bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of benchmarked kinetic resistive wall mode stability codes to ITER, including additional physics
Authors: Berkery J. W. , Wang Z. R. , Sabbagh S. A. , Liu Y. Q. , Betti R. , Guazzotto L.
Published: November 2017

Leading resistive wall mode (RWM) stability codes MARS-K [Liu et al., Phys. Plasmas 15, 112503 (2008)] and MISK [Hu et al., Phys. Plasmas 12, 057301 (2005)] have been previously benchmarked. The benchmarking has now been extended to include additional physics and used to project the stability of ITER in a realistic operating space. Due to ITER's relatively low plasma rotation and collisionality, collisions and non-resonance rotational effects were both found to have little impact on stability, and these non-resonance rotational effects will also not self-consistently affect the ITER RWM eigenfunction. Resonances between thermal ions and electrons and the expected level of ITER toroidal rotation were found to be important to stability, as were alpha particles, which are not in rotational resonance. MISK calculations show that without alpha particles, ITER is projected to be unstable to the RWM, but the expected level of alphas is calculated to provide a sufficient level of stability.
Ion sensitivity of large-area epitaxial graphene film on SiC substrate
Authors: Mitsuno Takanori , Taniguchi Yoshiaki , Ohno Yasuhide , Nagase Masao
Published: November 2017

We investigated the intrinsic ion sensitivity of graphene field-effect transistors (FETs) fabricated by a resist-free stencil mask lithography process from a large-scale graphene film epitaxially grown on a SiC substrate. A pH-adjusted phosphate-buffered solution was used for the measurement to eliminate the interference of other ions on the graphene FET's ion sensitivity. The charge neutrality point shifted negligibly with changing pH for the pH-adjusted phosphate-buffered solution, whereas for the mixed buffer solution, it shifted toward the negative gate voltage owing to the decrease in the concentration of phthalate ions. This phenomenon is contrary to that observed in previous reports. Overall, our results indicate that the graphene film is intrinsically insensitive to ions except for those with functional groups that interact with the graphene surface.
Effect of the RC time on photocurrent transients and determination of charge carrier mobilities
Authors: Kniepert Juliane , Neher Dieter
Published: November 2017

We present a closed analytical model to describe time dependent photocurrents upon pulsed illumination in the presence of an external RC circuit. In combination with numerical drift diffusion simulations, it is shown that the RC time has a severe influence on the shape of the transients. In particular, the maximum of the photocurrent is delayed due to a delayed recharging of the electrodes. This delay increases with the increasing RC constant. As a consequence, charge carrier mobilities determined from simple extrapolation of the initial photocurrent decay will be in general too small and feature a false dependence on the electric field. Here, we present a recipe to correct charge carrier mobilities determined from measured photocurrent transients by taking into account the RC time of the experimental set-up. We also demonstrate how the model can be used to more reliably determine the charge carrier mobility from experimental data of a typical polymer/fullerene organic solar cell. It is shown that further aspects like a finite rising time of the pulse generator and the current contribution of the slower charger carriers influence the shape of the transients and may lead to an additional underestimation of the transit time.
Plasmonic nanolaser for intracavity spectroscopy and sensorics
Authors: Melentiev P. , Kalmykov A. , Gritchenko A. , Afanasiev A. , Balykin V. , Baburin A. S. , Ryzhova E. , Filippov I. , Rodionov I. A. , Nechepurenko I. A. , Dorofeenko A. V. , Ryzhikov I. , Vinogradov A. P. , Zyablovsky A. A. , Andrianov E. S. , Lisyansky A. A.
Published: November 2017

We demonstrate intracavity plasmonic laser spectroscopy using a plasmonic laser created from a periodically perforated silver film with a liquid gain medium. An active zone of the laser is formed by a highly elongated spot of pumping. This results in a significantly more efficient diffusive mixing of dye molecules, which suppresses the effect of their bleaching, and in the ability to reduce the volume of the gain medium to as little as 400 nl. We use this design for a stable plasmonic laser in multiple measurements and demonstrate that it is highly effective as a spaser spectroscopy sensor for intracavity detection of an absorptive dye at 0.07 ppm. This work provides an opportunity to develop applications of intracavity plasmonic laser spectroscopy in biological label detection and other fields.
Electron refraction at lateral atomic interfaces
Authors: Abd El-Fattah Z. M. , Kher-Elden M. A. , Yassin O. , El-Okr M. M. , Ortega J. E. , García de Abajo F. J.
Published: November 2017

We present theoretical simulations of electron refraction at the lateral atomic interface between a “homogeneous” Cu(111) surface and the “nanostructured” one-monolayer (ML) Ag/Cu(111) dislocation lattice. Calculations are performed for electron binding energies barely below the 1 ML Ag/Cu(111) M¯-point gap (binding energy EB = 53 meV, below the Fermi level) and slightly above its Γ¯-point energy (EB = 160 meV), both characterized by isotropic/circular constant energy surfaces. Using plane-wave-expansion and boundary-element methods, we show that electron refraction occurs at the interface, the Snell law is obeyed, and a total internal reflection occurs beyond the critical angle. Additionally, a weak negative refraction is observed for EB = 53 meV electron energy at beam incidence higher than the critical angle. Such an interesting observation stems from the interface phase-matching and momentum conservation with the umklapp bands at the second Brillouin zone of the dislocation lattice. The present analysis is not restricted to our Cu-Ag/Cu model system but can be readily extended to technologically relevant interfaces with spin-polarized, highly featured, and anisotropic constant energy contours, such as those characteristic for Rashba systems and topological insulators.
Investigation on the effect of nonlinear processes on similarity law in high-pressure argon discharges
Authors: Fu Yangyang , Parsey Guy M. , Verboncoeur John P. , Christlieb Andrew J.
Published: November 2017

