bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes Following Low-Profile Mesh Plate Osteosynthesis of Patella Fractures
Authors: Siljander Matthew , Koueiter Denise , Gandhi Sapan , Wiater Brett , Wiater Patrick
Published: January 2018

Treatment of patella fractures is fraught with complications and historically poor functional outcomes. A fixation method that allows for early mobilization and decreases symptomatic hardware rates will improve knee range of motion, postoperative functional status, and reoperation rates. The purpose of this study was to evaluate the functional outcomes after locked plate osteosynthesis of patella fractures at a Level 1 trauma center. A retrospective case series was conducted of patients who underwent open reduction internal fixation (ORIF) of a patella fracture using a locked mesh plating technique coupled with neutralization of forces on the distal pole of the patella. Twelve patients were evaluated at a mean follow-up of 19 months (range, 6–30) with physical exam, functional outcomes, and radiographs. There were 9 women and 3 men with an average age of 66.1 years (range, 53–75). Radiographic bony union was achieved in all patients by 3-month follow-up. Visual Analog Pain Score averaged 1.7 (median, 1.0; range, 0–8), the mean Knee Outcome Score – Activities of Daily Living Scale was 83.9 (median, 92.1; range, 45.7–100.0), the mean Short Form Musculoskeletal Function Assessment (SMFA) Function Index was 9.9 (median, 3.7; range, 0.7–41.2), and the mean SMFA Bother Index was 11.1 (median, 3.1; range, 0–62.5). The SF-36 Physical Component Score mean was 48.4 ± 8.5 and the SF-36 Mental Component Score mean was 54.1 ± 9.6. No complications developed and there were no reoperations for nonunion, infection, or symptomatic hardware. This study demonstrates that locked plate osteosynthesis for operative patella fractures can reliably achieve bony union with potentially superior functional outcomes as compared with traditional methods. Further studies are needed to evaluate plate fixation for patella fractures, but early results are promising.
Optimierung der Überleitung von der stationären in die ambulante Gesundheitsversorgung nach Schlaganfall (OpTheraS)
Authors: Saal Susanne , Kirchner-Heklau Uta , Müller Tobias , Wohlfarth Kai , Hamzei Farsin , Müller Melanie , Strobel Susanne , Clewing Carsten
Published: January 2018

Ziel Identifikation von Einflussfaktoren der Überleitung in die Häuslichkeit nach Schlaganfall und Ansätzen zur Prozessverbesserung.

Methodik Vergleich der Überleitung aus medizinischer Rehabilitation nach Hause gegenüber der Überleitung aus dem Akutkrankenhaus nach Hause durch Experteninterviews und Gruppendiskussionen mit Gesundheitsprofessionen, ein Scoping Review und eine standardisierte Patientenbefragung 6 Wochen nach Entlassung aus stationärer Behandlung per Telefon.

Ergebnisse Es wurden 14 Experten- und 3 Gruppeninterviews (n=18) geführt. Als Einflussfaktoren der Überleitung wurden u. a. Aspekte der Kommunikation, der sozialen Unterstützung und des Rollenverständnisses der Patienten identifiziert. Die standardisierte Patientenbefragung (n=110) zeigte eine Umsetzung von Empfehlungen fachärztlicher Konsultationen von 37% und von ambulanten Therapien bis zu 86%. Der Scoping Review identifizierte 7 systematische Übersichtsarbeiten, 21 randomisierte Studien und 5 kontrollierte Studien zu edukativen Maßnahmen, Information und Beratung, Early Supported Discharge, stroke liaison services, interprofessionellen Teamkonferenzen und Versorgungspfaden.

Schlussfolgerung Zur Verbesserung der Überleitung nach Hause ist es notwendig, über die Fallebene der Patienten hinaus, Abläufe innerhalb und zwischen den versorgenden Einrichtungen zu berücksichtigen. Die Entwicklung solcher Konzepte sollte sich methodisch am Vorgehen der Entwicklung und Evaluation komplexer Interventionen orientieren.
Non-equilibrium effects of diatomic and polyatomic gases on the shock-vortex interaction based on the second-order constitutive model of the Boltzmann-Curtiss equation
Authors: Singh S. , Karchani A. , Myong R. S.
Published: January 2018

The rotational mode of molecules plays a critical role in the behavior of diatomic and polyatomic gases away from equilibrium. In order to investigate the essence of the non-equilibrium effects, the shock-vortex interaction problem was investigated by employing an explicit modal discontinuous Galerkin method. In particular, the first- and second-order constitutive models for diatomic and polyatomic gases derived rigorously from the Boltzmann-Curtiss kinetic equation were solved in conjunction with the physical conservation laws. As compared with a monatomic gas, the non-equilibrium effects result in a substantial change in flow fields in both macroscale and microscale shock-vortex interactions. Specifically, the computational results showed three major effects of diatomic and polyatomic gases on the shock-vortex interaction: (i) the generation of the third sound waves and additional reflected shock waves with strong and enlarged expansion, (ii) the dominance of viscous vorticity generation, and (iii) an increase in enstrophy with increasing bulk viscosity, related to the rotational mode of gas molecules. Moreover, it was shown that there is a significant discrepancy in flow fields between the microscale and macroscale shock-vortex interactions in diatomic and polyatomic gases. The quadrupolar acoustic wave source structures, which are typically observed in macroscale shock-vortex interactions, were not found in any microscale shock-vortex interactions. The physics of the shock-vortex interaction was also investigated in detail to examine vortex deformation and evolution dynamics over an incident shock wave. A comparative study of first- and second-order constitutive models was also conducted for the enstrophy and dissipation rate. Finally, the study was extended to the shock-vortex pair interaction case to examine the effects of pair interaction on vortex deformation and evolution dynamics.
Internal friction in an intrinsically disordered protein—Comparing Rouse-like models with experiments
Authors: Soranno Andrea , Zosel Franziska , Hofmann Hagen
Published: January 2018

