bluuebunny/crossref_metadata_2025 huggingface dataset:
Calibration of excitation function measurement based on corona cage test results
Authors: Lan Lei , Chen Xiaoyue , Wen Xishan , Li Wei , Xiao Guozhou
Published: November 2016

Corona cage approaches are crucial for research on the corona characteristics of conductors. Calibration is an indispensable task for determining excitation functions, which are used to predict corona performance of long transmission lines through extrapolation from measurements of short lines in corona cages. In this paper, the amplification factor G is calculated through a frequently adopted method, propagation analysis of high-frequency corona current along a short line. Another convenient calibration method, based on distributed parameter equivalent circuits, is established. The results for G obtained through propagation analysis and equivalent circuits are compared. To verify the rationality of calculation parameters in propagation analysis and equivalent circuits, a calibration experiment based on the excitation caused by a simulated monopulse current was performed. The results of the proposed calibration method and the calibration experiment are in good agreement.
Evaluation of the grand-canonical partition function using expanded Wang-Landau simulations. V. Impact of an electric field on the thermodynamic properties and ideality contours of water
Authors: Desgranges Caroline , Delhommelle Jerome
Published: November 2016

Using molecular simulation, we assess the impact of an electric field on the properties of water, modeled with the SPC/E potential, over a wide range of states and conditions. Electric fields of the order of 0.1 V/Å and beyond are found to have a significant impact on the grand-canonical partition function of water, resulting in shifts in the chemical potential at the vapor-liquid coexistence of up to 20%. This, in turn, leads to an increase in the critical temperatures by close to 7% for a field of 0.2 V/Å, to lower vapor pressures, and to much larger entropies of vaporization (by up to 35%). We interpret these results in terms of the greater density change at the transition and of the increased structural order resulting from the applied field. The thermodynamics of compressed liquids and of supercritical water are also analyzed over a wide range of pressures, leading to the determination of the Zeno line and of the curve of ideal enthalpy that span the supercritical region of the phase diagram. Rescaling the phase diagrams obtained for the different field strengths by their respective critical properties allows us to draw a correspondence between these systems for fields of up to 0.2 V/Å.
Bifurcations of the Lagrangian orbits from the classical to the curved 3-body problem
Authors: Diacu Florin
Published: November 2016

We consider the 3-body problem of celestial mechanics in Euclidean, elliptic, and hyperbolic spaces and study how the Lagrangian (equilateral) relative equilibria bifurcate when the Gaussian curvature varies. We thus prove the existence of new classes of orbits. In particular, we find some families of isosceles triangles, which occur in elliptic space.
Surface effects on nitrogen vacancy centers neutralization in diamond
Authors: Newell Arthur N. , Dowdell Dontray A. , Santamore D. H.
Published: November 2016

The performance of nitrogen vacancy (NV−) based magnetic sensors strongly depends on the stability of nitrogen vacancy centers near the diamond surface. The sensitivity of magnetic field detection is diminished as the NV− turns into the neutralized charge state NV0. We investigate the neutralization of NV− and calculate the ratio of NV0 to total NV (NV−+NV0) caused by a hydrogen terminated diamond with a surface water layer. We find that NV− neutralization exhibits two distinct regions: near the surface, where the NV− is completely neutralized, and in the bulk, where the neutralization ratio is inversely proportional to depth following the electrostatic force law. In addition, small changes in concentration can lead to large differences in neutralization behavior. This phenomenon allows one to carefully control the concentration to decrease the NV− neutralization. The presence of nitrogen dopant greatly reduces NV− neutralization as the nitrogen ionizes in preference to NV− neutralization at the same depth. The water layer pH also affects neutralization. If the pH is very low due to cleaning agent residue, then we see a change in the band bending and the reduction of the two-dimensional hole gas region. Finally, we find that dissolved carbon dioxide resulting from direct contact with the atmosphere at room temperature hardly affects the NV− neutralization.
Habitat use by grey-crowned babbler, Pomatostomus temporalis, in urban and peri-urban environments
Authors: Lambert Kathryn Teare Ada , Ford Hugh
Published: November 2016

Habitat loss in the urban environment leads to a high rate of local extinction of native fauna. In contrast, where key habitat structures, such as woody debris, shrubs and trees, are maintained, urban landscapes can retain many native species. To manage urban habitats successfully for urban bird communities, it is, therefore, necessary to understand the habitat requirements of the species using them. We have previously shown that the grey-crowned babbler, Pomatostomus temporalis, exhibits similar mean weight, sex ratio and group size in natural and altered habitat in and around Dubbo, New South Wales. In the present study, we detail the movements and habitat use of the groups that inhabit urban areas. We found that groups behaved similarly in urban and peri-urban areas, but showed small differences in the frequency of behaviours, based on the habitat feature that was available. The results suggested that, despite the decline of the grey-crowned babbler in the southern parts of its range, this species is able to survive in altered habitats, if nesting habitat and ground cover remain available and neighbouring groups persist nearby. Because other woodland bird species have shown similar responses to urban environments, managers of urban parkland should provide foraging substrates for a variety of woodland bird species, including vulnerable species, to ameliorate threatening processes and protect key habitat requirements.
Academic acculturation in language learning through Facebook
Authors: Peeters Ward , Fourie Christine
Published: November 2016

