bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of TiO2(110) surface roughness on growth and stability of thin organic films
Authors: Szajna K. , Kratzer M. , Wrana D. , Mennucci C. , Jany B. R. , Buatier de Mongeot F. , Teichert C. , Krok F.
Published: October 2016

We have investigated the growth and stability of molecular ultra-thin films, consisting of rod-like semiconducting para-hexaphenyl (6P) molecules vapor deposited on ion beam modified TiO2(110) surfaces. The ion bombarded TiO2(110) surfaces served as growth templates exhibiting nm-scale anisotropic ripple patterns with controllable parameters, like ripple depth and length. In turn, by varying the ripple depth one can tailor the average local slope angle and the local step density/terrace width of the stepped surface. Here, we distinguish three types of substrates: shallow, medium, and deep rippled surfaces. On these substrates, 6P sub-monolayer deposition was carried out in ultra-high vacuum by organic molecular beam evaporation (OMBE) at room temperature leading to the formation of islands consisting of upright standing 6P molecules, which could be imaged by scanning electron microscopy and atomic force microscopy (AFM). It has been found that the local slope and terrace width of the TiO2 template strongly influences the stability of OMBE deposited 6P islands formed on the differently rippled substrates. This effect is demonstrated by means of tapping mode AFM, where an oscillating tip was used as a probe for testing the stability of the organic structures. We conclude that by increasing the local slope of the TiO2(110) surface the bonding strength between the nearest neighbor standing molecules is weakened due to the presence of vertical displacement in the molecular layer in correspondence to the TiO2 atomic step height.
Residual stress in nano-structured stainless steel (AISI 316L) prompted by Xe+ ion bombardment at different impinging angles
Authors: Cucatti S. , Droppa R. , Figueroa C. A. , Klaus M. , Genzel Ch. , Alvarez F.
Published: October 2016

The effect of low energy (<1 keV) xenon (Xe+) ion bombardment on the residual stress of polycrystalline iron alloy (AISI 316L steel) is reported. The results take into account the influence of the ion incident angle maintaining constant all other bombarding parameters (i.e., ion energy and current density, temperature, and doses). The bombarded surface topography shows that ions prompt the formation of nanometric regular patterns on the surface crystalline grains and stressing the structure. The paper focalizes on the study of the surface residual stress state stemming from the ion bombardment studied by means of the “sin2 ψ” and “Universal Plot” methods. The analysis shows the absence of shear stress in the affected material region and the presence of compressive in-plane residual biaxial stress (∼200 MPa) expanding up to ∼1 μm depth for all the studied samples. Samples under oblique bombardment present higher compressive stress values in the direction of the projected ion beam on the bombarded surface. The absolute value of the biaxial surface stress difference (σ11-σ22) increases on ion impinging angles, a phenomenon associated with the momentum transfer by the ions. The highest stress level was measured for ion impinging angles of 45° (σ11 = −380 ± 10 MPa and σ22 = −320 ± 10 MPa). The different stresses obtained in the studied samples do not affect significantly the formation of characteristic surface patterns.
Controlled injection of a liquid into ultra-high vacuum: Submonolayers of adenosine triphosphate deposited on Cu(110)
Authors: Sobrado J. M. , Martín-Gago J. A.
Published: October 2016

We have combined a fast-valve device with vacuum technology for implementing a new method that allows introducing liquid solutions in an ultra-high vacuum chamber in the form of very small droplets. This technical development allows the easy deposition of (bio) organic molecules or small nanoparticles on a surface in a fully in-situ process, avoiding possible contamination due to the handle of the material. Moreover, our experimental set-up is suitable for any liquid and does not require any voltage application as in electrospray. We can easily change the operating regime from liquid droplet injection to the formation of a highly dispersive jet of micro-droplets by exclusively adjusting external parameters. Due to the nature of the injection process, the operational protocol makes possible the deposition of delicate molecular species that cannot be thermally sublimated. In particular, we have used this system to study the deposition of adenosine triphosphate on Cu(110). The structure of the layer was analyzed by X-ray photoemission spectroscopy and the evolution of the signal from the deposited molecule with the number of injections indicates that the molecular coverage can be controlled with submonolayer precision.
Gigawatt-class microwave generation from a novel Ku-band coaxial transit-time oscillator with low guiding magnetic field
Authors: Ling Junpu , Zhang Jiande , He Juntao , Jiang Tao , Song Lili
Published: October 2016

