bluuebunny/crossref_metadata_2025 huggingface dataset:
Chip-carrier thermal barrier and its impact on lateral thermal lens profile and beam parameter product in high power broad area lasers
Authors: Rieprich J. , Winterfeldt M. , Kernke R. , Tomm J. W. , Crump P.
Published: March 2018

High power broad area diode lasers with high optical power density in a small focus spot are in strong commercial demand. For this purpose, the beam quality, quantified via the beam parameter product (BPP), has to be improved. Previous studies have shown that the BPP is strongly affected by current-induced heating and the associated thermal lens formed within the laser stripe. However, the chip structure and module-assembly related factors that regulate the size and the shape of the thermal lens are not well known. An experimental infrared thermographic technique is used to quantify the thermal lens profile in diode lasers operating at an emission wavelength of 910 nm, and the results are compared with finite element method simulations. The analysis indicates that the measured thermal profiles can best be explained when a thermal barrier is introduced between the chip and the carrier, which is shown to have a substantial impact on the BPP and the thermal resistance. Comparable results are observed in further measurements of samples from multiple vendors, and the barrier is only observed for junction-down (p-down) mounting, consistent with the barrier being associated with the GaAs-metal transition.
Suppression in the electrical hysteresis by using CaF2 dielectric layer for p-GaN MIS capacitors
Authors: Sang Liwen , Ren Bing , Liao Meiyong , Koide Yasuo , Sumiya Masatomo
Published: March 2018

The capacitance-voltage (C-V) hysteresis in the bidirectional measurements of the p-GaN metal-insulator-semiconductor (MIS) capacitor is suppressed by using a CaF2 dielectric layer and a post annealing treatment. The density of trapped charge states at the CaF2/p-GaN interface is dramatically reduced from 1.3 × 1013 cm2 to 1.1 × 1011/cm2 compared to that of the Al2O3/p-GaN interface with a large C-V hysteresis. It is observed that the disordered oxidized interfacial layer can be avoided by using the CaF2 dielectric. The downward band bending of p-GaN is decreased from 1.51 to 0.85 eV as a result of the low-density oxides-related trap states. Our work indicates that the CaF2 can be used as a promising dielectric layer for the p-GaN MIS structures.
Deep level transient spectroscopic analysis of p/n junction implanted with boron in n-type silicon substrate
Authors: Wakimoto Hiroki , Nakazawa Haruo , Matsumoto Takashi , Nabetani Yoichi
Published: March 2018

For P-i-N diodes implanted and activated with boron ions into a highly-resistive n-type Si substrate, it is found that there is a large difference in the leakage current between relatively low temperature furnace annealing (FA) and high temperature laser annealing (LA) for activation of the p-layer. Since electron trap levels in the n-type Si substrate is supposed to be affected, we report on Deep Level Transient Spectroscopy (DLTS) measurement results investigating what kinds of trap levels are formed. As a result, three kinds of electron trap levels are confirmed in the region of 1–4 μm from the p-n junction. Each DLTS peak intensity of the LA sample is smaller than that of the FA sample. In particular, with respect to the trap level which is the closest to the silicon band gap center most affecting the reverse leakage current, it was not detected in LA. It is considered that the electron trap levels are decreased due to the thermal energy of LA. On the other hand, four kinds of trap levels are confirmed in the region of 38–44 μm from the p-n junction and the DLTS peak intensities of FA and LA are almost the same, considering that the thermal energy of LA has not reached this area. The large difference between the reverse leakage current of FA and LA is considered to be affected by the deep trap level estimated to be the interstitial boron.
Intermittent impact dynamics of a cantilever scanning a surface at high speed
Authors: Dey S. , Kartik V.
Published: March 2018

In contact-mode scanning probe microscopy (SPM), the cantilever's dynamics are conventionally investigated by assuming the tip to be always in contact with the sample's surface. At high scanning speeds, however, the cantilever's inertia becomes dominant and the tip can therefore completely detach from the surface and start impacting upon it. Experiments at the macro-scale cannot emulate the complex micro-scale dynamics, as the system exhibits negligible effects due to meniscus forces and the surrounding medium's squeeze film damping; however, they can provide qualitative insight into the cantilever's dynamics at high frequencies, corresponding to those likely to be excited during video-rate SPM imaging. This paper investigates such intermittent impact dynamics for an upscaled cantilever, analytically, numerically, and experimentally. In contact-mode scanning, a critical scan speed exists beyond which the cantilever's tip loses contact with the sample's surface; a closed-form expression for this contact loss frequency is derived. At high scan speeds, impacts cause the cantilever to switch between different contact regimes: in-, off-, and grazing-contact; within each regime, the system's modal configuration is different. Experimentally-obtained Poincare maps indicate quasi-periodic behaviour at frequencies for which the response is repetitive, as is also predicted by the model. Intermittent impacts excite the sub- and super-harmonics of the excitation frequency, which are related to the natural frequencies of different system configurations based on the “effective” tip-end boundary conditions. The cantilever's response exhibits several phenomena, such as modal transition, beating, grazing, and possible chaotic behaviour, depending upon the relation between the excitation harmonics and the natural frequencies.
Colossal permittivity and the polarization mechanism of (Mg, Mn) co-doped LaGaO3 ceramics
Authors: Luo Tingting , Liu Zhifu , Zhang Faqiang , Li Yongxiang
Published: March 2018

