plasma detachment from the associated target. The driving mechanism appears to rest on the strongly increased connection lengths. This reduces the parallel thermal gradient and then slows down the power streaming, hence forcing the flow channel to widen in order to convey the same amount of power. However, the other target can be significantly penalized by an unbalance in the power sharing between the two divertor plates. Similarly, modifying the topology of this region also could overcome this problem.
Dissociation dynamics of transient anion formed via electron attachment to sulfur dioxide
Authors: Gope K. , Prabhudesai V. S. , Mason N. J. , Krishnakumar E.
Published: August 2017

We report the molecular dynamics of dissociative electron attachment to sulfur dioxide (SO2) by measuring the momentum distribution of fragment anions using the velocity slice imaging technique in the electron energy range of 2–10 eV. The S− channel results from symmetric dissociation which exhibits competition between the stretch mode and bending mode of vibration in the excited parent anion. The asymmetric dissociation of parent anions leads to the production of O− and SO− channels where the corresponding neutral fragments are formed in their ground as well as excited electronic states. We also identify that internal excitation of SO− is responsible for its low yield at higher electron energies.
Probabilistic n/γ discrimination with robustness against outliers for use in neutron profile monitors
Authors: Uchida Y. , Takada E. , Fujisaki A. , Kikuchi T. , Ogawa K. , Isobe M.
Published: August 2017

A method to stochastically discriminate neutron and γ-ray signals measured with a stilbene organic scintillator is proposed. Each pulse signal was stochastically categorized into two groups: neutron and γ-ray. In previous work, the Expectation Maximization (EM) algorithm was used with the assumption that the measured data followed a Gaussian mixture distribution. It was shown that probabilistic discrimination between these groups is possible. Moreover, by setting the initial parameters for the Gaussian mixture distribution with a k-means algorithm, the possibility of automatic discrimination was demonstrated. In this study, the Student’s t-mixture distribution was used as a probabilistic distribution with the EM algorithm to improve the robustness against the effect of outliers caused by pileup of the signals. To validate the proposed method, the figures of merit (FOMs) were compared for the EM algorithm assuming a t-mixture distribution and a Gaussian mixture distribution. The t-mixture distribution resulted in an improvement of the FOMs compared with the Gaussian mixture distribution. The proposed data processing technique is a promising tool not only for neutron and γ-ray discrimination in fusion experiments but also in other fields, for example, homeland security, cancer therapy with high energy particles, nuclear reactor decommissioning, pattern recognition, and so on.
Numerical study of shear rate effect on unsteady flow separation from the surface of the square cylinder using structural bifurcation analysis
Authors: Ray Rajendra K. , Kumar Atendra
Published: August 2017

In this paper, an incompressible two-dimensional shear flow past a square cylinder problem is investigated numerically using a higher order compact finite difference scheme. Simulations are presented for three sets of Reynolds numbers, 100, 200, and 500, with various shear parameter (K) values ranging from 0.0 to 0.4. The purpose of the present study is to elaborate the influence of shear rate on the vortex shedding phenomenon behind the square cylinder. The results presented here show that the vortex shedding phenomenon strongly depends on Re as well as K. The strength and size of vortices shed behind the cylinder vary as a function of Re and K. When K is larger than a critical value, the vortex shedding phenomenon has completely disappeared depending on the Reynolds number. Apart from the numerical study, a thorough theoretical investigation has been done by using a topology based structural bifurcation analysis for unsteady flow separations from the walls of the cylinder. Through this analysis, we study the exact locations of the bifurcation points associated with secondary and tertiary vortices with appropriate non-dimensional time of occurrence. To the best of our knowledge, this is the first time, a topological aspect based structural bifurcation analysis has been done to understand the vortex shedding phenomenon and flow separation for this problem.
Mechanical oscillations in lasing microspheres
Authors: Toncelli A. , Capuj N. E. , Garrido B. , Sledzinska M. , Sotomayor-Torres C. M. , Tredicucci A. , Navarro-Urrios D.
Published: August 2017