Due to students’ growing networking needs, educational institutions are increasingly looking for tools to bolster peer communication and information exchange. These tools, furthermore, need to facilitate students’ adaptation to the new academic culture and support their academic acculturation. This study proposes to integrate the social networking site Facebook into the learning programme, providing students with a low-threshold online environment where they can share ideas , experiences and information while creating social bonds. Data from two case studies show that students experience various challenges associated with academic acculturation and try to overcome them by consulting their peers via Facebook. Ultimately, this study demonstrates that through social networking, careful assignment design and tutor support, students are encouraged to acculturate and become active, responsible learners.
The use of gerunds and infinitives in perceptive constructions
Authors: Casalicchio Jan
Published: November 2016

In this article I compare the use of gerunds with perceptive verbs in Spanish and in Gardenese, a Rhaeto-Romance variety spoken in Northern Italy: perceptive gerunds are used as secondary predicates in Spanish but as defective TP-complements in Gardenese. Following Rizzi’s (2014) account of parametric variation, I propose that the differences are due to the interplay of three parameters: (i) a [+progressive] feature on Gardenese perception verbs, (ii) the pure lexical status of perception verbs in Gardenese, and (iii) a [+Agreement] feature on Spanish gerunds. The discussion of the parameters involved leads to more general considerations, such as a new proposal for the structure of perceptive ECMs in Romance, the confirmation of Folli and Harley’s (2007) analysis of Romance causative constructions, and the necessity of both the [+Agreement] and the [+Tense] feature in order to allow nominative non-finite subjects. The comparison with other Romance varieties confirms the role played by this parametric variation in perceptive constructions.
Why a bed can be slept in but not under
Authors: Padovan Andrea
Published: November 2016

In English the verbs that collocate with prepositions are called prepositional verbs (V+P) and are often subsumed under the class of phrasal verbs (V+ particle) although they should be kept distinct: in fact, it is easy to show that prepositions and particles have different syntactic behaviors. One of the most striking characteristics of these verbs is that they can passivize, i.e. the prepositional object can be extracted from inside the PP and become the subject of the corresponding passive sentence. Not all prepositional verbs have a passive counterpart, though. Why? This paper addresses this question by regarding the prepositions entering (V+P) as functional elements, especially in view of their relationship with (“prepositional”) objects.
Which clues for which V2
Authors: Poletto Cecilia
Published: November 2016

In this article I argue that the V2-like property of Old Italian is to be found in all phases, i.e. not only at the CP level, but also at the vP and DP left periphery. This means that a change of perspective is in order to account for the OV scrambling cases in the vP and for scrambling in the DP/PP and AdjP, since they all derive from the same abstract property. Furthermore, this unified analysis of vP/DP/PP scrambling and V2 has consequences on the loss of the V2 property.
Object pronouns in the evolution of Romanian
Authors: Di Sciullo Anna Maria , Somesfalean Stanca
Published: November 2016

We examine pronominal objects in Old Romanian and show that the fluctuation in their position (pre-/post-verbal) and in their form (clitic/strong pronoun) is the result of the Directional Asymmetry Principle (DAP), a complexity-reducing principle proposed in Di Sciullo (2011), according to which language evolution is symmetry breaking. We show that DAP is sensitive to both derivational and representational complexity. Under its effects, on grounds of derivational complexity reduction, Romanian lost the discourse-driven verb movement that yielded enclisis. On grounds of representational (sensori-motor) complexity reduction, Romanian lost the use of strong pronouns in contexts that now only allow clitics. Thus, a fluctuating phase in the evolution of pronominal objects is followed by a phase where a preponderant use is attested (i.e. proclitics in Modern Romanian). We confirm previous findings on the diachronic development of the Romanian DP under the effects of DAP, showing the role of complexity reduction in language change.
The interplay of silent nouns and (reduced) relatives in Malay adjectival modification
Authors: Espanol-Echevarria Manuel
Published: November 2016

This paper considers parametric variation in the area of adnominal adjectival modification from the viewpoint of Malay. Cinque (2010) has shown that, in spite of the great deal of variation found in adjectival modification, it is possible to identify two main classes with clear-cut syntactic and semantic properties: direct and indirect modification. Working on a restricted subset of adjectival classes, namely intersective, subsective and evaluative adjectives, we put forward a general proposal aiming to characterize in a precise way the syntactic distinction between these two main types of adjectival modification. Our proposal crucially involves the presence of silent/overt nouns, cf. Kayne (2005), and a possessive relation in the case of direct modification, and (reduced) relatives for indirect modification. Under the set of proposals put forward in this paper, variation will mostly follow from (a) externalization, cf. Berwick and Chomsky (2011), Chomsky (2010), Richards (2008), Di Sciullo (2015), and (b) the set of silent nouns available, a “lexical parameter” of a quasi-inflectional nature, cf. Chomsky (2001).
A study on an alleged case of Spanish SLI and the founder effect
Authors: Gavarró Anna , Cantú-Sánchez Myriam
Published: November 2016