Mg and Mn co-doped LaGa0.7-xMgxMn0.3O3 (x = 0, 0.05, 0.10, 0.15) ceramics were prepared by a solid-state reaction method. The electrical properties of the LaGa0.7-xMgxMn0.3O3 ceramics were studied in detail by dielectric spectra, impedance spectra, and I-V characteristic analysis. Colossal permittivity up to 104 could be obtained across the frequency range up to 104 Hz. The impedance analysis of the co-doped LaGaO3 ceramics indicated that the Mott's variable range hopping (VRH) polarization should be the main origin of colossal permittivity. Mg and Mn co-doping suppressed the formation of Mn3+ and enhanced the VRH polarization, resulting in increased permittivity. Partial localization of electrons by Mg reduced the long-range electron hopping and led to the decrease in dielectric loss.
Spiral waves in driven dusty plasma medium: Generalized hydrodynamic fluid description
Authors: Kumar Sandeep , Patel Bhavesh , Das Amita
Published: March 2018

Spiral waves are observed in many natural phenomena. They have been extensively represented by the mathematical FitzHugh-Nagumo model [Barkley et al., Phys. Rev. A 42, 2489 (1990)] of excitable media. Also, in incompressible fluid simulations, the excitation of thermal spiral waves has been reported by Li et al. [Phys. of Fluids 22, 011701 (2010)]. In the present paper, the spatiotemporal development of spiral waves in the context of weak and strong coupling limits has been shown. While the weakly coupled medium has been represented by a simple fluid description, for strong coupling, a generalized visco-elastic fluid description has been employed. The medium has been driven by an external force in the form of a rotating electric field. It is shown that when the amplitude of force is small, the density perturbations in the medium are also small. In this case, the excitations do not develop as a spiral wave. Only when the amplitude of force is high so as to drive the density perturbations to nonlinear amplitudes does the spiral density wave formation occurs. The role of the forcing frequency and the effect of strong coupling and the sound velocity of medium in the formation and evolution of spiral waves have been investigated in detail.
A Fabry-Pérot interferometer with wire-grid polarizers as beamsplitters at terahertz frequencies
Authors: Harrison H. , Lancaster A. J. , Konoplev I. V. , Doucas G. , Aryshev A. , Shevelev M. , Terunuma N. , Urakawa J. , Huggard P. G.
Published: March 2018

The design of a compact Fabry-Pérot interferometer (FPi) and results of the experimental studies carried out using the device are presented. Our FPi uses freestanding wire-grid polarizers (WGPs) as beamsplitters and is suitable for use at terahertz (THz) frequencies. The FPi was studied at the LUCX facility, KEK, Japan, and an 8 MeV linear electron accelerator was used to generate coherent Smith-Purcell radiation. The FPi was designed to be easy to align and reposition for experiments at linear accelerator facilities. All of the components used were required to have a flat or well understood frequency response in the THz range. The performance of the FPi with WGPs was compared to that of a Michelson interferometer and the FPi is seen to perform well. The effectiveness of the beamsplitters used in the FPi is also investigated. Measurements made with the FPi using WGPs, the preferred beamsplitters, are compared to measurements made with the FPi using silicon wafers as alternative beamsplitters. The FPi performs well with both types of beamsplitter in the frequency range used (0.3–0.5 THz). The successful measurements taken with the FPi demonstrate a compact and adaptable interferometer that is capable of analyzing THz radiation over a broad frequency range. The scheme is particularly well suited for polarization studies of THz radiation produced in an accelerator environment.
Mapping the conduction band edge density of states of γ-In2Se3 by diffuse reflectance spectra
Authors: Kumar Pradeep , Vedeshwar Agnikumar G.
Published: March 2018

It is demonstrated that the measured diffuse reflectance spectra of γ-In2Se3 can be used to map the conduction band edge density of states through Kubelka-Munk analysis. The Kubelka-Munk function derived from the measured spectra almost mimics the calculated density of states in the vicinity of conduction band edge. The calculation of density of states was carried out using first-principles approach yielding the structural, electronic, and optical properties. The calculations were carried out implementing various functionals and only modified Tran and Blaha (TB-MBJ) results tally closest with the experimental result of band gap. The electronic and optical properties were calculated using FP-LAPW + lo approach based on the Density Functional Theory formalism implementing only TB-mBJ functional. The electron and hole effective masses have been calculated as me*=0.25m0 and mh*=1.11m0, respectively. The optical properties clearly indicate the anisotropic nature of γ-In2Se3.
Combined effect of Pt and W alloying elements on Ni-silicide formation
Authors: Luo T. , Mangelinck D. , Descoins M. , Bertoglio M. , Mouaici N. , Hallén A. , Girardeaux C.
Published: March 2018