A non-uniform buncher and a depth-tunable collector have been proposed to improve the power capacity and conversion efficiency of the coaxial foilless transit-time oscillator (TTO) in our previous work. Recently, our Ku-band coaxial TTO with low guiding magnetic field is improved by employing them, and the related experimental investigations are carried out on the TORCH-01 accelerator. It is shown that the non-uniform buncher plays a key role in the enhancement of microwave pulse duration. The influences of the collector's depth on characteristics of the device indicate that the conversion efficiency can be improved by optimizing the collector's depth in the experiments. With the diode voltage 460 kV, the beam current 8.7 kA, and the guiding magnetic field of 0.6 T, a radiation power of 1 GW with the conversion efficiency of 25% at 14.3 GHz is generated by our improved TTO. The output pulse duration is 26 ns and no obvious pulse shortening is observed. The experimental results demonstrate the abilities of this improved Ku-band device to generate gigawatt-class Ku-band microwave with low guiding magnetic field.
Quadrupole splittings in the near-infrared spectrum of 14NH3
Authors: Twagirayezu Sylvestre , Hall Gregory E. , Sears Trevor J.
Published: October 2016

Sub-Doppler, saturation dip, spectra of lines in the v1 + v3, v1 + 2v4, and v3 + 2v4 bands of 14NH3 have been measured by frequency comb-referenced diode laser absorption spectroscopy. The observed spectral line widths are dominated by transit time broadening and show resolved or partially-resolved hyperfine splittings that are primarily determined by the 14N quadrupole coupling. Modeling of the observed line shapes based on the known hyperfine level structure of the ground state of the molecule shows that, in nearly all cases, the excited state level has hyperfine splittings similar to the same rotational level in the ground state. The data provide accurate frequencies for the line positions and easily separate lines overlapped in Doppler-limited spectra. The observed hyperfine splittings can be used to make and confirm rotational assignments and ground state combination differences obtained from the measured frequencies are comparable in accuracy to those obtained from conventional microwave spectroscopy. Several of the measured transitions do not show the quadrupole hyperfine splittings expected based on their existing rotational assignments. Either the assignments are incorrect or the upper levels involved are perturbed in a way that affects the nuclear hyperfine structure.
Influence of deposited energy on shock wave induced by underwater pulsed current discharge
Authors: Li Xian-Dong , Liu Yi , Liu Si-Wei , Li Zhi-Yuan , Zhou Gu-Yue , Li Hua , Lin Fu-Chang , Pan Yuan
Published: October 2016

In this paper, an integrated experimental system is established to study the influence of deposited energy on the intensity of the shock wave induced by underwater pulse discharge. Considering the time varying behavior of the arc, the calculation methods of the deposited energy into the plasma channel and the average arc resistance are proposed and presented. The effect of the breakdown process on the deposited energy and the shock wave is analyzed. It can be concluded that the shock wave intensity can be improved by depositing more energy in the first half oscillation period and increasing the arc resistance. It is also found that the energy deposition and the shock wave intensity are significantly influenced by the breakdown time delay and the shape of the initial plasma channel.
High spatial frequency laser induced periodic surface structure formation in germanium by mid-IR femtosecond pulses
Authors: Austin Drake. R. , Kafka Kyle R. P. , Lai Yu Hang , Wang Zhou , Zhang Kaikai , Li Hui , Blaga Cosmin I. , Yi Allen Y. , DiMauro Louis F. , Chowdhury Enam A.
Published: October 2016

Formation of high spatial frequency laser induced periodic surface structures (HSFL) in germanium by 90 fs mid-IR pulses at a 1 kHz repetition rate with wavelengths between λ = 2 and 3.6 μm was studied with varying angle of incidence and polarization. The period of these structures varied from λ/3 to λ/8. A modified surface-scattering model including Drude excitation and the optical Kerr effect explains the spatial period scaling of HSFL across the mid-IR wavelengths. Transmission electron microscopy shows the presence of a 30 nm amorphous layer above the structure of crystalline germanium. Various mechanisms including two photon absorption and defect-induced amorphization are discussed as probable causes for the formation of this layer.
Breakdown of intermediate range order in AsSe chalcogenide glass
Authors: Ahmad Azkar S. , Glazyrin K. , Liermann H. P. , Franz H. , Wang X. D. , Cao Q. P. , Zhang D. X. , Jiang J. Z.
Published: October 2016

As-cast amorphous AsSe (a-AsSe) has been characterized by in-situ high pressure XRD and Raman spectroscopy up to the pressure of ∼30 GPa using diamond anvil cell together with ab-initio molecular dynamics simulations. A gradual densification has been observed under compression along with the breakdown of intermediate range ordering at ∼16 GPa. The whole transformation process can be divided into three relatively distinct pressure regimes from 1 bar to 7 GPa, from 7 to 16 GPa, and beyond 16 GPa. Our XRD results together with Raman spectroscopic studies confirm that in the a-AsSe pressure tuning results in network transformations only, without sudden jump in the density. The results obtained by high pressure ab-initio molecular dynamics simulations demonstrate the variations in the local structures associated with the experimentally observed transformations. The amorphous-to-amorphous network transformation is found to be reversible upon decompression.
Orbital configuration in CaTiO3 films on NdGaO3
Authors: Cao Yanwei , Park Se Young , Liu Xiaoran , Choudhury D. , Middey S. , Meyers D. , Kareev M. , Shafer P. , Arenholz E. , Chakhalian J.
Published: October 2016