Internal friction is frequently found in protein dynamics. Its molecular origin however is difficult to conceptualize. Even unfolded and intrinsically disordered polypeptide chains exhibit signs of internal friction despite their enormous solvent accessibility. Here, we compare four polymer theories of internal friction with experimental results on the intrinsically disordered protein ACTR (activator of thyroid hormone receptor). Using nanosecond fluorescence correlation spectroscopy combined with single-molecule Förster resonance energy transfer (smFRET), we determine the time scales of the diffusive chain dynamics of ACTR at different solvent viscosities and varying degrees of compaction. Despite pronounced differences between the theories, we find that all models can capture the experimental viscosity-dependence of the chain relaxation time. In contrast, the observed slowdown upon chain collapse of ACTR is not captured by any of the theories and a mechanistic link between chain dimension and internal friction is still missing, implying that the current theories are incomplete. In addition, a discrepancy between early results on homopolymer solutions and recent single-molecule experiments on unfolded and disordered proteins suggests that internal friction is likely to be a composite phenomenon caused by a variety of processes.
Sustainable synthesis of uniform silica microspheres from green liquor of wheat straw pulping and application in natural rubber
Authors: Li Donghan , Wang Lixia , Liao Mingyi , Jiang Kuo , Man Jianzong , Yin Jinpeng , Cui Jinlong , Cheng Fupeng , Sun Juncai
Published: January 2018

In order to recycle alkali chemicals from wheat straw alkaline pulping waste liquor effectively, an environmentally friendly route was developed to remove silicate containing in the green liquor of wheat straw pulping. In this route, silica (SiO2) microspheres were synthesized from wheat straw green liquor (WSGL) using carbon dioxide (CO2) as the precipitating reagent and anhydrous ethanol as the dispersant at different stirring rates. The resulting SiO2 microspheres with narrow size distribution had an amorphous structure with a diameter of about 190 nm under the optimal synthesis conditions with a pH value of 8.6, a stirring rate of 100 r min−1, and an ethanol addition amount of 60 ml. In this optimized route, the SiO2 removal rate (SRT) of WSGL was more than 99%. Except CO2, all the chemical reagents used in the designed process had been validly used. The SiO2 microspheres obtained from WSGL could be used as reinforcing agents to strengthen the mechanical properties of natural rubber.
Enzymatic microalgae oil transesterification with ethanol in mineral diesel fuel media
Authors: Gumbytė Milda , Makareviciene Violeta , Skorupskaite Virginija , Sendzikiene Egle , Kondratavicius Mindaugas
Published: January 2018

This article examines opportunities of enzyme application during the production of biodiesel from microalgae oil by its transesterification in the mixture with mineral diesel fuel. The oil and mineral diesel fuel ratio in the reaction mixture enabled a yield of 7% ester content in the mixture. Effectiveness tests were conducted on seven industrial lipases, and Lipozyme TL IM was selected as the most effective lipase for further optimization. The process of algae oil transesterification with ethanol was optimized by applying response surface methodology. The interactions and impacts of the following independent variables on the transesterification yield were evaluated: ethanol and oil molar ratio, process duration, lipase content, and temperature. Optimum conditions were determined: a temperature of 30 °C, 13.26% biocatalyst (from the oil content), an ethanol and oil molar ratio of 4.54:1, and a process duration of 13 h. The transesterification yield of the product under the above conditions reached 98%.
Two X-ray methods combine to map molarity of cellular substructures in a freeze-dried sample
Authors: Majors J. H.
Published: January 2018

X-ray phase nanotomagraphy maps molarity from X-ray fluorescence data to the subcellular structure of freeze-dried human phagocytic cells with nanometer resolution.
Dissipative solitons exhibit ability to split without losing amplitude in models
Authors: Liebendorfer Adam
Published: January 2018

Optical simulations show external magnetic fields can cause non-classical solitary waveforms to simultaneously replicate and amplify, which has broad implications for nonlinear physics.
Sensitivity and uncertainty analysis of the HYDRUS-1D model for root water uptake in saline soils
Authors: Zeng Wenzhi , Lei Guoqing , Zha Yuanyuan , Fang Yuanhao , Wu Jingwei , Huang Jiesheng
Published: January 2018