We investigate the feasibility of activating coherent mechanical oscillations in lasing microspheres by modulating the laser emission at a mechanical eigenfrequency. To this aim, 1.5%Nd3+:Barium-Titanium-Silicate microspheres with diameters around 50 μm were used as high quality factor (Q > 106) whispering gallery mode lasing cavities. We have implemented a pump-and-probe technique in which the pump laser used to excite the Nd3+ ions is focused on a single microsphere with a microscope objective and a probe laser excites a specific optical mode with the evanescent field of a tapered fibre. The studied microspheres show monomode and multi-mode lasing action, which can be modulated in the best case up to 10 MHz. We have optically transduced thermally activated mechanical eigenmodes appearing in the 50–70 MHz range, the frequency of which decreases with increasing the size of the microspheres. In a pump-and-probe configuration, we observed modulation of the probe signal up to the maximum pump modulation frequency of our experimental setup, i.e., 20 MHz. This modulation decreases with frequency and is unrelated to lasing emission, pump scattering, or thermal effects. We associate this effect to free-carrier-dispersion induced by multiphoton pump light absorption. On the other hand, we conclude that, in our current experimental conditions, it was not possible to resonantly excite the mechanical modes. Finally, we discuss on how to overcome these limitations by increasing the modulation frequency of the lasing emission and decreasing the frequency of the mechanical eigenmodes displaying a strong degree of optomechanical coupling.
Development of non-metallic and conformal dual band meta-skin and its absorption study for microwave applications
Authors: Borah Dipangkar , Bhattacharyya Nidhi S.
Published: August 2017

An efficient approach for achieving a dual, conformal and non-metallic metamaterial absorber for microwave applications is proposed in this paper. The unit cell structures are simple circular ring resonators, made up of non-metallic and conducting expanded graphite, fabricated on a linear low density polyethylene substrate. The expanded graphite is synthesized, characterized and processed to be used as a conducting layer. The materials properties of linear low density polyethylene is investigated and found to be a promising candidate for flexible microwave applications. The developed absorber showed more than 90% absorption at 7.72 GHz and 9.92 GHz. Electric and magnetic fields are also simulated at the resonating frequency to understand the absorption mechanism. The proposed expanded graphite based metamaterial absorber possesses the advantages of being ultra-thin, flexible and non-corrosive.
ALADIN is required for the production of fertile mouse oocytes
Authors: Carvalhal Sara , Stevense Michelle , Koehler Katrin , Naumann Ronald , Huebner Angela , Jessberger Rolf , Griffis Eric R.
Published: August 2017

Asymmetric cell divisions depend on the precise placement of the spindle apparatus. In mammalian oocytes, spindles assemble close to the cell’s center, but chromosome segregation takes place at the cell periphery where half of the chromosomes are expelled into small, nondeveloping polar bodies at anaphase. By dividing so asymmetrically, most of the cytoplasmic content within the oocyte is preserved, which is critical for successful fertilization and early development. Recently we determined that the nucleoporin ALADIN participates in spindle assembly in somatic cells, and we have also shown that female mice homozygously null for ALADIN are sterile. In this study we show that this protein is involved in specific meiotic stages, including meiotic resumption, spindle assembly, and spindle positioning. In the absence of ALADIN, polar body extrusion is compromised due to problems in spindle orientation and anchoring at the first meiotic anaphase. ALADIN null oocytes that mature far enough to be fertilized in vitro are unable to support embryonic development beyond the two-cell stage. Overall, we find that ALADIN is critical for oocyte maturation and appears to be far more essential for this process than for somatic cell divisions.
Basolateral delivery of the type I transforming growth factor beta receptor is mediated by a dominant-acting cytoplasmic motif
Authors: Yin Xueqian , Kang Jeong-Han , Andrianifahanana Mahefatiana , Wang Youli , Jung Mi-Yeon , Hernandez Danielle M. , Leof Edward B.
Published: August 2017