In this paper, the effect of nonlinear processes (such as three-body collisions and stepwise ionizations) on the similarity law in high-pressure argon discharges has been studied by the use of the Kinetic Global Model framework. In the discharge model, the ground state argon atoms (Ar), electrons (e), atom ions (Ar+), molecular ions (Ar2+), and fourteen argon excited levels Ar*(4s and 4p) are considered. The steady-state electron and ion densities are obtained with nonlinear processes included and excluded in the designed models, respectively. It is found that in similar gas gaps, keeping the product of gas pressure and linear dimension unchanged, with the nonlinear processes included, the normalized density relations deviate from the similarity relations gradually as the scale-up factor decreases. Without the nonlinear processes, the parameter relations are in good agreement with the similarity law predictions. Furthermore, the pressure and the dimension effects are also investigated separately with and without the nonlinear processes. It is shown that the gas pressure effect on the results is less obvious than the dimension effect. Without the nonlinear processes, the pressure and the dimension effects could be estimated from one to the other based on the similarity relations.
Howland current source for high impedance load applications
Authors: Morcelles K. F. , Sirtoli V. G. , Bertemes-Filho P. , Vincence V. C.
Published: November 2017

For Electrical Impedance Spectroscopy (EIS) applications, the Enhanced Howland Current Source (EHCS) is a popular choice as an excitation circuit due to its simplicity, reliability, and safety. However, its output impedance degradation at high frequency leads to errors that are unacceptable for high load impedance applications, such as the ones which use dry or microelectrodes. Based on a proposed mathematical model, this work designed an EHCS circuit which includes an output current buffer and frequency compensation. PSpice simulations were performed as proof of concept, and then the measured data were collected for comparison. For the proposed circuit, called here Load-in-the-Loop Compensated Enhanced Howland Source (LLC-EHCS), the results showed that the output current errors are lower than 1% up to 3.7 MHz over the load range of 560–2200 Ω and 1.2 MHz with 5.6 kΩ. On the other hand, for the case of the standard EHCS circuit, these frequencies are 170 and 80 kHz, respectively. Also, the output linear swing was found to be 3 times higher than the EHCS. It can be concluded that the proposed LLC-EHCS may be widely used as an excitation circuit for high load and wide bandwidth EIS applications.
Computational analysis of integrated biosensing and shear flow in a microfluidic vascular model
Authors: Wong Jeremy F. , Young Edmond W. K. , Simmons Craig A.
Published: November 2017

Fluid flow and flow-induced shear stress are critical components of the vascular microenvironment commonly studied using microfluidic cell culture models. Microfluidic vascular models mimicking the physiological microenvironment also offer great potential for incorporating on-chip biomolecular detection. In spite of this potential, however, there are few examples of such functionality. Detection of biomolecules released by cells under flow-induced shear stress is a significant challenge due to severe sample dilution caused by the fluid flow used to generate the shear stress, frequently to the extent where the analyte is no longer detectable. In this work, we developed a computational model of a vascular microfluidic cell culture model that integrates physiological shear flow and on-chip monitoring of cell-secreted factors. Applicable to multilayer device configurations, the computational model was applied to a bilayer configuration, which has been used in numerous cell culture applications including vascular models. Guidelines were established that allow cells to be subjected to a wide range of physiological shear stress while ensuring optimal rapid transport of analyte to the biosensor surface and minimized biosensor response times. These guidelines therefore enable the development of microfluidic vascular models that integrate cell-secreted factor detection while addressing flow constraints imposed by physiological shear stress. Ultimately, this work will result in the addition of valuable functionality to microfluidic cell culture models that further fulfill their potential as labs-on-chips.
Structural superlubricity of platinum on graphite under ambient conditions: The effects of chemistry and geometry
Authors: Özoğul Alper , İpek Semran , Durgun Engin , Baykara Mehmet Z.
Published: November 2017

An investigation of the frictional behavior of platinum nanoparticles laterally manipulated on graphite has been conducted to answer the question of whether the recent observation of structural superlubricity under ambient conditions [E. Cihan, S. İpek, E. Durgun, and M. Z. Baykara, Nat. Commun. 7, 12055 (2016)] is exclusively limited to the gold−graphite interface. Platinum nanoparticles have been prepared by e-beam evaporation of a thin film of platinum on graphite, followed by post-deposition annealing. Morphological and structural characterization of the nanoparticles has been performed via scanning electron microscopy and transmission electron microscopy, revealing a crystalline structure with no evidence of oxidation under ambient conditions. Lateral manipulation experiments have been performed via atomic force microscopy under ambient conditions, whereby results indicate the occurrence of structural superlubricity at mesoscopic interfaces of 4000–75 000 nm2, with a noticeably higher magnitude of friction forces when compared with gold nanoparticles of similar contact areas situated on graphite. Ab initio simulations of sliding involving platinum and gold slabs on graphite confirm the experimental observations, whereby the higher magnitude of friction forces is attributed to stronger energy barriers encountered by platinum atoms sliding on graphite, when compared with gold. On the other hand, as predicted by theory, the scaling power between friction force and contact size is found to be independent of the chemical identity of the sliding atoms, but to be determined by the geometric qualities of the interface, as characterized by an average “sharpness score” assigned to the nanoparticles.
Total cross sections for electron scattering by 1-propanol at impact energies in the range 40-500 eV
Authors: da Silva D. G. M. , Gomes M. , Ghosh S. , Silva I. F. L. , Pires W. A. D. , Jones D. B. , Blanco F. , Garcia G. , Buckman S. J. , Brunger M. J. , Lopes M. C. A.
Published: November 2017