Despite its use as a constituent layer for realization of a polar metal and interfacial conductivity, the microscopic study of electronic structure of CaTiO3 is still very limited. Here, we epitaxially stabilized CaTiO3 films on NdGaO3 (110) substrates in a layer-by-layer way by pulsed laser deposition. The structural and electronic properties of the films were characterized by reflection-high-energy-electron-diffraction, X-ray diffraction, and element-specific resonant X-ray absorption spectroscopy. To reveal the orbital polarization and the crystal field splitting of the titanium 3d state, X-ray linear dichroism was carried out on CaTiO3 films, demonstrating the orbital configuration of dxz/dyz < dxy < d3z2−r2 < dx2−y2. To further explore the origin of this configuration, we performed the first-principles density function theory calculations, which linked the orbital occupation to the on-site energy of Ti 3d orbitals. These findings can be important for understanding and designing exotic quantum states in heterostructures based on CaTiO3.
Monolithically integrated mid-IR interband cascade laser and photodetector operating at room temperature
Authors: Lotfi Hossein , Li Lu , Shazzad Rassel S. M. , Yang Rui Q. , Corrége Cédric J. , Johnson Matthew B. , Larson Preston R. , Gupta James A.
Published: October 2016

We report on the demonstration of a monolithically integrated mid-IR interband cascade (IC) laser and photodetector operating at room temperature. The base structure for the integrated laser and detector is a six-stage type-I IC laser with GaInAsSb quantum well active regions. The laser/detector pair was defined using focused ion beam milling. The laser section lased in cw mode with an emission wavelength of ∼3.1 μm at 20 °C and top-illuminated photodetectors fabricated from the same wafer had Johnson-noise-limited detectivity of 1.05 × 109 cm Hz1/2/W at this wavelength and temperature. Under the same condition, the detectivity for the edge illumination configuration for the monolithically integrated laser/photodetector pairs is projected to be as high as 1.85 × 1010 cm Hz1/2/W, as supported by experimentally observed high photocurrent and open-circuit voltage. These high performance characteristics for monolithically integrated IC devices show great prospects for on-chip integration of mid-IR photonic devices for miniaturized sensors and on-chip optical communication systems.
Fabrication of three dimensional diamond ultraviolet photodetector through down-top method
Authors: Liu Zhangcheng , Ao Jin-Ping , Li Fengnan , Wang Wei , Wang Jingjing , Zhang Jingwen , Wang Hong-Xing
Published: October 2016

Three dimensional diamond ultraviolet (UV) photodetector have been fabricated on diamond epitaxial layer through down-top approach, where diamond epitaxial layer was grown between metal electrodes. A thin diamond epitaxial layer was first grown on high-pressure high-temperature single crystal diamond substrate. Then, the diamond epitaxial layer was covered by interdigitated tungsten electrodes. Furthermore, another diamond epitaxial layer was grown on uncovered area. At last, UV-Ozone treatment was used to oxidize the surface. The optoelectronic performance of the photodetector was characterized, exhibiting a large responsivity and a repeatable transient response behavior. Moreover, down-top process is beneficial for the electrode conductivity stability. Also, an ohmic contact could be formed between tungsten and diamond during growth. The results indicate that down-top process is an efficient way for fabrication of three dimensional diamond photodetectors.
Socioeconomic impact of forage-technology adoption by smallholder cattle farmers in Cambodia
Authors: Ashley K. , Young J. R. , Kea P. , Suon S. , Windsor P. A. , Bush R. D.
Published: October 2016

