bluuebunny/crossref_metadata_2025 huggingface dataset:
Ring Opening of Donor–Acceptor Cyclopropanes with N-Nucleo­philes
Authors: Budynina Ekaterina , Ivanov Konstantin , Sorokin Ivan , Melnikov Mikhail
Published: May 2017

Ring opening of donor–acceptor cyclopropanes with various N-nucleophiles provides a simple approach to 1,3-functionalized compounds that are useful building blocks in organic synthesis, especially in assembling various N-heterocycles, including natural products. In this review, ring-opening reactions of donor–acceptor cyclopropanes with amines, amides, hydrazines, N-heterocycles, nitriles, and the azide ion are summarized.

1 Introduction

2 Ring Opening with Amines

3 Ring Opening with Amines Accompanied by Secondary Processes Involving the N-Center

3.1 Reactions of Cyclopropane-1,1-diesters with Primary and Secondary Amines

3.1.1 Synthesis of γ-Lactams

3.1.2 Synthesis of Pyrroloisoxazolidines and -pyrazolidines

3.1.3 Synthesis of Piperidines

3.1.4 Synthesis of Azetidine and Quinoline Derivatives

3.2 Reactions of Ketocyclopropanes with Primary Amines: Synthesis of Pyrrole Derivatives

3.3 Reactions of Сyclopropane-1,1-dicarbonitriles with Primary Amines: Synthesis of Pyrrole Derivatives

4 Ring Opening with Tertiary Aliphatic Amines

5 Ring Opening with Amides

6 Ring Opening with Hydrazines

7 Ring Opening with N-Heteroaromatic Compounds

7.1 Ring Opening with Pyridines

7.2 Ring Opening with Indoles

7.3 Ring Opening with Di- and Triazoles

7.4 Ring Opening with Pyrimidines

8 Ring Opening with Nitriles (Ritter Reaction)

9 Ring Opening with the Azide Ion

10 Summary
Assistance to Normal Delivery in Two Public Maternities: Perception of the Health Professionals
Authors: Oliveira Nayara Rodrigues Gomes de , Assis Thaís Rocha , Amaral Waldemar Naves do , Falone Valdivina Eterna , Salviano Lívia Maria Oliveira
Published: May 2017

Purpose To evaluate the perception of health professionals involved in the labor process and the assistance to normal delivery, comparing two hospitals in the city of Goiânia, Brazil, regarding the perception of these professionals when they are performing the routines and practices recommended by the World Health Organization (WHO).

Methods This is an analytical comparative study with a quantitative approach, performed in two public hospitals in the city of Goiânia, in the state of Goiás, Brazil. The study included 86 professionals working in assistance to immediate labor in two hospitals. A questionnaire containing 40 questions was applied. The questionnaire related to the Program for the Humanization of Prenatal and Childbirth Care (PHPN, in the Portuguese acronym) of the Brazilian Ministry of Health, the presence of a companion, and the procedures performed. For the data analysis, we used the chi-square and Fisher's exact tests.

Results Most of the professionals claimed to know about the PHPN proposed by Brazilian Ministry of Health in the two hospitals. With regard to good practices, most professionals said that they are performed in maternity ward 2, while on maternity 1, although many of them are present, there are still many unnecessary interventions.

Conclusion When comparing the two maternity hospitals, maternity 2, which was created as a routine humanization model, manages to better adhere to the WHO recommendations. In maternity 1, there was a series of interventions considered by the WHO as ineffective, or used in an inappropriate manner.
Lingual Artery Pseudoaneurysm after Severe Facial Trauma
Authors: Margallo Leyre , de Zárate Estibaliz Ortiz , Franco Maria , Garcia-Iruretagoyena Maria , Cherro Rosa , Barbier Luis , Mendiola Josu , Constantinescu Thomas
Published: May 2017

The mortality associated with high-energy trauma has several time peaks and variable prognosis. In the particular case of isolated head and neck trauma, management initially includes stabilizing the patient, especially the airway and circulation, and then proceeding to treat injured structures with debridement and often fracture fixation and coverage. We present a case of a male patient who suffered a severe facial trauma at his workplace. He underwent an initial uneventful emergency surgery for control of bleeding and mandibular osteosynthesis. At 2 weeks postoperatively, a second emergency surgery was required to treat a previously undiagnosed lingual pseudoaneurysm that ruptured spontaneously, with massive oral bleeding. The case highlights the clinical significance and timing of pseudoaneurysm formation, and the surveillance and high index of suspicion required for potentially life-threatening bleeding at later time peaks. Diagnostic and therapeutic angiography effectively treated the late complication. Multidisciplinary management options are reviewed, emphasizing the need for rapid decision making and collaboration to improve outcomes in such significant surgical trauma patients.
Comparison of the Stability of Mandibular Sagittal Osteotomy Fixation between Two Types of Titanium Miniplates: A Biomechanical Study in Sheep Mandibles
Authors: dos Santos Trento Guilherme , Pires Felipe Andrade , dos Santos Fábio André , da Costa Delson João , Rebellato Nelson Luis Barbosa , Klüppel Leandro Eduardo
Published: May 2017

This study aimed to compare the biomechanical stability of the fixation of mandibular sagittal split osteotomy of the ramus by two types of titanium miniplates in sheep mandibles. Seven preserved sheep mandibles with similar weight and size were selected, dissected with complete removal of soft-tissue structures, and sectioned in their midline. After performing sagittal split osteotomy, 5 mm of advancement was standardized and samples were divided into two groups according to the type of titanium miniplate (GI = seven hemimandibles were fixed with straight titanium miniplate, GII = seven hemimandibles were fixed with L-shaped titanium miniplates), and then subjected to compressive load. The means (standard deviation) of the compressive load and extension values were 70.68 N (22.26) and 63.36 mm (15.60) to straight miniplates, and 78.80 N (32.54) and 70.55 mm (5.42) to L-shaped miniplates. After comparison and statistical analysis, the results showed no significant difference between the two types of titanium miniplates.
Driving Problems in the Elderly and Cognitively Impaired
Authors: Haussmann Robert , Buthut Maria , Donix Markus
Published: May 2017

