bluuebunny/crossref_metadata_2025 huggingface dataset:
Birkhoff sum fluctuations in substitution dynamical systems
Authors: PAQUETTE ELLIOT , SON YOUNGHWAN
Published: September 2017

We consider the deviation of Birkhoff sums along fixed orbits of substitution dynamical systems. We show distributional convergence for the Birkhoff sums of eigenfunctions of the substitution matrix. For non-coboundary eigenfunctions with eigenvalue of modulus$1$, we obtain a central limit theorem. For other eigenfunctions, we show convergence to distributions supported on Cantor sets. We also give a new criterion for such an eigenfunction to be a coboundary, as well as a new characterization of substitution dynamical systems with bounded discrepancy.
Faith as extended knowledge
Authors: SHAW KEGAN J.
Published: September 2017

You don't know that p unless it's on account of your cognitive abilities that you believe truly that p. Virtue epistemologists think there's some such ability constraint on knowledge. This looks to be in considerable tension, though, with putative faith-based knowledge. For at least on a popular Christian conception, when you believe something truly on the basis of faith this isn't because of anything you're naturally competent to do. Rather, faith-based beliefs are entirely a product of divine agency. Appearances to the contrary, I argue in this article that there's no deep tension between faith-based knowledge and virtue epistemology. Not if we learn to conceive of faith as a kind of extended knowledge.
Une requête (petition) au calife fatimide al-Ḥākim bi-amr Allāh (Rémondon 1, musée du Louvre)
Authors: Regourd Anne
Published: September 2017

The document Rémondon 1 (The Louvre) is, as yet, the only petition addressed explicitly to the Caliph al-Ḥākim bi-amr Allāh which is known to us. An edition and translation of its fragmentary text are presented, and its interest for papyrological, palaeographical and historical studies is explored.
Assessing complexity. Group composing for a secondary school qualification
Authors: Thorpe Vicki
Published: September 2017

This article examines a unique music curriculum and assessment environment through the findings of a practical action research project carried out in secondary schools. I address two current international educational issues: the relationship between formal and informal learning in music, and how individuals’ contributions in collaborative groups might be summatively assessed. Following this I present a model of group composing and explain how it was used as a pedagogical tool in secondary music classrooms. The purpose of this was to help students and their teacher to conceptualise collaborative composing, thereby leading to a clearer understanding and more valid assessment of the processes in which they were engaged.
In their own voices: Development of English as a gender-neutral language
Authors: Brutt-Griffler Janina , Kim Sumi
Published: September 2017

This study explores how learning English among one subset of English learners, Asian female international students at US colleges, contributes to the larger project of advancing gender equality. Using their narratives, we ask why Asian female international students invest so much of their identities and effort into learning English. We discuss the ways in which their endeavours may even silently promote the development of English as a gender-neutral language. The population of Asian students offers a compelling case of how the English language is potentially transformed via its spread to this English learner population and how it presents new avenues for identity formation for the growing number of female English users worldwide (cf. Brutt-Griffler, 2010: 232).
This here town: evidence for the development of the English determiner system from a vernacular demonstrative construction in York English
Authors: RUPP LAURA , TAGLIAMONTE SALI A.
Published: September 2017

The English variety spoken in York provides a unique opportunity to study the evolution of the English determiner system as proposed in the Definiteness Cycle (Lyons 1999). York English has three vernacular determiners that appear to represent different stages in the cycle: the zero article, reduced determiners and complex demonstratives of the type this here NP (Rupp 2007; Tagliamonte & Roeder 2009). Here, we probe the emergence and function of demonstratives in the cycle from the joint perspective of language variation and change, historical linguistics and discourse-pragmatics. We will argue that initially, the demonstrative reduced in meaning (Millar 2000) and also in form, resulting in Demonstrative Reduction (DR) (previously known as Definite Article Reduction (DAR)). This caused it to become reinforced. Data from the York English Corpus (Tagliamonte 1996–8) and historical corpora suggest that the use of complex demonstratives was subsequently extended from conveying ‘regular’ deictic meanings to a new meaning of ‘psychological deixis’ (Johannessen 2006). We conclude that survival of transitory stages in the cycle by several historical demonstrative forms, each in a range of functions, has given rise to a particular sense of ‘layering’ (Hopper 1991). Our analysis corroborates the idea that grammaticalization trajectories can be influenced by discourse-pragmatic factors (Epstein 1995; Traugott's 1995subjectification).
LRP6 is identified as a potential prognostic marker for oral squamous cell carcinoma via MALDI-IMS
Authors: Yuan Yao , Xie Xiaoyan , Jiang Yuchen , Wei Zihao , Wang Peiqi , Chen Fangman , Li Xinyi , Sun Chongkui , Zhao Hang , Zeng Xin , Jiang Lu , Zhou Yu , Dan Hongxia , Feng Mingye , Liu Rui , Wang Zhiyong , Chen Qianming
Published: September 2017

