bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of Resistive Micromegas for Sampling Calorimetry
Authors: Geralis T. , Fanourakis G. , Kalamaris A. , Nikas D. , Psallidas A. , Chefdeville M. , Karyotakis I. , Koletsou I. , Titov M.
Published: February 2018

Resistive micromegas is proposed as an active element for sampling calorimetry. Future linear collider experiments or the HL-LHC experiments can profit from those developments for Particle Flow Calorimetry. Micromegas possesses remarkable properties concerning gain stability, reduced ion feedback, response linearity, adaptable sensitive element granularity, fast response and high rate capability. Recent developments on Micromegas with a protective resistive layer present excellent results, resolving the problem of discharges caused by local high charge deposition, thanks to its RC-slowed charge evacuation. Higher resistivity though, may cause loss of the response linearity at high rates. We have scanned a wide range of resistivities and performed laboratory tests with X-rays that demonstrate excellent response linearity up to rates of (a few) times 10MHz/cm2, with simultaneous mitigation of discharges. Beam test studies at SPS/CERN with hadrons have also shown a remarkable stability of the resistive Micromegas and low currents for rates up to 15MHz/cm2. We present results from the aforementioned studies confronted with MC simulation
Development of the micro pixel chamber based on MEMS technology
Authors: Takemura T. , Takada A. , Kishimoto T. , Komura S. , Kubo H. , Matsuoka Y. , Miuchi K. , Miyamoto S. , Mizumoto T. , Mizumura Y. , Motomura T. , Nakamasu Y. , Nakamura K. , Oda M. , Ohta K. , Parker J. D. , Sawano T. , Sonoda S. , Tanimori T. , Tomono D. , Yoshikawa K.
Published: February 2018

Micro pixel chambers (μ-PIC) are gaseous two-dimensional imaging detectors originally manufactured using printed circuit board (PCB) technology. They are used in MeV gamma-ray astronomy, medicalimaging, neutron imaging, the search for dark matter, and dose monitoring. The position resolution of the present μ-PIC is approximately 120 μm (RMS), however some applications require a fine position resolution of less than 100 μm. To this end, we have started to develop a μ-PIC based on micro electro mechanical system (MEMS) technology, which provides better manufacturing accuracy than PCB technology. Our simulation predicted the gains of MEMS μ-PICs to be twice those of PCB μ-PICs at the same anode voltage. We manufactured two MEMS μ-PICs and tested them to study their behavior. In these experiments, we successfully operated the fabricatedMEMS μ-PICs and we achieved a maximum gain of approximately 7×103 and collected their energy spectra under irradiation of X-rays from 55Fe. However, the measured gains of the MEMS μ-PICs were less than half of the values predicted in the simulations. We postulated that the gains of the MEMS μ-PICs are diminished by the effect of the silicon used as a semiconducting substrate.
Development of large area resistive electrodes for ATLAS NSW Micromegas
Authors: Ochi Atsuhiko
Published: February 2018

Micromegas with resistive anodes will be used for the NSW upgrades of the ATLAS experiment at LHC. Resistive electrodes are used in MPGD devices to prevent sparks in high-rate operation. Large-area resistive electrodes for Micromegas have been developed using two different technologies: screen printing and carbon sputtering. The maximum resistive foil size is 45 × 220 cm with a printed pattern of 425-μm pitch strips. These technologies are also suitable for mass production. Prototypes of a production model series have been successfully produced. In this paper, we report the development, the production status, and the test results of resistive Micromegas.
Characterization of the water diffusion in GEM foil material
Authors: Benussi L. , Bianco S. , Saviano G. , Muhammad S. , Piccolo D. , Raffone G. , Caponero M. , Passamonti L. , Pierluigi D. , Russo A. , Primavera F. , Cerbelli S. , Lalli A. , Valente M. , Ferrini M. , Teissandier B. , Taborelli M. , Parvis M. , Grassini S. , Tirilló J. , Sarasini F. , Franchi A.V.
Published: February 2018

Systematic studies on the GEM foil material are performed to measure the moisture diffusion rate and saturation level. These studies are important because the presence of this compound inside the detector’ s foil can possibly change its mechanical and electrical properties, and in such a way, the detector performance can be affected. To understand this phenomenon, a model is developed with COMSOL Multiphysics v. 4.3 [1], which described the adsorption and diffusion within the geometry of GEM foil, the concentration profiles and the time required to saturate the foil. The COMSOL model is verified by experimental observations on a GEM foil sample. This note will describe the model and its experimental verification results.
Investigation of the microstructure of Thick-GEMs with single photo-electrons
Authors: Hamar Gergő , Torre Silvia Dalla , Dasgupta Shuddha Shankar , Levorato Stefano , Tessarotto Fulvio , Varga Dezső
Published: February 2018

Novel Cherenkov detector upgrades favour GEM and ThickGEM based MPGD systems. These detectors have reduced ion backflow, fast signal formation, high gain, and could suppress the MIP signals as well. Their common drawbacks are the inefficiencies of photo-electron collection fromthe top of the ThickGEM and the local variation of multiplication due to the special geometry.

The developed high resolution scanner using focused UV light gave the possibility to study single photo-electron response of MPGDs in the sub-millimeter scale. Revealing the microstructure of photo-efficiency and local gain provides a new tool to quantitatively compare different ThickGEM geometries and field-configurations, and thus optimize the detector parameters.