Absolute total cross section (TCS) measurements for electron scattering from 1-propanol molecules are reported for impact energies from 40 to 500 eV. These measurements were obtained using a new apparatus developed at Juiz de Fora Federal University—Brazil, which is based on the measurement of the attenuation of a collimated electron beam through a gas cell containing the molecules to be studied at a given pressure. Besides these experimental measurements, we have also calculated TCS using the Independent-Atom Model with Screening Corrected Additivity Rule and Interference (IAM-SCAR+I) approach with the level of agreement between them being typically found to be very good.
Communication: Recovering the flat-plane condition in electronic structure theory at semi-local DFT cost
Authors: Bajaj Akash , Janet Jon Paul , Kulik Heather J.
Published: November 2017

The flat-plane condition is the union of two exact constraints in electronic structure theory: (i) energetic piecewise linearity with fractional electron removal or addition and (ii) invariant energetics with change in electron spin in a half filled orbital. Semi-local density functional theory (DFT) fails to recover the flat plane, exhibiting convex fractional charge errors (FCE) and concave fractional spin errors (FSE) that are related to delocalization and static correlation errors. We previously showed that DFT+U eliminates FCE but now demonstrate that, like other widely employed corrections (i.e., Hartree-Fock exchange), it worsens FSE. To find an alternative strategy, we examine the shape of semi-local DFT deviations from the exact flat plane and we find this shape to be remarkably consistent across ions and molecules. We introduce the judiciously modified DFT (jmDFT) approach, wherein corrections are constructed from few-parameter, low-order functional forms that fit the shape of semi-local DFT errors. We select one such physically intuitive form and incorporate it self-consistently to correct semi-local DFT. We demonstrate on model systems that jmDFT represents the first easy-to-implement, no-overhead approach to recovering the flat plane from semi-local DFT.
Simulations of water nano-confined between corrugated planes
Authors: Zubeltzu Jon , Artacho Emilio
Published: November 2017

Water confined to nanoscale widths in two dimensions between ideal planar walls has been the subject of ample study, aiming at understanding the intrinsic response of water to confinement, avoiding the consideration of the chemistry of actual confining materials. In this work, we study the response of such nanoconfined water to the imposition of a periodicity in the confinement by means of computer simulations, both using empirical potentials and from first-principles. For that we propose a periodic confining potential emulating the atomistic oscillation of the confining walls, which allows varying the lattice parameter and amplitude of the oscillation. We do it for a triangular lattice, with several values of the lattice parameter: one which is ideal for commensuration with layers of Ih ice and other values that would correspond to more realistic substrates. For the former, the phase diagram shows an overall rise of the melting temperature. The liquid maintains a bi-layer triangular structure, however, despite the fact that it is not favoured by the external periodicity. The first-principles liquid is significantly affected by the modulation in its layering and stacking even at relatively small amplitudes of the confinement modulation. Beyond some critical modulation amplitude, the hexatic phase present in flat confinement is replaced by a trilayer crystalline phase unlike any of the phases encountered for flat confinement. For more realistic lattice parameters, the liquid does not display higher tendency to freeze, but it clearly shows inhomogeneous behaviour as the strength of the rugosity increases. In spite of this expected inhomogeneity, the structural and dynamical response of the liquid is surprisingly insensitive to the external modulation. Although the first-principles calculations give a more triangular liquid than the one observed with empirical potentials (TIP4P/2005), both agree remarkably well for the main conclusions of the study.
Observation of radially inward turbulent particle flux in ETG dominated plasma of LVPD
Authors: Srivastav Prabhakar , Singh Rameswar , Awasthi L. M. , Sanyasi A. K. , Srivastava P. K. , Sugandhi R. , Singh R. , Kaw P. K.
Published: November 2017

Radially inward turbulent particle flux is observed in the core region of target plasma of Large Volume Plasma Device where electron temperature gradient (ETG) driven turbulence conditions are satisfied with threshold, ηETG=Ln/LT>2/3 [Mattoo et al., Phys. Rev. Lett. 108, 255007 (2012)]. The observed mode satisfies the scale length and frequency ordering of ETG (k⊥ρe≤1≪k⊥ρi,Ωi<ω≪Ωe), where k⊥ is the perpendicular wave vector, ρe ,ρi are Larmor radii of electron and ion, respectively, and Ωi,Ωe, and ω are the ion, electron gyro frequencies, and the mode frequency, respectively. The measured flux is dominantly electrostatic (Γes≈105Γem), although the nature of the turbulence is electromagnetic (β∼0.1−0.6). Experimental observations of the phase angle between density and potential fluctuations, θñ,ϕ̃, and turbulent particle flux, Γes, shows good agreement with the theoretical estimations derived for ETG turbulence.
Lifetime of primary runaway electrons estimated for high-plasma-current fusion devices
Authors: Kim Meeri
Published: November 2017