Oral squamous cell carcinoma (OSCC) is a leading cause of cancer-related deaths worldwide, with 500 000 new cases each year. However, the mechanisms underlying OSCC development are relatively unknown. In this study, matrix-assisted laser desorption ionization imaging mass spectrometry (MALDI-IMS)-based proteomic strategy was used to profile the differentially expressed peptides/proteins between OSCC tissues and their adjacent noncancerous tissues. Sixty-seven unique peptide peaks and five distinct proteins were identified with changed expression levels. Among them, LRP6 expression was found to be upregulated in OSCC tissues, and correlated with a cluster of clinicopathologic parameters, including smoking, drinking, tumor differentiation status, lymph node metastasis and survival time. Notably, knockdown of LRP6 inhibited the proliferation ability of OSCC cells. Furthermore, we demonstrated that the expression of LRP6 in OSCC cells is positively correlated with its downstream oncogene, FGF8. The present study suggests that LRP6 could be a potential biomarker for OSCC patients, and might further assist in the therapeutic decisions in OSCC treatment.
Tailored therapy guided by multichannel intraluminal impedance pH monitoring for refractory non-erosive reflux disease
Authors: Ranaldo Nunzio , Losurdo Giuseppe , Iannone Andrea , Principi Mariabeatrice , Barone Michele , De Carne Massimo , Ierardi Enzo , Di Leo Alfredo
Published: September 2017

A relevant percentage of non-erosive reflux disease (NERD) is refractory to proton pump inhibitors (PPIs) treatment. Multichannel intraluminal impedance pH (MII-pH) monitoring should give useful pathophysiological information about refractoriness. Therefore, our aim was to assess whether this technique could be useful to guide a 'tailored' therapy in refractory NERD. We retrospectively recruited NERD patients undergoing MII-pH monitoring for unsuccessful treatment. All patients had undergone upper endoscopy, and those with erosive esophagitis were excluded. No patient received PPI during MII-pH monitoring. Subjects were subgrouped into three categories: acid reflux, non-acid reflux and functional heartburn. MII-pH-guided therapy was performed for 4 weeks as follows: patients with acid reflux received PPI at double dose, patients with non-acid reflux PPI at full dose plus alginate four times a day and patients with functional heartburn levosulpiride 75 mg per day. A visual analog scale (VAS) ranging from 0 to 100 mm was administered before and after such tailored therapy to evaluate overall symptoms. Responders were defined by VAS improvement of at least 40%. Sixty-nine patients with refractory NERD were selected (female–male ratio 43 : 26, mean age 47.6±15.2 years). Overall effectiveness of tailored therapy was 84% without statistical difference among subgroups (88.5% acid reflux, 92% non-acid reflux, 66.6% functional heartburn; P=0.06). Univariate analysis showed that therapy failure directly correlated with functional heartburn diagnosis (OR=4.60) and suggested a trend toward a negative correlation with smoking and a positive one with nausea. However, at multivariate analysis, these parameters were not significant. Functional heartburn experienced a lower median percent VAS reduction than acid reflux (52.5% versus 66.6%, P<0.01) even if equal to non-acid reflux (66.6%). In conclusion, a tailored approach to refractory NERD, guided by MII-pH monitoring, demonstrated to be effective and should be promising to cure symptom persistence after conventional therapy failure. Nevertheless, standardized guidelines are advisable.
Enhanced Bandwidth of High Directive Emission Fabry-Perot Resonator Antenna with Tapered Near-Zero Effective Index Using Metasurface
Authors: Liu Zhen-Guo , Lu Wei-Bing , Yang Wu
Published: September 2017

In this paper, a novel explanation on high directive emission of Fabry-Perot resonator antenna with subwavelength metasurface is proposed. Based on image theory and effective constitutive parameter retrieval, the whole Fabry-Perot resonant cavity structure composed of a single-layer metasurface with square ring element and a PEC ground plate can be acted as an effective metamaterial media with very low refractive index (near zero index). According to Snell’s theory, this property can be used to enhance the directive emission. Based on this, with tapered size square ring unitcell, the overlapped bandwidth in which the effective refractive index is near to zero is obtained to widen the bandwidth of high directive emission. It is demonstrated that the maximum of directivity is nearly approaching to 19 dBi, and its 3-dB bandwidth can be improved to 19.5%. A final prototype has been fabricated and measured to validate the proposed design concept. The measured 3-dB gain bandwidth is approximately 20.3% with a peak gain of 17.9 dBi. These results indicate the feasibility of such kind of antenna for broadband and high directivity applications simultaneously.
Changing smoking-mortality association over time and across social groups: National census-mortality cohort studies from 1981 to 2011
Authors: Teng Andrea , Atkinson June , Disney George , Wilson Nick , Blakely Tony
Published: September 2017

The difference in mortality between current and never-smokers varies over time, affecting future projections of health gains from tobacco control. We examine this heterogeneity by sex, ethnicity and cause of death on absolute and relative scales using New Zealand census data. These data included smoking status, and were linked to subsequent mortality records in 1981–84, 1996–99 and 2006–11 for 25–74 year olds (16.1 million person-years of follow-up). Age-standardised mortality rates and rate differences (SRDs) were calculated comparing current to never-smokers, and Poisson regression was used to adjust for multiple socioeconomic factors and household smoking. We found that mortality declined over time in never-smokers; however, mortality trends in current-smokers varied by sex, ethnicity and cause of death. SRDs were stable over time in European/Other men, moderately widened in European/Other women and markedly increased in Māori men and women (Indigenous population). Poisson smoking-mortality rate ratios (RRs) increased from 1981–84 to 1996–99 with a moderate increase from 1996–99 to 2006–11 (RRs 1.48, 1.77, 1.79 in men and 1.51, 1.80, 1.90 in women). Socioeconomic confounding increased over time. In summary, this marked heterogeneity in smoking-mortality RRs over time has implications for estimating the future health and inequality impacts of tobacco control interventions.
Preparation and application of a poly (ionic liquid)-based molecularly imprinted polymer for multiple monolithic fiber solid-phase microextraction of phenolic acids in fruit juice and beer samples
Authors: Chen Lei , Huang Xiaojia
Published: September 2017