Delivery of biomolecules to the correct subcellular locales is critical for proper physiological function. To that end, we have previously determined that type I and II transforming growth factor beta (TGF-β) receptors (TβRI and TβRII, respectively) localize to the basolateral domain in polarized epithelia. While TβRII targeting was shown to be regulated by sequences between amino acids 529 and 538, the analogous region(s) within TβRI is unknown. To address that question, sequential cytoplasmic TβRI truncations and point mutations identified a targeting motif between residues 158 and 163 (VxxEED) required for basolateral TβRI expression. Further studies documented that receptor internalization, down-regulation, direct recycling, or Smad signaling were unaffected by motif mutations that caused TβRI mislocalization. However, inclusion of amino acids 148–217 containing the targeting motif was able to direct basolateral expression of the apically sorted nerve growth factor receptor (NGFR, p75; extracellular and transmembrane regions) in a dominant manner. Finally, coexpression of apically targeted type I and type II TGF-β receptors mediated Smad3 signaling from the apical membrane of polarized epithelial cells. These findings demonstrate that the absence of apical TGF-β signaling in normal epithelia is primarily a reflection of domain-specific receptor expression and not an inability to couple with the signaling machinery.
A critical appraisal of guidelines for electronic communication between patients and clinicians: the need to modernize current recommendations
Authors: Lee Joy L , Matthias Marianne S , Menachemi Nir , Frankel Richard M , Weiner Michael
Published: August 2017

Background

Patient-provider electronic communication has proliferated in recent years, yet there is a dearth of published research either leading to, or including, recommendations that improve clinical care and prevent unintended negative consequences. We critically appraise published guidelines and suggest an agenda for future work in this area.

Objective

To understand how existing guidelines align with current practice, evidence, and technology.

Methods

We performed a narrative review of provider-targeted guidelines for electronic communication between patients and providers, searching Ovid MEDLINE, Embase, and PubMed databases using relevant terms. We limited the search to articles published in English, and manually searched the citations of relevant articles. For each article, we identified and evaluated the suggested practices.

Results

Across 11 identified guidelines, the primary focus was on technical and administrative concerns, rather than on relational communication. Some of the security practices recommended by the guidelines are no longer needed because of shifts in technology. It is unclear the extent to which the recommendations that are still relevant are being followed. Moreover, there is no guideline-cited evidence of the effectiveness of the practices that have been proposed.

Conclusion

Our analysis revealed major weaknesses in current guidelines for electronic communication between patients and providers: the guidelines appear to be based on minimal evidence and offer little guidance on how best to use electronic tools to communicate effectively. Further work is needed to systematically evaluate and identify effective practices, create a framework to evaluate quality of communication, and assess the relationship between electronic communication and quality of care.
Bacteremia and Skin Infections in Four Patients Caused by
Helicobacter-Like Organisms
Authors: Pérez-Santiago Josué , Ramirez-Gaona Miguel , Holm-Kennedy Robert , Smith Davey M , Fierer Joshua
Published: August 2017

Background

Enterohepatic Helicobacter-like organisms (HLO) have been recognized as causes of human infection since 1984, primarily as a cause of bacteremia and cellulitis in immunocompromised individuals, but the spectrum of illness due to HLO has expanded based on numerous reports from Japan.

Methods

We report 4 epidemiologically unrelated immunocompetent patients with HLO bacteremia diagnosed within a 2-year period. Three patients had cellulitis and 1 patient had unexplained fever. 16S ribosomal deoxyribonucleic acid (rDNA) sequence analysis of 2 isolates suggested that they were Helicobacter cinaedi, and whole-genome sequencing showed that they differed only slightly from reference strains.

Conclusions

We believe that this syndrome is more common than reported, but it is easily overlooked because the skin lesions resemble streptococcal cellulitis and respond very rapidly to β-lactam antibiotics, and the organism is difficult to isolate from the blood. All HLO in our series were isolated from blood using the ESP system and were not detected in 2 other widely used commercial blood culture systems.
Drug Use Is Associated With Purulent Skin and Soft Tissue Infections in a Large Urban Jail: 2011–2015
Authors: Szeto Betsy , Kaba Fatos , Herzig Carolyn T A , Befus Montina , Lowy Franklin D , Miko Benjamin A , Rosner Zachary , Larson Elaine L
Published: August 2017

Background

Skin and soft tissue infections (SSTIs) are a common problem in jails in the United States. This study aimed to identify factors associated with purulent SSTIs in the New York City jail system.

Methods

We conducted a case-control study of purulent SSTIs at the New York City jail. Cases were matched to controls by visit date to the jail’s urgent care clinic. Bivariate and multivariable analyses were conducted using conditional logistic regression.