A combinatorial study of the combined effect of Pt and W on Ni silicide formation is performed. Ni(Pt, W) films with thickness and composition gradients were prepared by a co-deposition composition spread technique using sputtering deposition from Pt, W, and Ni targets. The deposited Ni(Pt,W) films were characterized by X-ray diffraction, X-ray reflectivity, Rutherford backscattering, and atom probe tomography. The maximum content of alloying elements is close to 27 at. %. Simulations of the thickness and composition were carried out and compared with experimental results. In situ X-ray diffraction and atom probe tomography were used to study the phase formation. Both additive alloying elements (Pt + W) slow down the Ni consumption and the effect of W is more pronounced than the one of Pt. Regarding the effect of alloying elements on Ni silicides formation, three regions could be distinguished in the Ni(Pt,W)/Si wafer. For the region close to the Ni target, the low contents of alloying elements (Pt + W) have little impact on the phase sequence (δ-Ni2Si is the first silicide and NiSi forms when Ni is entirely consumed) but the kinetics of silicide formation slows down. The region close to the Pt target has high contents of (Pt + W) and is rich in Pt and a simultaneous phase formation of δ-Ni2Si and NiSi is observed. For the high (Pt + W) contents and W-rich region, NiSi forms unexpectedly before δ-Ni2Si and the subsequent growth of δ-Ni2Si is accompanied by the NiSi consumption. When Ni is entirely consumed, NiSi regrows at the expense of δ-Ni2Si.
Effect of pressure on β relaxation in La60Ni15Al25 metallic glass
Authors: Xu H. Y. , Sheng H. W. , Li M. Z.
Published: March 2018

The effect of pressure on β relaxation in La60Ni15Al25 metallic glass (MG) was investigated by activation-relaxation technique in combination with molecular dynamics simulation. It is found that the β relaxation behavior and the potential energy landscape are significantly modulated by pressure. With increasing pressure, the atomic motion in β relaxation in La60Ni15Al25 MG changes from hopping-dominated to the string-like-dominated motion with increased activation energy. Moreover, while the hopping motion is gradually suppressed as pressure is increased, the cooperative rearrangements with more atoms involved but very low activation energies are significantly enhanced by pressure. It is further found that the “subbasins” in the potential energy landscape in La60Ni15Al25 MG become deeper and steeper with increasing pressure, leading to the increase of activation energy. Meanwhile, some neighboring “subbasins” merge under pressure accompanied by the disappearance of energy barriers in-between, leading to events with very low activation energies in the β relaxation. The atomic structure analysis reveals that the transformation of atomic motions in β relaxation in La60Ni15Al25 MG under pressure is strongly correlated with the decrease of pentagon-rich atomic clusters and the increase of clusters with fewer pentagons. These findings provide a new understanding of the β relaxation mechanism and some clues for tuning β relaxation in MGs.
Effects of oxygen-inserted layers on diffusion of boron, phosphorus, and arsenic in silicon for ultra-shallow junction formation
Authors: Zhang X. , Connelly D. , Takeuchi H. , Hytha M. , Mears R. J. , Rubin L. M. , Liu T.-J. K.
Published: March 2018

The effects of oxygen-inserted (OI) layers on the diffusion of boron (B), phosphorus (P), and arsenic (As) in silicon (Si) are investigated, for ultra-shallow junction formation by high-dose ion implantation followed by rapid thermal annealing. The projected range (Rp) of the implanted dopants is shallower than the depth of the OI layers. Secondary ion mass spectrometry is used to compare the dopant profiles in silicon samples that have OI layers against the dopant profiles in control samples that do not have OI layers. Diffusion is found to be substantially retarded by the OI layers for B and P, and less for As, providing shallower junction depth. The experimental results suggest that the OI layers serve to block the diffusion of Si self-interstitials and thereby effectively reduce interstitial-aided diffusion beyond the depth of the OI layers. The OI layers also help to retain more dopants within the Si, which technology computer-aided design simulations indicate to be beneficial for achieving shallower junctions with lower sheet resistance to enable further miniaturization of planar metal-oxide-semiconductor field-effect transistors for improved integrated-circuit performance and cost per function.
Plasma block acceleration based upon the interaction between double targets and an ultra-intense linearly polarized laser pulse
Authors: Xu Yanxia , Wang Jiaxiang , Hora Heinrich , Qi Xin , Xing Yifan , Yang Lei , Zhu Wenjun
Published: March 2018

A new scheme of plasma block acceleration based upon the interaction between double targets and an ultra-intense linearly polarized laser pulse with intensity I ∼ 1022 W/cm2 is investigated via two-dimensional particle-in-cell simulations. The targets are composed of a pre-target of low-density aluminium plasma and an overdense main-target of hydrogen plasma. Through intensive parameter optimization, we have observed highly efficient plasma block accelerations with a monochromatic proton beam peaked at GeVs. The underlying mechanism is attributed to the enhancement of the charge separation field due to the properly selected pre-target.
A community-led, harm-reduction approach to chemsex: case study from Australia’s largest gay city
Authors: Stardust Zahra , Kolstee Johann , Joksic Stefan , Gray James , Hannan Siobhan
Published: March 2018