According to Villanueva et al. (2008), the incidence of Specific Language Impairment in the child population of a Chilean South Pacific island is 35%, five to seven times higher than in the continental population. While this research pinpointed a relationship between the children’s genetic profile and SLI, it failed to provide much detail as regards their linguistic performance. The goal of our research is to start filling this gap through the administration of a series of language tests carried out on the children of the island. The tests are intended to measure areas of linguistic development formerly identified as vulnerable in Spanish SLI and include non-word and sentence repetition, the use of determiners and the production of relative clauses. Our preliminary results show some age effect but no difference between the children of islander ascent and those of continental origin.
Potato powders prepared by successive cooking-process depending on resistant starch content affect the intestinal fermentation in rats
Authors: Kawakami Sakura , Han Kyu-Ho , Araki Takahiro , Ohba Kiyoshi , Wakabayashi Tatsuya , Shimada Kenichiro , Fukushima Michihiro
Published: November 2016

The effects of resistant starch (RS) in dry potato powders prepared by various processes on intestinal fermentation in rats were assessed. Rats were fed raw potato powder (RP), blanched potato powder (BP), steamed potato powder (SP), or drum-dried potato powder (DP) for 4 weeks. The cecal RS content was significantly higher in the RP group than in the control diet (CN) group and other dry potato powder groups. Cecum pH was significantly lower in the RP group compared to the CN group, and was also significantly lower than that in the SP, BP, and DP groups. Lactic acid bacteria levels in the RP group were significantly higher than those in the CN group, and levels in the SP group also increased relative to the control group. Lactobacillus levels in the RP group were higher than in the CN and other dry potato powder groups. Cecal short-chain fatty acid (SCFA) concentrations in the RP group followed by the SP group exhibited significantly higher levels relative to the control levels. Dry potato powders containing RS produced during the cooking process may represent a useful food material that increases intestinal concentrations of SCFA and enhances the growth of certain lactic acid bacteria.
Deuterium supersaturation in low-energy plasma-loaded tungsten surfaces
Authors: Gao L. , Jacob W. , von Toussaint U. , Manhard A. , Balden M. , Schmid K. , Schwarz-Selinger T.
Published: November 2016

Fundamental understanding of hydrogen–metal interactions is challenging due to a lack of knowledge on defect production and/or evolution upon hydrogen ingression, especially for metals undergoing hydrogen irradiation with ion energy below the displacement thresholds reported in literature. Here, applying a novel low-energy argon-sputter depth profiling method with significantly improved depth resolution for tungsten (W) surfaces exposed to deuterium (D) plasma at 300 K, we show the existence of a 10 nm thick D-supersaturated surface layer (DSSL) with an unexpectedly high D concentration of ~10 at.% after irradiation with ion energy of 215 eV. Electron back-scatter diffraction reveals that the W lattice within this DSSL is highly distorted, thus strongly blurring the Kikuchi pattern. We explain this strong damage by the synergistic interaction of energetic D ions and solute D atoms with the W lattice. Solute D atoms prevent the recombination of vacancies with interstitial W atoms, which are produced by collisions of energetic D ions with W lattice atoms (Frenkel pairs). This proposed damaging mechanism could also be active on other hydrogen-irradiated metal surfaces. The present work provides deep insight into hydrogen-induced lattice distortion at plasma–metal interfaces and sheds light on its modelling work.
Finite homological dimension and a derived equivalence
Authors: Sanders William , Sane Sarang
Published: November 2016

For a Cohen-Macaulay ring

R
R

, we exhibit the equivalence of the bounded derived categories of certain resolving subcategories, which, amongst other results, yields an equivalence of the bounded derived category of finite length and finite projective dimension modules with the bounded derived category of projective modules with finite length homologies. This yields isomorphisms of

K
K

-theory and Witt groups (amongst other invariants) and improves on terms of associated spectral sequences and Gersten complexes.
The Effects of Development Constraints on Forest Management at the Urban‐Forest Interface
Authors: Cunha‐e‐Sá Maria A. , Franco Sofia F.
Published: November 2016

This article develops a model of a forest owner operating in a small, open‐city environment where the rent for developed land is increasing concave in nearby preserved open space and is rising over time, reflecting an upward trend in households’ income. Within this framework we examine how changes in nearby preserved open space and alternative development constraints affect an individual private landowner's decisions regarding both regeneration harvests and conversion dates. We also examine how such policies affect development density once conversion from forestry to residential use occurs. We show that when residential rents change over time, the nature of the timber problem at the urban‐forest interface changes because it forces us to allow for the possibility of changes in land use from timber to residential use. As a result, the traditional Faustmann setup is not suitable to study forest management decisions at this interface. We also find that in the presence of rising income, increases in permanently preserved open space hasten regeneration and conversion cuts of a neighboring parcel currently under forest use and leads to lower density development once conversion takes place compared to the case where income is constant. We also find that both a binding development moratorium and a binding minimum‐lot‐size policy can postpone regeneration and conversion cut dates and thus help to protect open space, even if only temporarily. However, the policies do not have the same effects on development density of converted forestland. While the former leads to high‐density development, the latter encourages low‐density development.
Central Haemodynamics and Prediction of Cardiovascular Events in Patients With Erectile Dysfunction
Authors: Vlachopoulos Charalambos , Ioakeimidis Nikolaos , Rokkas Konstantinos , Angelis Athanassios , Terentes-Printzios Dimitrios , Kratiras Zisis , Georgakopoulos Christos , Tousoulis Dimitrios
Published: November 2016

BACKGROUND

We investigated whether central hemodynamics predict major adverse cardiovascular events (MACEs) in erectile dysfunction (ED) patients beyond traditional risk factors.