Driving ability in the elderly and cognitively impaired is of growing demographic relevance. Driving represents a complex task for which multiple central resources are needed. In mild cognitive impairment and dementia, we need to closely monitor driving ability, as it gets irrecoverably lost in the course of the disease. In normal aging, people are often able to self-regulate driving behavior with respect to their medical conditions. Some studies demonstrated that older drivers perform well compared with younger drivers. Others suggest a decline of driving ability in the process of normal aging and an increasing involvement of older drivers in car crashes. However, these findings have been questioned because of several possible biases. Therefore, unnecessary driving restrictions need to be avoided. The reliable evaluation of driving ability requires a specialist assessment with detailed neurocognitive evaluation, investigation of medical history and medical history by proxy, as well as on-the-the-road tests. Highlighting current knowledge in this field, we would like to increase our readers’ awareness for the complexity of driving-associated challenges in an aging population.
Impact of toroidal and poloidal mode spectra on the control of non-axisymmetric fields in tokamaks
Authors: Lanctot M. J. , Park J.-K. , Piovesan P. , Sun Y. , Buttery R. J. , Frassinetti L. , Grierson B. A. , Hanson J. M. , Haskey S. R. , In Y. , Jeon Y. M. , La Haye R. J. , Logan N. C. , Marrelli L. , Orlov D. M. , Paz-Soldan C. , Wang H. H. , Strait E. J. ,   JET Contributors
Published: May 2017

In several tokamaks, non-axisymmetric magnetic field studies show that applied magnetic fields with a toroidal harmonic n = 2 can lead to disruptive n = 1 locked modes. In Ohmic plasmas, n = 2 magnetic reconnection thresholds in otherwise stable discharges are readily accessed at edge safety factors q ∼ 3, low density, and low rotation. Similar to previous studies with n = 1 fields, the thresholds are correlated with the “overlap” field computed with the IPEC code. The overlap field quantifies the plasma-mediated coupling of the external field to the resonant field. Remarkably, the “critical overlap fields” at which magnetic islands form are similar for applied n = 1 and 2 fields. The critical overlap field increases with plasma density and edge safety factor but is independent of the toroidal field. Poloidal harmonics m > nq dominate the drive for resonant fields while m < nq harmonics have a negligible impact. This contrasts with previous results in H-mode discharges at high plasma pressure in which the toroidal angular momentum is sensitive to low poloidal harmonics. Together, these results highlight unique requirements for n > 1 field control including the need for multiple rows of coils to control selected plasma parameters for specific functions (e.g., rotation control or ELM suppression).
Magnetic resonance imaging of granular materials
Authors: Stannarius Ralf
Published: May 2017

Magnetic Resonance Imaging (MRI) has become one of the most important tools to screen humans in medicine; virtually every modern hospital is equipped with a Nuclear Magnetic Resonance (NMR) tomograph. The potential of NMR in 3D imaging tasks is by far greater, but there is only “a handful” of MRI studies of particulate matter. The method is expensive, time-consuming, and requires a deep understanding of pulse sequences, signal acquisition, and processing. We give a short introduction into the physical principles of this imaging technique, describe its advantages and limitations for the screening of granular matter, and present a number of examples of different application purposes, from the exploration of granular packing, via the detection of flow and particle diffusion, to real dynamic measurements. Probably, X-ray computed tomography is preferable in most applications, but fast imaging of single slices with modern MRI techniques is unmatched, and the additional opportunity to retrieve spatially resolved flow and diffusion profiles without particle tracking is a unique feature.
Electronic and structural analysis of ultra-small-diameter metal disilicide nanowires
Authors: Lanzillo Nicholas A. , Standaert Theo , Lavoie Christian
Published: May 2017

This work describes an ab initio study of the electronic structure, electron transport, and energetic properties of cobalt disilicide (CoSi2) and nickel disilicide (NiSi2) nanowires with widths ranging from approximately 0.5 to 2.5 nm using density functional theory. The effects of oxidation on the nanowire surface are considered and are found to reduce the ballistic conductance by approximately 27% for both species considered. The cohesive energies for both the bulk species as well as the nanowires are found to be significantly stronger than for copper, indicating excellent structural stability. While the lower limit of electrical resistance calculated via the ballistic conductance is still significantly larger than that of Cu nanowires of comparable dimensions, the strong intrinsic lattice energy of the disilicide nanowires suggests that they can be fabricated without the need for diffusion barriers and will exhibit superior resistance to self-diffusion and electromigration.
Adaptable metasurface for dynamic anomalous reflection
Authors: Yan L. B. , Zhu W. M. , Wu P. C. , Cai H. , Gu Y. D. , Chin L. K. , Shen Z. X. , Chong P. H. J. , Yang Z. C. , Ser W. , Tsai D. P. , Liu A. Q.
Published: May 2017