Results

From April 2011 to April 2015, 1010 cases of SSTIs were identified and matched to 1010 controls. In multivariable analyses, report upon entry to jail of current injection drug use (odds ratio [OR], 2.76; 95% confidence interval [CI], 1.77–4.31), current snorting of drugs (OR, 1.50; 95% CI, 1.12–2.00), current heroin use (OR, 1.53; 95% CI, 1.08–2.17), current cocaine use (OR, 1.76; 95% CI, 1.18–2.65), and antibiotic use within the previous 6 months (OR, 4.05; 95% CI, 2.98–5.49) were significantly associated with SSTI diagnosis.

Conclusions

Skin and soft tissue infections were strongly associated with a history of drug use at jail entry. Targeting intravenous drug use may be a preventive strategy for SSTIs in this population. Strategies such as harm reduction programs may be investigated.
Validating Performance of a Hospital Discharge Planning Decision Tool in Community Hospitals
Authors: Holland Diane E. , Brandt Cheryl , Targonski Paul V. , Bowles Kathryn H.
Published: August 2017

Purpose of Study:

The Early Screen for Discharge Planning (ESDP) is a decision support tool developed in an urban academic medical center. High ESDP scores identify patients with nonroutine discharge plans who would benefit from early discharge planning intervention. We aimed to determine the predictive performance of the ESDP in a different practice setting.

Primary Practice Setting:

Rural regional community hospital.

Methodology and Sample:

We designed a comparative, descriptive survey study and enrolled a convenience sample of 222 patients (identified at admission) who provided informed consent. Sample characteristics and ESDP scores were collected during enrollment. The Problems After Discharge Questionnaire, EuroQoL-5Dimensions quality-of-life measure, length of stay, and use of post-acute care services were recorded after discharge. We compared outcomes between patients with low and high ESDP scores.

Results:

More than half of the sample (51.8%) had a high ESDP score. Patients with high ESDP scores reported more problems after discharge (p = .02), reported lower quality of life (p < .001), had longer length of stays (p = .04), and used post-acute care services (p = .006) more than patients with low ESDP scores. The difference in the average percentage of unmet needs was not statistically significant (p = .12), but patients with high ESDP scores reported more unmet needs than patients with low ESDP scores.

Implications for Case Management Practice:

The value of systematically proactive approaches to discharge planning is increasingly recognized, but establishing the performance capacity of support tools is critical for optimizing benefit. These study findings support use of the ESDP in regional community hospitals, making it a useful, open-source decision support tool for various health care delivery systems.
Planar Bone Scan Versus Computerized Tomography in Staging Locally Advanced Breast Cancer in Asymptomatic Patients: Does Bone Scan Change Patient Management Over Computerized Tomography?
Authors: Bansal Gaurav Jyoti , Vinayan Changaradil Deepthi
Published: August 2017

Aim

The Royal College of Radiologists guidelines from 2013 recommend that contrast-enhanced computerized tomography of chest, abdomen and pelvis (CT TAP) for breast cancer patients with suspected metastasis could obviate the need for bone scan in asymptomatic patients. The purpose of this study was to perform a head-to-head comparison of bone scan and CT scan in locally advanced breast cancer patients. The aim of this study was to evaluate the utility of planar bone scan in changing the stage or management of locally advanced breast cancer patients.

Methods

Between June 2006 and January 2016, 156 breast cancer patients had staging investigations (either CT and bone scans, bone scans only, or CT only). All images and reports on picture archiving and communication system were evaluated retrospectively.

Results

One hundred five of 156 patients had both CT TAP and bone scan within 10 days of each other. Of the total of 105 patients, 33 (31.4%) had concordant normal results on CT TAP and bone scan. There were 18/105 (17.1%) patients with extraosseous metastasis on CT with negative or inconclusive bone scan. Bone scans diagnosed peripheral osseous metastasis in 5/105 (4.7%), which were either skull or extremity metastasis outside CT TAP field of view. All of these 5 patients had other metastatic lesions within axial skeleton or soft tissues on CT and led to no change in patient management.

Conclusions

Our findings suggest routine use of bone scan in asymptomatic patients with locally advanced breast cancer did not change patient management.
Automated Segmentation of Head Computed Tomography Images Using FSL
Authors: Cauley Keith A. , Och Joe , Yorks Patrick J. , Fielden Samuel W.
Published: August 2017

Objective

The aim of this study was to investigate the use of one magnetic resonance image-processing tool, FSL, in its ability to perform automated segmentation of computed tomographic images of the brain.