METHODS

MACEs in relation to aortic pressures and augmentation index (AIx) were analyzed in 398 patients (mean age, 56 years) with ED but without established cardiovascular (CV) disease.

RESULTS

During the mean follow-up period of 6.5 years, a total of 29 (6.5%) MACEs occurred. The adjusted relative risk of MACEs was 1.062 (95% confidence interval (CI), 1.016–1.116) for a 10-mm Hg increase of aortic systolic pressure, 1.119 (95% CI, 1.036–1.155) for a 10-mm Hg increase of aortic pulse pressure (PP), and 1.191 (95% CI, 1.056–1.372) for a 10% absolute increase of AIx. While aortic pressures and AIx did not significantly improve the C-statistic models, the calibration for all indices was satisfactory. Regarding reclassification, the integrated discrimination improvement index (IDI) indicated improvement in risk discrimination of the models that included AIx and aortic PP compared to the reference model in identifying MACEs (IDI = 0.0069; P = 0.024, and IDI = 0.0060; P = 0.036, respectively). The based on categories for 10-year coronary heart disease risk and adapted at 6.5 years overall net reclassification index showed marginal and indicative risk reclassification for AIx (15.7%, P = 0.12) and aortic PP (7.2%, P = 0.20) respectively.

CONCLUSIONS

Our results show for the first time that higher central pressures and AIx are associated with increased risk for a MACE in ED patients without known CV disease. Considering the adverse prognostic role of central hemodynamics on outcomes, the present findings may explain part of the increased CV risk associated with ED.
Systematic review of public-targeted communication interventions to improve antibiotic use
Authors: Cross Elizabeth Louise Anne , Tolfree Robert , Kipping Ruth
Published: November 2016

Background: Excessive use of antibiotics accelerates the acquisition/spread of antimicrobial resistance. A systematic review was conducted to identify the components of successful communication interventions targeted at the general public to improve antibiotic use.

Methods: The databases MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library were searched. Search terms were related to the population (public, community), intervention (campaign, mass media) and outcomes (antibiotic, antimicrobial resistance). References were screened for inclusion by one author with a random subset of 10% screened by a second author. No date restrictions were applied and only articles in the English language were considered. Studies had to have a control group or be an interrupted time-series. Outcomes had to measure change in antibiotic-related prescribing/consumption and/or the public’s knowledge, attitudes or behaviour. Two reviewers assessed the quality of studies. Narrative synthesis was performed.

Results: Fourteen studies were included with an estimated 74–75 million participants. Most studies were conducted in the United States or Europe and targeted both the general public and clinicians. Twelve of the studies measured changes in antibiotic prescribing. There was quite strong (P < 0·05 to ≥ 0·01) to very strong (P < 0·001) evidence that interventions that targeted prescribing for RTIs were associated with decreases in antibiotic prescribing; the majority of these studies reported reductions of greater than −14% with the largest effect size reaching −30%.

Conclusion: Multi-faceted communication interventions that target both the general public and clinicians can reduce antibiotic prescribing in high-income countries but the sustainability of reductions in antibiotic prescribing is unclear.
Cerebrovascular Disease
Authors: Chong Ji Y. , Lerario Michael P.
Published: November 2016

Part of the “What Do I Do Now?” series, Cerebrovascular Disease uses a case-based approach to cover common and important topics in the examination, investigation, and management of stroke, embolism, thrombosis, hemorrhage, and other critical presentations of cerebrovascular disease. Each chapter provides a discussion of the diagnosis, key points to remember, and selected references for further reading. For this edition, all cases and references have been updated and new cases have been added, including the following: ischemic stroke in cancer, posterior reversible encephalopathy syndrome (PRES), primary angiitis of the central nervous system, symptomatic spinal vascular malformation, and vascular dementia. Cerebrovascular Disease is an engaging collection of thought-provoking cases that clinicians can utilize when they encounter difficult patients. The volume is also a self-assessment tool that tests the reader’s ability to answer the question, “What do I do now?”
To Comfort Always
Authors: Clark David
Published: November 2016

Palliative medicine was first recognized as a specialist field in the United Kingdom in 1987. One hundred years earlier, the London-based doctor William Munk had published a treatise on ‘easeful death’ that mapped out the principles of practical, spiritual, and medical support at the end of life. In the intervening years a major process of development took place, which led to innovative services, new approaches to the study and relief of pain and other distressing symptoms, a growing interest in ‘holistic’ care for those with advanced disease, and a desire to gain more recognition for end-of-life care. This book traces the history of palliative medicine, from its nineteenth-century origins, to its modern practice around the world today. It takes in the changing meaning of ‘euthanasia’; assesses the role of religious and philanthropic organizations in the creation of homes for the dying; and explores how twentieth-century doctors created a special focus on the care of those for whom cure or recovery is not possible. To Comfort Always traces the rise of clinical studies, academic programmes, and international collaborations to promote palliative care. It examines the continuing need to provide evidence in support of development and assesses the dilemmas of unequal access to services and pain-relieving drugs, as well as the periodic accusations of creeping medicalization within the field. The first history of its kind, it concludes with some reflections on the achievements of palliative medicine to date and the challenges that remain.
The first simultaneous mapping of four 7 mm SiO maser lines using the OCTAVE system
Authors: Oyama Tomoaki , Kono Yusuke , Suzuki Syunsaku , Kanaguchi Masahiro , Nishikawa Takashi , Kawaguchi Noriyuki , Hirota Tomoya , Nagayama Takumi , Kobayashi Hideyuki , Imai Hiroshi , Kuwahara Sho , Kano Amane , Oyadomari Miyako , Chong Sze Ning
Published: November 2016