In Cambodia, adoption of forage technology is recommended to smallholder cattle farmers as an alternative to the widespread practice of feeding nutritionally inferior rice straw and collected or grazed native grasses. Although field research has demonstrated the nutritional benefits to cattle of smallholders adopting forage technology in Cambodia, we extended these studies by investigating the impacts and financial metrics of forage technology adoption in January 2011 by 120 smallholder participants from the ‘Best practice health and husbandry of cattle Cambodia’ (AH/2005/086) project. Farmers were classified by intervention level (high (HI) or low (LI) intervention) and forage technology adoption (adopter HI, non-adopter HI and non-adopter LI). Information on cattle-feeding practices, including household labour demands of sourcing feed for cattle, plus input costs of forage-plot establishment by adopter HI farmers, was collected and analysed. Results were that while the establishment of forages did not have a significant effect on the use of traditional feed sources such as rice straw, crop bi-products and crop residues, grazing of cattle on native pastures was less common among adopter households. Adopter households also reported a significant (P < 0.05) reduction in daily time spent sourcing feed and reduced involvement of women and children in sourcing feed for cattle compared with non-adopter households. Average total cost of inputs to forage-plot establishment per 100 m2 ranged from US$1.40 to US$16.88, with an average cost of US$5.60. Seed costs were estimated at US$0.50 per 100 m2 for a total input cost of US$6.10 per 100 m2. Partial budget analysis was used to compare the value of forage feeding of the following two scenarios over a 6-month wet-season period: (1) forage-plot establishment and forage feeding across the herd; and (2) forage-plot establishment and target feeding (fattening) of one animal. A net profit of US$139.01 was indicated for Scenario 1 and US$152.94 for Scenario 2 and Monte Carlo simulation indicated similar financial outcomes for both scenarios, namely US$169.09 (95% CI: –17.00, 402.00) and US$172.33 (95% CI: 66.80, 305.80) respectively. We conclude that the reduced labour burden on women and children plus the potential increased household income from forage establishment and forage feeding, support recommendations of forage technology as a strategy to improve the livelihoods of smallholder cattle farmers in Cambodia.
The identity crisis in Jordan: historical pathways and contemporary debates
Authors: Salameh Mohammed Torki Bani , El-Edwan Khalid Issa
Published: October 2016

This study aims to identify the attempts to form a Jordanian national identity from the establishment of the Jordanian state in 1921 to date. This study reviews the efforts of the Jordanian state, which was subject to internal, external, political, social, economic, and cultural circumstances, and variables that led to change the Jordanian national identity to incorporate religious, national, regional, ethnic, and tribal aspects. The regime has been unable to address and resolve the issue of national identity; instead, it has tried several means to circumvent the problem of national identity. The identity card is a means that the regime has used to achieve its goals. These policies led to the state's failure to define, establish, and maintain a comprehensive national identity for its citizens. The formation of a national identity has been a dilemma for Jordan since the establishment of the state; there is almost no known national identity. This situation calls for the construction of the Jordanian national identity on a fixed and clear basis to prevent its disintegration, to facilitate the process of social integration, and to build a final national identity that is both inclusive and representative. Without this identity, division and conflict may prevail in Jordanian society.
Concurrent deployment of visual attention and response selection bottleneck in a dual-task: Electrophysiological and behavioural evidence
Authors: Reimer Christina B. , Strobach Tilo , Schubert Torsten
Published: October 2016

Visual attention and response selection are limited in capacity. Here, we investigated whether visual attention requires the same bottleneck mechanism as response selection in a dual-task of the psychological refractory period (PRP) paradigm. The dual-task consisted of an auditory two-choice discrimination Task 1 and a conjunction search Task 2, which were presented at variable temporal intervals (stimulus onset asynchrony, SOA). In conjunction search, visual attention is required to select items and to bind their features resulting in a serial search process around the items in the search display (i.e., set size). We measured the reaction time of the visual search task (RT2) and the N2pc, an event-related potential (ERP), which reflects lateralized visual attention processes. If the response selection processes in Task 1 influence the visual attention processes in Task 2, N2pc latency and amplitude would be delayed and attenuated at short SOA compared to long SOA. The results, however, showed that latency and amplitude were independent of SOA, indicating that visual attention was concurrently deployed to response selection. Moreover, the RT2 analysis revealed an underadditive interaction of SOA and set size. We concluded that visual attention does not require the same bottleneck mechanism as response selection in dual-tasks.
Number comparison and number ordering as predictors of arithmetic performance in adults: Exploring the link between the two skills, and investigating the question of domain-specificity
Authors: Morsanyi Kinga , O'Mahony Eileen , McCormack Teresa
Published: October 2016

Recent evidence has highlighted the important role that number-ordering skills play in arithmetic abilities, both in children and adults. In the current study, we demonstrated that number comparison and ordering skills were both significantly related to arithmetic performance in adults, and the effect size was greater in the case of ordering skills. Additionally, we found that the effect of number comparison skills on arithmetic performance was mediated by number-ordering skills. Moreover, performance on comparison and ordering tasks involving the months of the year was also strongly correlated with arithmetic skills, and participants displayed similar (canonical or reverse) distance effects on the comparison and ordering tasks involving months as when the tasks included numbers. This suggests that the processes responsible for the link between comparison and ordering skills and arithmetic performance are not specific to the domain of numbers. Finally, a factor analysis indicated that performance on comparison and ordering tasks loaded on a factor that included performance on a number line task and self-reported spatial thinking styles. These results substantially extend previous research on the role of order processing abilities in mental arithmetic.
Perceived Income Adequacy and Well-being Among Older Adults in Six Low- and Middle-Income Countries
Authors: Gildner Theresa E , Liebert Melissa A , Capistrant Benjamin D , D’Este Catherine , Snodgrass J Josh , Kowal Paul
Published: October 2016

Objectives

Perceived income adequacy is positively associated with self-rated health (SRH) and quality of life (QOL) among adults in higher-income countries. Additionally, older individuals often report higher levels of income adequacy. However, it is unclear if these associations, documented primarily in high-income countries, are also evident across economically and culturally distinctive low- and middle-income countries.