A variance-based global sensitivity analysis (extended Fourier amplitude sensitivity test, EFAST) was applied to the Feddes module of the HYDRUS-1D model, and the sensitivity indices including both main and total effects of actual root water uptake (RWUa) to seven Feddes parameters were quantified at different growth stages of sunflower (Helianthus annuus L.): seedling, bud, flowering and maturity. The effects of soil salinity, climate conditions, and crop root growth on parameter sensitivity were explored by analysing three precipitation frequencies and two maximum root depths across four field locations with different soil salinity levels in China’s sunflower-growing regions. Uncertainties for RWUa were evaluated at four stages with varying Feddes parameters for different field locations, precipitation frequencies and maximum root depths. We found that the water stress factor concerning ceasing root water uptake (h4), and two salt stress factors ht and Sp, indicating the salinity threshold and the slope of the curve determining the fractional decline in root water uptake per unit increase in salinity below the threshold, respectively, were three most important Feddes parameters for RWUa estimation in HYDRUS-1D. In addition, the effects of soil salinity and precipitation frequencies were stronger than maximum root depth on the order of the parameters’ impacts on RWUa. Our study suggested that h1, h2, h3h, and h3l might be determined by an economical method (e.g. literature review) in saline soils with limited observations, but it is better to calibrate wilting point (h4) and salt stress parameters (ht and Sp) based on local measurements.
Polaronic behavior in a weak-coupling superconductor
Authors: Swartz Adrian G. , Inoue Hisashi , Merz Tyler A. , Hikita Yasuyuki , Raghu Srinivas , Devereaux Thomas P. , Johnston Steven , Hwang Harold Y.
Published: January 2018

Significance

The perovskite oxide SrTiO3 is an n-type semiconductor, which exhibits superconductivity at low temperatures even though there are extraordinarily few electrons. In most materials, with so few electrons it becomes difficult to pair them into a macroscopic superconducting ground state. This regime is also unusual in that most theories of superconductivity rely on electrons that are much faster than their coupling (typically lattice vibrations or phonons). By using techniques in which tunneling junctions are engineered with atomic recision, we are able to probe the electronic structure of this material. The experiments indicate a large discrepancy between the electron–phonon coupling strength and the superconducting properties. This places SrTiO3, a host material for a variety of exotic quantum phases (i.e., in FeSe/SrTiO3, LaAlO3/SrTiO3), in a unique regime of superconductivity.
Effects of the ecto-ATPase apyrase on microglial ramification and surveillance reflect cell depolarization, not ATP depletion
Authors: Madry Christian , Arancibia-Cárcamo I. Lorena , Kyrargyri Vasiliki , Chan Victor T. T. , Hamilton Nicola B. , Attwell David
Published: January 2018

Significance

ATP mediates interactions between cells in many tissues, but is particularly important for microglia, the brain’s immune cells, which constantly survey the brain to detect infection and regulate the brain’s wiring during development. It is controversial whether the ceaseless movement of microglia is driven by ATP release from brain cells. We show that an enzyme (apyrase) widely used to manipulate ATP levels is contaminated with K+ions which inhibit microglial surveillance, and that no ATP release is needed to drive microglial process movement. Thus, all conclusions about a role of ATP in signaling based on applying apyrase need reexamining, and brain immune surveillance is not regulated by ATP release.
Restoring GABAergic inhibition rescues memory deficits in a Huntington’s disease mouse model
Authors: Dargaei Zahra , Bang Jee Yoon , Mahadevan Vivek , Khademullah C. Sahara , Bedard Simon , Parfitt Gustavo Morrone , Kim Jun Chul , Woodin Melanie A.
Published: January 2018

Significance

Huntington’s disease (HD) is a fatal neurodegenerative disorder that currently has no cure. Although HD is classically considered a motor disorder, HD patients experience learning and memory deficits years before the onset of motor symptoms, and these deficits resemble those observed in HD mouse models. In this work, using transgenic mouse models of HD, we demonstrate that the action of the neurotransmitter GABA has switched from inhibitory to excitatory. By treating HD mice with a clinically used diuretic (bumetanide), which restores inhibitory GABA, we rescued the learning and memory deficits. Our data suggest a potential therapeutic approach for the treatment of the cognitive deficits in early HD that can improve patient quality of life and reduce caregiver burden.
Farming the mitochondrial ancestor as a model of endosymbiotic establishment by natural selection
Authors: Zachar István , Szilágyi András , Számadó Szabolcs , Szathmáry Eörs
Published: January 2018

The origin of mitochondria was a major evolutionary transition leading to eukaryotes, and is a hotly debated issue. It is unknown whether mitochondria were acquired early or late, and whether it was captured via phagocytosis or syntrophic integration. We present dynamical models to directly simulate the emergence of mitochondria in an ecoevolutionary context. Our results show that regulated farming of prey bacteria and delayed digestion can facilitate the establishment of stable endosymbiosis if prey-rich and prey-poor periods alternate. Stable endosymbiosis emerges without assuming any initial metabolic benefit provided by the engulfed partner, in a wide range of parameters, despite that during good periods farming is costly. Our approach lends support to the appearance of mitochondria before any metabolic coupling has emerged, but after the evolution of primitive phagocytosis by the urkaryote.
A Theoretical and Empirical Review of Dialectical Behavior Therapy Within Forensic Psychiatric and Correctional Settings Worldwide
Authors: Tomlinson Monica F.
Published: January 2018