A novel poly (ionic liquid)-based molecularly imprinted polymer for multiple monolithic fiber solid-phase microextraction of phenolic acids.
Evaluation of dilute-and-shoot and solid-phase extraction methods for the determination of S-metolachlor and metolachlor-OA in runoff water samples by liquid chromatography tandem mass spectrometry
Authors: Arias Jean Lucas de Oliveira , Schneider Antunielle , Batista-Andrade Jahir Antonio , Vieira Augusto Alves , Gehrke Vinicios Rafael , Camargo Edinalvo Rabaioli , Caldas Sergiane Souza , Primel Ednei Gilberto
Published: September 2017

Two fast methods employing dilute-and-shoot and SPE were evaluated for fast determination of S-metolachlor and Metolachlor-OA in runoff water samples.
Characterization of the major chemical constituents in Ardisia gigantifolia by high performance liquid chromatography coupled to electrospray ionization and quadrupole time-of-flight mass spectrometry
Authors: Chen Zhenyuan , Ling Yun , Zhang Qing , Wan Haitong
Published: September 2017

Rapid detection and characterization of the major chemical constituents from Ardisia gigantifolia by HPLC-ESI-QTOF-MS/MS.
Photoredox catalysis enabled alkylation of alkenyl carboxylic acids with N-(acyloxy)phthalimide via dual decarboxylation
Authors: Xu Kun , Tan Zhoumei , Zhang Haonan , Liu Juanli , Zhang Sheng , Wang Zhiqiang
Published: September 2017

A ruthenium based photoredox catalyst in combination with DBACO efficiently catalyzed dual decarboxylative couplings between alkenyl carboxylic acids and redox active esters.
Electronic and molecular structure relations in diiron compounds mimicking the [FeFe]-hydrogenase active site studied by X-ray spectroscopy and quantum chemistry
Authors: Kositzki Ramona , Mebs Stefan , Schuth Nils , Leidel Nils , Schwartz Lennart , Karnahl Michael , Wittkamp Florian , Daunke Daniel , Grohmann Andreas , Apfel Ulf-Peter , Gloaguen Frédéric , Ott Sascha , Haumann Michael
Published: September 2017

X-ray spectroscopy and DFT on diiron complexes revealed correlations of spectroscopic, electronic, and structural features.
Bowl shaped deformation in a planar aromatic polycycle upon reduction. Li and Na separated dianions of the aromatic polycycle 5,6:11,12-di-o-phenylene-tetracene
Authors: Wombacher T. , Goddard R. , Lehmann C. W. , Schneider J. J.
Published: September 2017

Reduction of the PAH LDOPTwith lithium metal in DME results in a massive deformation in the resulting dianionic π-perimeter.
Encapsulation of nor-β-lapachone into poly(d,l)-lactide-co-glycolide (PLGA) microcapsules: full characterization, computational details and cytotoxic activity against human cancer cell lines
Authors: Costa Marcília P. , Feitosa Anderson C. S. , Oliveira Fátima C. E. , Cavalcanti Bruno C. , Dias Gleiston G. , Caetano Ewerton W. S. , Sales Francisco A. M. , Freire Valder N. , Di Fiore Stefano , Fischer Rainer , Ladeira Luiz O. , da Silva Júnior Eufrânio N. , Pessoa Claudia
Published: September 2017

Nor-β-lapachone-loaded (NβL-loaded) microcapsules were characterized. The NβL-loaded PLGA microcapsules exhibited a pronounced initial burst release. The cytotoxic activity against a set of cancer cell lines was investigated.
Switchable aerobic/anaerobic multi-substrate biofuel cell operating on anodic and cathodic enzymatic cascade assemblies
Authors: Herkendell Katharina , Tel-Vered Ran , Stemmer Andreas
Published: September 2017

A dually cascaded enzymatic multi-substrate biofuel cell assembly that can be effectively switched between aerobic and anaerobic states is demonstrated.
Multivalent polyrotaxane vectors as adaptive cargo complexes for gene therapy
Authors: Ardeleanu Rodinel , Dascalu Andrei I. , Neamtu Andrei , Peptanariu Dragos , Uritu Cristina M. , Maier Stelian S. , Nicolescu Alina , Simionescu Bogdan C. , Barboiu Mihail , Pinteala Mariana
Published: September 2017

The philosophy to design and construct polyrotaxane carriers, as efficient gene delivery systems.
Protonation tuning of quantum interference in azulene-type single-molecule junctions
Authors: Yang Guogang , Sangtarash Sara , Liu Zitong , Li Xiaohui , Sadeghi Hatef , Tan Zhibing , Li Ruihao , Zheng Jueting , Dong Xiaobiao , Liu Junyang , Yang Yang , Shi Jia , Xiao Zongyuan , Zhang Guanxin , Lambert Colin , Hong Wenjing , Zhang Deqing
Published: September 2017

The protonation of azulene cores offers significant conductance tuning in single-molecule junctions with quantum interference.
Repulsion–attraction switching of nematic colloids formed by liquid crystal dispersions of polygonal prisms
Authors: Senyuk B. , Liu Q. , Nystrom P. D. , Smalyukh I. I.
Published: September 2017

Elastic interactions between polygonal prisms in liquid crystals can be switched between repulsive and attractive by controlled re-pinning the disclinations at different edges using laser tweezers.
Membership‐Function‐Dependent Stability Analysis of Interval Type‐2 Polynomial Fuzzy‐Model‐Base Control Systems
Authors: Song Ge , Lam Hak‐Keung , Yang Xiaozhan
Published: September 2017