Rates of drug use remain substantially higher among gay and bisexual men (GBM) and people living with HIV (PLHIV) in Sydney, New South Wales, Australia. The use of drugs to enhance sexual pleasure within cultures of Party and Play creates opportunities to discuss sexual health, mental health, consent and wellbeing. Community organisations with a history of HIV prevention, care, treatment are well-placed to respond. ACON’s (formerly the AIDS Council of New South Wales) multi-dimensional response to ‘chemsex’ includes: direct client services support for individuals seeking to manage or reduce their use; health promotion activities that support peer education; partnerships with research institutions to better understand cultures of chemsex; and policy submissions that call for drug use to be approached as a health, rather than a criminal, issue. The approach speaks the language of Party and Play subcultures; employs culturally relevant terminology and imagery; uses content designed, created and delivered by peers; and operates within a pleasure-positive, harm-reduction and community-led framework. These interventions have led to increased service uptake, strong community engagement, robust research partnerships and the recognition of GBM as a priority population in relevant strategies.
Associations of Alcohol Use Disorder, Alcohol Use, Housing, and Service use in a Homeless Sample of 255 Individuals Followed over 2 Years
Authors: Asana Olubunmi O. , Ayvaci Emine R. , Pollio David E. , Hong Barry A. , North Carol S.
Published: March 2018

Background: Homeless individuals with alcohol use disorders have multiple comorbidities and therefore various service needs. Despite need for services, homeless individuals face numerous barriers to treatment. Little is known about the associations of specific services in relation to homelessness in the context of alcohol problems. The current study analyzed 2-year prospective longitudinal data on a homeless sample, examining relationships between alcohol use disorder, alcohol use, housing status, and service use over time. Methods: Two hundred fifty-five of 400 individuals recruited systematically from shelters and street locations completed 3 annual assessments (69% completion). Data on lifetime and current psychiatric disorders, housing status, and past-year service use were obtained and merged with service use data gathered from local agencies. Generalized estimating equation (GEE) models were created to predict dependent outcome variables of stable housing, alcohol use, and service use in both follow-up years. Results: Lifetime alcohol use disorder was positively associated with substance and medical service use. Alcohol problems did not hinder attainment of stable housing, and placement in housing did not necessarily increase risk for alcohol use. Stable housing was negatively associated with psychiatric and substance service use. In the second year, when alcohol use was finally associated with receiving substance services, it appears that these services provided a gateway to psychiatric services. The psychiatric services in turn appeared to provide a gateway to medical services. Conclusions: Alcohol use behaved differently compared with lifetime alcohol use disorder in relation to service use. Lack of association between alcohol use and housing supports Housing First policy. Obtaining housing may have ameliorative effects on mental health, diminishing perceived need for psychiatric services. Services may also be more accessible during homelessness. Obtaining substance treatment may provide a gateway for those who use alcohol after becoming homeless to connect with psychiatric and medical services, informing policy and practice.
The role of the Liwonde National Park in conserving fish species diversity in the upper Shire River, Malawi
Authors: Kapute Fanuel
Published: March 2018

Tremendous decline of fish catches in Lake Malawi, mainly due to uncontrolled fishing, is a clear evidence of challenges of managing a common/open resource. East of the Shire River lies the protected area known as Liwonde National Park about 538 km2. Species diversity around the National Park including the southeast arm of Lake Malawi, Lake Malombe, and the upper Shire River were studied to determine if the moratorium in the park has any impact to the fishery in these areas. Fish samples were collected using a variety of fishing gears including mosquito nets, gill nets, scoop nets, cast nets, and hand lines from southeast arm of Lake Malawi, Upper Shire River, Lake Malombe, and the area near the Liwonde Barrage. Over 40 species belonging to 27 genera and 6 families were sampled compared to 50 species recorded in earlier studies suggesting that, despite the general decline in the fish species diversity, this area still maintains its resilience. The family Cichlidae was the most diverse with 19 genera followed by the Cyprinidae with 4 genera. These results showed that Cichlidae and Cyprinidae fish species that have nearly disappeared in Lake Malawi are still found in considerable abundance in the Shire River especially in areas around the National Park. Most of the determined fish species originated from surrounding areas to the park suggesting that it is a breeding area for fishes that are caught upstream and downstream. Findings underpin the importance of managing and protecting the National Park or even establishing other moratoriums for the same.
Can Turkish-Armenian music diplomacy emulate the Turkish-Greek example?: prospects and limitations
Authors: Çevik Senem B.
Published: March 2018

Intractable conflicts and rooted enmity can hardly be eradicated through top-down policy changes unless the policy involves people to people interactions, which lie at the heart of citizen diplomacy. Citizen diplomacy initiatives that rest on civil society are essential tools in creating spaces for discussion and understanding. Although citizen diplomacy initiatives such as cultural exchanges transcend borders and cultures by way of building bridges, these initiatives may have limited impact unless they reach the mainstream and have the necessary political will. This paper aims to analyze the role of music as a cultural catalyzer in turning over a new leaf on the Turkish-Greek conflict, and in doing so it assesses its potential role in alleviating the historical tension between Turkey and Armenia. Cultural collaboration and exchange by way of music has not been a significant part of Turkish-Armenian rapprochement efforts despite the historical interconnectedness of Turkish and Armenian music traditions. This paper concludes that music diplomacy is a positive confidencebuilding measure in culturally normalizing the “other”, however its application by civil society and popularity is interdependent on simultaneous political processes in which high politics determine low politics interactions.
An Novel Architecture of Large-scale Communication in IOT
Authors: Ma Wubin , Deng Su , Huang Hongbin
Published: March 2018