Cognitive-behavioral programs which are structured, skills-based, and risk-focused have been found to reduce recidivism rates by up to 55%. Dialectical behavior therapy (DBT) exemplifies all of these components, and has been rapidly adapted and implemented in correctional and forensic psychiatric facilities worldwide to reduce recidivism. Regrettably, the widespread implementation of adapted DBT has outpaced the research on its effectiveness for this purpose. Thus, it is currently unclear whether these programs are meeting the rehabilitation needs of these systems. In the following article, a qualitative systematic literature review of all DBT programs within forensic psychiatric and correctional populations using the PRISMA statement guidelines is presented, along with a detailed exploration of how these programs align with best practices in offender rehabilitation, and whether they are effective in reducing recidivism risk. Results offer very preliminary evidence that DBT has the potential to reduce recidivism risk in criminal justice systems if applied within a Risk-Need-Responsivity framework.
Psychiatric and Other Contributing Factors in Homicide-Suicide Cases, from Northern Gauteng, South Africa Over a Six-Year Period
Authors: Kotzé Carla , Khamker Nadira , Lippi Gian , Naidu Kalai , Pooe J. Mosidi , Sokudela Funeka B. , Roos J. Louw
Published: January 2018

Homicide committed by a person who subsequently commits suicide within one week of the homicide is a relatively rare event. The current study used an explanatory sequential design, including psychological autopsies, to identify psychiatric and other contributing factors in 35 homicide-suicide cases in northern Gauteng Province, South Africa. This research highlighted the complex multifactorial nature of these events. Identification of high-risk individuals and delineation of contributing factors is important. Early recognition and effective treatment of psychiatric illness, particularly depression and substance use problems, in people experiencing relationship issues (with pending/recent separations) and financial stressors, is an essential component in the prevention of homicide-suicide incidents. Evaluations should always include direct questioning about suicidal and homicidal ideations. Mental health practitioners have a definite role to play in offering comfort, support, and treatment to all those who remain behind after these devastating events. Urgent attention needs to be given to the availability of support and treatment for investigating police officers and surviving family and friends.
Report of the key-comparison of spectral diffuse reflectance (EURAMET.PR-K5) (Ref. 619)
Authors: Andor György , Gál Péter
Published: January 2018

This report details the final results of the EURAMET comparison on regular spectral transmittance carried out between 2006 and 2016.

The aim of this comparison was to check the agreement of measurement of the spectral diffuse reflectance among participants, using the measurement geometry of d/0 or 0/d in the wavelength range of 360 nm to 780 nm at 20 nm increment. We used a star type comparison: first the participants sent their samples to the pilot, than the pilot measured all the samples of the participants and sent them back. The participants measured the samples and sent them to the pilot for control measurement.

Six standards were used as reference standards in order to maintain the scale during the comparison. These were three samples of BCR-406 opal glasses (BCR 30506; BCR 30303; BCR 30704), an MC20 Russian opal glass (MC 4777) and two samples made of pressed halon (polytetrafluoroethylene) powder (halon 2007A; halon 2007C). These six samples were designated as the Comparison reference standards. The diffuse reflectance was initially measured on the OMH (BFKH) absolute reflectometer.

The link to the CCPR-K5 results was BFKH, and the check on BFKH was the PTB results who also participated in the CCPR-K5 comparison.

The participants were GUM, INM, LNE, METAS, BFKH, PTB, SP.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCPR, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Three-dimensional Simulation and Prediction of Solenoid Valve Failure Mechanism Based on Finite Element Model
Authors: Li Jianfeng , Xiao Mingqing , Liang Yajun , Tang Xilang , Li Chao
Published: January 2018

The solenoid valve is a kind of basic automation component applied widely. It’s significant to analyze and predict its degradation failure mechanism to improve the reliability of solenoid valve and do research on prolonging life. In this paper, a three-dimensional finite element analysis model of solenoid valve is established based on ANSYS Workbench software. A sequential coupling method used to calculate temperature filed and mechanical stress field of solenoid valve is put forward. The simulation result shows the sequential coupling method can calculate and analyze temperature and stress distribution of solenoid valve accurately, which has been verified through the accelerated life test. Kalman filtering algorithm is introduced to the data processing, which can effectively reduce measuring deviation and restore more accurate data information. Based on different driving current, a kind of failure mechanism which can easily cause the degradation of coils is obtained and an optimization design scheme of electro-insulating rubbers is also proposed. The high temperature generated by driving current and the thermal stress resulting from thermal expansion can easily cause the degradation of coil wires, which will decline the electrical resistance of coils and result in the eventual failure of solenoid valve. The method of finite element analysis can be applied to fault diagnosis and prognostic of various solenoid valves and improve the reliability of solenoid valve’s health management.
The Study of “big data” to support internal business strategists
Authors: Ge Mei
Published: January 2018

How is big data different from previous data analysis systems? The primary purpose behind traditional small data analytics that all managers are more or less familiar with is to support internal business strategies. But big data also offers a promising new dimension: to discover new opportunities to offer customers high-value products and services. The study focus to introduce some strategists which big data support to. Business decisions using big data can also involve some areas for analytics. They include customer satisfaction, customer journeys, supply chains, risk management, competitive intelligence, pricing, discovery and experimentation or facilitating big data discovery.
The Optimization dispatching of Micro Grid Considering Load Control
Authors: Zhang Pengfei , Xie Jiqiang , Yang Xiu , He Hongli
Published: January 2018

This paper proposes an optimization control of micro-grid system economy operation model. It coordinates the new energy and storage operation with diesel generator output, so as to achieve the economic operation purpose of micro-grid. In this paper, the micro-grid network economic operation model is transformed into mixed integer programming problem, which is solved by the mature commercial software, and the new model is proved to be economical, and the load control strategy can reduce the charge and discharge times of energy storage devices, and extend the service life of the energy storage device to a certain extent.
Evaluation of tools for highly variable gene discovery from single-cell RNA-seq data
Authors: Yip Shun H , Sham Pak Chung , Wang Junwen
Published: January 2018