Methods

Data were drawn from the World Health Organization’s Study on global AGEing and adult health (SAGE), a study of adults aged 50 years or older in China, Ghana, India, Mexico, the Russian Federation, and South Africa. Smaller samples of younger adults (18–49 years) were included for comparison purposes. Participants reported income adequacy, SRH, and QOL. Associations between age and income adequacy and between income adequacy and SRH/QOL were examined using country-specific logistic regression analysis.

Results

Older adults in China and Russia were more likely to report better income adequacy than their 18- to 49-year-old counterparts; however, the opposite was observed in Ghana and India. SRH and QOL improved as income adequacy increased in all countries.

Discussion

As expected, income adequacy was correlated with SRH and QOL. However, the relationship between age and income adequacy varied cross-culturally, potentially due to differences in familial and governmental financial support.
Rising temperatures increased recruitment of brown tiger prawn (Penaeus esculentus) in Moreton Bay (Australia)
Authors: Kienzle Marco , Sterling David J.
Published: October 2016

Abiotic factors are fundamental drivers of the dynamics of wild marine fish populations. Identifying and quantifying their influence on species targeted by the fishing industry is difficult and very important for managing fisheries in a changing climate. Using multiple regression, we investigated the influence of both temperature and rainfall on the variability of recruitment of a tropical species, the brown tiger prawn (Penaeus esculentus), in Moreton Bay which is located near the southern limit of its distribution on the east coast of Australia. A step-wise selection between 60 environmental variables identified temperature as the most important environmental factor to explain the variations of recruitment between 1990 and 2014. Including temperature into the Beverton and Holt stock–recruitment relationship explained 69% of the recruitment variability compared with 9.5% when omitted. This analysis indicates that increasing temperatures have increased recruitment of brown tiger prawn in Moreton Bay.
Surgeon Experience and Complications of Transvaginal Prolapse Mesh
Authors: Kelly Erin C. , Winick-Ng Jennifer , Welk Blayne
Published: October 2016

(Abstracted from Obstet Gynecol 2016;128:65–72)

Surgery for pelvic organ prolapse (POP) is performed by the age of 80 years in approximately 1 in 8 American women. There is a high recurrence rate following POP surgery (39%), and a repeat repair is needed in 29% of cases.
Ovarian Stimulation for In Vitro Fertilization and Long-term Risk of Breast Cancer
Authors: van den Belt-Dusebout Alexandra W. , Spaan Mandy , Lambalk Cornelis B. , Kortman Marian , Laven Joop S. E. , van Santbrink Evert J. P. , van der Westerlaken Lucette A. J. , Cohlen Ben J. , Braat Didi D. M. , Smeenk Jesper M. J. , Land Jolande A. , Goddijn Mariëtte , van Golde Ron J. T. , van Rumste Minouche M. , Schats Roel , Jóźwiak Katarzyna , Hauptmann Michael , Rookus Matti A. , Burger Curt W. , van Leeuwen Flora E.
Published: October 2016

(Abstracted from JAMA 2016;316:300–312)

Previous studies have shown that both exogenous and endogenous estrogens and progestogens increase the risk of breast cancer. it has been suggested that in vitro fertilization (IVF) procedures may increase breast cancer risk.
Recent developments in emerging therapeutic targets of osteoarthritis
Authors: Sun Margaret Man-Ger , Beier Frank , Pest Michael A.
Published: October 2016

Purpose of review

Despite the tremendous individual suffering and socioeconomic burden caused by osteoarthritis, there are currently no effective disease-modifying treatment options. This is in part because of our incomplete understanding of osteoarthritis disease mechanism. This review summarizes recent developments in therapeutic targets identified from surgical animal models of osteoarthritis that provide novel insight into osteoarthritis pathology and possess potential for progression into preclinical studies.

Recent findings

Several candidate pathways and processes that have been identified include chondrocyte autophagy, growth factor signaling, inflammation, and nociceptive signaling. Major strategies that possess therapeutic potential at the cellular level include inhibiting autophagy suppression and decreasing reactive oxygen species (ROS) production. Cartilage anabolism and prevention of cartilage degradation has been shown to result from growth factor signaling modulation, such as TGF-β, TGF-α, and FGF; however, the results are context-dependent and require further investigation. Pain assessment studies in rodent surgical models have demonstrated potential in employing anti-NGF strategies for minimizing osteoarthritis-associated pain.