Analysis of field and collision influence on runaway electrons produced during plasma disruptions provides insight into lifetime trends.
Hospital admissions and emergency department presentations for dental conditions indicate access to hospital, rather than poor access to dental health care in the community
Authors: Yap Matthew , Kok Mei-Ruu , Nanda Soniya , Vickery Alistair , Whyatt David
Published: November 2017

High rates of dental-related potentially preventable hospitalisations are thought to reflect poor access to non-hospital dental services. The association between accessibility (geographic and financial) to non-hospital dentists and potentially preventable hospitalisations was examined in Western Australia. Areas with persistently high rates of dental-related potentially preventable hospitalisations and emergency department (ED) presentations were mapped. Statistical models examined factors associated with these events. Persistently high rates of dental-related potentially preventable hospitalisations were clustered in metropolitan areas that were socioeconomically advantaged and had more dentists per capita (RR 1.06, 95% CI 1.04–1.08) after adjusting for age, sex, socioeconomics, and Aboriginality. Persistently high rates of ED presentations were clustered in socioeconomically disadvantaged areas near metropolitan EDs and with fewer dentists per capita (RR 0.91, 0.88–0.94). A positive association between dental-related potentially preventable hospitalisations and poor (financial or geographic) access to dentists was not found. Rather, rates of such events were positively associated with socioeconomic advantage, plus greater access to hospitals and non-hospital dental services. Furthermore, ED presentations for dental conditions are inappropriate indicators of poor access to non-hospital dental services because of their relationship with hospital proximity. Health service planners and policymakers should pursue alternative indicators of dental service accessibility.
Phosphorylation of huntingtin at residue T3 is decreased in Huntington’s disease and modulates mutant huntingtin protein conformation
Authors: Cariulo Cristina , Azzollini Lucia , Verani Margherita , Martufi Paola , Boggio Roberto , Chiki Anass , Deguire Sean M. , Cherubini Marta , Gines Silvia , Marsh J. Lawrence , Conforti Paola , Cattaneo Elena , Santimone Iolanda , Squitieri Ferdinando , Lashuel Hilal A. , Petricca Lara , Caricasole Andrea
Published: November 2017

Significance

The findings in this manuscript report on the identification of a posttranslational modification in the huntingtin protein (phosphorylation on residue T3 in the N17 region of the protein), which can revert the conformational effects of the Huntington’s disease (HD) mutation itself on the huntingtin protein and inhibit its aggregation properties in vitro. Using the first ultrasensitive immunoassay for a posttranslational modification of huntingtin protein, we demonstrate that pT3 levels are decreased in mutant huntingtin in preclinical models as well as in clinically relevant samples from HD patients. These findings are of high significance to Huntington’s disease biology, provide insights into mechanisms of Huntington’s disease pathogenesis, and open new opportunities for the development of therapeutics and diagnostics for Huntington’s disease.
Pantheon on a tablecloth: Yugoslav dictatorship and the confrontation of national symbols in Croatia (1929-1935)
Authors: Grgić Stipica
Published: November 2017

This paper questions the effects of the state- and nation-building that occurred in the Kingdom of Yugoslavia during the 6 January Dictatorship (1929–1935) and points to the importance of symbols during this process. By using an ethno-symbolist approach and extending it to “banal nationalism,” the article analyzes some of the most prominent and influential symbols from within an everyday environment. Using the Croatian ethnic space as a framework, the article traces the population's attitudes toward the Yugoslav national flag and representations of King Alexander – two of the most forced symbols in the centralized Yugoslavone state and one nationconcept of nation-building. The regime possessed all the mechanisms of power necessary to impose these symbols, though most Croats clearly felt no connection to them. Despite severe penalties, they opposed the regime's plans for national reconstruction of the country by displaying Croatian flags and various symbolic representations of Stjepan Radić – as a martyr of the Croatian nation. By linking this problem to specific studies that deal with the development of nationalism, this paper outlines the struggle between Yugoslavism and Croatianism through acceptance and resistance toward the Yugoslav symbolism.
Is Southeast Asian experience relevant for Sino-African relations?
Authors: Adem Seifudein
Published: November 2017

While economic and geo-political considerations might continue to underpin China’s diplomacy in Africa, China’s changing identity and international behaviours in the future would make it difficult to precisely predict which of them would be central and how African countries should react under the circumstances. But, we can gain helpful clues about the parameters of desirable course of action for Africa by looking at Southeast Asia. This article has two interrelated parts. The first part focuses on the foreign policies of Southeast Asian countries towards China to show how Africa could incorporate some of the lessons into Sino-African relations. The second part zooms in on the remarkable economic transformation in Southeast Asia to see what Africa could learn from the experience.
Active shooter on campus!
Authors: Sikes Deborah L. , Barnes Glenn A. , Casida Deborah L.
Published: November 2017

Prepare for when, not if.
Roles and Experiences of Parents in Necrotizing Enterocolitis
Authors: Gadepalli Samir K. , Canvasser Jennifer , Eskenazi Yael , Quinn Megan , Kim Jae H. , Gephart Sheila M.
Published: November 2017

Background:

Although partnering with parents is important to improving neonatal outcomes, no studies have investigated what parents are taught, remember, or experience when their child is afflicted with necrotizing enterocolitis (NEC).