Traditional RNA sequencing (RNA-seq) allows the detection of gene expression variations between two or more cell populations through differentially expressed gene (DEG) analysis. However, genes that contribute to cell-to-cell differences are not discoverable with RNA-seq because RNA-seq samples are obtained from a mixture of cells. Single-cell RNA-seq (scRNA-seq) allows the detection of gene expression in each cell. With scRNA-seq, highly variable gene (HVG) discovery allows the detection of genes that contribute strongly to cell-to-cell variation within a homogeneous cell population, such as a population of embryonic stem cells. This analysis is implemented in many software packages. In this study, we compare seven HVG methods from six software packages, including BASiCS, Brennecke, scLVM, scran, scVEGs and Seurat. Our results demonstrate that reproducibility in HVG analysis requires a larger sample size than DEG analysis. Discrepancies between methods and potential issues in these tools are discussed and recommendations are made.
Electronic problem lists: a thematic analysis of a systematic literature review to identify aspects critical to success
Authors: Hodge Chad M , Narus Scott P
Published: January 2018

Objective

Problem list data is a driving force for many beneficial clinical tools, yet these data remain underutilized. We performed a systematic literature review, pulling insights from previous research, aggregating insights into themes, and distilling themes into actionable advice. We sought to learn what changes we could make to existing applications, to the clinical workflow, and to clinicians’ perceptions that would improve problem list utilization and increase the prevalence of problems data in the electronic medical record.

Materials and Methods

We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to systematically curate a corpus of pertinent articles. We performed a thematic analysis, looking for interesting excerpts and ideas. By aggregating excerpts from many authors, we gained broader, more inclusive insights into what makes a good problem list and what factors are conducive to its success.

Results

Analysis led to a list of 7 benefits of using the problem list, 15 aspects critical to problem list success, and knowledge to help inform policy development, such as consensus on what belongs on the problem list, who should maintain the problem list, and when.

Conclusions

A list of suggestions is made on ways in which the problem list can be improved to increase utilization by clinicians. There is also a need for standard measurements of the problem list, so that lists can be measured, compared, and discussed with rigor and a common vocabulary.
Hypertension Among Persons Living With HIV in Medical Care in the United States—Medical Monitoring Project, 2013–2014
Authors: Olaiya Oluwatosin , Weiser John , Zhou Wen , Patel Pragna , Bradley Heather
Published: January 2018

Hypertension is a leading modifiable risk factor for cardiovascular disease (CVD), and persons living with HIV are at increased risk for both hypertension and CVD. Therefore, using data from a nationally representative sample of patients living with HIV, we assessed missed opportunities for the optimal management of hypertension.
MAPKK Inhibitor U0126 Inhibits Plasmodiophora brassicae Development
Authors: Chen Tao , Bi Kai , Zhao Yanli , Lyu Xueliang , Gao Zhixiao , Zhao Ying , Fu Yanping , Cheng Jiasen , Xie Jiatao , Jiang Daohong
Published: January 2018

Mitogen-activated protein kinase (MAPK) cascades play a central role in cellular growth, proliferation, and survival. MAPK cascade genes have been extensively investigated in model plants, mammals, yeast, and fungi but are not characterized in Plasmodiophora brassicae, which causes clubroot disease in cruciferous plants. Here, we identified 7 PbMAPK, 3 PbMAPKK, and 9 PbMAPKKK genes in the P. brassicae genome. Transcriptional profiling analysis demonstrated that several MAPK, MAPK kinase (MAPKK), and MAPK kinase kinase (MAPKKK) genes were preferentially expressed in three different zoosporic stages. Based on yeast two-hybrid assays, PbMAKKK7 interacted with PbMAKK3 and PbMAKK3 interacted with PbMAK1/PbMAK3. The PbMAKKK7-PbMAKK3-PbMAK1/PbMAK3 cascade may be present in P. brassicae. U0126, a potent and specific inhibitor of MAPKK, could inhibit the germination of P. brassicae resting spores. U0126 was used to treat the resting spores of P. brassicae and coinoculate rapeseed, and was proven to significantly relieve the severity of clubroot symptoms in the host plant and delay the life cycle of P. brassicae. These results suggest that MAPK signaling pathways may play important roles in P. brassicae growth, development, and pathogenicity.
Menstrual Cycle in Women Who Co-use Marijuana and Tobacco
Authors: Lammert Sara , Harrison Katherine , Tosun Nicole , Allen Sharon
Published: January 2018

Objective:

Marijuana is the most commonly used illicit drug in the United States and co-use with tobacco is increasing. Preliminary studies have indicated that marijuana may suppress luteinizing hormone (LH) or shorten the luteal phase. Although the literature is mixed, these sex hormones may play a role in smoking cessation outcomes. This secondary subgroup analysis aims to explore the menstrual cycle of females who co-use marijuana and tobacco compared with females who only use tobacco in a sample of tobacco treatment-seeking individuals.

Methods:

Female participants, aged 18 to 50 years, who self-reported regular menstrual cycles and co-use of marijuana and tobacco were matched 1:3 by age to participants who only use tobacco. Length of the follicular and luteal phases was determined using First Response Urine LH tests. Wilcoxon 2-sample t tests were used to determine differences in phase lengths between groups.