Studies of potential therapeutic targets in osteoarthritis using animal surgical models are helping to elucidate osteoarthritis pathology and propel therapeutics development. Further studies should continue to elucidate pathological mechanisms and therapeutic targets in various joint tissues to improve overall joint health.
Breast Cancer Screening, Mammography, and Other Modalities
Authors: FIORICA JAMES V.
Published: October 2016

This article is an overview of the modalities available for breast cancer screening. The modalities discussed include digital mammography, digital breast tomosynthesis, breast ultrasonography, magnetic resonance imaging, and clinical breast examination. There is a review of pertinent randomized controlled trials, studies and meta-analyses which contributed to the evolution of screening guidelines. Ultimately, 5 major medical organizations formulated the current screening guidelines in the United States. The lack of consensus in these guidelines represents an ongoing controversy about the optimal timing and method for breast cancer screening in women. For mammography screening, the Breast Imaging Reporting and Data System lexicon is explained which corresponds with recommended clinical management. The presentation and discussion of the data in this article are designed to help the clinician individualize breast cancer screening for each patient.
Prevalence of Ocular Manifestations and Visual Outcomes in Patients With Herpes Zoster Ophthalmicus
Authors: Szeto Simon K. H. , Chan Tommy C. Y. , Wong Raymond L. M. , Ng Alex L. K. , Li Emmy Y. M. , Jhanji Vishal
Published: October 2016

Purpose:

To investigate the prevalence of ocular manifestations and visual outcomes in patients with herpes zoster ophthalmicus (HZO).

Methods:

Consecutive cases diagnosed with HZO who attended 2 hospitals between July 1, 2011, and June 30, 2015, were retrospectively reviewed. Patient demographics, clinical presentations, and management were reviewed. The logistic regression model was used to estimate the odds ratio of visual loss with ocular manifestations.

Results:

A total of 259 patients were included. Of these, 110 (42.5%) patients were <60 years old and 149 patients (57.5%) were ≥60 years old. None of the patients had received zoster vaccination before presentation. Ocular manifestations were present in 170 (65.6%) patients with no difference between both age groups (P = 0.101). Conjunctivitis was the most common ocular manifestation, followed by anterior uveitis and keratitis. After resolution of HZO, 58.7% of patients had a visual acuity of 6/12 or worse. Epithelial keratitis and stromal keratitis were independent risk factors for visual loss after resolution of HZO (P = 0.003 and P = 0.004, respectively). The corresponding odds ratio was 6.59 [95% confidence interval (CI): 1.87–23.19] and 7.55 (95% CI: 1.88–30.30), respectively. The number of ocular manifestations was also associated with an increased risk of visual loss with an odds ratio of 1.49 (95% CI: 1.01–2.20; P = 0.043).

Conclusions:

A substantial proportion of patients with HZO were <60 years old in this study. The absence of zoster vaccination across the study cohort was noteworthy. Keratitis was the main reason for poor visual outcome in these patients.
Improvement of Gynecological Screening of Female Renal Transplant Recipients by Self-Sampling for Human Papillomavirus Detection
Authors: Hinten Floor , Hilbrands Luuk B. , Meeuwis Kim A. , van Bergen-Verkuyten Muriël C. , Slangen Brigitte F. , van Rossum Michelle M. , Rahamat-Langendoen Janette , Massuger Leon F. , de Hullu Joanne A. , Melchers Willem J.
Published: October 2016

Objectives

Female renal transplant recipients (RTRs) have increased risk for developing human papillomavirus (HPV)–related (pre)malignancies of the lower genital tract. Annual cervical screening is advised for RTRs, but the participation rate is low. The aim of this study is to investigate whether HPV self-sampling is suitable for gynecological screening of RTRs to increase participation rate.

Methods

A large cohort of 253 RTRs was investigated for the prevalence of HPV. All participants received a device for a cervicovaginal self-sample. Questionnaires were sent to assess the experience with this device. High-risk (hrHPV) presence was determined with the SPF10-LiPA25 system and GP5+/6+ PCR. HrHPV-positive patients underwent gynecological examination.

Results

More than 90% of the patients rated their experience with the self-sample device as good to excellent, and 77% preferred self-sampling over a physician taken sample. Approximately thirty-five of 217 women tested hrHPV positive with SPF10- LiPA25, and 22 tested positive with the GP5+/6+ PCR. Eleven hrHPV-positive patients had clinically relevant gynecological abnormalities, and they all tested positive with GP5+/6+ PCR.