In this paper, we demonstrate an adaptable metasurface with a periodic array of liquid-metal ring-shaped resonators. Its optical properties can be dynamically controlled by individually reconfiguring the geometry (shape and orientation) of the resonators. For the proof of concept, by tailoring the phase profile of the scattered electromagnetic wave, a dynamic anomalous reflection is demonstrated, whereby the reflection angle is fixed at −45° for three different normal incident frequencies of 10.5, 12, and 14 GHz. The demonstrated adaptable metasurfaces pave a way for promising applications in multi-frequency tracking radar systems and broadband scanning systems.
Epitaxial growth of Y3Fe5O12 thin films with perpendicular magnetic anisotropy
Authors: Fu Jianbo , Hua Muxin , Wen Xin , Xue Mingzhu , Ding Shilei , Wang Meng , Yu Pu , Liu Shunquan , Han Jingzhi , Wang Changsheng , Du Honglin , Yang Yingchang , Yang Jinbo
Published: May 2017

Here, we report the realization of epitaxial Y3Fe5O12 (YIG) thin films with perpendicular magnetic anisotropy (PMA). The films are grown on the substituted gadolinium gallium garnet substrate (SGGG) by pulsed laser deposition. It was found that a thin buffer layer of Sm3Ga5O12 (SmGG) grown on top of SGGG can suppress the strain relaxation, which helps induce a large enough PMA to overcome the shape anisotropy in YIG thin films. The reciprocal space mappings analysis reveals that the in-plane strain relaxation is suppressed, while the out-of-plane strain relaxation exhibits a strong dependence on the film thickness. We found that the PMA can be achieved for both bilayer (YIG/SmGG) and tri-layer (SmGG/YIG/SmGG) structural films with YIG layer thicknesses up to 20 nm and 40 nm, respectively.
A multi-state memory device based on the unidirectional spin Hall magnetoresistance
Authors: Avci Can Onur , Mann Maxwell , Tan Aik Jun , Gambardella Pietro , Beach Geoffrey S. D.
Published: May 2017

We report on a memory device concept based on the recently discovered unidirectional spin Hall magnetoresistance (USMR), which can store multiple bits of information in a single ferromagnetic heterostructure. We show that the USMR with possible contribution of Joule heating-driven magnetothermal effects in ferromagnet/normal metal/ferromagnet (FM/NM/FM) trilayers gives rise to four different 2nd harmonic resistance levels corresponding to four magnetization states (⇉, ⇄, ⇆, ⇇) in which the system can be found. Combined with the possibility of controlling the individual FMs by spin-orbit torques, we propose that it is possible to build an all-electrical lateral two-terminal multi-bit-per-cell memory device.
Achromatic flat focusing lens based on dispersion engineering of spoof surface plasmon polaritons
Authors: Yang Jie , Wang Jiafu , Feng Mingde , Li Yongfeng , Wang Xinhua , Zhou Xiaoyang , Cui Tiejun , Qu Shaobo
Published: May 2017

In this letter, we first analyze the dispersion relation for achromatic focusing and obtain the achromatic focusing conditions for discretized unit cells of flat lenses. Then, we propose to engineer the dispersion of spoof surface plasmon polaritons (SSPPs) to satisfy the achromatic focusing conditions. Metallic blades structures are utilized to achieve the linear dispersion response by tailoring the weak dispersion region of SSPPs. A broadband achromatic flat focusing lens (AFFL) is implemented with delicate combinations of the blade structures. A prototype was designed, fabricated, and measured. Both the simulated and experimental results demonstrate that the proposed AFFL can achieve achromatic focusing from 7.5 to 9.0 GHz under the normal incidence.
MoO2 Formed on Mesoporous Graphene Oxide: Efficient and Stable Catalyst for Epoxidation of Olefins
Authors: Bian Gang , Jiang Pingping , Jiang Kelei , Shen Yirui , Kong Linggang , Hu Ling , Dong Yuming , Zhang Weijie
Published: May 2017

A novel mesoporous MoO2 composite supported on graphene oxide (m-MoO2/GO) has been designed and applied as an efficient epoxidation catalyst. The m-MoO2/GO composite was characterised by X-ray diffraction, Raman spectroscopy, X-ray photoelectron spectroscopy, Brunauer–Emmet–Teller surface area analysis, field emission scanning electron microscopy, and transmission electron microscopy. Compared with pure mesoporous MoO2 (m-MoO2) and amorphous MoO2-graphene oxide (a-MoO2/GO), m-MoO2/GO exhibits the best catalytic activity. The conversion and selectivity for cyclooctene are both over 99 % in 6 h. Remarkably, the mesoporous structure in m-MoO2/GO which derives from SiO2 nanospheres endows the catalyst better catalytic performance for long chain olefins: the conversion of methyl oleate can be as high as 82 %. Such a robust catalyst can be easily recycled and reused five times without significant loss of catalytic activity. This novel catalyst is promising in the synthesis of epoxides with a long carbon chain or large ring size.
Total evidence phylogeny of the North American harvestman family Stygnopsidae (Opiliones : Laniatores : Grassatores) reveals hidden diversity
Authors: Cruz-López Jesús A. , Francke Oscar F.
Published: May 2017