Purpose:

To characterize parental perceptions of communication and support they were given about NEC.

Methods:

An online survey was developed, reviewed for face validity, and then administered to parents whose child had experienced NEC. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using a qualitative descriptive approach.

Findings:

Parents (N = 110) wanted to know the risk factors and warning signs for NEC and wanted to be told as soon as their child was admitted to the neonatal intensive care unit (NICU). Information provided before diagnosis was felt to be poor by the majority of families, with only 32% feeling satisfied or very satisfied. No parent wrote that they were “scared” by information provided to them about NEC; in fact, parents were dissatisfied when they received “sugar-coated” information. Engaged parents were significantly more satisfied than those who were not informed, had their concerns and suggestions dismissed, or who had to advocate for their baby against clinician opposition (eg, activating the chain of command).

Implications for Practice:

Areas for quality improvement include better communication and collaboration with parents through early engagement in NEC prevention using modalities beyond verbal instruction.

Implications for Research:

More research is needed on how best to engage parents, especially to engage in prevention, and how doing so affects satisfaction and outcomes.
Associations of Race and Ethnicity With Patient-Reported Outcomes and Health Care Utilization Among Older Adults Initiating a New Episode of Care for Back Pain
Authors: Milani Carlo J. , Rundell Sean D. , Jarvik Jeffrey G. , Friedly Janna , Heagerty Patrick J. , Avins Andy , Nerenz David , Gold Laura S. , Turner Judith A. , Annaswamy Thiru , Nedeljkovic Srdjan S. , Suri Pradeep
Published: November 2017

Study Design.

Secondary analysis of the Back Pain Outcomes using Longitudinal Data (BOLD) cohort study.

Objective.

To characterize associations of self-reported race/ethnicity with back pain (BP) patient-reported outcomes (PROs) and health care utilization among older adults with a new episode of care for BP.

Summary of Background Data.

No prior longitudinal studies have characterized associations between multiple race/ethnicity groups, and BP-related PROs and health care utilization in the United States.

Methods.

This study included 5117 participants ≥65 years from three US health care systems. The primary BP-related PROs were BP intensity and back-related functional limitations over 24 months. Health care utilization measures included common diagnostic tests and treatments related to BP (spine imaging, spine-related relative value units [RVUs], and total RVUs) over 24 months. Analyses were adjusted for multiple potential confounders including sociodemographics, clinical characteristics, and study site.

Results.

Baseline BP ratings were significantly higher for blacks vs. whites (5.8 vs. 5.0; P < 0.001). Participants in all race/ethnicity groups showed statistically significant, but modest improvements in BP over 24 months. Blacks and Hispanics did not have statistically significant improvement in BP-related functional limitations over time, unlike whites, Asians, and non-Hispanics; however, the magnitude of differences in improvement between groups was small. Blacks had less spine-related health care utilization over 24 months than whites (spine-related RVU ratio of means 0.66, 95% confidence interval [CI] 0.51–0.86). Hispanics had less spine-related health care utilization than non-Hispanics (spine-related RVU ratio of means 0.60; 95% CI 0.40–0.90).

Conclusion.

Blacks and Hispanics had slightly less improvement in BP-related functional limitations over time, and less spine-related health care utilization, as compared to whites and non-Hispanics, respectively. Residual confounding may explain some of the association between race/ethnicity and health outcomes. Further studies are needed to understand the factors underlying these differences and which differences reflect disparities.

Level of Evidence: 3
The Glucagon-Like Peptide-1 Analog Exenatide Increases Blood Glucose Clearance, Lactate Clearance, and Heart Rate in Comatose Patients After Out-of-Hospital Cardiac Arrest
Authors: Wiberg Sebastian , Kjaergaard Jesper , Schmidt Henrik , Thomsen Jakob Hartvig , Frydland Martin , Winther-Jensen Matilde , Lindholm Matias Greve , Høfsten Dan Eik , Engstrøm Thomas , Køber Lars , Møller Jacob Eifer , Hassager Christian
Published: November 2017

Objectives:

To investigate the effects of the glucagon-like peptide-1 analog exenatide on blood glucose, lactate clearance, and hemodynamic variables in comatose, resuscitated out-of-hospital cardiac arrest patients.

Design:

Predefined post hoc analyzes from a double-blind, randomized clinical trial.

Setting:

The ICU of a tertiary heart center.

Patients:

Consecutive sample of adult, comatose patients undergoing targeted temperature management after out-of-hospital cardiac arrest from a presumed cardiac cause, irrespective of the initial cardiac rhythm.

Interventions:

Patients were randomized 1:1 to receive 6 hours and 15 minutes of infusion of either 17.4 μg of the glucagon-like peptide-1 analog exenatide (Byetta; Lilly) or placebo within 4 hours from sustained return of spontaneous circulation. The effects of exenatide were examined on the following prespecified covariates within the first 6 hours from study drug initiation: lactate level, blood glucose level, heart rate, mean arterial pressure, and combined dosage of norepinephrine and dopamine.