Conclusions

Self-sampling is clinically applicable in a gynecological screening and is preferred by female RTRs. Therefore, self-sampling could be implemented with the aim to increase the participation rate of female RTRs in yearly gynecological screening.
A Retrospective Review of Temporal Bone Imaging With Respect to Bone-Anchored Hearing Aid Placement
Authors: Baker Aaron R. , Fanelli David G. , Kanekar Sangam , Isildak Huseyin
Published: October 2016

Objective:

Current bone-anchored hearing aid (BAHA) guidelines recommend placement of the titanium implant 5 to 7 cm posterior to the ear canal. Previous studies show that bone conducted hearing is maximized the closer the transducer is to the cochlea. We aim to investigate the position of the sigmoid sinus with respect to BAHA implants to determine whether they may be safely placed closer to the ear canal in patients with chronic ear disease, enhancing the amplification available to the patient.

Study Design:

We performed a retrospective review of high-resolution temporal bone computed tomographies (CTs), comparing multiple measurements between ears with chronic ear disease and normal controls.

Setting:

Images were obtained at a single academic medical center.

Patients:

Eighty patients (160 ears) with temporal bone CTs performed between 2006 and 2009 were measured. Patients with chronic ear disease were identified by international statistical classification of diseases and related health problems, revision 9 code and confirmation by review of the imaging.

Main Outcome Measures:

Measurements were made on axial CT slices from a point 1 cm posterior to the sigmoid sinus to the posterior margin of the external canal. The squamous temporal bone thickness was also measured at this point.

Results:

Forty-seven patients (55 ears) had chronic ear disease. Distance from the posterior canal was significantly different between normal and diseased ears (36.3 mm versus 33.5 mm, p < 0.001). Squamous temporal bone thickness varied widely, and was similar between groups (6.9 mm versus 6.8 mm, p = 0.76).

Conclusions:

According to our data, titanium implants for bone-anchored hearing aids may be safely placed closer to the external canal than the current recommendations. This could allow for better transduction as well as sound localization in BAHA patients.
The Effect of Scala Tympani Morphology on Basilar Membrane Contact With a Straight Electrode Array: A Human Temporal Bone Study
Authors: Verberne Juul , Risi Frank , Campbell Luke , Chambers Scott , O’Leary Stephen
Published: October 2016

Hypothesis:

Scala tympani morphology influences the insertion dynamics and intra-scalar position of straight electrode arrays.

Background:

Hearing preservation is the goal of cochlear implantation with current thin straight electrode arrays. These hug the lateral wall, facilitating full, atraumatic insertions. However, most studies still report some postoperative hearing loss. This study explores the influence of scala tympani morphology on array position relative to the basilar membrane and its possible contribution to postoperative hearing loss.

Materials and Methods:

Twenty-six fresh-frozen human temporal bones implanted with a straight electrode array were three-dimensionally reconstructed from micro-photographic histological sections. Insertion depth and the proximity between the array and basilar membrane were recorded. Lateral wall shape was quantified as a curvature ratio.

Results:

Insertion depths ranged from 233 to 470 degrees. The mean first point of contact between the array and basilar membrane was 185 degrees; arrays tended to remain in contact with the membrane after first contacting it. Eighty-nine and 93% of arrays that reached the upper basal (>240–360 degrees) and second (>360–720 degrees) turns respectively contacted the basilar membrane in these regions. Scalar wall curvature ratio decreased significantly (the wall became steeper) from the basal to second turns. This shift correlated with a reduced distance between the array and basilar membrane.

Conclusion:

Scala tympani morphology influences the insertion dynamics and intra-scalar position of a straight electrode array. In addition to gross trauma of cochlear structures, contact between the array and basilar membrane and how this impacts membrane function should be considered in hearing preservation cases.
Searching for the Perfect Homeostasis
Authors: Nicola Stefania , Amoruso Angela , Deidda Francesca , Pane Marco , Allesina Serena , Mogna Luca , Del Piano Mario , Mogna Giovanni
Published: October 2016

Goals:

To investigate the modulation of human cytokines by Bifidobacterium longum strains isolated from Centenarians. In particular, we measured the production of interleukin (IL)-12p70, interferon-γ, IL-17A, and IL-4 from human peripheral blood mononuclear cells after stimulation with live bacteria.

Background:

Probiotics may inhibit pathogens and modulate the immune system, bringing a beneficial effect on human health. Among the probiotic strains, bifidobacteria play a key role in the maturation of the host’s immune system. At present, only a few comparative data are available on the effects of bifidobacteria associations on cytokine production.

Study:

Peripheral blood mononuclear cells were isolated, cultured, and stimulated (ratio 1:1) with B. longum DLBL07, B. longum DLBL08, B. longum DLBL09, B. longum DLBL10, or B. longum DLBL11, either alone or in association. Cytokine production was determined by an enzyme-linked immunosorbent assay.

Results:

Both the B. longum DLBL mixture and the individual B. longum DLBL strains induced similar levels of IL-4, interferon-γ, and IL-17A. Under all conditions tested, no IL-12p70 release was detected.