Systematic relationships among Laniatores have received considerable attention during the past few years. Many significant taxonomic changes have been proposed, particularly in the superfamily Gonyleptoidea. As part of this superfamily, the basalmost Stygnopsidae is the least known family. In order to propose the first total evidence phylogeny of the family, we produced four datasets: three molecular markers – partial nuclear 28S, mitochondrial ribosomal 16S, mitochondrial protein-encoding cytochrome c oxidase subunit I; and 72 morphological characters. With these data, we performed three different phylogenetic analyses: (1) Bayesian Inference with molecular data, and (2) Bayesian Inference and (3) Maximum Likelihood using combined data. Our results are congruent: a monophyletic Stygnopsidae subdivided into two major clades: Stygnopsinae and Karosinae, subfam. nov. The following genera are redefined: Stygnopsis, Hoplobunus and Serrobunus stat. rev. The following taxa are described: Iztlina venefica, gen. nov., sp. nov. and Tonalteca, gen. nov. Additionally, the following changes are proposed: Serrobunus queretarius (Šilhavý, 1974), comb. nov., Stygnopsis apoalensis (Goodnight & Goodnight, 1973), comb. nov., Stygnopsis mexicana (Roewer, 1915), comb. nov., Stygnopsis oaxacensis (Goodnight & Goodnight, 1973), comb. nov., and Tonalteca spinooculorum (Goodnight & Goodnight, 1973), comb. nov. We also discuss the status of the genera Isaeus stat. rev. and Mexotroglinus. Finally, we discuss the evolution of male genitalia and convergence of selected homoplastic diagnostic characters.
Beyond diagnosis and survivorship: findings from a mixed-methods study of a community-based cancer support service
Authors: Blignault Ilse , McDonnell Louise , Aspinall Diana , Yates Robyn , Reath Jennifer
Published: May 2017

This consumer-led research investigated the client experiences and the individual and community benefits of a community-based cancer support service operating in a regional setting. The study included cross-sectional surveys, focus group discussions and key-informant interviews. In total, 114 clients, 28 carers and 20 therapists were surveyed; three client focus groups were conducted and five directors and staff were interviewed. For many clients and carers, the warm welcome experienced at first contact sets the tone for a long-term association with the organisation. The feeling of being cared for extends to the broader community and living with cancer becomes more than survivorship. Integral to the organisational model are opportunity (second-hand) shops that enable subsidised complementary therapies and other services, offer a way of giving back and assist disadvantaged community members. The organisational model has benefits, not only for people living with cancer and their families, but also for the wider community.
Control of Hsp90 chaperone and its clients by N-terminal acetylation and the N-end rule pathway
Authors: Oh Jang-Hyun , Hyun Ju-Yeon , Varshavsky Alexander
Published: May 2017

Significance

We found that the yeast Hsp90 chaperone system is greatly impaired in
naa10Δ
cells, which cannot N-terminally acetylate a majority of normally N-terminally acetylated proteins, including Hsp90 and its cochaperones. Hsp90 clients, including Chk1, Kar4, Tup1, Gpd1, Ste11, and even the Hsp90 chaperone (Hsc82) itself, became short-lived substrates of the Arg/N-end rule pathway in
naa10Δ
cells. Ubr1 targets the Chk1 kinase through its internal degron. Interactions of Hsp90 with Chk1 could be detected in wild-type but not in
naa10Δ
cells. These results revealed a major role of N-terminal acetylation in the Hsp90-mediated protein homeostasis and showed that a number of Hsp90 clients are previously unknown substrates of the Arg/N-end rule pathway.
Fabrication of nanostructured pearlite steel wires using electropulsing
Authors: Qin Rongshan , Luo Yongkun , Elliott-Bowman Bernadette , Omoigiade Osamudiamen
Published: May 2017

This work reports the refinement of pearlite structure into nanostructure using electropulsing. Nanostructured pearlitic steel wires possess nanoscale lamellae or nanoscale grain microstructures. Fabrication of nanostructures by severe plastic deformation and lamellar to grain transformation have been investigated. It is suggested that an aligned pearlite structure is preferred in severe plastic deformation. The lamellar to grain transformation is controlled by diffusion of carbon within cementite and also from cementite to ferrite phases. Carbon mobility is changed by mechanical, thermal and electrical states. The interface between nanoscale sub-grains in the ferrite phase has considerable carbon content. Numerical calculations and experimental observations demonstrated these mechanisms.
PhyD3: a phylogenetic tree viewer with extended phyloXML support for functional genomics data visualization
Authors: Kreft Łukasz , Botzki Alexander , Coppens Frederik , Vandepoele Klaas , Van Bel Michiel
Published: May 2017

Motivation

Comparative and evolutionary studies utilize phylogenetic trees to analyze and visualize biological data. Recently, several web-based tools for the display, manipulation and annotation of phylogenetic trees, such as iTOL and Evolview, have released updates to be compatible with the latest web technologies. While those web tools operate an open server access model with a multitude of registered users, a feature-rich open source solution using current web technologies is not available.

Results

Here, we present an extension of the widely used PhyloXML standard with several new options to accommodate functional genomics or annotation datasets for advanced visualization. Furthermore, PhyD3 has been developed as a lightweight tool using the JavaScript library D3.js to achieve a state-of-the-art phylogenetic tree visualization in the web browser, with support for advanced annotations. The current implementation is open source, easily adaptable and easy to implement in third parties’ web sites.

Availability and implementation

More information about PhyD3 itself, installation procedures and implementation links are available at http://phyd3.bits.vib.be and at http://github.com/vibbits/phyd3/.

Supplementary information

Supplementary data are available at Bioinformatics online.
Simple, scalable and accurate posterior interval estimation
Authors: Li Cheng , Srivastava Sanvesh , Dunson David B.
Published: May 2017

Standard posterior sampling algorithms, such as Markov chain Monte Carlo procedures, face major challenges in scaling up to massive datasets. We propose a simple and general posterior interval estimation algorithm to rapidly and accurately estimate quantiles of the posterior distributions for one-dimensional functionals. Our algorithm runs Markov chain Monte Carlo in parallel for subsets of the data, and then averages quantiles estimated from each subset. We provide strong theoretical guarantees and show that the credible intervals from our algorithm asymptotically approximate those from the full posterior in the leading parametric order. Our algorithm has a better balance of accuracy and efficiency than its competitors across a variety of simulations and a real-data example.
Emerging Safety of Intramedullary Transplantation of Human Neural Stem Cells in Chronic Cervical and Thoracic Spinal Cord Injury
Authors: Levi Allan D , Okonkwo David O , Park Paul , Jenkins Arthur L , Kurpad Shekar N , Parr Ann M , Ganju Aruna , Aarabi Bizhan , Kim Dong , Casha Steven , Fehlings Michael G , Harrop James S , Anderson Kim D , Gage Allyson , Hsieh Jane , Huhn Stephen , Curt Armin , Guzman Raphael
Published: May 2017

BACKGROUND

Human central nervous system stem cells (HuCNS-SC) are multipotent adult stem cells with successful engraftment, migration, and region-appropriate differentiation after spinal cord injury (SCI).