We report on simultaneous very long baseline interferometry (VLBI) mapping of 28SiO v = 1, 2, 3, and 29SiO v = 0 J = 1 → 0 maser lines at the 7 mm band toward the semi-regular variable star, W Hydrae (W Hya), using the new data acquisition system (OCTAVE-DAS), installed in the VLBI Exploration of Radio Astrometry (VERA) array and temporarily operated in the 45 m telescope of the Nobeyama Radio Observatory. Although these masers were spatially resolved, their compact maser spots were fortunately detected in the 1000 km baselines of VERA. We found the locations of the v = 3 maser emission which are unexpected from the currently proposed maser pumping models. Mapping of the 29SiO maser line in W Hya is the third result after those in WX Psc and R Leo. This paper shows the scientific implication of simultaneous VLBI observations of multiple SiO maser lines as realized by using the OCTAVE system.
Asthma–chronic obstructive pulmonary disease overlap syndrome: a controversial concept
Authors: Rodrigo Gustavo J. , Neffen Hugo , Plaza Vicente
Published: November 2016

Purpose of review

To illustrate the scant evidence and the shortcomings of the concept of ‘asthma-COPD overlap syndrome’ (ACOS) in terms of clinical utility.

Recent findings

Asthma and chronic obstructive pulmonary disease (COPD) are considered as two distinct and heterogeneous diseases. For many years, physicians have been aware that asthma and COPD can coexist in some patients. Recently, the term ACOS has been applied when a person has clinical features of both asthma and COPD. However, the lack of an accurate diagnosis has led to inconsistent data regarding reported prevalence, prognosis and therapeutics. Even today, it has not been possible to establish a phenotypic characterization of ACOS, although it is part of the overall complexity and heterogeneity of COPDs. No high quality data exist on which to base treatment recommendations for ACOS. Consequently, in clinical practice, treatment is extrapolated from the available evidence on asthma and COPD.

The current concept of ACOS seems clinically irrelevant because it has no influence on the prognosis and treatment of these patients. The authors concluded that the term ACOS should be avoided in the case of patients with features of both asthma and COPD.
Pressure Pain Threshold and Anxiety in Adolescent Females With and Without Juvenile Fibromyalgia
Authors: King Christopher D. , Jastrowski Mano Kristen E. , Barnett Kimberly A. , Pfeiffer Megan , Ting Tracy V. , Kashikar-Zuck Susmita
Published: November 2016

Objectives:

Reduced pain thresholds have been documented in adult fibromyalgia, but there are no quantitative studies of altered pain sensitivity in adolescents with juvenile fibromyalgia (JFM). The current study examined differences in pressure pain sensitivity between adolescent females with JFM and healthy controls. The relationship between levels of anxiety and pain were also examined.

Methods:

A total of 34 JFM (15.4±1.4 y old) and 31 controls (14.5±1.3 y old) completed self-report measures of pain and anxiety. Pressure pain threshold was assessed (palm and forehead sites) with a hand-held algometer. Participants indicated the first sensation of pain and then rated the intensity of pain on a Numerical Rating Scale.

Results:

Adolescents with JFM exhibited greater sensitivity to pressure pain compared with controls. While the difference between JFM and controls was only observed at the forehead, the intensity of pain produced by the pressure algometry at both sites was significantly higher in the JFM participants compared with controls. Correlations between clinical pain and anxiety were significant for the JFM group only. No relationships were observed between anxiety and pressure pain for either group.

Discussion:

This study is a first step toward investigating mechanisms of altered pain processing in adolescents with JFM. Adolescents with JFM were found be more sensitive to pressure pain than their healthy peers, which suggests a propensity for sensitization of peripheral and/or central nociceptive information often reported in adult fibromyalgia, and which does not appear to be affected by anxiety.
Chronic Pain and Obesity Within a Pediatric Interdisciplinary Pain Clinic Setting
Authors: Santos Melissa , Murtaugh Taylor , Pantaleao Ashley , Zempsky William T. , Guite Jessica W.
Published: November 2016

Objectives:

Pediatric obesity and chronic pain are 2 of the most significant public health crises affecting youth today. Despite the high number of youth experiencing both chronic pain and obesity, little research has been done examining their relationship. This study aims to both replicate and extend this research base.

Methods:

A retrospective chart review of 99 patients presenting for evaluation in a pediatric pain clinic was conducted. Demographic information, including patient weight status, and self-report measures completed by both patients and their parents, including the Pain Frequency-Severity-Duration scale, the Functional Disability Inventory, and the Pain Catastrophizing Scale were examined.