The presentation will focus on the key elements of the scanning system; and on the microstructure evolution of different ThickGEM configurations.
Noble gas cluster ions
Authors: Kaya Yunus , Kalkan Yalçin , Veenhof Rob
Published: February 2018

In this work, a reaction mechanism of formation of noble gas (Ng) cluster ions has been theoretically investigated in detail. The kinetic studies of formation of Xe+Xe cluster in Xe, Ar+Ar cluster ions in Ar, and Ne+Ne cluster ions in Ne have been made as theoretically. The optimized structures in the ground state were calculated using the density functional theory (DFT) by the B3LYP method combined with the Stuttgart/Dresden effective core potential basis set (SDD). In addition, we calculated the rate constants of all cluster formations. The results are 1.15 × 10−31, 3.58 × 10−31, 0.23 × 10−31cm6/s, respectively for Neon, Argon, Xenon cluster ions.
Investigation of Micro Hardness, Cooling Rate and Microstructure of ATIG Welded samples of Al-SiC composite
Authors: Pichumani Sivachidambaram , Srinivasan Raghuraman , Ramamoorthi Venkatraman
Published: February 2018

Activated TIG welding has been performed on Al – 8% SiC composite 5mm plate with various fluxes such as Al2O3, MnO2, CaO, MgO, SiO2 & TiO2, to study & analyze the Microstructure, Micro hardness and cooling rate. Correlation study between micro hardness, microstructure and cooling rate for Constant Current TIG welding and Activated TIG welding on Al-SiC composite are also carried out to analyze the relation between the effect of cooling rate on microstructure & the effect of microstructure on micro hardness. The experimental results of ATIG welding on Al-SiC composite shows fine grain weld microstructure on ATIG – SiO2 & ATIG – TiO2, which results in higher micro hardness. Micro hardness values are taken in different locations of weld surface at 1mm, 2mm & 3mm below the weld surface and the same is also observed along the weld zone to heat affected zone upto 12mm for the center of the weldment. Minimum micro hardness values found in ATIG – MnO2, ATIG – CaO & ATIG – MgO are due to intermediate micro structure between coarse and fine in heat affected zone. ATIG – Al2O3 weld zone & heat affected zone and heat affected zone of ATIG – MnO2, ATIG – CaO & ATIG – MgO shows coarse microstructure leading to reduction in micro hardness value. Cooling rate for the different CCTIG & ATIG welding are recorded and correlation between the micro structures are studied. Coarse micro structure in weld zone and heat affected zone have least cooling rate whereas fine micro structure in weld zone resulted at higher cooling rate. Heat affected zone strongly depends on temperature gradient between the weld center and weldment’s heat affected zone.
Facial Asymmetry: Brow and Ear Position
Authors: Meyer Dale , Perumal Balaji
Published: February 2018

The purpose of the current study was to analyze brow and ear position, and examine the relationship between these structures in patients presenting for blepharoplasty evaluation. A retrospective chart review was performed, which included all patients presenting to one oculoplastic physician for a blepharoplasty evaluation from November, 2012 to March, 2014. The prevalence of brow ptosis and brow and ear asymmetry was calculated; the proportional distribution was determined, and chi-square analysis and the z-test of proportions were used to calculate the significance. Institutional Review Board approval was obtained for this study. A total of 133 patients met the inclusion criteria. Some degree of brow ptosis was noted in 83% of patients. Brow asymmetry was found in 88% of patients, and ear asymmetry in 77%. Of those patients who had asymmetry, 61% had the right brow lower and 75% had the right ear lower; 73% of all patients had the brow and ear lower on the same side (p < 0.001). In this study, brow ptosis and asymmetry were quite common. In addition, the side of the lower brow correlated strongly with the side of the lower ear, and the right side structures were lower more often than the left. Patients presenting for blepharoplasty evaluation may have an element of generalized facial asymmetry which includes the brows and ears. These observations can be important for preoperative planning and patient counseling.
Luxationsfraktur untere HWS – ventral beginnen!
Authors: Schären Stefan
Published: February 2018

Die Luxationsfraktur an der unteren HWS ist eine komplexe Verletzung, die häufig mit neurologischen Ausfällen vergesellschaftet ist. Die korrekte Reposition und Stabilisation sind Voraussetzung für ein gutes Behandlungsresultat. Die Wahl des chirurgischen Zugangs, um dieses Ziel am besten zu erreichen, ist umstritten. Die Entscheidungsfindung und das Vorgehen werden durch das Vorhandensein eines Bandscheibenprolapses zusätzlich kompliziert.

Der vorliegende Beitrag stellt die Argumente für ein primär ventrales Vorgehen anhand eigener Fallbeispiele und der Literatur dar.
Effects of three methods of oral selenium-enriched yeast supplementation on blood components and growth in Holstein dairy calves
Authors: Mohrekesh M. , Shahraki A. D. Foroozandeh , Ghalamkari G. R. , Guyot H.
Published: February 2018

The objective of this study was to investigate the effect of three methods of oral selenium-enriched yeast (Se-yeast) supplementation on the blood characteristics and growth of Holstein dairy calves. The three methods were: (1) maternal (dams supplemented with 0.3 mg Se per kg of dietary DM during 3 weeks pre-calving), (2) post-calving (calf starter enriched with 0.3 mg Se per kg of DM), and (3) maternal and post-calving Se-yeast supplementation. These three methods were compared with a control group (no supplementation). Maternal supplementation with Se-yeast successfully increased Se concentration in the colostrum and the serum of calves 24 h after calving (P < 0.05). At day 56, the Se concentration in the blood of calves supplemented with Se-yeast pre- (maternal) or post-calving (via starter) was greater than the control group (P < 0.05), but maternal plus post-calving supplementation was not more effective than either maternal or post-calving supplementation. Globulin and total protein concentration in the blood of calves at day 0 increased and albumins:globulins decreased with maternal supplementation (P < 0.05), but these variables were similar for all treatments at day 56. Immunoglobulins in the blood of calves and colostrum were not affected by maternal Se-yeast supplementation. Maternal supplementation increased the concentration of urea in the blood of calves at 0 days (P < 0.05), but not at 56 days. Calf birthweight was increased with maternal supplementation of Se-yeast (P < 0.01), but growth to day 56 was not affected by the methods of Se supplementation. Maternal supplementation with Se-yeast may improve growth and health characteristics of calves at calving time.
Farmed red deer home range, habitat use and daily movement patterns in a Southland, New Zealand, tussock grassland over calving and lactation
Authors: Wall A. J. , Asher G. W. , Netzer M. S. , Johnson M. G. H. , O'Neill K. T. , Littlejohn R. P. , Cox N.
Published: February 2018