OBJECTIVE

To present data on the surgical safety profile and feasibility of multiple intramedullary perilesional injections of HuCNS-SC after SCI.

METHODS

Intramedullary free-hand (manual) transplantation of HuCNS-SC cells was performed in subjects with thoracic (n = 12) and cervical (n = 17) complete and sensory incomplete chronic traumatic SCI.

RESULTS

Intramedullary stem cell transplantation needle times in the thoracic cohort (20 M HuCNS-SC) were 19:30 min and total injection time was 42:15 min. The cervical cohort I (n = 6), demonstrated that escalating doses of HuCNS-SC up to 40 M range were well tolerated. In cohort II (40 M, n = 11), the intramedullary stem cell transplantation needle times and total injection time was 26:05 ± 1:08 and 58:14 ± 4:06 min, respectively. In the first year after injection, there were 4 serious adverse events in 4 of the 12 thoracic subjects and 15 serious adverse events in 9 of the 17 cervical patients. No safety concerns were considered related to the cells or the manual intramedullary injection. Cervical magnetic resonance images demonstrated mild increased T2 signal change in 8 of 17 transplanted subjects without motor decrements or emerging neuropathic pain. All T2 signal change resolved by 6 to 12 mo post-transplant.

CONCLUSION

A total cell dose of 20 M cells via 4 and up to 40 M cells via 8 perilesional intramedullary injections after thoracic and cervical SCI respectively proved safe and feasible using a manual injection technique.
Quantitative Comparison of the Intraoperative Utility of Indocyanine Green and Fluorescein Videoangiographies in Cerebrovascular Surgery
Authors: Matano Fumihiro , Mizunari Takayuki , Murai Yasuo , Kubota Asami , Fujiki Yu , Kobayashi Shiro , Morita Akio
Published: May 2017

BACKGROUND: A quantitative analysis comparing indocyanine green videoangiography (ICG-VAG) and fluorescein videoangiography (FL-VAG) in cerebrovascular surgery has not been reported so far.

OBJECTIVE: To clear the differences of characteristics of ICG-VAG and FL-VAG by quantitative assessment.

METHODS: We prospectively analyzed results from 23 patients (3 males; mean age at surgery: 60.9 years, range: 14-75 years) at our hospital from August 2014 to July 2015. Eighteen patients had cerebral aneurysms for clipping, and 5 had intracranial arterial stenosis for superficial temporal artery (STA)–middle cerebral artery bypass. We imported data from the operative image data, converted by Audio Video Interleave to Aquacosmos as picture fluorescence intensity-analyzing software. Regions of interest were set at the parent artery, dome of aneurysms, and perforating artery in cases of clipping of aneurysms, and setting at 3 points in STA, in case of bypass. The transition of fluorescence intensity at each region of interest was calculated and plotted using Aquacosmos.

RESULTS: Thick-walled artery, such as parent artery (P = .0017) and STA (P = .0182), was more significantly visualized by ICG-VAG than FL-VAG, whereas the perforating artery, especially in deep surgical fields, such as anterior communicating artery, internal carotid artery, and basilar artery, was better visualized by FL-VAG than ICG-VAG (P < .0001).

CONCLUSION: In this quantitative analysis of fluorescence study, ICG-VAG showed greater efficacy than FL-VAG in visualizing relatively thick arteries, such as parent artery and STA. However, FL-VAG has greater efficacy than ICG-VAG in visualizing perforating artery, especially in deep surgical fields with characteristic vessel walls.
Risk Assessment of Hemorrhage of Posterior Inferior Cerebellar Artery Aneurysms in Posterior Fossa Arteriovenous Malformations
Authors: Hung Alice L , Yang Wuyang , Braileanu Maria , Garzon-Muvdi Tomas , Caplan Justin M , Colby Geoffrey P , Coon Alexander L , Tamargo Rafael J , Huang Judy
Published: May 2017

BACKGROUND

Posterior fossa arteriovenous malformations (AVMs) are associated with increased risk of rupture and severe consequences from such rupture. The hemorrhagic risk of prenidal aneurysms (anr) on the posterior inferior cerebellar artery (PICA) may exceed that of the AVM in posterior fossa AVMs fed by PICA (PICA-AVM).

OBJECTIVE

To characterize the relative risks of aneurysm and AVM hemorrhage in patients with posterior fossa AVMs.

METHODS

We retrospectively reviewed patients diagnosed with AVM. Patients with posterior fossa AVMs were divided into 3 groups: PICA-AVM with prenidal aneurysm (PICA-AVM-anr group), PICA-AVM without prenidal aneurysm (PICA-AVM group), and AVMs without PICA feeder with/without aneurysm (AVM-only group). Patient and lesion characteristics and treatment outcomes were compared. ANOVA and chi squared tests were used for statistical analyses.