Results:

Abdominal pain was the most frequently reported primary pain diagnosis category, with headache, diffuse musculoskeletal, localized musculoskeletal, and back pain categories reported from greatest to least frequency. Results show that 29% of our sample was obese. Age was related to weight status such that older children were more likely to have a higher body mass index. Among school-aged children, a higher body mass index percentile was associated with greater parent-reported pain catastrophizing. Obese youth had higher parent-reported Functional Disability Inventory scores than those in the normal weight group. Post hoc comparisons identified that this finding was only significant for girls. Further, obese youth were more likely to have a longer pain duration than those classified as normal weight.

Discussion:

The results of this study add to the growing literature regarding the importance of taking weight status into account when intervening with youth with chronic pain.
Comparison of Ultrasonography-guided Bilateral Intercostal Nerve Blocks and Conventional Patient-controlled Intravenous Analgesia for Pain Control After the Nuss Procedure in Children
Authors: Luo Mengqiang , Liu Xiaoming , Ning Li , Sun Yuan , Cai Ying , Shen Sai’e
Published: November 2016

Objectives:

Patients experience severe pain after pectus excavatum (PE) surgery. The aim of this prospective, randomized study was to compare analgesic effects of ultrasonography-guided bilateral intercostal nerve blocks (UG-ICNBs) with those of conventional patient-controlled intravenous analgesia (PCIA) on acute pain after the Nuss procedure for PE repair in children.

Methods:

A prospective randomized study was performed in children with PE who were scheduled for the Nuss procedure. Participants were randomly assigned to receive either UG-ICNBs or PCIA for postoperative analgesia. Faces Pain Scale-Revised scores, opioid consumption, analgesia-associated side effects (respiratory depression, pruritus, nausea, vomiting) during the first 24 hours, and lengths of stay in the postanesthesia care unit (PACU) and hospital were recorded after the surgery.

Results:

Sixty-two children undergoing the Nuss procedure were enrolled in the trial. Faces Pain Scale-Revised scores were significantly decreased in the UG-ICNBs group compared with the PCIA group for up to 6 hours after surgery. The opioid doses required in the PACU and during the first 24 hours after surgery were significantly greater in the PCIA group compared with the UG-ICNBs group. Accordingly, patients in the UG-ICNBs group showed a lower incidence of analgesia-associated side effects and faster PACU discharge compared with the PCIA group.

Conclusions:

Our study suggests that UG-ICNBs might be more effective than PCIA for postoperative analgesia in children who undergo the Nuss procedure for PE.
Sex Life and Impact of Operative Intervention on Sex Life-related Pain in Degenerative Spinal Conditions
Authors: Horst Patrick K. , Khanna Krishn , Racine Linda , Theologis Alexander , Zhao Wenyan , Lurie Jon , Burch Shane
Published: November 2016

Study Design.

This study is a therapeutic retrospective cohort study

Objectives.

This study aims to determine whether sexual function is relevant for patients with spinal stenosis (SPS) and degenerative spondylolisthesis (DS) and to determine the impact of operative inter vqAvention on sexual function for these patients.

Summary of Background Data.

The benefits of nonoperative versus operative treatment for patients with SPS and DS with regards to sexual function are unknown.

Methods.

Demographic, treatment, and follow-up data, including the Oswestry Disability Index (ODI), were obtained on patients enrolled in the SPORT study. Based on the response to question #9 in the ODI, patients were classified into a sexual life relevant (SLR) or sexual life not relevant (NR) group. Univariate and multivariate analysis of patient characteristics comparing the NR and SLR group were performed. Operative treatment groups were compared to the nonoperative group with regards to response to ODI question #9 to determine the impact of surgery on sexual function.

Results.

A total of 1235 patients were included to determine relevance of sex life. Three hundred sixty-six patients (29%) were included in the NR group. Eight hundred sixty-nine patients (71%) were included in the SLR group. Patients that were older, female, unmarried, had three or more stenotic levels, and had central stenosis were more likely to be in the NR group. Eight hundred twenty-five patients were included in the analysis comparing operative versus nonoperative treatment. At all follow-up time points, the operative groups had a lower percentage of patients reporting pain with their sex life compared to the nonoperative group (P < 0.05 at all time points except between more than one level fusion and nonoperative at 4 years’ follow-up).

Conclusion.

Sex life is a relevant consideration for the majority of patients with DS and SPS; operative treatment leads to improved sex life-related pain.

Level of Evidence: 3
Reconstruction after Excision of Hidradenitis Suppurativa: Are Skin Grafts Better than Flaps?
Authors: Sugio Yuta , Tomita Koichi , Hosokawa Ko
Published: November 2016