In recent years, many scholars have done a great deal of research on the development of Internet of Things and networked physical systems. However, few people have made the detailed visualization of the large-scale communications architecture in the IOT. In fact, the non-uniform technology between IPv6 and access points has led to a lack of broad principles of large-scale communications architectures. Therefore, this paper presents the Uni-IPv6 Access and Information Exchange Method (UAIEM), a new architecture and algorithm that addresses large-scale communications in the IOT.
A refined version of Grothendieck’s anabelian conjecture for hyperbolic curves over finite fields
Authors: Saïdi Mohamed , Tamagawa Akio
Published: March 2018

In this paper we prove a refined version of a theorem by Tamagawa and Mochizuki on isomorphisms between (tame) arithmetic fundamental groups of hyperbolic curves over finite fields, where one “ignores” the information provided by a “small” set of primes.
Laboratory Evaluation Of Dose And Manner Of Pickup Of Spinosad On The Migratory Grasshopper, 1995
Authors: Foster R. N. , Reuter K.C. , Black L. , Kahler E. , Fulle B. , Flora E. A.
Published: March 2018

Using a spray tower to simulate aerially applied liquid sprays, three doses of Spinosad (a bacteria derived product) were each applied to grasshoppers and pots of growing grass separately on 7 Sept. For each dose, untreated grasshoppers were confined on treated grass, treated grasshoppers were confined on untreated grass and treated grasshoppers were confined on treated grass. Untreated grasshoppers were confined on untreated grass as a control. Grasshoppers treated with Fyfanon ULV (malathion) were confined on grass treated with Fyfanon as a standard for comparison. All spray treatments were applied at an equivalent total volume of 32 fluid oz/acre. Spinosad treatments were applied in distilled water and Fyfanon was diluted and applied in oil. The study design consistedof 10 replicates per treatment. Each replicate consisted of a caged pot of grass containing five fourth instar grasshoppers. Pots were 4 inches X 4 inches square with a 9 inch high cage attached and contained grass approximately 4 inches high at time of treatment. Caged grasshoppers were held at 78°2±°F and a photoperiod of 14:10 (L:D). Dead grasshopperswere removed from the cages and mortality recorded daily.
Inpatient burden of esophageal cancer and analysis of factors affecting in-hospital mortality and length of stay
Authors: Sarvepalli S , Garg S K , Sarvepalli S S , Parikh M P , Wadhwa V , Jang S , Thota P N , Sanaka M R
Published: March 2018

Esophageal cancer (EC) continues to be a major source of morbidity and mortality in the United States. However, there has been a relative dearth of research into hospital utilization in patients with EC. This study examines temporal trends in hospital admissions, length of stay (LOS), mortality, and costs associated with EC. In addition, we also analyzed factors associated with inpatient mortality and LOS. We interrogated National Inpatient Sample (NIS), a large registry of inpatient data, to retrieve information about various demographic and factors associated with hospital stay in patients who were admitted for EC between the years 1998 and 2013 in the United States. After examining trends over time, multivariate analysis was performed to identify factors associated with LOS and mortality. During 1998–2013, 538,776 hospital stays with principal diagnosis of EC were reviewed. Number of hospital stays and inpatient charges increased by 397 per year (±67.8;P < 0.0001) and $3,033 per patient per year (±135; <0.0001) respectively. Mortality and LOS decreased by 0.23% per year (±0.03;P < 0.0001) and 0.07 days per year (±0.006;P < 0.0001) respectively. Multiple factors associated with LOS and mortality were outlined. Despite overall increase in hospital utilization with respect to number of admissions and inpatient charges, inpatient mortality and LOS associated with EC declined. Factors associated with inpatient mortality and LOS may help drive clinical decision-making and influence healthcare or hospital policy.
Human germline gene editing. Recommendations of ESHG and ESHRE†‡
Authors: de Wert Guido , Pennings Guido , Clarke Angus , Eichenlaub-Ritter Ursula , van El Carla G , Forzano Francesca , Goddijn Mariëtte , Heindryckx Björn , Howard Heidi C , Radojkovic Dragica , Rial-Sebbag Emmanuelle , Tarlatzis Basil C , Cornel Martina C ,   on behalf of the European Society of Human Genetics and the European Society of Human Reproduction and Embryology
Published: March 2018

Technological developments in gene editing raise high expectations for clinical applications, first of all for somatic gene editing but in theory also for germline gene editing (GLGE). GLGE is currently not allowed in many countries. This makes clinical applications in these countries impossible now, even if GLGE would become safe and effective. What were the arguments behind this legislation, and are they still convincing? If a technique can help to avoid serious genetic disorders, in a safe and effective way, would this be a reason to reconsider earlier standpoints? The European Society of Human Reproduction and Embryology (ESHRE) and the European Society of Human Genetics (ESHG) together developed a Background document and Recommendations to inform and stimulate ongoing societal debates. After consulting its membership and experts, this final version of the Recommendations was endorsed by the Executive Committee and the Board of the respective Societies in May 2017. Taking account of ethical arguments, we argue that both basic and pre-clinical research regarding human GLGE can be justified, with conditions. Furthermore, while clinical GLGE would be totally premature, it might become a responsible intervention in the future, but only after adequate pre-clinical research. Safety of the child and future generations is a major concern. Future discussions must also address priorities among reproductive and potential non-reproductive alternatives, such as PGD and somatic editing, if that would be safe and successful. The prohibition of human germline modification, however, needs renewed discussion among relevant stakeholders, including the general public and legislators.
Reification in IR: The Process and Consequences of Reifying the Idea of International Society
Authors: Kaczmarska Katarzyna
Published: March 2018