RESULTS

Our cohort included 85 patients. Mean age was 45.3 ± 18.1 yr, with 43(50.6%) female patients. Fifty-one patients (60.0%) had hemorrhagic presentation, and 27 (31.8%) experienced acute hydrocephalus. Patients in the PICA-AVM-anr group (n = 11) were more likely to present with aneurysmal subarachnoid hemorrhage (SAH; P = .005) and less likely to have AVM rupture (P < .001). Ten (90.9%) patients presented with hemorrhage, 6 (60.0%) of which resulted from aneurysm rupture. Of these 6, 5 (83.3%) had acute hydrocephalus. No patients with AVM rupture had hydrocephalus. Eight (72.7%) received aneurysm treatment prior to AVM treatment. There were no significant differences in post-treatment outcomes dependent on treatment order.

CONCLUSION

In addition to relatively higher risk of AVM rupture from infratentorial location and prenidal aneurysm, a higher risk of aneurysm rupture rather than AVM rupture was observed in patients with PICA-AVM-anr complex.
The Effects of Health Insurance within Families: Experimental Evidence from Nicaragua
Authors: Fitzpatrick Anne , Thornton Rebecca
Published: May 2017

This paper measures the causal effects of parent enrollment into voluntary health insurance on healthcare utilization among insured and uninsured children in Nicaragua. The study utilizes a randomized trial and age-eligibility cutoff in which insurance subsidies were randomly allocated to parents that covered their dependent children under 12; children age 12 and older were not eligible for coverage. Among eligible children, the insurance increased utilization at covered providers by 0.56 visits and increased overall utilization by 1.3 visits. Ineligible children with insured parents experienced 1.7 fewer healthcare visits driven by parent, not sibling, enrollment. The results suggest complementarities across healthcare provider type and provide evidence that households reallocate resources across all members in response to changes in healthcare prices for some.
POMICS: A Simulation Disease Model for Timing Fungicide Applications in Management of Powdery Mildew of Cucurbits
Authors: Sapak Z. , Salam M. U. , Minchinton E. J. , MacManus G. P. V. , Joyce D. C. , Galea V. J.
Published: May 2017

A weather-based simulation model, called Powdery Mildew of Cucurbits Simulation (POMICS), was constructed to predict fungicide application scheduling to manage powdery mildew of cucurbits. The model was developed on the principle that conditions favorable for Podosphaera xanthii, a causal pathogen of this crop disease, generate a number of infection cycles in a single growing season. The model consists of two components that (i) simulate the disease progression of P. xanthii in secondary infection cycles under natural conditions and (ii) predict the disease severity with application of fungicides at any recurrent disease cycles. The underlying environmental factors associated with P. xanthii infection were quantified from laboratory and field studies, and also gathered from literature. The performance of the POMICS model when validated with two datasets of uncontrolled natural infection was good (the mean difference between simulated and observed disease severity on a scale of 0 to 5 was 0.02 and 0.05). In simulations, POMICS was able to predict high- and low-risk disease alerts. Furthermore, the predicted disease severity was responsive to the number of fungicide applications. Such responsiveness indicates that the model has the potential to be used as a tool to guide the scheduling of judicious fungicide applications.
In Vitro Evaluation of Betafoam, a New Polyurethane Foam Dressing
Authors: Jung Jae-A , Han Seung-Kyu , Jeong Seong-Ho , Dhong Eun-Sang , Park Kang-Gyun , Kim Woo-Kyung
Published: May 2017

BACKGROUND:

A new polyurethane foam dressing impregnated with 3% povidone-iodine (Betafoam; Genewell, Seoul, Korea) was recently developed based on the hypothesis that its physical properties, including improved moisture-retention capacity and antimicrobial activity, are at least as good as those achieved with the current foam dressings that contain silver, but also associated with reduced cost and cytotoxicity to host cells. The purpose of this in vitro study was to evaluate the efficacy of Betafoam by comparing its physical properties, antimicrobial activity, and cytotoxicity with those of 3 silver foam dressings (Allevyn-Ag [Smith & Nephew, Hull, United Kingdom]; Mepilex-Ag [Mölnlycke Health Care, Gothenburg, Sweden]; and PolyMem-Ag [Ferris MFG Corp, Burr Ridge, Illinois]) used worldwide.

METHODS:

This study measured each dressing’s pore size, fluid absorption time, fluid absorption capacity, fluid retention capacity, antimicrobial activity against Staphylococcus aureus and Pseudomonas aeruginosa, and cytotoxicity to mouse fibroblasts.

RESULTS:

Betafoam had the smallest pore size, the fastest fluid absorption time, greatest fluid absorption, and best retention capacities among the tested foam dressings. Antimicrobial activity was not significantly different among the dressings. However, Betafoam also demonstrated the lowest cytotoxicity to the fibroblasts.

CONCLUSIONS:

Betafoam may result not only in desirable rapid regulation of exudation but also antimicrobial activity with minimal cytotoxicity to host cells that are key requirements for wound healing.
Allergen immunotherapy for the treatment of respiratory allergies in the elderly
Authors: Hur Gyu-Young , Lee Ji-Ho , Park Hae-Sim
Published: May 2017

Purpose of review

Respiratory allergies, including asthma and allergic rhinitis can also occur in the elderly. Allergen immunotherapy for allergic diseases is the only disease-modifying treatment for patients with allergies available thus far. Here, we review current evidence supporting the use of allergen immunotherapy in the elderly and discuss its efficacy and utility for the treatment of respiratory allergic diseases in this setting.

Recent findings

Subcutaneous and/or sublingual immunotherapy are effective therapeutic options in not only young but also older patients. Allergen immunotherapy reduces medication and symptom scores in the elderly and can thus be safely prescribed in this population.