Methods

Head computed tomography (CT) images were brain extracted and segmented using the FSL tools BET and FAST, respectively. The products of segmentation were analyzed by histogram. The impact of image intensity inhomogeneity correction was investigated using simulated bias fields, 14 routine head CT scans, and selected illustrative clinical cases.

Results

FSL FAST performs direct segmentation of head CT images, permitting quantitation of gray and white matter densities and volumes, achieving a more complete segmentation than masking methods. “Bias field correction” reduced the covariance of image signal intensities of the total brain and gray matter images (P < 0.01). Correction is larger when the effects of beam hardening and radiation scatter are larger, resulting in improved segmentation.

Conclusions

FSL FAST enables direct segmentation of head CT images.
Overt Hepatic Encephalopathy Experienced by Individuals With Cirrhosis: A Qualitative Interview Study
Authors: Ladegaard Grønkjær Lea , Hoppe Sehstedt Thomas , Norlyk Annelise , Vilstrup Hendrik
Published: July 2017

Hepatic encephalopathy (HE) markedly reduces an individual's quality of life as measured by established scoring systems. However, the experiences of having HE that can be assumed to cause the loss of quality of life have not yet been examined. This study aimed to explore how individuals with cirrhosis experienced overt HE by means of an in-depth interview with a tailored semistructured interview guide and qualitative analysis. Eight patients with cirrhosis who had clinically recovered from disorientation, somnolence, and stupor due to episodic HE Grade II or III were interviewed. The collected data were analyzed using systematic text condensation, as described by K. Malterud (2012). The analysis process identified 4 themes, “multiple losses,” “anxiety,” “dependence on others,” and “social isolation,” which described the experiences of HE both during an episode and in recovery. We believe that these findings provide an important contribution to gain a deeper understanding of the widespread loss of quality of life caused by HE. Management of these individuals should involve procedures and attitudes targeted against the described experiences. However, more research is needed about the individuals' experiences of HE to further detail such efforts.
Dopaminergic drug effects on probability weighting during risky decision-making
Authors: Ojala Karita E. , Janssen Lieneke K. , Hashemi Mahur M. , Timmer Monique H. M. , Geurts Dirk E. M. , ter Huurne Niels P. , Cools Roshan , Sescousse Guillaume
Published: August 2017

Dopamine has been associated with risky decision-making, as well as with pathological gambling, a behavioural addiction characterized by excessive risk-taking behaviour. However, the specific mechanisms through which dopamine might act to foster risk-taking and pathological gambling remain elusive. Here we test the hypothesis that this might be achieved, in part, via modulation of subjective probability weighing during decision-making. Healthy controls (n = 21) and pathological gamblers (n = 16) played a decision-making task involving choices between sure monetary options and risky gambles both in the gain and loss domains. Each participant played the task twice, either under placebo or the dopamine D2/D3 receptor antagonist sulpiride, in a double-blind, counter-balanced, design. A prospect theory modelling approach was used to estimate subjective probability weighting and sensitivity to monetary outcomes. Consistent with prospect theory, we found that participants presented a distortion in the subjective weighting of probabilities, i.e. they overweighted low probabilities and underweighted moderate to high probabilities, both in the gain and loss domains. Compared with placebo, sulpiride attenuated this distortion in the gain domain. Across drugs, the groups did not differ in their probability weighting, although in the placebo condition, gamblers consistently underweighted losing probabilities. Overall, our results reveal that dopamine D2/D3 receptor antagonism modulates the subjective weighting of probabilities in the gain domain, in the direction of more objective, economically rational decision-making.

Significance statement

Dopamine has been implicated in risky decision-making and gambling addiction, but the exact mechanisms underlying this influence remain partly elusive. Here we tested the hypothesis that dopamine modulates subjective probability weighting, by examining the effect of a dopaminergic drug on risk-taking behaviour, both in healthy individuals and pathological gamblers. We found that selectively blocking dopamine D2/D3 receptors diminished the typically observed distortion of winning probabilities, characterized by an overweighting of low probabilities and underweighting of high probabilities. This made participants more linear in their subjective estimation of probabilities, and thus more rational in their decision-making behaviour. Healthy participants and pathological gamblers did not differ in their risk-taking behaviour, except in the placebo condition in which gamblers consistently underweighted losing probabilities.