Considerable expansion of red deer farming has occurred in the South Island high country of New Zealand. On these farms, breeding hinds are usually continuously grazed (set-stocked) at low population densities in large highly modified native-tussock grassland paddocks during their calving and lactation seasons. The present study determined how these hinds use the tussock grassland over this critical period, identifying the most essential resources for them and also some potential long-term consequences of their behaviour on the grassland ecosystem. This was achieved by tracking nine GPS-collared hinds over 2 years on a high-country deer farm in Te Anau, Southland, New Zealand. The home ranges of the GPS-tracked hinds varied widely, occupying between 15% and 52% of the total paddock area. Vegetation dominated by naturalised exotic pasture species covered the greatest proportion (>60%) of eight of nine hind home ranges. In contrast, tussock-dominant vegetation coverage was far more variable (0.4–46%), with several indicators suggesting that this vegetation type was used as a substitute for pasture areas under high intra-specific competition among the deer. Both pasture- and tussock-dominant vegetation was used in proportion to its availability. In contrast, shrub-dominated vegetation was used less than its proportional availability, indicating that it was not being put under as much foraging or grazing pressure. This has implications for the further ingression of this vegetation type over time. There was also clear evidence that certain paddock topography was being favoured by the hinds, namely steeper and higher-altitude areas of a paddock. On the basis of these findings, some potential methods for aiding in the management of these extensive tussock grassland paddocks under deer grazing are suggested.
Epigenetic alterations in longevity regulators, reduced life span, and exacerbated aging-related pathology in old father offspring mice
Authors: Xie Kan , Ryan Devon P. , Pearson Brandon L. , Henzel Kristin S. , Neff Frauke , Vidal Ramon O. , Hennion Magali , Lehmann Isabelle , Schleif Melvin , Schröder Susanne , Adler Thure , Rathkolb Birgit , Rozman Jan , Schütz Anna-Lena , Prehn Cornelia , Mickael Michel E. , Weiergräber Marco , Adamski Jerzy , Busch Dirk H. , Ehninger Gerhard , Matynia Anna , Jackson Walker S. , Wolf Eckhard , Fuchs Helmut , Gailus-Durner Valerie , Bonn Stefan , Hrabě de Angelis Martin , Ehninger Dan
Published: February 2018

Significance

Aging-associated diseases are increasingly common in an aging global population. However, the contributors and origins of differential risk for unhealthy aging remain poorly understood. Using a mouse model, we found that offspring of aged fathers exhibited a reduced life span and more pronounced aging-associated pathologies than animals sired by young fathers. Tissue of offspring and aged fathers revealed shared epigenetic signatures and showed altered activation states of longevity-related cell signaling. Our results suggest that variability in aging trajectories could derive, in part, from the age at conception of the father, a possibility that warrants human epidemiological investigation.
Optimal bounds for the growth of Sobolev norms of solutions of a quadratic Szegő equation
Authors: Thirouin Joseph
Published: February 2018

In this paper, we study a quadratic equation on the one-dimensional torus
\[
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="i partial-differential Subscript t Baseline u equals 2 upper J normal upper Pi left-parenthesis StartAbsoluteValue u EndAbsoluteValue squared right-parenthesis plus upper J overbar u squared comma u left-parenthesis 0 comma dot right-parenthesis equals u 0 comma">

i

∂
t

u
=
2
J
Π
(

|

u

|

2

)
+

J
¯

u
2

,

u
(
0
,
⋅
)
=

u
0

,

i \partial _t u = 2J\Pi (|u|^2)+\bar {J}u^2, \quad u(0, \cdot )=u_0,

\]
where

J
=

∫

T

|

u

|

2

u
∈

C

J=\int _\mathbb {T}|u|^2u \in \mathbb {C}

has constant modulus, and

Π
\Pi

is the Szegő projector onto functions with nonnegative frequencies. Thanks to a Lax pair structure, we construct a flow on

B
M
O
(

T

)
∩

I
m

Π

BMO(\mathbb {T})\cap \mathrm {Im}\Pi

which propagates

H
s

H^s

regularity for any

s
>
0

s>0

, whereas the energy level corresponds to

s
=
1

/

2

s=1/2

. Then, for each

s
>
1

/

2

s>1/2

, we exhibit solutions whose

H
s

H^s

norm goes to

+
∞

+\infty

exponentially fast, and we show that this growth is optimal.
The IDA3 adapter, required for intraflagellar transport of I1 dynein, is regulated by ciliary length
Authors: Hunter Emily L. , Lechtreck Karl , Fu Gang , Hwang Juyeon , Lin Huawen , Gokhale Avanti , Alford Lea M. , Lewis Brian , Yamamoto Ryosuke , Kamiya Ritsu , Yang Fan , Nicastro Daniela , Dutcher Susan K. , Wirschell Maureen , Sale Winfield S.
Published: February 2018