In this paper, the stability analysis for interval type‐2 (IT2) polynomial fuzzy‐model‐based (PFMB) control system using the information of membership functions is investigated. To tackle uncertainties, IT2 membership functions are used in the IT2 polynomial fuzzy model and IT2 polynomial fuzzy controller. The stability of IT2 PFMB control system is investigated based on the Lyapunov stability theory and both sets of membership function independent (MFI) and membership function dependent (MFD) stability conditions are derived on the basis of the sum‐of‐squares (SOS) approach. To make the stability conditions MFD, the boundary information of IT2 membership functions is used in the stability analysis. To extract richer information of IT2 membership functions, the operating domain is partitioned into sub‐domains. In each sub‐domain, the boundary information of IT2 membership functions and those of the upper and lower membership function are obtained. Furthermore, to further relax the conservativeness, a switching polynomial fuzzy controller, together with the informations obtained in each sub‐domain, is employed in investigating the stability analysis. Numerical examples and simulation results are given to demonstrate the validity of MFD and MFD switching methods.
Demand response‐based enhanced LRIC pricing framework
Authors: Sharma Amita , Bhakar Rohit , Tiwari Har Pal
Published: September 2017

Increasing penetration of intermittent renewable generators (RGs) results in variable generation. This is likely to create congestion of varying quantum and temporal distribution in distribution networks. The existing distribution network charging methodologies like long‐run incremental cost (LRIC) offer location‐specific signal to users and charge customers reflecting their use of system. These methodologies can be modified using contribution factor to reflect users demand coincident with peak network demand. RGs are encouraged by relieving them from such contribution‐based pricing signals. Congestion caused by intermittent RG could be mitigated by utilising demand customers’ flexibility. This study incorporates short‐term demand‐side response (DSR) signal for demand customers to manage variability caused by RG in the modified LRIC pricing model. These short‐term DSR signals in the form of peak/off‐peak charge offers, in conjunction with demand elasticity, helps to assess customer response. This result in modified load profile for various class customers connected at the nodes, which is used for evaluating network charges. The proposed approach is applied to a practical Indian reference network with consideration of distributed generation. Results from modified LRIC pricing model encourage users to change their short‐term consumption and help network owner to alleviate congestion and minimise network investment.
Comparative study between the fracture stress of poly‐ and single‐crystalline graphene using a novel nanoelectromechanical system structure
Authors: Ng Jimmy , Chen Qi , Xie Ya‐Hong , Wang Albert , Wu Tianru
Published: September 2017

Graphene is a two‐dimensional carbon material with extraordinary mechanical properties. However, recent studies have found that the presence of grain boundaries significantly decreases fracture stress of graphene, warranting further investigation. This work reports the development of a new method to measure the fracture stress of monolayer graphene with a novel nanoelectromechanical system (NEMS) structure. Suspended graphene ribbon devices with a range of geometries were electrostatically actuated while the graphene sheet was pinned down with various nail structures. By recording the electromechanical responses at fracture and using finite element simulations, the fracture stress was calculated. Using this novel NEMS structure, the fracture stress of polycrystalline graphene grown using conventional chemical vapour deposition (CVD) and single‐crystalline graphene grown using local feeding CVD were found to be ∼30 and ∼90 GPa, respectively.
An ALMA survey of submillimeter galaxies in the COSMOS field: Multiwavelength counterparts and redshift distribution
Authors: Brisbin Drew , Miettinen Oskari , Aravena Manuel , Smolčić Vernesa , Delvecchio Ivan , Jiang Chunyan , Magnelli Benjamin , Albrecht Marcus , Arancibia Alejandra Muñoz , Aussel Hervé , Baran Nikola , Bertoldi Frank , Béthermin Matthieu , Capak Peter , Casey Caitlin M. , Civano Francesca , Hayward Christopher C. , Ilbert Olivier , Karim Alexander , Le Fevre Olivier , Marchesi Stefano , McCracken Henry Joy , Navarrete Felipe , Novak Mladen , Riechers Dominik , Padilla Nelson , Salvato Mara , Scott Kimberly , Schinnerer Eva , Sheth Kartik , Tasca Lidia
Published: September 2017

We carried out targeted ALMA observations of 129 fields in the COSMOS region at 1.25 mm, detecting 152 galaxies at S/N ≥ 5 with an average continuum RMS of 150 μJy. These fields represent a S/N-limited sample of AzTEC/ASTE sources with 1.1 mm S/N ≥ 4 over an area of 0.72 square degrees. Given ALMA’s fine resolution and the exceptional spectroscopic and multiwavelength photometric data available in COSMOS, this survey allows us unprecedented power in identifying submillimeter galaxy counterparts and determining their redshifts through spectroscopic or photometric means. In addition to 30 sources with prior spectroscopic redshifts, we identified redshifts for 113 galaxies through photometric methods and an additional nine sources with lower limits, which allowed a statistically robust determination of the redshift distribution. We have resolved 33 AzTEC sources into multi-component systems and our redshifts suggest that nine are likely to be physically associated. Our overall redshift distribution peaks at z ~ 2.0 with a high-redshift tail skewing the median redshift to \hbox{$\tilde{z}=2$}.48 ± 0.05. We find that brighter millimeter sources are preferentially found at higher redshifts. Our faintestsources, with S1.25 mm < 1.25 mJy, have a median redshift of \hbox{$\tilde{z}=2$}.18 ± 0.09, while the brightest sources, S1.25 mm > 1.8 mJy, have a median redshift of \hbox{$\tilde{z}=3$}.08 ± 0.17. After accounting for spectral energy distribution shape and selection effects, these results are consistent with several previous submillimeter galaxy surveys, and moreover, support the conclusion that the submillimeter galaxy redshift distribution is sensitive to survey depth.
Was gibt’s zu essen?
Authors: Schmidt Maximilian
Published: September 2017