Results:

Thirteen women who co-use marijuana and tobacco, and 39 women who only use tobacco were included in this analysis. Overall, participants were 37.3 ± 8.0 (SD) years of age, mostly Caucasian (67%), and smoked 12.6 ± 5.2 (SD) cigarettes per day. The luteal phase length among participants who co-use marijuana and tobacco (11.4 days ± 2.2 [SD]) was significantly shorter than among participants who only use tobacco (16.8 days ± 11.3 [SD]; P = 0.002). No differences were found in follicular phase length or menstrual cycle length.

Conclusions:

These data suggest that females who co-use marijuana and tobacco may have a shortened luteal phase in comparison with females who only use tobacco. Further studies are needed to better understand how marijuana use may impact the menstrual cycle and affect smoking outcomes.
Reducing Anxiety and Improving Engagement in Health Care Providers Through an Auricular Acupuncture Intervention
Authors: Buchanan Teresa M. , Reilly Patricia M. , Vafides Carol , Dykes Patricia
Published: January 2018

Background

Stress and anxiety are experienced by health care providers as a consequence of caregiving and may result in physical, emotional, and psychological outcomes that negatively impact work engagement.

Aim

The purpose of this study was to determine whether auricular acupuncture can reduce provider anxiety and improve work engagement.

Methods

Study participants received 5 auricular acupuncture sessions within a 16-week period utilizing the National Acupuncture Detoxification Association protocol for treating emotional trauma. Each participant completed the State-Trait Anxiety Inventory and the Utrecht Work Engagement Scale (UWES-9) prior to their first session and again after their fifth treatment.

Results

Significant reductions were found in state and trait anxiety (State-Trait Anxiety Inventory), as well as significant increases in the overall scores on the UWES as compared with baseline. Only the dedication subcategory of the UWES showed significant improvement.

Conclusions

Engagement has been linked to increased productivity and well-being and improved patient and organizational outcomes. Providing effective strategies such as auricular acupuncture to support health care providers in reducing anxiety in the workplace may improve engagement.
Early Predictors for Long-Term Functional Outcome After Mild Traumatic Brain Injury in Frail Elderly Patients
Authors: Abdulle Amaal Eman , de Koning Myrthe E. , van der Horn Harm J. , Scheenen Myrthe E. , Roks Gerwin , Hageman Gerard , Spikman Jacoba M. , van der Naalt Joukje
Published: January 2018

Objective:

To identify the effect of frailty and early postinjury measures on the long-term outcome after mild traumatic brain injury in elderly patients.

Setting:

Patients admitted to 3 Dutch hospitals designated as level 1 trauma centers.

Participants:

The elderly (≥60 years) with mild traumatic brain injury (N = 161).

Design:

A prospective observational cohort study.

Main Measures:

Posttraumatic complaints and the Hospital Anxiety and Depression Scale determined 2 weeks postinjury; the Glasgow Outcome Scale Extended and Groningen frailty indicator determined 1 to 3 years postinjury.

Results:

A total of 102 nonfrail (63%) and 59 frail elderly (37%) patients, mean age of 70.8 (6.3) years were included. Most patients (54%; 72% nonfrail and 24% frail) recovered completely 1 to 3 years postinjury. Two weeks postinjury, 81% had posttraumatic complaints (83% frail and 80% nonfrail elderly), and 30% showed emotional distress (50% frail and 20% nonfrail). Frailty (odds ratio, 2.1; 95% confidence interval, 1.59-2.77) and presence of early complaints (odds ratio, 1.13; 95% confidence interval, 1.01-1.27) (Nagelkerke R
2 = 46%) were found to predict long-term outcome, whereas age was not a significant predictor.

Conclusion:

The frail elderly had worse long-term outcome, and early complaints were found to be a stronger predictor of unfavorable outcome than age. Understanding the implications of frailty on outcome could help clinicians recognize patients at risk of a poor outcome and allocate care more efficiently.
Cardiovascular Stress Reactivity and Carotid Intima-Media Thickness: The Buffering Role of Slow-Wave Sleep
Authors: Brindle Ryan C. , Duggan Katherine A. , Cribbet Matthew R. , Kline Christopher E. , Krafty Robert T. , Thayer Julian F. , Mulukutla Suresh R. , Hall Martica H.
Published: January 2018

Objective

Exaggerated cardiovascular reactivity to acute psychological stress has been associated with increased carotid intima-media thickness (IMT). However, interstudy variability in this relationship suggests the presence of moderating factors. The current study aimed to test the hypothesis that poor nocturnal sleep, defined as short total sleep time or low slow-wave sleep, would moderate the relationship between cardiovascular reactivity and IMT.

Methods

Participants (N= 99, 65.7% female, age = 59.3 ± 9.3 years) completed a two-night laboratory sleep study and cardiovascular examination where sleep and IMT were measured. The multisource interference task was used to induce acute psychological stress, while systolic and diastolic blood pressure and heart rate were monitored. Moderation was tested using the PROCESS framework in SPSS.

Results

Slow-wave sleep significantly moderated the relationship between all cardiovascular stress reactivity variables and IMT (allpinteraction≤ .048, all ΔR2interaction≥ .027). Greater stress reactivity was associated with higher IMT values in the low slow-wave sleep group and lower IMT values in the high slow-wave sleep group. No moderating effects of total sleep time were observed.