Elderly individuals with proven, clinically relevant immunoglobulin E sensitization to inhalant allergens may benefit from allergen immunotherapy for respiratory allergic diseases. Older patients without contraindications should therefore be considered for treatment, with the additional benefit of reduced medication and symptom scores.
Delayed Dural Leak Following Posterior Spinal Fusion for Idiopathic Scoliosis Using All Posterior Pedicle Screw Technique
Authors: Floccari Lorena V. , Larson A. Noelle , Stans Anthony A. , Fogelson Jeremy , Helenius Iikka
Published: May 2017

Background:

In pediatric patients, pedicle screws are malpositioned 5% to 15% of the time. Complications associated with malpositioned screws are infrequently reported in the literature. We present a series of adolescent idiopathic scoliosis (AIS) patients who presented in a delayed manner with positional headache and chronic dural leak adjacent to the pedicle screw tract.

Methods:

Scoliosis databases at 2 centers were reviewed, and cases of delayed positional headaches following posterior spinal fusion for AIS were identified. Demographic and clinical data were collected.

Results:

Of 322 patients, 4 patients presented with positional headaches at a mean of 12.8 weeks following posterior spinal fusion surgery for AIS, with an interval time to diagnosis of 5 months. Computed tomographic myelogram demonstrated severe pedicle screw malposition in 1 patient, and minimal malposition in 3 patients (<2 mm violation). The patients had delayed presentation with positional headaches secondary to dural leak. All patients successfully underwent revision surgery with repair of the dural leak. At the time of latest follow-up, all patients are asymptomatic.

Conclusions:

Pedicle screw malposition can result in dural leaks. Patients may present in a delayed manner with positional headaches and an acquired Chiari malformation. Clinical suspicion should prompt imaging of the brain or cervical spine followed by computed tomographic myelogram to determine site of leak. This is a rare complication from pedicle screw malposition.

Levels of Evidence:

Level IV—case series.
Evaluation of Community-Based Policy, Systems, and Environment Interventions Targeting the Vending Machines
Authors: Garcia Kristen M. , Garney Whitney R. , Primm Kristin M. , McLeroy Kenneth R.
Published: May 2017

The American Heart Association conducted policy, systems, and environmental (PSE) focused interventions to increase healthy vending in 8 communities. PSE interventions were assessed using the Nutrition Environment Measures Survey Vending Assessment to see changes in the food environment. Baseline and follow-up assessments were conducted with 3 settings and a total of 19 machines. PSE changes resulted in increased availability of healthy options and decreased unhealthy options. Implementation of PSE interventions targeting the food environment can be an effective method of providing increased access to healthy foods and beverages with the goal of increasing consumption to decrease chronic diseases.
Feasibility and Parental Acceptability of an 8-Week, Slow-Speed, High-Intensity, Community-Based Resistance Training Program for Preadolescent Children
Authors: Mullane Sarah L. , Bocchicchio Vincent B. , Crespo Noe C.
Published: May 2017

High-intensity resistance training (RT) shows promise for improved cardiometabolic health in children. Achieving high-intensity RT safely is a challenge for community-based programs because of parental concerns and group engagement. Twenty preadolescent children completed an 8-week, twice per week program using slow speed to achieve high-intensity RT. Parent and child surveys were conducted to measure acceptability and effectiveness. Child fitness levels were assessed, and fasting blood draws and dual-energy x-ray absorptiometry were performed on a subset population. Perceived RT safety, self-efficacy, body composition, waist circumference, and fitness tests exhibited significant improvements. Using slow speed to achieve high-intensity RT may provide a safe and effective community-based alternative for preadolescents.
Predictors of Satisfaction With Life in Veterans After Traumatic Brain Injury: A VA TBI Model Systems Study
Authors: Gause Leah R. , Finn Jacob A. , Lamberty Greg J. , Tang Xinyu , Stevens Lillian Flores , Eapen Blessen C. , Nakase-Richardson Risa
Published: May 2017

Objective:

To identify predictors of satisfaction with life in Veterans 1 year after traumatic brain injury (TBI).

Setting:

The VA TBI Model Systems (TBIMS) project includes 5 Veterans Affairs (VA) Polytrauma Rehabilitation Centers.

Participants:

Veterans enrolled in the VA TBIMS study who completed the Satisfaction With Life Scale at year 1 follow-up. The sample is largely male (96%) and Caucasian (72%), with a median age of 27 years upon enrollment.

Design:

Prospective observational cohort study measuring including demographics (eg, education), preinjury variables (eg, mental health history and employment), and military variables (eg, injury during deployment and injury during active duty status).

Main Outcome Measure:

Satisfaction With Life Scale.

Results:

Multivariate regression analyses revealed that age, marital status, preinjury employment status, preinjury mental health history, and active duty status at the time of injury were significant predictors of life satisfaction at year 1 follow-up.

Conclusions:

Results of this study suggest that satisfaction with life in Veterans with TBI is mediated by several factors that might inform rehabilitation interventions and discharge recommendations. Preinjury variables and active duty status (a unique aspect of the Veteran population) influence life satisfaction at 1 year postinjury. Limitations and future clinical implications will be discussed.
Supervision Needs Following Veteran and Service Member Moderate to Severe Traumatic Brain Injury: A VA TBI Model Systems Study
Authors: Bailey Erin K. , Nakase-Richardson Risa , Patel Nitin , Dillahunt-Aspillaga Christina , Ropacki Susan A. , Sander Angelle M. , Stevens Lillian , Tang Xinyu
Published: May 2017

Objective:

To characterize supervision levels across residential settings at 1 year post-TBI and explore predictors of supervision in a Veteran and Service-member population.

Setting:

Five VA Polytrauma Rehabilitation Centers.