After surgical excision of hidradenitis suppurativa, reconstruction with a skin graft or a flap is performed when primary closure is not possible. However, the recurrence rate is reportedly high even after wide surgical excision. It is still unclear which reconstruction method provides the lowest recurrence rate. In this report, we present a case of intractable hidradenitis suppurativa in the bilateral perineal region. After wide excision and repair with bilateral groin flaps, a unilateral groin flap was replaced with a split-thickness skin graft because of flap necrosis. Although the skin graft repair region has been recurrence free for 4 years postoperatively, other regions with flap repair showed recurrence 1 year postoperatively, leading to reexcision and repair with a split-thickness skin graft. The current case provides an opportunity to reconsider the optimal surgical strategy for hidradenitis suppurativa. Taking into consideration the fact that hair follicles and sweat glands are involved in the etiology of hidradenitis suppurativa, split-thickness skin grafting, which lack cutaneous appendages, may be superior to flap repair or primary closure in terms of recurrence.
Corneal Densitometry for Quantification of Corneal Deposits in Monoclonal Gammopathies
Authors: Enders Philip , Holtick Udo , Schaub Friederike , Tuchscherer Armin , Hermann Manuel M. , Scheid Christoph , Cursiefen Claus , Bachmann Björn O.
Published: November 2016

Purpose:

To assess the capability of Scheimpflug-based densitometry of the cornea to quantify light chain deposits in patients with active monoclonal gammopathies.

Methods:

This is a case–control study in which data from a leading tertiary university center in myeloma care were analyzed. Ten eyes of 5 patients with monoclonal gammopathy and 26 eyes of 13 healthy controls undergoing clinical evaluation and Scheimpflug-based measurements were included in the study. The main outcome measures were densitometry data of the 4 corneal layers—anterior layer (AL), central layer (CL), posterior layer, and total layer (TL)—in 4 different annuli (central annular zone 0–2 mm, intermediate annular zone 2–6 mm, peripheral annular zone 6–10 mm, and total annular zone 0–12 mm).

Results:

In 8 eyes of 4 patients with IgG-based gammopathy, corneal light backscatter was highest in the AL and decreased with increasing corneal depth. The peripheral annular zone showed a higher densitometry value compared with the corneal center. Compared with healthy controls, the AL (P < 0.001), the CL (P < 0.001), and the TL (P < 0.001) had significantly higher corneal light backscatter in patients with gammopathy in the total and the peripheral annular zones. In one patient with predominantly IgA-based disease, corneal light backscatter was not elevated.

Conclusions:

Scheimpflug-based densitometry of the cornea is able to quantify opacification by immunoglobulin G light chain deposits in monoclonal gammopathies. This noninvasive technique can complement presently used in vivo confocal microscopy and corneal photography to objectivize corneal changes. Densitometry might allow monitoring of corneal immunoglobulin deposits in follow-up examinations.
Combined Ab Interno Glaucoma Surgery Does not Increase the Risk of Pseudophakic Cystoid Macular Edema in Uncomplicated Eyes
Authors: Schaub Friederike , Adler Werner , Koenig Meike C. , Enders Philip , Dietlein Thomas S. , Cursiefen Claus , Heindl Ludwig M.
Published: November 2016

Purpose:

To assess the risk of pseudophakic cystoid macular edema (PCME) following cataract surgery (bimanual phacoemulsification with posterior chamber lens implantation) combined with ab interno glaucoma surgery (trabecular aspiration or ab interno trabeculotomy) compared with solely cataract extraction.

Patients and Methods:

In total, 360 consecutive eyes of 180 patients with age-related cataract, and thereof 162 with coexistent glaucoma, who underwent sole cataract surgery or in combination with ab interno glaucoma surgery (trabecular aspiration or ab interno trabeculotomy) were compared retrospectively regarding PCME development. Patients with known risk factors of PCME were excluded. Macular examination was performed using spectral-domain optical coherence tomography before and at 4, 8, 12, 16, 24, 36, and 48 weeks after surgery. Main outcome measure was the incidence of PCME.

Results:

In total, 126 eyes (35%) underwent cataract surgery combined with ab interno glaucoma surgery (96 trabecular aspiration (76.2%), 30 ab interno trabeculotomy (23.8%), and 234 eyes (65%) received cataract surgery alone. PCME overall occurred in 23 eyes (6.4%). Following combined trabecular aspiration 5 eyes (5.2%) developed PCME, following ab interno trabeculotomy 2 eyes (6.7%), and following sole cataract surgery 16 eyes (6.8%), reaching no significant difference (P=0.676). Risk of PCME in fellow eye was significantly increased (P=0.025; odds ratio 7.177; 95% confidence interval, 5.667-8.687).

Conclusions:

Additional ab interno glaucoma surgery combined with phacoemulsification does not seem to increase the risk of PCME in uncomplicated eyes. However, in patients with history of PCME a significantly increased risk of PCME in fellow eye should be taken into account.
Endovascular Management of a Traumatic Infraorbital Pseudoaneurysm Causing Orbital Compartment Syndrome
Authors: Leung Victoria C. , Hussain Ahsen , Krings Timo , DeAngelis Dan
Published: November 2016

An 89-year-old woman presented after blunt injury to the left orbit from a fall. Examination findings were suggestive of left-sided orbital compartment syndrome, unresponsive to emergent lateral canthotomy and cantholysis. CT revealed a left-sided orbital floor blowout fracture involving the infraorbital canal, with a large maxillary and infraorbital hematoma. Angiography revealed a pseudoaneurysm supplied by the infraorbital artery. Interventional neuroradiology successfully achieved hemorrhage control by endovascular obliteration of the parent artery close to the pseudoaneurysm. To our knowledge, this is the first reported case of successfully managing active intraorbital hemorrhage causing orbital compartment syndrome by endovascular vessel sacrifice of an infraorbital artery pseudoaneurysm.
An update on the diagnosis and treatment of chronic idiopathic neutropenia
Authors: Dale David C. , Bolyard Audrey A.
Published: November 2016

Purpose of review

Neutropenia lasting for at least for 3 months and not attributable to drugs or a specific genetic, infectious, inflammatory, autoimmune or malignant cause is called chronic idiopathic neutropenia (CIN). CIN and autoimmune neutropenia (AIN) are very similar and overlapping conditions. The clinical consequences depend upon the severity of neutropenia, but it is not considered a premalignant condition.