This article studies the contentious problem of reification in international relations (IR) on the example of the idea of international society. It shows how the idea became reified, that is, how the move was made from approaching international society as one of several competing frameworks for the study of international politics to considering it an objective fact, a self-evident reality of international politics, and an entity in the possession of agency. For this purpose, I trace key writings of the English school and survey their contribution to the idea’s development and gradual reification. I posit that reification has been the outcome of individual strategies and disciplinary practices pertaining to the knowledge production process, in particular the perceived need to establish and maintain a research program while continuing to provide viable explanations of world events. In discussing the consequences, I argue that reification adversely affects not only research outcomes but also the study process. A reified category, once it becomes a default language through which to think and talk about international politics, narrows down avenues for diverging interpretations of international politics. Furthermore, endowing international society with agency hides real agents behind specific actions in international politics.
Weight Gain: A Possible Side Effect of All Antiretrovirals
Authors: Taramasso Lucia , Ricci Elena , Menzaghi Barbara , Orofino Giancarlo , Passerini Simone , Madeddu Giordano , Martinelli Canio Vito , De Socio Giuseppe Vittorio , Squillace Nicola , Rusconi Stefano , Bonfanti Paolo , Di Biagio Antonio ,   CISAI Study Group, Quirino T , Bonfanti P , Ricci E , Bellacosa C , Maggi P , Calza L , Abeli C , Menzaghi B , Celesia B M , Grosso C , Stagno A , Vichi F , Mazzotta F , Martinelli C , Penco G , Cassola G , Di Biagio A , Taramasso L , Nicolini L A , Dentone C , Molteni C , Palvarini L , Scalzini A , Carenzi L , Rizzardini G , Valsecchi L , Cordier L , Rusconi S , Colombo V , Galli M , Franzetti M , De Socio G V , Mazzotta E , Parruti G , Madeddu G , Bagella P , S. Mura M , Libertone R , Antinori A , Di Giambenedetto S , Orofino G , Guastavigna M , Caramell P
Published: March 2018

Weight gain and body mass index (BMI) increase are central issues in patients living with HIV who need to minimize the risk of metabolic disease. Information collected through the SCOLTA cohort revealed significant 1-year BMI increase in patients treated with dolutegravir (P = .004), raltegravir (P = .0004), elvitegravir (P = .004), darunavir (P = .0006), and rilpivirine (P = .029). BMI gain correlated with low baseline BMI (P = .002) and older age (P = .0007) in Centers for Disease Control and Prevention stages A/B, with lower BMI (P = .005) and CD4+ T-cell count (P = .007) at enrollment in stage C.
Systemic Inflammation, Coagulation, and Clinical Risk in the START Trial
Authors: Baker Jason V , Sharma Shweta , Grund Birgit , Rupert Adam , Metcalf Julia A , Schechter Mauro , Munderi Paula , Aho Inka , Emery Sean , Babiker Abdel , Phillips Andrew , Lundgren Jens D , Neaton James D , Lane H Clifford ,   INSIGHT START (Strategic Timing of AntiRetroviral Treatment) Study Group
Published: March 2018

Background

The Strategic Timing of AntiRetroviral Treatment (START) trial demonstrated that immediate (at CD4+ >500 cells/µL) vs deferred (to CD4+ <350 cells/µL or AIDS) antiretroviral therapy (ART) initiation reduced risk for AIDS and serious non-AIDS (SNA). We investigated associations of inflammation, coagulation, and vascular injury biomarkers with AIDS, SNA or death, and the effect of immediate ART initiation.

Methods

Biomarkers were measured from stored plasma prior to randomization and at month 8. Associations of baseline biomarkers with event risk were estimated with Cox regression, pooled across groups, adjusted for age, gender, and treatment group, and stratified by region. Mean changes over 8 months were estimated and compared between the immediate and deferred ART arms using analysis of covariance models, adjusted for levels at entry.

Results

Baseline biomarker levels were available for 4299 START participants (92%). Mean follow-up was 3.2 years. Higher levels of IL-6 and D-dimer were the only biomarkers associated with risk for AIDS, SNA or death, as well as the individual components of SNA and AIDS events (HRs ranged 1.37–1.41 per 2-fold higher level), even after adjustment for baseline CD4+ count, HIV RNA level, and other biomarkers. At month 8, biomarker levels were lower in the immediate arm by 12%–21%.