Measurements and Main Results:

The population consisted of 106 patients receiving either exenatide or placebo. During the first 6 hours from study drug initiation, the levels of blood glucose and lactate decreased 17% (95% CI, 8.9–25%; p = 0.0004) and 21% (95% CI, 6.0–33%; p = 0.02) faster in patients receiving exenatide versus placebo, respectively. Exenatide increased heart rate by approximately 10 beats per minute compared to placebo (p < 0.0001). There was no effect of exenatide on other hemodynamic variables.

Conclusions:

In comatose out-of-hospital cardiac arrest patients, infusion with exenatide lowered blood glucose and resulted in increased clearance of lactate as well as increased heart rate. The clinical importance of these physiologic effects remains to be investigated.
Accuracy of Invasive and Noninvasive Parameters for Diagnosing Ventilatory Overassistance During Pressure Support Ventilation*
Authors: Pletsch-Assuncao Renata , Caleffi Pereira Mayra , Ferreira Jeferson George , Cardenas Letícia Zumpano , de Albuquerque André Luis Pereira , de Carvalho Carlos Roberto Ribeiro , Caruso Pedro
Published: November 2017

Objective:

Evaluate the accuracy of criteria for diagnosing pressure overassistance during pressure support ventilation.

Design:

Prospective clinical study.

Setting:

Medical-surgical ICU.

Patients:

Adults under mechanical ventilation for 48 hours or more using pressure support ventilation and without any sedative for 6 hours or more. Overassistance was defined as the occurrence of work of breathing less than 0.3 J/L or 10% or more of ineffective inspiratory effort. Two alternative overassistance definitions were based on the occurrence of inspiratory esophageal pressure-time product of less than 50 cm H2O s/min or esophageal occlusion pressure of less than 1.5 cm H2O.

Interventions:

The pressure support was set to 20 cm H2O and decreased in 3-cm H2O steps down to 2 cm H2O.

Measurements and Main Results:

The following parameters were evaluated to diagnose overassistance: respiratory rate, tidal volume, minute ventilation, peripheral arterial oxygen saturation, rapid shallow breathing index, heart rate, mean arterial pressure, change in esophageal pressure during inspiration, and esophageal and airway occlusion pressure. In all definitions, the respiratory rate had the greatest accuracy for diagnosing overassistance (receiver operating characteristic area = 0.92; 0.91 and 0.76 for work of breathing, pressure-time product and esophageal occlusion pressure in definition, respectively) and always with a cutoff of 17 incursions per minute. In all definitions, a respiratory rate of less than or equal to 12 confirmed overassistance (100% specificity), whereas a respiratory rate of greater than or equal to 30 excluded overassistance (100% sensitivity).

Conclusion:

A respiratory rate of 17 breaths/min is the parameter with the greatest accuracy for diagnosing overassistance. Respiratory rates of less than or equal to 12 or greater than or equal to 30 are useful clinical references to confirm or exclude pressure support overassistance.
Facial Treatment With Botulinum Toxin Improves Attractiveness Rated by Self and Others, and Psychological Wellbeing
Authors: Petrie Taylor , Moore Fhionna
Published: November 2017

BACKGROUND

Treatment of dynamic facial lines with botulinum toxin has been shown to improve various measures of psychological wellbeing.

OBJECTIVE

Here we sought to determine whether the positive effects of treatment on wellbeing occurred via improvements in attractiveness rated by self and others, using a pretreatment and post-treatment comparison experimental design.

MATERIALS AND METHODS

We tested the effects of treatment on self-esteem, satisfaction with life, attractiveness rated by self and others in a sample of 32 Scottish women. Participants completed validated psychological measures of self-esteem, satisfaction with life, and self-perceived attractiveness pretreatment and 4 weeks post-treatment. Facial photographs with neutral expression of participants were rated for attractiveness by a group of raters pretreatment and 4 weeks post-treatment.

RESULTS

Treatment significantly improved all measures (self-esteem, satisfaction with life, and attractiveness rated by self and others). Furthermore, self-rated attractiveness mediated the relationship between treatment and self-esteem.

CONCLUSION

Treatment of dynamic facial lines with botulinum toxin significantly improves self-esteem and general life satisfaction. It also improves self-perceived attractiveness and attractiveness rated by others. The effects of treatment on self-esteem occur via the positive effects of treatment on self-perceived attractiveness. Our study is a carefully controlled analysis of the effects of treatment with botulinum toxin, using statistical analyses to show significant benefits of the treatment on psychology, wellbeing, and attractiveness as rated by self and others. This is further support for the psychological benefits of botulinum A facial therapy.
The dynamics of stress and fatigue across menopause: attractors, coupling, and resilience
Authors: Taylor-Swanson Lisa , Wong Alexander E. , Pincus David , Butner Jonathan E. , Hahn-Holbrook Jennifer , Koithan Mary , Wann Kathryn , Woods Nancy F.
Published: November 2017

Objective:

The objective of this study was to evaluate the regulatory dynamics between stress and fatigue experienced by women during the menopausal transition (MT) and early postmenopause (EPM). Fatigue and perceived stress are commonly experienced by women during the MT and EPM. We sought to discover relationships between these symptoms and to employ these symptoms as possible markers for resilience.