Ernährung Immer mehr ältere und multimorbide Patienten werden auf unseren Intensivstationen versorgt. Die richtige Ernährung besonders
bei geriatrischen Intensivpatienten gewinnt zukünftig an Relevanz und zwingt Krankenhäuser dazu, sich intensiver mit dem Thema zu
beschäftigen. Besonders die häufig bereits bestehende Mangelernährung eines auf der Intensivstation eingelieferten Patienten sorgt für einen
schwereren Verlauf der Erkrankung. Damit verbunden sind längere Liegezeiten und höhere Sterberaten.
Liquid and Vapor-Phase Activity of Artemisia annua Essential Oil against Pathogenic Malassezia spp.
Authors: Santomauro Francesca , Donato Rosa , Pini Gabriella , Sacco Cristiana , Ascrizzi Roberta , Bilia Anna
Published: September 2017

Artemisia annua essential oil has given us many encouraging results for its numerous antimicrobial properties. In this study, the essential oil, both in liquid and in vapor phases, was tested against various Malassezia species closely related to many skin disorders in humans and animals. Malassezia treatment and eradication are mainly based on old azole drugs, which are characterized by poor compliance, unpredictable clinical efficacy, emerging resistance, and several side effects. Monoterpenes (ca. 88%) represent the most abundant group of compounds in the essential oil, mainly the oxygenated derivatives (ca. 74%) with camphor (25.2%), 1,8-cineole (20%), and artemisia ketone (12.5%). In vapor phase, monoterpenes represent more than 98% of the constituents, α-pinene being the main constituent (22.8%), followed by 1,8-cineole (22.1%) and camphene (12.9%). Essential oil of A. annua, both in vapor phase and liquid, showed strong antimicrobial activity towards almost the tested twenty strains of Malassezia analyzed. The minimum fungicidal concentrations from most of the strains tested were from 0.78 µL/mL to 1.56 µL/mL, and only three strains of Malassezia sympodialis required a higher concentration of 3.125 µL/mL. Overall, the minimal inhibitor concentrations obtained by vapor diffusion assay were lower than those obtained by the liquid method. The average values of minimal inhibitor concentrations obtained by the two methods at 72 h are 1.3 – 8.0 times higher in liquid compared to those in the vapor phase.
Shock generation comparison with planar and hemispherical targets in shock ignition relevant experiment
Authors: Baton S. D. , Le Bel E. , Brygoo S. , Ribeyre X. , Rousseaux C. , Breil J. , Koenig M. , Batani D. , Raffestin D.
Published: September 2017

We performed an experiment on the “Ligne d'Intégration Laser” facility to produce strong shocks with plasma conditions relevant for the Shock Ignition approach to Inertial Confinement Fusion. Two kinds of targets have been used: planar and hemispherical. We observe an increase in the shock velocity in hemispherical geometry, which entails a fairly planar shock despite the Gaussian focal spot. Numerical results reproduce the shock dynamics in the two cases in a successful way, indicating, for laser intensities around 1.5 × 1015 W/cm2 at 3ω, an ablation pressure of (90 ± 20) Mbar and (120 ± 20) Mbar in planar and hemispherical geometry, respectively.
Novel performances of in situ plasma nitriding-PVD duplex-treated nanocrystalline TiN coatings
Authors: Tan Chaolin , Zhou Kesong , Kuang Tongchun , Li Yuling , Ma Wenyou
Published: September 2017

To improve the load-bearing capacity, hardness and adhesion strength of the TiN coatings, the in situ plasma nitriding-PVD duplex treatment was applied. The substrate was pretreated by bombardment with highly ionised Ar+, functioned as an ‘ionic abrasive blasting’ for better adhesion. The microstructure and properties of the duplex-treated TiN coatings were characterized and analysed. The results show that the thickness of the plasma nitriding zone and the nanocrystalline TiN coating are about 50 μm and 4.1 μm, respectively. Owing to the ion etch-cleaning process prior to the duplex treatment and the γ′-Fe4N phase formed in the compound layer, the adhesion strength level of the TiN coating reaches HF1. The indentation profile analysis reveals that the nitriding process effectively increases the load-bearing capacity. Meanwhile, the instinct hardness reaches 2166HV0.05 and the sufficiently low wear rate coefficient is 8.30 × 10−9 mm−3 Nm−1. Moreover, the duplex-treated TiN coating has significantly improved the corrosion resistance.
Multi-band photometry of trans-Neptunian objects in the Subaru Hyper Suprime-Cam survey
Authors: Terai Tsuyoshi , Yoshida Fumi , Ohtsuki Keiji , Lykawka Patryk Sofia , Takato Naruhisa , Higuchi Arika , Ito Takashi , Komiyama Yutaka , Miyazaki Satoshi , Wang Shiang-Yu
Published: September 2017