Conclusions

The results provide evidence that nocturnal slow-wave sleep moderates the relationship between cardiovascular stress reactivity and IMT and may buffer the effect of daytime stress-related disease processes.
Nickel–Titanium Wire as Suture Material: A New Technique for the Fixation of Skin
Authors: Li Haidong , Song Tao
Published: January 2018

Purpose:

To introduce nickel–titanium wire as suture material for closure of incisions in cleft lip procedures.

Method:

Closure of skin incisions using nickel–titanium wire as suture material, with postoperative follow-up wound evaluation.

Results:

There was excellent patient satisfaction and good cosmetic outcome.

Conclusion:

Nickel–titanium wire is an excellent alternative for suture closure of cleft lip surgical incisions.
Trismus in Face Transplantation Following Ballistic Trauma
Authors: Krezdorn Nicco , Alhefzi Muayyad , Perry Bridget , Aycart Mario A. , Tasigiorgos Sotirios , Bueno Ericka M. , Green Jordan R. , Pribaz Julian J. , Pomahac Bohdan , Caterson Edward J.
Published: January 2018

Background:

Trismus can be a challenging consequence of ballistic trauma to the face, and has rarely been described in the setting of face transplantation. Almost half of all current face transplant recipients in the world received transplantation to restore form and function after a ballistic injury. Here we report our experience and challenges with long standing trismus after face transplantation.

Methods:

We reviewed the medical records of our face transplant recipients whose indication was ballistic injury. We focused our review on trismus and assessed the pre-, peri- and postoperative planning, surgery and functional outcomes.

Results:

Two patients received partial face transplantation, including the midface for ballistic trauma. Both patients suffered from impaired mouth opening, speech intelligibility, and oral competence. Severe scarring of the temporomandibular joint (TMJ) required intraoperative release in both patients, and additional total condylectomy on the left side 6 months posttransplant for 1 patient. Posttransplant, both patients achieved an improvement in mouth opening; however, there was persistent trismus. One year after transplantation, range of motion of the jaw had improved for both patients. Independent oral food intake was possible 1 year after surgery, although spillage of liquids and mixed consistency solids persisted. Speech intelligibility testing showed impairments in the immediate postoperative period, with improvement to over 85% for both patients at 1 year posttransplant.

Conclusions:

Ballistic trauma to the face and subsequent reconstructive measures can cause significant scarring and covert injuries to structures such as the TMJ, resulting in long standing trismus. Meticulous individual planning prior to interventions such as face transplantation must take these into account. We encourage intraoperative evaluation of these structures as well as peri- and postoperative treatment when necessary. Due to the nature of the primary injury, functional outcomes after face transplantation in these patients may differ substantially from those of other indications.
Treatment of Mandibular Ameloblastoma Involving the Mandibular Condyle: Resection and Concomitant Reconstruction With a Custom Hybrid Total Joint Prosthesis and Iliac Bone Graft
Authors: Sarlabous Mathilde , Psutka David J.
Published: January 2018

Aim:

To describe the treatment of ameloblastoma involving the mandibular body and condyle in 3 patients.

Methods:

This report describes 3 patients with large ameloblastomas (2 were second recurrences) treated by partial mandibular resection. Involvement of the mandibular condyle in these 3 patients made the reconstruction more challenging. Reconstruction included immediate temporomandibular joint replacement by a custom-made alloplastic total joint and mandibular body (Zimmer-Biomet, Jacksonville, FL). These devices were designed using virtual surgical planning software. The 3 patients underwent concomitant bone graft reconstruction using autogenous-free corticocancellous block bone grafts from the iliac crest. This facilitated later dental implant placement and full dental rehabilitation. Direct inferior alveolar nerve repair or nerve graft reconstruction with allograft was also carried out for all 3 patients. Maxillomandibular fixation was not used in all 3 patients.

Results:

All the 3 patients underwent successful surgery and recovery. Mandibular function was preserved. The concomitant bone graft allowed successful dental implant placement for subsequent planned restorative dentistry.

Conclusion:

Ameloblastoma involving the mandibular condyle can be successfully treated by resection and concomitant total joint replacement with an alloplastic device. This technique shows promise in that there is rapid return to excellent function thanks to rigid fixation of the construct. Mirroring software used in the prosthesis design facilitates excellent cosmetic outcomes.
The Current State of Surgical Ergonomics Education in U.S. Surgical Training
Authors: Epstein Sherise , Tran Bao N. , Capone Avery C. , Ruan Qing Z. , Fukudome Eugene Y. , Ricci Joseph A. , Testa Marcia A. , Dennerlein Jack T. , Lee Bernard T. , Singhal Dhruv
Published: January 2018

Objective:

The aim of this study was to characterize the current state of surgical ergonomics education in the United States.

Background:

The burden of work-related musculoskeletal disorders (MSDs) in surgeons is high and no overarching strategy for redress exists. Twelve distinct specialties describe an unmet need for surgical ergonomics education (SEE). This study aimed to define the current state of SEE in U.S. surgical training programs.

Methods:

We performed a descriptive analysis of a 20-item questionnaire of ACGME-certified program directors from 14 surgical and interventional medical specialties. Formal SEE was defined as any organized education module that reviewed the occupation-specific burden of common work-related MSDs and described a framework for prevention via occupation-specific applied ergonomics. Program directors were queried regarding SEE provision, characteristics, and perceived trainee attitude toward the education.