Recent findings

Long-term observational studies in children indicate that the disease often lasts for 3–5 years in children, then spontaneously remits, but it rarely remits in adult cases. The value of antineutrophil antibody testing in both children and adults is uncertain. Most recent data suggest that CIN and AIN are immune-mediated diseases, but there are no new clinical or genetic tests to aid in diagnosis. Treatment with granulocyte colony stimulating factor (G-CSF) is effective to increase blood neutrophils in almost all cases; this treatment is reserved, however, for patients with both neutropenia and evidence of recurrent fevers, inflammatory symptoms and infections. There is little or no evidence to indicate that G-CSF treatment predisposes to myeloid malignancies in this population.

It is important to recognize CIN and AIN, the most common causes of chronic neutropenia in both children and adults. If the neutropenia is not severe, that is more than 0.5 × 109/l, most patients can be observed and not treated prophylactically with antibiotics or a growth factor. When neutropenia is severe, treatment with G-CSF is often beneficial.
What is the evidence for genetics in chronic rhinosinusitis?
Authors: Yoo Frederick , Suh Jeffrey D.
Published: November 2016

Purpose of review

To perform analysis of evidence in current literature on the topic of genetics and chronic rhinosinusitis (CRS), with a particular focus on recent findings in the cystic fibrosis transmembrane regulator (CFTR), genes associated with primary ciliary dyskinesia, and taste receptor T2R38. Other genes that have been found to have association with CRS are also presented and discussed.

Recent findings

Recent studies in CFTR and CRS research have investigated possible CFTR-potentiators for treatment of refractory CRS. The T2R38 gene has been shown to be applicable in the clinical setting with a testable phenotype and may have a role in the prognosis and influencing management strategies of CRS patients. Many genes of the immune system have been studied, with genome-wide association studies and candidate-gene approaches identifying new associations that will need replication and further elucidation.

CRS is a multifactorial disease, with strong evidence of a genetic component in its pathophysiology for some cases. Currently, there are over 70 genes that have been genetically associated with CRS in the past 15 years. Future investigations into genetic causes and predispositions of CRS may allow for improved prognostication and development of disease-prevention strategies as well as novel therapeutic targets.
Updates in the biology and therapy for infant acute lymphoblastic leukemia
Authors: Guest Erin M. , Stam Ronald W.
Published: November 2016

Purpose of review

The prognosis for infants less than 12 months of age who are diagnosed with acute lymphoblastic leukemia (ALL) remains poor despite overall advances in the treatment of childhood ALL. In this review, we highlight the recent advances in the understanding of the pathogenesis of infant ALL and discuss opportunities for translating these findings into clinical trials.

Recent findings

Infant ALL can be divided into two major disease types, defined by the presence or absence of KMT2A (MLL) rearrangement (KMT2A-R). Recent molecular profiling studies have found that infant ALL with KMT2A-R is an epigenomic disease that lacks other somatic driver mutations. Strategies to intensify therapy have not improved survival for infants with KMT2A-R ALL. In contrast, infant ALL without KMT2A-R is more similar to ALL of older children and survival has improved modestly with intensification of chemotherapy. Discovery of clonal molecular markers that predict chemoresistance will allow further risk classification and development of novel treatment strategies. Modern clinical trials are integrating molecularly targeted therapies into the treatment of infant ALL.

Advances in molecular profiling and integration of targeted therapy have the potential to reduce toxicity and improve survival for infants with ALL.
Physical exam of the adolescent shoulder: tips for evaluating and diagnosing common shoulder disorders in the adolescent athlete
Authors: Lazaro Lionel E. , Cordasco Frank A.
Published: November 2016

Purpose of review

In the young athlete, the shoulder is one of the most frequently injured joints during sports activities. The injuries are either from an acute traumatic event or overuse. Shoulder examination can present some challenges; given the multiple joints involved, the difficulty palpating the underlying structures, and the potential to have both intra- and/or extra-articular problems.

Recent findings

Many of the shoulder examination tests can be positive in multiple problems. They usually have high sensitivity but low specificity and therefore low predictive value. The medical history coupled with a detailed physical exam can usually provide the information necessary to obtain an accurate diagnosis. A proficient shoulder examination and the development of an adequate differential diagnosis are important before considering advanced imaging.

The shoulder complex relies upon the integrity of multiple structures for normal function. A detailed history is of paramount importance when evaluating young athletes with shoulder problems. A systematic physical examination is extremely important to guiding an accurate diagnosis. The patient's age and activity level are very important when considering the differential diagnosis. Findings obtain through history and physical examination should dictate the decision to obtain advanced imaging of the shoulder.