We present visible multi-band photometry of trans-Neptunian objects (TNOs) observed by the Subaru Telescope in the framework of the Hyper Suprime-Cam Subaru Strategic Program (HSC-SSP) from 2014 March to 2016 September. We measured the five broad-band (g, r, i, z, and Y) colors over the wavelength range from 0.4 μm to 1.0 μm for 30 known TNOs using the HSC-SSP survey data covering ∼500 deg2 of sky within ±30° of ecliptic latitude. This dataset allows us to investigate the correlations between the dynamical classes and visible reflectance spectra of TNOs. Our results show that the hot classical and scattered populations with orbital inclination (I) of I ≳ 6° share similar color distributions, while the cold classical population with I ≲ 6° has a different color distribution from the others. The low-I population has reflectance increasing toward longer wavelengths up to ∼0.8 μm, with a steeper slope than the high-I population at ≲ 0.6 μm. We also find a significant anti-correlation between g − r/r − i colors and inclination in the high-I population, as well as a possible bimodality in the g − i color vs. eccentricity plot.
Novel ssIIa Alleles Produce Specific Seed Amylose Levels in Hexaploid Wheat
Authors: Hogg Andrew C. , Martin John M. , Giroux Michael J.
Published: September 2017

Novel starch synthase II (ssIIa) alleles were created in a soft wheat (Triticum aestivum L.) via ethyl methanesulfonate mutagenesis and combined by crossing to create four unique ssIIa triple mutant haplotypes. A range of starch amylose content was obtained from the ssIIa triple mutant lines (35.6–46.8%), with moderate increases in amylose content found in lines carrying two ssIIa null alleles and one partially functional ssIIa allele. Seeds from all ssIIa triple mutants had significantly higher amylose and protein contents but also lower starch content, kernel weight, and flour swelling power compared with their wild‐type sister lines. Seed starch amylose content was negatively correlated with individual kernel weight (r = –0.54), starch content (r = –0.85), and flour swelling power (r = –0.91) but positively correlated with grain protein (r = 0.78), demonstrating that unique ssIIa triple mutant null combinations confer defined levels of seed starch amylose, protein content, and kernel size. The ssIIa mutant lines also had a hard grain texture (≈86 single kernel characterization system units), whereas all parental material and wild‐type sister lines had soft grain texture (≈35). This change in grain texture was independent of Ha locus genotype, because all lines carried a functional (soft type) Ha locus. The ssIIa alleles and allelic combinations reported here demonstrate the ability to create defined levels of seed starch, amylose, and protein.
Postpartum Management After Obstetric Anal Sphincter Injuries
Authors: Eubanks Allison , Petersen Scott M.
Published: September 2017

A 26-year-old woman, gravida 1 para 1, experiences a severe perineal laceration that extends through the rectal mucosa after a vaginal delivery. She asks you, “What can be done to optimize my recovery?”
Safety of Medical Abortion Provided Through Telemedicine Compared With In Person
Authors: Grossman Daniel , Grindlay Kate
Published: September 2017

OBJECTIVE:

To compare the proportion of medical abortions with a clinically significant adverse event among telemedicine and in-person patients at a clinic system in Iowa during the first 7 years of the service.

METHODS:

We conducted a retrospective cohort study. We analyzed data on clinically significant adverse events (hospital admission, surgery, blood transfusion, emergency department treatment, and death) for all medical abortions performed by telemedicine or in person at a clinic system in Iowa between July 1, 2008, and June 30, 2015. Data on adverse events came from required reporting forms submitted to the mifepristone distributor. We calculated the prevalence of adverse events and 95% CIs comparing telemedicine with in-person patients. The analysis was designed as a noninferiority study. Assuming the prevalence of adverse events to be 0.3%, telemedicine provision was considered to be inferior to in-person provision if the prevalence were 0.6% or higher. The required sample size was 6,984 in each group (one-sided α=0.025, power 90%). To explore whether patients with adverse events presented to emergency departments and were not reported, we conducted a survey of the 119 emergency departments in Iowa, asking whether they had treated a woman with an adverse event in the prior year.

RESULTS:

During the study period, 8,765 telemedicine and 10,405 in-person medical abortions were performed. Forty-nine clinically significant adverse events were reported (no deaths or surgery; 0.18% of telemedicine patients with any adverse event [95% CI 0.11–0.29%] and 0.32% of in-person patients [95% CI 0.23–0.45%]). The difference in adverse event prevalence was 0.13% (95% CI −0.01% to 0.28%, P=.07). Forty-two emergency departments responded to the survey (35% response rate); none reported treating a woman with an adverse event after medical abortion.

CONCLUSION:

Adverse events are rare with medical abortion, and telemedicine provision is noninferior to in-person provision with regard to clinically significant adverse events.
A Brief Prenatal Intervention of Behavioral Change to Reduce the Risk of Maternal Cytomegalovirus
Authors: Hughes Brenna L. , Gans Kim M. , Raker Christina , Hipolito Evelyn R. , Rouse Dwight J.
Published: September 2017

OBJECTIVE:

To estimate the effects of a brief prenatal behavioral intervention on risk behaviors for maternal cytomegalovirus (CMV) infection.

METHODS:

Women were screened with CMV serology during prenatal care before 20 weeks of gestation and followed for at least 10 weeks. Women without serologic evidence of primary CMV infection were approached. Participants were apprised of serostatus and then randomized 2:1 to either a brief behavioral intervention during their prenatal care visit or to standard care (a brochure). The 7- to 10-minute in-office intervention included a video and hygiene education using motivational interviewing. Participants were then given a reminder calendar to take home and weekly text message reminders. The primary outcome was change in behavioral compliance score on a scale of 0–100. Secondary outcomes included process evaluation and domains of behavior change. A sample size of 180 participants was planned to compare the behavioral compliance score change of at least 15% between intervention and control groups with 80% power and 2.5% two-sided α.