Axonemal dyneins, including inner dynein arm I1, assemble in the cytoplasm prior to transport into cilia by intraflagellar transport (IFT). How I1 dynein interacts with IFT is not understood. We take advantage of the Chlamydomonas reinhardtii ida3 mutant, which assembles the inner arm I1 dynein complex in the cytoplasm but fails to transport I1 into the cilium, resulting in I1 dynein-deficient axonemes with abnormal motility. The IDA3 gene encodes an ∼115-kDa coiled-coil protein that primarily enters the cilium during ciliary growth but is not an axonemal protein. During growth, IDA3, along with I1 dynein, is transported by anterograde IFT to the tip of the cilium. At the tip, IDA3 uncouples from IFT and diffuses within the cilium. IFT transport of IDA3 decreases as cilia lengthen and subsides once full length is achieved. IDA3 is the first example of an essential and selective IFT adapter that is regulated by ciliary length.
IDP-denovo: de novo transcriptome assembly and isoform annotation by hybrid sequencing
Authors: Fu Shuhua , Ma Yingke , Yao Hui , Xu Zhichao , Chen Shilin , Song Jingyuan , Au Kin Fai
Published: February 2018

Motivation

In the past years, the long read (LR) sequencing technologies, such as Pacific Biosciences and Oxford Nanopore Technologies, have been demonstrated to substantially improve the quality of genome assembly and transcriptome characterization. Compared to the high cost of genome assembly by LR sequencing, it is more affordable to generate LRs for transcriptome characterization. That is, when informative transcriptome LR data are available without a high-quality genome, a method for de novo transcriptome assembly and annotation is of high demand.

Results

Without a reference genome, IDP-denovo performs de novo transcriptome assembly, isoform annotation and quantification by integrating the strengths of LRs and short reads. Using the GM12878 human data as a gold standard, we demonstrated that IDP-denovo had superior sensitivity of transcript assembly and high accuracy of isoform annotation. In addition, IDP-denovo outputs two abundance indices to provide a comprehensive expression profile of genes/isoforms. IDP-denovo represents a robust approach for transcriptome assembly, isoform annotation and quantification for non-model organism studies. Applying IDP-denovo to a non-model organism, Dendrobium officinale, we discovered a number of novel genes and novel isoforms that were not reported by the existing annotation library. These results reveal the high diversity of gene isoforms in D.officinale, which was not reported in the existing annotation library.

Availability and implementation

The dataset of Dendrobium officinale used/analyzed during the current study has been deposited in SRA, with accession code SRP094520. IDP-denovo is available for download at www.healthcare.uiowa.edu/labs/au/IDP-denovo/.

Supplementary information

Supplementary data are available at Bioinformatics online.
PhyloMAd: efficient assessment of phylogenomic model adequacy
Authors: Duchêne David A , Duchêne Sebastian , Ho Simon Y W
Published: February 2018

Statistical phylogenetic inference plays an important role in evolutionary biology. The accuracy of phylogenetic methods relies on having suitable models of the evolutionary process. Various tools allow comparisons of candidate phylogenetic models, but assessing the absolute performance of models remains a considerable challenge. We introduce PhyloMAd, a user-friendly application for assessing the adequacy of commonly used models of nucleotide substitution and among-lineage rate variation. Our software implements a fast, likelihood-based method of model assessment that is tractable for analyses of large multi-locus datasets. PhyloMAd provides a means of informing model improvement, or selecting data to enhance the evolutionary signal in phylogenomic analyses.

Availability and implementation

PhyloMAd, together with a manual, a tutorial and the source code, are freely available from the GitHub repository github.com/duchene/phylomad
A Mean Value Formula and a Liouville Theorem for the Complex Monge–Ampère Equation
Authors: Li Chao , Li Jiayu , Zhang Xi
Published: February 2018

In this paper, we prove a mean value formula for bounded subharmonic Hermitian matrix valued function on a complete Riemannian manifold with nonnegative Ricci curvature. As its application, we obtain a Liouville type theorem for the complex Monge–Ampère equation on product manifolds.
Content analysis of Twitter chatter about indoor tanning
Authors: Waring Molly E , Baker Katie , Peluso Anthony , May Christine N , Pagoto Sherry L
Published: February 2018

Twitter may be useful for learning about indoor tanning behavior and attitudes. The objective of this study was to analyze the content of tweets about indoor tanning to determine the extent to which tweets are posted by people who tan, and to characterize the topics of tweets. We extracted 4,691 unique tweets from Twitter using the terms “tanning bed” or “tanning salon” over 7 days in March 2016. We content analyzed a random selection of 1,000 tweets, double-coding 20% of tweets (κ = 0.74, 81% agreement). Most tweets (71%) were by tanners (n = 699 individuals) and included tweets expressing positive sentiment about tanning (57%), and reports of a negative tanning experience (17%), burning (15%), or sleeping in a tanning bed (9%). Four percent of tweets were by tanning salon employees. Tweets posted by people unlikely to be tanners (15%) included tweets mocking tanners (71%) and health warnings (29%). The term “tanning bed” had higher precision for identifying individuals who engage in indoor tanning than “tanning salon”; 77% versus 45% of tweets captured by these search terms were by individuals who engaged in indoor tanning, respectively. Extrapolating to the full data set of 4,691 tweets, findings suggest that an average of 468 individuals who engage in indoor tanning can be identified by their tweets per day. The majority of tweets were from tanners and included reports of especially risky habits (e.g., burning, falling asleep). Twitter provides opportunity to identify indoor tanners and examine conversations about indoor tanning.
Creation and Implementation of a Taxonomy for Educational Activities: A Common Vocabulary to Guide Curriculum Mapping
Authors: Stoddard Hugh A. , Brownfield Erica D.
Published: February 2018

Problem

Undergraduate medical education (UME) has trended toward outcomes-based education, unveiling new issues for UME program organization and leadership. Using a common language for categorizing and linking all program components is essential. The Emory Curriculum Alignment Taxonomy (ECAT) was designed as a common vocabulary for curriculum mapping in the outcomes-based environment of the Emory University School of Medicine.