Conclusions

These data, combined with evidence from prior biomarker studies, demonstrate that IL-6 and D-dimer consistently predict clinical risk across a broad spectrum of CD4 counts for those both ART-naïve and treated. Research is needed to identify disease-modifying treatments that target inflammation beyond the effects of ART.
A Tomato Nucleotide Binding Sites−Leucine-Rich Repeat Gene Is Positively Involved in Plant Resistance to Phytophthora infestans
Authors: Jiang Ning , Cui Jun , Meng Jun , Luan Yushi
Published: March 2018

The nucleotide binding sites−leucine-rich repeat (NBS-LRR) genes are key regulatory components of plant to pathogens. Phytophthora infestans-inducible coding sequence encoding an NBS-LRR (SpNBS-LRR) protein in tomato (Solanum pimpinellifolium L3708) was cloned and characterized based on our RNA-Seq data and tomato genome. After sequence analysis, SpNBS-LRR was identified as a hydrophilic protein with no transmembrane topological structure and no signal peptide. SpNBS-LRR had a close genetic relationship to RPS2 of Arabidopsis thaliana by phylogenetic analysis. In addition, SpNBS-LRR gene was mainly expressed in root, with low expression observed in leaf and stem. To further investigate the role of SpNBS-LRR in tomato−P. infestans interaction, SpNBS-LRR was introduced in susceptible tomatoes and three transgenic lines with higher expression level of SpNBS-LRR were selected. These transgenic tomato plants that overexpressed SpNBS-LRR displayed greater resistance than wild-type tomato plants after infection with P. infestans, as shown by decreased disease index, lesion diameters, number of necrotic cells, P. infestans abundance, and higher expression levels of the defense-related genes. This information provides insight into SpNBS-LRR involved in the resistance of tomato to P. infestans infection and candidate for breeding to enhance biotic stress-resistance in tomato.
Is there a correlation between growing pains and parent-child bed-sharing?
Authors: Smith Patrick J. , Moisan Alice , Sawyer Jeffrey R. , Spence David D. , Warner William C. , Kelly Derek M.
Published: March 2018

Background:

The objective of this study was to evaluate a possible correlation between parent-child bed-sharing and growing pains.

Methods:

A questionnaire inquiring about bed-sharing habits of children and parents and the location, duration, intensity, and treatment of the child’s growing pain was completed by a consecutive series of families whose child (ages 3-10 yr) presented for evaluation of pain ultimately diagnosed as growing pains. A consecutive series of children (ages 3-10 yr) with a distal radial buckle fracture served as the control group.

Results:

Twenty-two of 44 (50%) families in the growing pain group answered “yes” to the bed-sharing question. Only 16 of 54 (29%) in the control group answered “yes.” Bed-sharing rates were significantly different between groups (P = 0.048). However, the mean age between the groups was also significantly different (growing pains group = 6.9 yr, control group = 5.5 yr, P = 0.002). To control for age, all patients over 7 yr from both groups were eliminated for analysis. Results revealed that the mean age was similar (P = 0.15) in both groups, but the rate of bed-sharing was no longer significantly different (growing pains group [50%], control group group [38%], P = 0.123).

Conclusions:

Despite finding that the rate of parent-child bed-sharing was 50% in our growing pains population, when we controlled for age, there was no difference from our control. Parent-child bed-sharing does not seem to be a significant component of growing pains. Bed-sharing could be a possible mechanism to manage a child’s growing pains.
How precise are clinical height measurements in scoliosis patients?
Authors: Woon Regina P. , Skaggs David L. , Sanders James , Garg Sumeet , Sawyer Jeffrey R. , Fletcher Nicholas , Andras Lindsay M.
Published: March 2018

Background:

The purpose of this study was to determine the accuracy of height measurements in patients with scoliosis at five pediatric institutions and the influence on treatment decisions. Clinical height measurements are used to monitor growth in children and adolescents and may impact treatment recommendations. To our knowledge, measurement variability of patient height in scoliosis clinics has not been evaluated.

Methods:

At the five participating centers, patient height was measured by clinical staff members using their institution’s standard clinic protocol and then by an attending Scoliosis Research Society member surgeon using one identical protocol among the five centers. To negate the possibility of the Hawthorne Effect, the clinical staff members who completed the initial height measurements were unaware of the subsequent SRS spine surgeon measurements or the protocol used for measurement.

Results:

The mean height difference in measurement between surgeons and clinical staff for all five centers was 0.7 cm (Center 1: 0.5 cm, Center 2: 0.5 cm, Center 3: 0.9 cm, Center 4: 0.6 cm, Center 5: 1.2 cm). Twenty-three percent (21/92) of patients had measurements that were more than 1 cm different between the clinical staff and surgeon measurement.

Conclusions:

Our study found a mean 7 mm clinical height measurement variation between surreptitious measurements by SRS surgeons and standard clinical protocol. This variability can lead to inappropriate treatment decisions if growth is used as an indication for brace treatment. With such variability in clinical height measurement, one may want to consider using criteria for bracing independent of height measurement.
Revisited: A Systematic Review of Therapeutic Hypothermia for Adult Patients Following Traumatic Brain Injury
Authors: Watson Hannah I. , Shepherd Andrew A. , Rhodes Jonathan K. J. , Andrews Peter J. D.
Published: March 2018

Objectives:

Therapeutic hypothermia has been of topical interest for many years and with the publication of two international, multicenter randomized controlled trials, the evidence base now needs updating. The aim of this systematic review of randomized controlled trials is to assess the efficacy of therapeutic hypothermia in adult traumatic brain injury focusing on mortality, poor outcomes, and new pneumonia.

Data Sources:

The following databases were searched from January 1, 2011, to January 26, 2018: Cochrane Central Register of Controlled Trial, MEDLINE, PubMed, and EMBASE.