RESULTS:

From April 2013 to October 2014, 197 women were randomized. One hundred eighty-seven (96%) had outcome data available. Mean gestational age at screening and randomization was 9 4/7 and 13 6/7 weeks of gestation, respectively. Primary outcome assessment occurred at a mean of 28 4/7 weeks of gestation. Baseline behavioral compliance scores increased modestly in the intervention group (mean: 7-point increase from 80.7 to 87.7, 95% CI 2.4–5.9) compared with the comparison group (mean: 4-point increase from 79.7 to 84.1, 95% CI 5.9–8.4; mean difference in change score: 3.0, 95% CI, 0.8–5.2; P=.007). Those in the intervention group reported change in risk perception related to perceived severity and susceptibility, self-efficacy, and perceived norms (P<.05 for all).

CONCLUSION:

A brief behavioral intervention delivered in the prenatal care setting was modestly effective at changing behaviors related to CMV infection risk.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT01819519.
Reducing False-Positive Pregnancy Test Results in Patients With Cancer
Authors: McCash Samuel I. , Goldfrank Deborah J. , Pessin Melissa S. , Ramanathan Lakshmi V.
Published: September 2017

OBJECTIVE:

To assess whether the use of a laboratory test specific for intact human chorionic gonadotropin (hCG) would reduce the number of false-positive pregnancy test results.

METHODS:

From October 21, 2014, to January 20, 2015, and April 1, 2015, to June 2, 2015, all serum samples sent for pregnancy screening at a large cancer center with a value of 5 milli-international units/mL or greater total β-hCG were frozen and stored and then retested using intact hCG reagent. We compared the accuracy of total β-hCG and intact hCG results for the diagnosis of clinically confirmed pregnancy. A negative test was defined as 14 milli-international units/mL or less, our current institutional cutoff. We also assessed a cutoff of less than 5 milli-international units/mL, a historical cutoff to rule out pregnancy.

RESULTS:

We performed intact hCG testing on 64 patient samples, of which 34 had originally resulted positive when tested for total β-hCG. These included 21 cases of clinically confirmed pregnancy and 13 false-positive cases. No women were pregnant when their intact hCG concentration was 14 milli-international units/mL or less, and all pregnancies were detected at and above this concentration. Intact hCG reduced the number of false-positive pregnancy test results from 13 to 1, a 92% reduction (95% CI 64–99%), corresponding to a reduction in the false-positive rate from 38% (95% CI 22–56%) to 3% (95% CI 1–15%).

CONCLUSION:

The use of intact hCG reagent in patients with cancer reduces the rate of false-positive pregnancy test results without increasing the rate of false-negative test results.
Aggressive Angiomyxoma of the Vulva and Bladder
Authors: Song Mihae , Glasgow Michelle , Murugan Paari , Rivard Colleen
Published: September 2017

BACKGROUND:

Aggressive angiomyxoma is a rare, locally infiltrative tumor, frequently occurring in female patients. Although wide local excision is considered standard therapy, radical surgery may be needed.

CASE:

A 49-year-old woman presented with an aggressive angiomyxoma involving the vulva and bladder. Given the hormone receptor status and size of the tumor, the patient was initially treated with fulvestrant and goserelin acetate in an attempt to reduce the size of the mass. She was followed up at 1- to 3-month intervals; after 6 months of treatment, owing to increasing size of the mass and worsening symptoms, the decision was made to proceed with radical surgery.

CONCLUSION:

Although a less radical surgical approach is preferred, radical surgery is possible for treatment of aggressive angiomyxoma when needed.
Geographic Comparison of Women in Academic Obstetrics and Gynecology Department-Based Leadership Roles
Authors: Ricciotti Hope A. , Dodge Laura E. , Aluko Ashley , Hofler Lisa G. , Hacker Michele R.
Published: September 2017

OBJECTIVE:

To describe and compare geographic representation of women in obstetrics and gynecology department-based leadership roles across American Congress of Obstetricians and Gynecologists (ACOG) districts and U.S. Census Bureau regions while accounting for the proportion of women practicing in each area.

METHODS:

We conducted a cross-sectional observational study. To more meaningfully quantify representation of women as leaders in ACOG districts and U.S. Census Bureau regions, we calculated representation ratios—the proportion of department-based leaders who were women divided by the proportion of obstetrician–gynecologists who were women. A ratio of 1.0 indicates proportionate representation and less than 1.0 indicates underrepresentation. We calculated 95% CIs to compare representation of women in leadership roles across geographic areas. The gender of major department-based leaders (chair, vice chair, division director) and educational leaders (fellowship, residency, associate residency, medical student clerkship director) was determined from websites.

RESULTS:

The proportion of department chairs who were women was highest in the West and lowest in the South Census Bureau regions. Representation ratios for women in major department-based leadership roles demonstrated underrepresentation relative to the practicing base nationally and in all four regions. Although women were underrepresented in major department-based leadership throughout the country, there was significantly higher women's representation in major department-based leadership roles in the West (ratio 0.82, 95% CI 0.68–0.99) compared with the Northeast (ratio 0.50, 95% CI 0.42–0.59) and the South (ratio 0.45, 95% CI 0.36–0.57). Similarly, in the division director role, the West (ratio 0.85, 95% CI 0.68–1.1) had significantly higher representation of women compared with the Northeast (ratio 0.50, 95% CI 0.40–0.62). Nationally, women were underrepresented as fellowship directors, proportionately represented as residency program directors, and overrepresented as medical student clerkship directors.

CONCLUSION:

Representation ratios of women in major department-based leadership roles, which account for the proportion of women practicing in each geographic area, suggest that women were more likely to advance to the department-based leadership roles of chair, vice chair, or division director in the western United States.
Clinical Risk Factors Associated With Peripartum Maternal Bacteremia
Authors: Easter Sarah Rae , Molina Rose L. , Venkatesh Kartik K. , Kaimal Anjali , Tuomala Ruth , Riley Laura E.
Published: September 2017

OBJECTIVE:

To evaluate risk factors associated with maternal bacteremia in febrile peripartum women.