Approach

The ECAT, developed in 2016, uses a set of 291 controlled identifiers, or “tags,” to describe every educational activity’s content, instruction, assessment, and outcomes, and thereby to align teaching inputs with student outcomes. Tags were drawn from external frameworks or developed by local stakeholders. A key feature is the arrangement of tags into eight categories, with the aim of balancing specificity and parsimony. Tags from multiple categories can be combined using Boolean operators to search for specific topics across the curriculum.

Outcomes

In 2016–2017, all educational activities were tagged, including classroom events, workplace learning, mentored research, and student assessments. Tagging was done by two assistant deans and course/clerkship directors, which reinforced the importance of aligning instruction with assessment and aligning both of these with student outcomes.

Next Steps

Using the ECAT tags has linked instruction with achievement of student outcomes, has shown the compromises between specificity and parsimony were workable, and has facilitated comprehensive program management and evaluation. As the ECAT tags can be modified, other programs could adapt this approach to suit their context. Next steps will include aggregating data into a centralized repository to support reporting and research.
Advances in prostate-specific membrane antigen PET of prostate cancer
Authors: Bouchelouche Kirsten , Choyke Peter L.
Published: February 2018

Purpose of review

In recent years, a large number of reports have been published on prostate-specific membrane antigen (PSMA)/PET in prostate cancer (PCa). This review highlights advances in PSMA PET in PCa during the past year.

Recent findings

PSMA PET/computed tomography (CT) is useful in detection of biochemical recurrence, especially at low prostate-specific antigen (PSA) values. The detection rate of PSMA PET is influenced by PSA level. For primary PCa, PSMA PET/CT shows promise for tumour localization in the prostate, especially in combination with multiparametric MRI (mpMRI). For primary staging, PSMA PET/CT can be used in intermediate and high-risk PCa. Intraoperative PSMA radioligand guidance seems promising for detection of malignant lymph nodes. While the use of PSMA PET/MRI in primary localized disease is limited to high and intermediate-risk patients and localized staging, in the recurrence setting, PET/MRI can be particularly helpful when the lesions are subtle. PSMA PET/CT is superior to choline PET/CT and other conventional imaging modalities.

Molecular imaging with PSMA PET continues to pave the way for personalized medicine in PCa.

However, large prospective clinical studies are still needed to fully evaluate the role of PSMA PET/CT and PET/MRI in the clinical workflow of PCa.
Pulmonary Rehabilitation in Patients With Advanced Idiopathic Pulmonary Fibrosis Referred for Lung Transplantation
Authors: da Fontoura Fabrício Farias , Berton Danilo Cortozi , Watte Guilherme , Florian Juliessa , Schio Sadi Marcelo , Camargo José de Jesus Peixoto , Teixeira Paulo José Zimermann , Moreira José da Silva
Published: February 2018

Purpose:

Currently, pulmonary rehabilitation (PR) has a weak recommendation for idiopathic pulmonary fibrosis (IPF) and is often recommended for mild to moderate disease. We aimed to investigate the completion rate of PR in patients with advanced IPF, to analyze whether the severity of disease influences PR response and whether there is any difference between subjects who are able or not able to successfully complete the program.

Methods:

Patients with IPF referred to lung transplantation (n = 48) were enrolled in an outpatient PR program including 3 times/wk supervised exercise training during 12 wk. A short-form 36-item health-related quality-of-life (HRQL) questionnaire and 6-min walk test distance (6MWD) were evaluated before and after PR.

Results:

We found that 64.5% of patients successfully completed PR (31/48). Baseline forced vital capacity (FVC) and lung diffusion capacity for carbon monoxide (DLCO) were 49% ± 13% and 46% ± 17% of predicted, respectively. There was no difference comparing those who did and did not complete PR. In the former group, 6MWD (58 ± 63 m) and several domains of the HRQL questionnaire improved significantly. No significant association was found between markers of disease severity (FVC, DLCO, and dyspnea) and improvement in clinical outcomes.

Conclusions:

Two-thirds of our sample with advanced IPF referred to lung transplant successfully attended PR and improved exercise capacity and HRQL, without association with markers of disease severity. No difference was found at baseline compared with subjects who were not able to complete the program.
Effects of β-Blockers on Maximal Heart Rate Prediction Equations in a Cardiac Population
Authors: Godlasky Elizabeth , Hoffman Trisha , Weber-Peters Sonya , Bradford Richard , Miller Nathan , Kunselman Allen R. , Lott Mary E. J.
Published: February 2018

Purpose:

To derive specific maximal heart rate (HRmax) prediction equations for a coronary artery disease (CAD) population based upon status of β-blocker (BB) therapy and to compare these to prior HRmax equations (Fox and Brawner-specific for CAD).

Methods:

We retrospectively reviewed stress echocardiogram treadmill tests in patients with CAD, dividing subjects into 3 groups based upon BB use on test day: not prescribed BB therapy (no BB group; n = 110); held for 12 to 24 hr prior (held BB group; n = 155); and continued taking (took BB group; n = 72).