Methods:

Participants were drawn from the longitudinal Seattle Midlife Women's Health Study. Eligible women completed questionnaires on 60+ occasions (annual health reports and monthly health diaries) (n = 56 women). The total number of observations across the sample was 4,224. STRAW+10 criteria were used to stage women in either in late reproductive, early or late transition, or EPM stage. Change values were generated for fatigue and stress and analyzed with a multilevel structural equation model; slopes indicate how quickly a person returns to homeostasis after a perturbation. Coupling of stress and fatigue was modeled to evaluate resilience, the notion of maintaining stability during change.

Results:

Eligible women were on average 35 years old (SD = 4.71), well educated, employed, married or partnered, and white. Fit indices suggested the model depicts the relationships of stress and fatigue (χ
2(9 df) = 7.638, P = 0.57, correction factor = 4.9244; root mean square error of approximation (RMSEA) 90% CI = 0.000 ≤ 0.000 ≤ 0.032; comparative fit index (CFI) = 1.00). A loss in model fit across stages suggests that the four stages differed in their dynamics (χ
2Δ(12 df) = 21.181, P = .048). All stages showed fixed-point attractor dynamics: fatigue became less stable over time; stress generally became more stable over time. Coupling relationships of stress on fatigue show evidence for shifts in regulatory relationships with one another across the MT.

Conclusions:

Results are suggestive of general dysregulation via disruptions to coupling relationships of stress and fatigue across the MT. Findings support a holistic approach to understanding symptoms and supporting women during the MT.
Gluteal Black Market Silicone–induced Renal Failure: A Case Report and Literature Review
Authors: Matson Andrea , Faibisoff Burt
Published: November 2017

Very few cases of successful surgical treatment for renal failure due to gluteal silicone injections have been reported in the literature. The silicone toxicity and subsequent renal failure seem to follow repetitive silicone injections and silicone injections in large quantities. This is a case of a 31-year-old woman who developed renal failure after 6 years of gluteal silicone injections who underwent radical resection of bilateral gluteal regions in an attempt to mitigate her impending complete renal failure. A systematic review of the literature was conducted using PubMed database and with assistance from medical library staff to conduct keyword searches for “Silicone,” “Renal failure,” “Silicone emboli syndrome,” “Silicone granuloma,” and “Silicone end organ toxicity.” The search results were reviewed by the authors and selected based on the relevance to the case report presented. Extensive literature relating to silicone granulomas and their systemic effects supports the use of steroids for immediate treatment and eventual surgical resection for cure of the various silicone-related end-organ toxicities including renal failure.
Considerations in the Care of Athletes With Attention Deficit Hyperactivity Disorder
Authors: Pujalte George G. A. , Maynard Jennifer R. , Thurston McKennan J. , Taylor Walter C. , Chauhan Mohit
Published: November 2017

Objectives:

Uncover literature pertaining to: (1) attention deficit hyperactivity disorder (ADHD) and how it impacts athletes; (2) ADHD medication effects; (3) regulations regarding ADHD medications; (4) approaches to conditions similar to, and occurring with, ADHD; and (5) use of stimulants.

Data Sources:

MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Ovid interface.

Main Results:

ADHD can have many effects on athletes and sports participation. Exercise has positive benefits on ADHD behaviors and players' attitudes. Athletes with ADHD can have worsened ADHD symptoms after concussions. Attention deficit hyperactivity disorder is a modifier of return to play; baseline ADHD symptoms should be used to guide management. Management should include medications, behavioral/psychosocial therapy, and academic accommodations. Behavioral therapy combined with medication is superior to behavioral treatment alone. Sustained exercise as ADHD treatment should be considered mainstay in management. Sports can increase thermogenic effects of stimulants, heat injury, and cardiac arrhythmias. Increased aggressiveness, improved pain tolerance, and decreased sense of fatigue are some attributes of stimulants that are presumed to impart some advantage to athletes, but evidence is uncertain. Attention deficit hyperactivity disorder medications may lead to myocardial infarctions, cerebrovascular accidents, paranoid psychoses, seizures, insomnia, tremors, anxiety, hypertension, and death.

Conclusions:

Athletes' performance and quality of life can be negatively affected by ADHD. Risks exist for those who take ADHD medications. More research is needed on the implications ADHD may have in specific sports, and on possible advantages of medication use. Potential deleterious effects of these medications should be addressed.
Outcomes of Anterior Cruciate Ligament Reconstruction in Obese and Overweight Patients: A Systematic Review
Authors: DiSilvestro Kevin J. , Jauregui Julio J. , Glazier Elizabeth , Cherkalin Denis , Bennett Craig H. , Packer Jonathan D. , Henn Ralph Frank
Published: November 2017

Objective:

To evaluate the mechanism of injury, outcomes, and complications of anterior cruciate ligament (ACL) reconstruction in overweight and obese patients.

Data Sources:

MEDLINE, EMBASE, and OVID electronic libraries were systematically searched from inception to December, 2017 for any eligible articles using a combination of the phrases “anterior cruciate ligament,” “ACL,” “overweight,” “obese,” and “BMI.”

Results:

Studies that evaluated patients with primary ACL reconstruction, classified patients as overweight or obese, and reported a minimum of 1-year follow-up data were included. Eight cohorts from 9 studies fulfilled the inclusion criteria. There were no significant differences for mechanism of injury, Lysholm scores, Knee injury and Osteoarthritis Outcome Scores values, or return to sports with a body mass index (BMI) above or below 25 kg/m2. A significant difference was described in International Knee Documentation Committee (IKDC) scores when comparing obese patients (BMI >30 kg/m2) to patients with BMI <25 kg/m2 (P <0.01). In patients with BMI >25 kg/m2, the risk for arthritis was significantly higher but the risk for revision surgery or contralateral ACL tear was lower (P <0.05). There was no significant difference in complication rates (P = 0.77).