Results:

Questionnaires were received from 130 of 441 (29.5%) program directors. Two (1.5%) provided formal SEE and 33 (25.4%) provided informal SEE, which consisted of unstructured intraoperative directives and isolated lectures. Two programs previously provided SEE but discontinued the effort due to lack of an evidence-based framework and instructors. Trainees appeared to think that learning surgical ergonomics skills was a worthwhile time investment in 100% and 76.7% of current formal and informal SEE, respectively.

Conclusion:

SEE is rarely provided in any capacity (25.4%), let alone in a consistent or evaluable fashion (1.5%). Impediments to sustainable SEE include lack of an evidence-based framework for education and instructors. An evidence-based, reproducible, and accreditation council-compliant SEE module would be a valuable resource for the surgical and interventional medical communities.
Identification of Variable and Joining germline genes and alleles for Rhesus macaque from B-cell receptor repertoires
Authors: Zhang Wei , Li Xinyue , Wang Longlong , Deng Jianxiang , Lin Liya , Tian Lei , Wu Jinghua , Yang Huanming , Wang Jian , Qiu Ping , Fu Tong-Ming , Saksena Nitin K. , Wang I-Ming , Liu Xiao
Published: January 2018

The Rhesus macaque is a valuable preclinical animal model to estimate vaccine effectiveness, and is also important for understanding antibody maturation and B-cell repertoire evolution responding to vaccination; however, incomplete mapping of rhesus immunoglobulin germline genes hinders the research efforts. To address this deficiency, we sequenced B-cell receptor (BCR) repertoires of 75 India Rhesus macaques. Using a bioinformatic method that has been validated with BCR repertoire analysis of three human donors, we were able to infer rhesus Variable (V) and Joint(J) germline alleles, identifying a total of 122 V and 20 J germline alleles. Importantly, 91 V and 13 J alleles were novel, and 40 V and 13 J genes were found at a novel genome region that has not been previously recorded. The novelty of these newly identified alleles was supported by two observations. Firstly, 50 V and 5 J novel alleles were observed in whole genome sequencing data of 10 Rhesus macaques. Secondly, using alignment reference including the novel alleles, the mutation rate of rearranged repertoires was significant declined in 9 other irrelevant samples, and all our identified novel V and J alleles were 100% identity mapped by rearranged repertoire data. These newly identified novel alleles, along with previous reported alleles, provide an important reference for future investigations of rhesus immune repertoire evolution, in response to vaccination or infection. In addition, the method outlined in our study offered an example to future efforts in identifying novel immunoglobulin alleles.
The primacy model and the structure of olfactory space
Authors: Giaffar Hamza , Shuvaev Sergey , Rinberg Dmitry , Koulakov Alexei A.
Published: January 2018

Understanding sensory processing relies on establishing a consistent relationship between the stimulus space, its neural representation, and perceptual quality. In olfaction, the difficulty in establishing these links lies partly in the complexity of the underlying odor input space and perceptual responses. Based on the recently proposed primacy code for concentration invariant odor identity representation and a few assumptions, we have developed a theoretical framework for mapping the odor input space to the response properties of olfactory receptors. We analyze a geometrical structure containing odor representations in a multidimensional space of receptor affinities and describe its low-dimensional implementation, the primacy hull. We propose the implications of the primacy hull for the structure of feedforward connectivity in early olfactory networks. We test the predictions of our theory by comparing the existing receptor-ligand affinity and connectivity data obtained in the fruit fly olfactory system. We find that the Kenyon cells of the insect mushroom body integrate inputs from the high-affinity (primacy) sets of olfactory receptors in agreement with the primacy theory.
Investigating the shared genetics of non-syndromic cleft lip/palate and facial morphology
Authors: Howe Laurence J , Lee Myoung Keun , Sharp Gemma C , Smith George Davey , Pourcain Beate St , Shaffer John R , Marazita Mary L , Feingold Eleanor , Zhurov Alexei , Stergiakouli Evie , Sandy Jonathan , Richmond Stephen , Weinberg Seth M , Hemani Gibran , Lewis Sarah J
Published: January 2018

There is increasing evidence that genetic risk variants for non-syndromic cleft lip/palate (nsCL/P) are also associated with normal-range variation in facial morphology. However, previous analyses are mostly limited to candidate SNPs and findings have not been consistently replicated. Here, we used polygenic risk scores (PRS) to test for genetic overlap between nsCL/P and seven biologically relevant facial phenotypes. Where evidence was found of genetic overlap, we used bidirectional Mendelian randomization (MR) to test the hypothesis that genetic liability to nsCL/P is causally related to implicated facial phenotypes. Across 5,804 individuals of European ancestry from two studies, we found strong evidence, using PRS, of genetic overlap between nsCL/P and philtrum width; a 1 S.D. increase in nsCL/P PRS was associated with a 0.10 mm decrease in philtrum width (95% C.I. 0.054, 0.146; P = 0.00002). Follow-up MR analyses supported a causal relationship; genetic variants for nsCL/P homogeneously cause decreased philtrum width. In addition to the primary analysis, we also identified two novel risk loci for philtrum width at 5q22.2 and 7p15.2 in our Genome-wide Association Study (GWAS) of 6,136 individuals. Our results support a liability threshold model of inheritance for nsCL/P, related to abnormalities in development of the philtrum.