Results:

Derived HRmax equations for our CAD population were no BB = 200 − 0.79 × age; held BB = 193 − 0.71 × age; and took BB = 168 − 0.51 × age. Achieved HRmax mean was not significantly different between held BB and no BB groups; however, HRmax in the took BB group was significantly lower. Fox and Brawner (no BB)-HRmax equations significantly overestimated (+6 and +9 mean bias) and underestimated (−8 and −6 mean bias) achieved HRmax in no BB and held BB groups, respectively. The Brawner (no BB) equation intercept and slope were not significantly different from our CAD-held BB and no BB equations. The Brawner (on BB) equation intercept and slope were similar to our took BB equation, but greatly underestimated achieved HRmax (−17 mean bias).

Conclusion:

For patients holding BB therapy on test day, a similar CAD HRmax estimation equation to those patients never on BB can be used, comparable to the Brawner (no BB) equation. Further research is needed to determine when patients should take their BB therapy in conjunction with exercise testing.
HYDRATION FOLDS IN RHEGMATOGENOUS RETINAL DETACHMENT
Authors: Dalvin Lauren A. , Spaide Richard F. , Yannuzzi Lawrence A. , Freund K. Bailey , Pulido Jose S.
Published: February 2018

Purpose:

To describe two cases of retinal detachment with hydration folds and discuss the possible cause of these outer retinal abnormalities.

Methods:

The medical and imaging records of two patients with retinal detachment and hydration folds were examined.

Patients:

A 43-year-old myopic woman who developed a retinal detachment secondary to a macular hole and a 35-year-old man referred with a rhegmatogenous retinal detachment masquerading as an exudative detachment were each found to have retinal hydration folds.

Results:

On near-infrared reflectance imaging, the hydration folds appeared similar to eddy currents, and these corresponded to curvilinear outer retinal plications on optical coherence tomography. The photoreceptor outer segments appeared thickened and elongated, and there was apparent lateral expansion of the outer retinal layers.

Conclusion:

Hydration folds are found in rhegmatogenous retinal detachment and demonstrate reproducible imaging characteristics on near-infrared imaging and optical coherence tomography. The cause for such outer retinal plications is currently unknown. We suspect that they form as a result of hydration of the glycosaminoglycans in the interphotoreceptor matrix, which lies between the photoreceptors. Additional studies are warranted to explore this pathophysiology.
Comparison of Automated Titanium Fasteners to Hand-Tied Knots in Open Aortic Valve Replacement
Authors: Lee Candice Y. , Johnson Carl A. , Siordia Juan A. , Lehoux Juan M. , Knight Peter A.
Published: February 2018

Objective

Aortic cross-clamp and cardiopulmonary bypass times are independent predictors of postoperative morbidity and mortality. Reducing ischemic times with automated titanium fasteners may improve surgical outcomes. This study compared operative times and costs of titanium fasteners versus hand-tied knots for prosthesis securement in open aortic valve replacement.

Methods

A randomized control trial was conducted during a 16-month period at a single university medical center. Patients undergoing elective aortic valve replacement were randomized to the titanium fastener (n = 37) or hand-tied groups (n = 36). Knotting, aortic cross-clamp, cardiopulmonary bypass, and total operating room times were recorded. Hospital charges were also calculated for these procedures.

Results

Baseline characteristics, concomitant procedures, prosthetic valve size, and sutures were similar between groups. The titanium fastener group had significantly reduced knotting (7.4 vs. 13.0 minutes, P < 0.001), aortic cross-clamp (69 vs. 90 minutes, P < 0.05), cardiopulmonary bypass (86 vs. 114 minutes, P < 0.05), and total operating room times (234 vs. 266 minutes, P < 0.05). Intraoperative complications occurred more frequently in the hand-tied group compared with the titanium fastener group. Postoperative complications were similar between groups. Operating room costs were significantly higher in the titanium fastener group (US $10,428 vs. US $9671, P = 0.01). Hospitalization costs did not differ significantly between the titanium fastener and hand-tied group (US $23,987 vs. US $21,068, P = 0.12).

Conclusions

Titanium fastener use was associated with shorter knotting, aortic cross-clamp, cardiopulmonary bypass, and operating room times and fewer intraoperative complications in open aortic valve replacement, without significantly increasing hospitalization cost.
Injustice perceptions about pain: parent–child discordance is associated with worse functional outcomes
Authors: Miller Megan M. , Wuest David , Williams Amy E. , Scott Eric L. , Trost Zina , Hirsh Adam T.
Published: February 2018

Pain is experienced within and influenced by social environments. For children with chronic pain, the child–parent relationship and parental beliefs about pain are particularly important and may influence pain outcomes. Pain-related injustice perceptions have recently been identified as an important cognitive–emotional factor for children with pain. The current study aimed to better understand the pain-related injustice perceptions of children with chronic pain and their parents. The sample consisted of 253 pediatric chronic pain patients (mean age = 14.1 years, 74% female) presenting to a tertiary pain clinic. Patients completed measures of pain intensity, pain-related injustice perceptions, stress, functional disability, and quality of life. Parents completed a measure of pain-related injustice perceptions about their child's pain. Child–parent dyads were categorized into 1 of 4 categories based on the degree of concordance or discordance between their scores on the injustice measures. One-way analysis of variances examined differences in pain intensity, stress, functional disability, and quality of life across the 4 dyad categories. Our findings indicated that both the degree (concordant vs discordant) and direction (discordant low child–high parent vs discordant high child–low parent) of similarity between child and parent injustice perceptions were associated with child-reported pain intensity, stress, functional disability, and quality of life. The poorest outcomes were reported when children considered their pain as highly unjust, but their parents did not. These findings highlight the important role of parents in the context of pain-related injustice perceptions in pediatric chronic pain.
Body Parts Matter: Social, Behavioral, and Biological Considerations for Urethral, Pharyngeal, and Rectal Gonorrhea and Chlamydia Screening Among MSM in Lima, Peru
Authors: Passaro Ryan Colby , Segura Eddy R. , Perez-Brumer Amaya , Cabeza Jeanne , Montano Silvia M. , Lake Jordan E. , Sanchez Jorge , Lama Javier R. , Clark Jesse L.
Published: February 2018