Participants:

A total of 302 individuals enrolled in the VA TBI Model Systems (TBIMS) research program.

Design:

Prospective, longitudinal, multisite.

Main Measures:

Primary residence and supervision levels measured via scores on the Supervision Rating Scale. For predictive modeling, scores were dichotomized into 2 groups: those that were fully independent/living alone or required only some supervision during the day (independent group, n = 195) and those that required overnight supervision, full-time indirect supervision, and full-time direct supervision (dependent group, n = 107).

Results:

Thirty-five percent were receiving supervision at 1 year post-TBI across residential settings and 28% were living in alternative settings. Multivariate modeling indicated that older age and longer posttraumatic amnesia (PTA) were predictive of having a need for supervision at 1 year postinjury.

Conclusions:

Supervision needs are long-term features of moderate and severe TBI. Results of this study lend support to the shift toward conceptualizing TBI as a chronic disease.
Neutrophil to Lymphocyte Ratio as a Novel Predictor of Outcome in Patients With Severe Traumatic Brain Injury
Authors: Chen Weiqiang , Yang Jinhua , Li Bingbing , Peng Guoyi , Li Tianfei , Li Lianjie , Wang Shousen
Published: May 2017

Objective:

The neutrophil to lymphocyte ratio (NLR) has been reported to be a predictor of outcome in critical illness. Objective of this study was to investigate the changes of the NLR in patients with severe traumatic brain injury (TBI) and analyze the relationship between the NLR and TBI outcome.

Setting:

China.

Participants:

A total of 855 patients with severe TBI from January 2007 to April 2012.

Design:

Retrospective.

Main Measurement:

Data on the NLR and other indicators were collected. After follow-up until death or 1 year, the relationship between the NLR and TBI outcome was analyzed retrospectively.

Results:

The final analysis included 688 patients. There were 508 (73.8%) who had an unfavorable outcome by 1 year after head trauma. The value of the NLR on admission was significantly higher in the unfavorable outcome group than in the favorable outcome group (P < .001). Multivariate logistic analysis showed that higher NLR was associated with an unfavorable outcome (odds ratio, 1.100; P < .001). Receiver operating characteristic curve analysis showed that the NLR had a sensitivity of 60.2% and a specificity of 71.1% for predicting unfavorable outcome at 1 year on the basis of the best threshold.

Conclusion:

The NLR might be useful as a novel predictor for 1-year outcome and mortality in severe TBI.
Describing Weight Loss Attempts and Physical Activity Among Individuals With TBI Prior to Participation in a Weight-Loss Program
Authors: Driver Simon , Reynolds Megan , Douglas Megan , Bennett Monica
Published: May 2017

Objective:

Describe (1) weight loss history, (2) perceptions about lifestyle changes, and (3) physical activity among a sample of individuals with traumatic brain injury prior to a 12-month lifestyle change program.

Setting:

Community-based.

Participants:

Individuals enrolled in a lifestyle change program, 6 months or more post–traumatic brain injury, body mass index of 25 or greater, 18 to 64 years of age, with physician's clearance to participate.

Design:

Convenience sample.

Main Measures:

Self-report data were collected before beginning the lifestyle change program including descriptive, weight loss history and physical activity behavior using the Modifiable Activity Questionnaire.

Results:

The final sample included 22 participants (M age = 46 years) injured a median of 8 years ago. Mean weight was 208.5 lb (SD = 40.2), with average body mass index of 31.84 (SD = 4.4). Since injury, 72.7% reported prior weight loss attempts, with 50% gaining 10 lb or more. All participants indicated high motivation for lifestyle changes. Perceived benefits included feeling better, improving overall health, and increased energy. Barriers included physical health complications. Types of physical activity completed included walking (68%, 180 min/mo) and swimming (32%, 79 min/mo).

Conclusion:

Results indicate that many individuals gained weight since injury and attempted weight loss, demonstrating a need for evidence-based lifestyle interventions. Future research is needed to determine whether individuals with traumatic brain injury are able to achieve and maintain weigh loss through intervention.
Blepharoplasty Effect on a Described Algorithmic Approach to External Ptosis Repair: Is It Time for Unbundling?
Authors: Rubinstein Tal J. , Repp Daniel J. , Sires Bryan S.
Published: May 2017

Purpose:

To investigate the effects of performing a previously described algorithmic levator resection for involutional ptosis with a blepharoplasty instead of through a small incision.

Methods:

Eyelids with involutional ptosis and normal levator function were included in the study. An upper blepharoplasty was performed first. An external levator resection was then performed based on a described technique involving 2 mm resection of aponeurosis for 1 mm of desired lift, consistent tension on the aponeurosis between surgical cases, and standardized suture placement.

Results:

Forty-one eyelids of 25 patients were included. Mean postoperative margin to reflex distance 1 (MRD1) was 2.98 mm, which was significantly higher than preoperative MRD1 (0.67 mm), but lower than the predetermined goal MRD1 (3.35 mm). Eight eyelids did not meet primary outcome of MRD1 within 1 mm of goal MRD1, with 5 undercorrections. There was no difference between the postoperative MRD1 compared with the same ptosis technique performed through a small incision only, but there were more intraoperative suture adjustments and fewer eyelids meeting the primary outcome when a concurrent blepharoplasty was performed.

Conclusions:

The addition of blepharoplasty with a previously described algorithmic approach external levator resection has an 80% success rate in achieving the primary outcome. When compared with a small-incision ptosis repair, concurrent blepharoplasty results in a less predictable outcome and an increased need for intraoperative adjustment. Performing an algorithmic technique for external levator resection with a blepharoplasty has less predictable outcomes, which raises the question of separating the procedures to improve patient care.