Conclusion:

Patient-reported outcome measures were similar for patients with BMI above and below 25 kg/m2, but there is evidence that obese patients have lower IKDC scores. There is a consistent association between overweight status and developing arthritis among patients having an ACL reconstruction. Overweight and obese patients have a lower risk of revision ACL reconstruction and contralateral ACL tear. There is insufficient data to make any conclusions regarding mechanism of injury or complications. More research is needed to better understand what is the appropriate counsel and treatment for overweight or obese patients with ACL tears.

Prospero Registration Number:

CRD42017055594.
Fingolimod-Associated Intracerebral Lymphoproliferative Disorder
Authors: Baharnoori Moogeh , Mahajan Rahul , Solomon Issac H. , Pinkus Geraldine , Houtchens Maria
Published: November 2017

Most epidemiological studies indicate that incidence of cancer in multiple sclerosis patients is lower than general population. However these studies were performed prior to the emergence of disease-modifying therapies (DMTs). The incidence of cancer may be influenced by newer generation DMTs which are immunomodulatory or immunosuppressant. We describe an atypical case of intracerebral plasmacytic lymphoproliferative disorder in a 47 years old patient on fingolimod. As worldwide usage of oral and infusion DMTs increases, heightened clinical suspicion and early recognition of these serious adverse events remain crucial.
Nutrition and Boxing Performance
Authors: Martínez-Rodríguez Alejandro , Cumbicus-Jiménez Yovanny , Cuestas-Calero Bernardo J. , Leyva-Vela Belén
Published: November 2017

Boxing is a contact sport in which the athletes compete in weight categories. The athletes use different strategies to achieve their desired weight, some of which may affect their sports performance. This systematic review assesses the scientific literature regarding the nutritional and dietetic strategies used by boxers and their effects on performance. The Physiotherapy Evidence Database (PEDro) scale was used to evaluate the quality of the articles; the maximum score was 10 points, because item 1 on the scale was not evaluated. Of a total 1549 articles obtained, only 14 remained after applying the inclusion criteria. Of these, only 2 articles scored more than 7 points on the PEDro scale and were considered to be high-quality scientific evidence. The remaining 12 articles, with scores less than 7 points, were of low quality due mainly to their small sample size (N’s for boxers range from 1–32), poor methodology, and short duration (1–12 weeks). The article included boxers of various ages, adolescents, and adults and 2 very-low-quality articles on female boxers (2 and 3 on the PEDro scale). The boxers used many unhealthy strategies to lose weight in the days prior to competition, including dehydration, energy restriction, diuretics, laxatives, and increased energy expenditure by strenuous physical activity.
Protecting Americans’ Food Security and Health: The Role of the Farm Bill
Authors: Chapman Nancy
Published: November 2017

Federal domestic nutrition programs are critical to food security, children’s growth and development, and improved diet quality, yet federal spending on nutrition assistance faces potential severe reductions and has declined over the past 4 years. The engagement of nutrition professionals in nutrition policy is critical for evidence-based policy development. But that will require an understanding of the benefits of nutrition assistance to chronic disease prevention and economic development, as well as the process for development of Farm Bill nutrition policy. This article provides the basics that nutrition advocates will need.
Dendritic Cell Markers and PD-L1 are Expressed in Mediastinal Gray Zone Lymphoma
Authors: Pelland Kevin , Mathews Stephanie , Kamath Anitha , Cohen Paul , Hudnall S. David , Cotta Claudiu V. , Xu Mina L.
Published: November 2017

Aims:

Mediastinal gray zone lymphoma (MGZL) is a rare entity with morphologic, immunophenotypic, and genetic features intermediate between classic Hodgkin lymphoma (CHL) and primary mediastinal large B-cell lymphoma (PMBL). It is challenging to differentiate from CHL and PMBL. A specific dendritic cell gene expression profile can distinguish CHL and MGZL from PMBL. We hypothesized that the dendritic markers fascin and CD123 may be helpful in distinguishing MGZL from CHL and PMBL. We also investigated programmed death-ligand 1 (PD-L1) expression in MGZL, which may have therapeutic significance in this difficulty to treat tumor.

Methods:

Representative sections from 89 CHL, 20 PMBL, and 7 MGZL cases were stained for fascin, CD123, and PD-L1, and scored on a scale from 0 to 3+. Most (71%) MGZLs stained for CD123, as well as some (23%) CHLs, and few (11%) PMBLs. All MGZLs stained for fascin, as well as most (90%) CHLs, and approximately half (53%) of the PMBLs. PD-L1 was positive in all MGZLs, most (77%) CHLs and most (66%) PMBLs.

Conclusions:

Our study is the first to show CD123 is positive in a subset of formalin-fixed, paraffin-embedded MGZLs and CHLs, in contrast to PMBL which is largely negative. Staining for fascin was not significantly different between the lymphomas, but was less likely to be positive in PMBL. These findings suggest a role for CD123 and fascin in supporting diagnoses of MGZL and CHL, and in ruling out PMBL. By immunohistochemistry, PD-L1 is positive in MGZL, pointing to its therapeutic potential.