Background

Gonorrhea (Neisseria gonorrhoeae [GC]) and chlamydia (Chlamydia trachomatis [CT]) disproportionately affect men who have sex with men (MSM), and public health implications vary by anatomic site and bacterial agent. Urethral and rectal GC and CT can increase risk of HIV transmission, whereas pharyngeal GC may be a reservoir for antimicrobial resistance. To define screening priorities in Latin America, we compare differences in the prevalence and correlates of urethral, pharyngeal, and rectal GC and CT among MSM in Peru.

Methods

A cross-sectional sample of 787 MSM from Lima was screened between 2012 and 2014. We described prevalence of urethral, pharyngeal, and rectal GC and CT infection and conducted bivariate analyses of associations with social, behavioral, and biological characteristics. Poisson regression analyses assessed the correlates of each infection at each anatomic site.

Results

The most commonly symptomatic infection (urethral GC; 42.1%) was the least prevalent (2.4%). The most prevalent infections were rectal CT (15.8%) and pharyngeal GC (9.9%). Rectal CT was the least commonly symptomatic (2.4%) infection, and was associated with younger age (adjusted prevalence ratio [95% confidence interval], 0.96 [0.94–0.98]), HIV infection (1.46 [1.06–2.02]), and pasivo (receptive; 3.59 [1.62–7.95]) and moderno (versatile; 2.63 [1.23–5.60]) sexual roles.

Conclusions

Results highlight limitations of current syndromic screening strategies for sexually transmitted diseases in Peru, wherein urethral CT and rectal GC and CT may be missed due to their frequently asymptomatic presentations. Successful management of GC and CT infections among MSM in low-resource settings requires differentiating between bacterial agent, symptomatic presentation, associated risk factors, and public health implications of untreated infection at different anatomic sites.
Effects of Anodal Transcranial Direct Current Stimulation on Somatosensory Recovery After Stroke
Authors: Koo Woo Ram , Jang Baek Hee , Kim Chung Reen
Published: February 2018

Objective

Objective: The aim of this study was to evaluate the effect of anodal transcranial direct current stimulation over the primary somatosensory cortex on the recovery of somatosensation, motor function, and the activities of daily living in patients with subacute stroke.

Design

This study was a prospective, randomized sham controlled, double-blinded study. Patients with subacute stroke having somatosensory deficits (N = 24) were enrolled and assigned randomly to the anodal and sham stimulation groups. Patients received 10 consecutive anodal or sham transcranial direct current stimulations over the primary somatosensory cortex on the side of the stroke lesion. Before and after each stimulation session, Nottingham sensory assessments, Semmes Weinstein monofilaments examination, and manual function tests were performed, and modified Brunnstrom classification, modified Barthel index, and functional ambulation categories were assessed.

Results

Although there was no clear significant difference between the two groups, when the changes from baseline to posttreatment evaluation were compared between the groups, a partially significant improvement was observed in the anodal stimulation group compared with the sham stimulation group. Interestingly, the tactile sensation of the unaffected side also improved. Moreover, the greater improvement in activities of daily living function was observed in the anodal stimulation group too.

Conclusion

Anodal transcranial direct current stimulation over the primary somatosensory cortex may be a useful adjuvant therapy for the recovery of somatosensation and activities of daily living function in patients with sensory deficits after stroke.
HIV Serostatus and Having Access to a Physician for Regular Hepatitis C Virus Care Among People Who Inject Drugs
Authors: Beaulieu Tara , Hayashi Kanna , Milloy Michael J. , Nosova Ekaterina , DeBeck Kora , Montaner Julio , Kerr Thomas , Ti Lianping
Published: February 2018

Background:

People who inject drugs (PWIDs) and who are living with HIV and hepatitis C virus (HCV) infection are vulnerable to a range of health-related harms, including liver cirrhosis, hepatocellular carcinoma, and death. There is limited evidence describing how HIV serostatus shapes access to a physician for regular HCV care among PWID.

Setting:

Data were collected through the Vancouver Injection Drug Users Study (VIDUS), the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS), and the At-Risk Youth Study (ARYS), 3 prospective cohorts involving people who use illicit drugs in Vancouver, Canada, between 2005 and 2015.

Methods:

Using generalized estimating equations, we examined the relationship between HIV-seropositivity and having access to a physician for regular HCV care. We conducted a mediation analysis to examine whether this association was mediated by increased frequency of engagement in health care.

Results:

In total, 1627 HCV-positive PWID were eligible for analysis; 582 (35.8%) were HIV-positive at baseline; and 31 (1.9%) became HIV-positive during follow-up. In multivariable analyses, after adjusting for a range of confounders, HIV serostatus [adjusted odds ratio = 1.99; 95% confidence interval: 1.77 to 2.24] was significantly associated with having access to HCV care. Approximately 26% of the effect was due to mediation.