Study Selection:

Only foreign articles published in the English language were included. Only articles that were randomized controlled trials investigating adult traumatic brain injury sustained following an acute, closed head injury were included. Two authors independently assessed at each stage.

Data Extraction:

Quality was assessed using the Cochrane Collaboration’s tool for assessing the risk of bias. All extracted data were combined using the Mantel-Haenszel estimator for pooled risk ratio with 95% CIs. p value of less than 0.05 was considered statistically significant. All statistical analyses were conducted using RevMan 5 (Cochrane Collaboration, Version 5.3, Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014).

Data Synthesis:

Twenty-two studies with 2,346 patients are included. Randomized controlled trials with a low risk of bias show significantly more mortality in the therapeutic hypothermia group (risk ratio, 1.37; 95% CI, 1.04–1.79; p = 0.02), whereas randomized controlled trials with a high risk of bias show the opposite with a higher mortality in the control group (risk ratio, 0.70; 95% CI, 0.60–0.82; p < 0.00001).

Conclusions:

Overall, this review is in-keeping with the conclusions published by the most recent randomized controlled trials. High-quality studies show no significant difference in mortality, poor outcomes, or new pneumonia. In addition, this review shows a place for fever control in the management of traumatic brain injury.
Increasing the Number of Medical Emergency Calls Does Not Improve Hospital Mortality
Authors: Santamaria John , Moran John , Reid David
Published: March 2018

Objectives:

Medical emergency teams were established to rescue patients experiencing clinical deterioration thus preventing cardiac arrest and unexpected hospital mortality. Although hospitals are encouraged to increase emergency calling rates to improve in-hospital mortality, there are increasing concerns about the impact these calls have on the workload of the teams and the skill levels on the general wards. We set out to examine the relationship between emergency calling rates and adjusted in-hospital mortality.

Design:

Retrospective analysis of prospectively collected patient and emergency call data.

Setting:

Tertiary, metropolitan, and regional hospitals in the State of Victoria, Australia.

Patients:

Consecutive patients discharged from 1) St Vincent’s Hospital Melbourne from January 2008 to June 2016 and 2) 15 Victorian hospitals from July 2010 to June 2015.

Measurements and Main Results:

We studied 441,029 patients from St Vincent’s Hospital Melbourne. Median age was 61.0 years (interquartile range, 45–74 yr), 57.2% were men, and 0.70% died; monthly emergency calling rates varied between 9.21 and 30.69 (median 18.4) per 1,000 discharges. In-hospital mortality adjusted for age, gender, emergency status, same day admission, year of discharge, and Charlson Comorbidity Index was not reduced by higher calling rates in the month of discharge (odds ratio, 1.019; 95% CI, 1.008–1.031). We then examined 3,339,789 discharges from 15 Victorian hospitals with median age 61 years (interquartile range, 43–74 yr), 51.4% men, and hospital mortality 0.83% where yearly emergency calling rates varied from 18.46 to 33.40 (median, 25.75) per 1,000 discharges. Again, adjusted mortality was not reduced by higher calling rates in the year of discharge (odds ratio, 1.003; 95% CI, 1.001–1.006).

Conclusions:

With adjustment for patient factors, illness, and comorbidities, increased emergency calling rates were not associated with reduced in-hospital mortality. Efforts to increase calling rates do not seem warranted.
Diagnostic Accuracy of Chest Radiograph, and When Concomitantly Studied Lung Ultrasound, in Critically Ill Patients With Respiratory Symptoms: A Systematic Review and Meta-Analysis
Authors: Winkler Michiel H. , Touw Hugo R. , van de Ven Peter M. , Twisk Jos , Tuinman Pieter R.
Published: March 2018

Objectives:

Chest radiograph is considered the first-line diagnostic imaging modality for patients presenting with pulmonary symptoms in the ICU. In this meta-analysis, we aim to evaluate the diagnostic accuracy of chest radiograph, and when concomitantly studied lung ultrasound, in comparison with the gold-standard CT for adult critically ill patients with respiratory symptoms.

Data Sources:

PubMed, EMBASE, and Gray literature.

Study Selection:

Studies comparing chest radiograph, and if performed lung ultrasound, with CT for adult ICU patients with respiratory symptoms.

Data Extraction:

Quality was scored with Quality Assessment of Diagnostic Accuracy Studies-2, and study setting, test characteristics, and study design were extracted.

Data Synthesis:

In the meta-analysis, we included 10 full-text studies, including 543 patients, and found that chest radiograph has an overall sensitivity of 49% (95% CI, 40–58%) and specificity of 92% (86–95%). In seven studies, where also lung ultrasound was studied, lung ultrasound had an overall sensitivity of 95% (92–96%) and specificity of 94% (90–97%). Substantial heterogeneity was found. A planned subgroup analysis for individual pathologies was performed. The results of four abstract-only studies, included in the systematic review, were considered unlikely to significantly influence results of our meta-analysis. Study limitations were that most studies were of low power combined with methodological limitations.

Conclusions:

This meta-analysis demonstrates that chest radiograph has a low sensitivity and reasonable specificity compared with CT for detecting lung pathology in critically ill patients. The studies also investigating lung ultrasound, showed lung ultrasound to be clearly superior to chest radiograph in terms of sensitivity with similar specificity, thereby opting to be the first-line diagnostic tool in these patients.