METHODS:

We performed a case–control study of women with fevers occurring between 7 days before and up to 42 days after delivery of viable neonates at two academic hospitals. Women with positive blood cultures were matched with the next two febrile women meeting inclusion criteria with negative blood cultures in the microbiology data without other matching parameters. We compared maternal and neonatal characteristics and outcomes between women in the case group and those in the control group with univariate analysis. We then used logistic regression to examine the association between clinical characteristics and maternal bacteremia.

RESULTS:

After excluding blood cultures positive only for contaminants, we compared 115 women in the case group with 285 in the control group. Bacteremic women were more likely to experience their initial fever during labor (40.9% compared with 22.8%, P<.01) and more likely to have fever at or above 102°F (62.6% compared with 31.6%, P<.01). These associations persisted in the adjusted analysis: multiparity (adjusted odds ratio [OR] 1.75, 95% CI 1.07–2.87), initial fever during labor (adjusted OR 2.82, 95% CI 1.70–4.70), and fever at or above 102°F (adjusted OR 3.83, 95% CI 2.37–6.19). In an analysis restricted to neonates whose mothers had initial fevers before or in the immediate 24 hours after delivery, neonates born to women in the case group had higher rates of bacteremia compared with those born to women in the control group (9.0% compared with 1.3%, P<.01). Eight of the nine bacteremic neonates born to bacteremic mothers (89%) grew the same organism as his or her mother in blood culture.

CONCLUSION:

Maternal bacteremia is associated with multiparity, initial fever during labor, and fever at or above 102°F; however, 37.5% of cases of bacteremia occurred in women with maximum fevers below this threshold. Obstetricians should maintain a heightened suspicion for an infectious source of fever in women with these clinical characteristics.
What Is New in Obstetrics and Gynecology Simulation?
Authors: Burda Marianne L.
Published: September 2017

This month we focus on obstetrics and gynecology simulation. Dr. Burda discusses four recent publications, which are concluded with a “bottom line” that is the take-home message. The complete reference for each can be found in Box 1 on this page, along with direct links to the abstracts.
Reliability of the Shuttle Walk Test With Controlled Incremental Velocity in Patients With Difficult-to-Control Asthma
Authors: Costa Ivan Peres , Dal Corso Simone , Borghi-Silva Audrey , Peixoto Fabiana , Stirbulov Roberto , Arena Ross , Cahalin Lawrence P. , Malosá Sampaio Luciana Maria
Published: September 2017

Purpose:

Asthma is a chronic inflammatory condition characterized by bronchial hypersensitivity to endogenous or exogenous agents and variable airflow limitation, which is reversible either spontaneously or with the use of medication. The evaluation of functional capacity in these patients is commonly performed using field tests to gauge activity of daily living. However, the reliability of the symptom-controlled shuttle walk test has not yet been determined for individuals with difficult-to-control asthma. The aim of the present study was to determine the reliability of the shuttle walk test in patients with severe, difficult-to-control asthma.

Methods:

Forty-five patients were evaluated including lung function tests, the International Physical Activity Questionnaire (IPAQ), and the Asthma Control Questionnaire. The participants performed a shuttle walk test twice, with a 20-min rest period between tests.

Results:

The mean distance walked for this cohort was 330.5 m (range, 50-570 m) on the first walk test and 336.3 m (range, 60-571 m) on the second test. There was no statistical difference between the mean distances walked. The Bland-Altman plots of the 2 tests revealed a mean difference of −12.7 m, with a 95% CI of 37.9 to −63.2 m. Significant correlations were found between the distance walked in meters and the IPAQ (r = 0.36, P < .01) and distance in meters and muscle mass (r = 0.39, P < .009).

Conclusion:

The shuttle walk test is reliable for individuals with difficult-to-control asthma and can be used in the evaluation of functional capacity.
Vertigo in Vestibular Schwannoma Patients Due to Other Pathologies
Authors: Sahyouni Ronald , Moshtaghi Omid , Haidar Yarah M. , Mahboubi Hossein , Moshtaghi Afsheen , Lin Harrison W. , Djalilian Hamid R.
Published: September 2017

Objective:

To report findings from a cohort of vestibular schwannoma (VS) patients presenting with vertigo from a secondary comorbid vestibular disorder; and to discuss management strategies for this subset of patients presenting with both episodic vertigo and VS.

Patients:

All VS patients who presented with vertigo as the primary symptom from 2012 to 2015 and endorsing no other major complaints were examined.

Intervention:

Treatment with migraine lifestyle and prophylactic therapy, or Epley maneuver.

Main Outcome Measure:

Resolution of vertigo following medical treatment alone.

Results:

Of the nine patients studied, seven (78%) suffered from vestibular migraine, and two (22%) experienced benign positional vertigo. All patients experienced complete resolution of symptoms after treatment. As a result of symptomatic improvement, seven patients (78%) avoided surgery in favor of observation, while two patients (22%) underwent radiosurgery due to continued tumor growth and other nonvertigo symptoms.

Conclusion:

VS patients can sometimes present with a history of recurrent episodic vertigo. The etiology of the vertigo could be due to the tumor itself or may be due to an underlying comorbidity such as vestibular migraine or benign positional vertigo. VS patients presenting with vertigo should undergo a standard vertigo history and examination to identify other potential causes of vertigo. Most VS patients in our cohort avoided intervention and had resolution of their vertigo.