Conclusion:

Our results demonstrate a positive relationship between HIV-seropositivity and having access to a physician for regular HCV care, which is partially explained through increased frequency of engagement in health care. These findings highlight the need to address patterns of inequality in access to HCV care among PWID.
Burden of Exposure to Potential Interactions Between Antiretroviral and Non-Antiretroviral Medications in a Population of HIV-Positive Patients Aged 50 Years or Older
Authors: Ranzani Alice , Oreni Letizia , Agrò Massimiliano , van den Bogaart Lorena , Milazzo Laura , Giacomelli Andrea , Cattaneo Dario , Gervasoni Cristina , Ridolfo Anna Lisa
Published: February 2018

Background:

As HIV-infected patients aged 50 years or older are at increased risk of comorbidities and multidrug treatments, we examined their exposure to the potential drug–drug interactions (PDDIs) of antiretroviral (ARV) and other medications.

Methods:

This cross-sectional study involved the patients aged 50 years or older receiving ARV and non-ARV medications at our clinic. PDDIs were identified using the University of Liverpool HIV Drug Interaction Checker. Logistic regression models were used to assess risk factors for PDDIs. The American Geriatrics Society Beers Criteria were used to identify potentially inappropriate medications (PIMs).

Results:

A total of 395 (53.9%) of 744 patients showed ≥1 PDDI: 47.4% ≥ 1 amber-PDDI (comedications requiring appropriate management) and 5.6% ≥ 1 red-PDDI (contraindicated comedications). A higher risk of PDDIs was associated with the use of ≥5 medications (P < 0.001), of antiosteoporotics (P < 0.001), calcium channel blockers (P < 0.001), anti–benign prostatic hypertrophy agents (P < 0.001), hypnotics/sedatives (P = 0.022), and anticoagulants (P = 0.006). A higher risk of red-PDDIs was associated with the use of antacids (P < 0.001), anti–benign prostatic hypertrophy agents (P < 0.001) and antipsychotics (P = 0.023). The use of nucleoside reverse transcriptase inhibitor + nonnucleoside reverse transcriptase inhibitor and nucleoside reverse transcriptase inhibitor + integrase strand transfer inhibitor rather than protease inhibitor–based regimens was associated with a reduced risk of PDDIs (P < 0.001). Overall, 119 (16.0%) patients were receiving PIMs (mainly hypnotics/sedatives) and 49 (41.2%) of them had PDDIs able to increase the blood levels of these medications.

Conclusions:

Older patients with HIV are highly exposed to PDDIs between ARVs and comedications. The knowledge of their complete medication regimens and the screening for PDDIs and PIMs is therefore crucial to prevent drug-related adverse outcomes in this population.
Outcome of Patients With Small Vessel Vasculitis After Renal Transplantation: National Database Analysis
Authors: El-Husseini Amr , Saleh Sherif , Hamad Omer , Mei Xiaonan , Castellanos Ana Lia , Davenport Daniel L. , Gedaly Roberto , Sawaya B. Peter
Published: February 2018

Background

Small vessel vasculitis commonly affects the kidney and can progress to end-stage renal disease. The goal of this study is to compare outcomes of patients who received a renal transplant as a result of small vessel vasculitis (group A) with those who received kidney transplants because of other causes (group B).

Methods

This is a retrospective analysis of United Network for Organ Sharing registry data for adult primary kidney transplants from January 2000 to December 2014. Group A patients (N = 2196) were compared with a group B (N = 6588); groups were case matched for age, race, sex, donor type, and year of transplant in a 1:3 ratio.

Results

Renal and patient survivals were better in the group A (P < 0.001). New-onset diabetes after transplant developed in 8.3% of the group A and 11.3% of group B (P < 0.001). Seventeen (0.8%) patients in group A developed recurrent disease. Of these, 7 patients had graft failure, 3 of which were due to disease recurrence. Group A patients had significantly higher risk of developing posttransplant solid organ malignancies (11.3% vs 9.3%, P = 0.006) and lymphoproliferative disorder (1.3% vs 0.8%, P = 0.026). Independent predictors of graft failure and patient mortality were recipients' morbid obesity, diabetes, age, and dialysis duration (hazard ratio of 1.7, 1.4, 1.1/10 years, and 1.1/year for graft failure, and 1.7, 1.7, 1.6/10 years and 1.1/year for patient mortality, respectively).

Conclusions

Renal transplantation in patients with small vessel vasculitis has favorable long-term graft and patient outcomes with a low disease recurrence rate. However, they may have a higher risk of developing posttransplant malignancies.
Controlled iris radiance in a diurnal fish looking at prey
Authors: Michiels Nico K. , Seeburger Victoria C. , Kalb Nadine , Meadows Melissa G. , Anthes Nils , Mailli Amalia A. , Jack Colin B.
Published: February 2018

Active sensing using light, or active photolocation, is only known from deep sea and nocturnal fish with chemiluminescent ‘search’ lights. Bright irides in diurnal fish species have recently been proposed as a potential analogue. Here, we contribute to this discussion by testing whether iris radiance is actively modulated. The focus is on behaviourally controlled iris reflections, called ‘ocular sparks’. The triplefin
Tripterygion delaisi
can alternate between red and blue ocular sparks, allowing us to test the prediction that spark frequency and hue depend on background hue and prey presence. In a first experiment, we found that blue ocular sparks were significantly more often ‘on’ against red backgrounds, and red ocular sparks against blue backgrounds, particularly when copepods were present. A second experiment tested whether hungry fish showed more ocular sparks, which was not the case. However, background hue once more resulted in a significant differential use of ocular sparks. We conclude that iris radiance through ocular sparks in
T. delaisi
is not a side effect of eye movement, but adaptively modulated in response to the context under which prey are detected. We discuss the possible alternative functions of ocular sparks, including an as yet speculative role in active photolocation.