Conclusions:

The fact that B. longum strains were obtained from Centenarians suggests a perfect homeostasis between this specific species and the host. Moreover all the B. longum strains from Centenarians used in our study share some biological similarities.
In Vitro Inhibition of Klebsiella pneumoniae by Lactobacillus delbrueckii Subsp. delbrueckii LDD01 (DSM 22106)
Authors: Mogna Luca , Deidda Francesca , Nicola Stefania , Amoruso Angela , Del Piano Mario , Mogna Giovanni
Published: October 2016

Goals:

To determine the in vitro antimicrobial activity of selected Lactobacillus strains isolated from the feces of healthy humans against Klebsiella pneumoniae.

Background:

Klebsiella is ubiquitous in nature and may colonize the skin, the pharynx, or the gastrointestinal tract of humans. Despite the widespread use of antibiotic molecules with a broad spectrum in hospitalized patients, an increased overall load of klebsiellae as well as the subsequent development of multidrug-resistant strains able to synthesize extended-spectrum beta-lactamase have been registered. These strains are particularly virulent, express capsular-type K55, and have a considerable ability to propagate.

Study:

The 4 strains Lactobacillus paracasei LPC01 (CNCM I-1390), Lactobacillus rhamnosus LR04 (DSM 16605), Bifidobacterium longum B2274 (DSM 24707), and Lactobacillus delbrueckii subsp. delbrueckii LDD01 (DSM 22106) were tested. The analysis was performed using both a disc-diffusion assay and the broth-dilution procedure, also including an evaluation of the supernatants obtained from a fresh broth culture of each bacterium.

Results:

L. delbrueckii subsp. delbrueckii LDD01 demonstrated the best inhibitory results among all the tested strains. The antibacterial activity of the supernatant was retained even after treatment with α-amylase and neutralization with NaOH 1N, thus suggesting the protein structure of the inhibitory molecule. In contrast, it was completely lost after treatment with proteinase K.

Conclusions:

Overall results suggest that the inhibitory effect of L. delbrueckii subsp. delbrueckii LDD01 should be attributed to the production of a bacteriocin. This strain may be prospectively useful for strengthening probiotic formulations and possibly counteract infections by K. pneumoniae in humans.
Development of an Ex Vivo Organ Culture Technique to Evaluate Probiotic Utilization in IBD
Authors: Pagnini Cristiano , Martorelli Michela , Lanini Claudio , Delle Fave Gianfranco
Published: October 2016

The consistent technical and conceptual progress in the study of the microbiota has led novel impulse to the research for therapeutical application of probiotic bacteria in human pathologies, such as inflammatory bowel disease (IBD). Considering the heterogenous results of probiotics in clinical studies, the model of translational medicine may lead to a more specific and efficacious utilization of probiotic bacteria in IBD. In this regard, the selection and utilization of appropriate experimental models may drive the transition from pure in vitro systems to practical clinical application. We developed a simple and reproducible ex vivo organ culture method with potential utilization for the evaluation of probiotic bacteria efficacy in IBD patients.
Topical Benzocaine and Methemoglobinemia
Authors: Hieger Michelle A. , Afeld Jamiee L. , Cumpston Kirk L. , Wills Brandon K.
Published: October 2016

Methemoglobinemia can cause life-threatening hypoxia associated with cyanosis and dyspnea not responsive to oxygen. We present a case of recurrent methemoglobinemia because of occult use of topical benzocaine to the vulva. A 47-year-old female with medical history of vulvar cancer and HIV undergoing chemoradiation was sent by the oncology clinic to the emergency department for worsening dyspnea, fatigue, hypoxia to 78% on room air, and gradual onset of cyanosis over the past week. A methemoglobin (MetHb) level was 49%. She received methylene blue, and repeat MetHb levels initially decreased but later increased to 56% despite continued treatment. Additional interviews with the patient revealed she was applying vagicaine (20% benzocaine), an over the counter preparation to the vulvar area for analgesia, and she continued application while hospitalized. She received a total of 6 mg/kg methylene blue and underwent vaginal lavage with 60 mL of sterile saline and cleansed with soapy water. Cyanosis, hypoxia, and dyspnea resolved, and the MetHb level decreased to 5.4% on the day of discharge. Benzocaine is a frequent cause of iatrogenic methemoglobinemia. In this case, additional medication inquiries were helpful in making the diagnosis. Many patients do not consider over-the-counter medications to be potentially harmful. Methemoglobinemia from occult topical benzocaine administration to the vulva is an uncommon exposure route. Occult medication use can be a source of methemoglobinemia.
Stigmatizing Attitudes and Beliefs About Anorexia and Bulimia Nervosa Among Italian Undergraduates
Authors: Caslini Manuela , Crocamo Cristina , Dakanalis Antonios , Tremolada Martina , Clerici Massimo , Carrà Giuseppe
Published: October 2016

Stigmatizing attitudes toward eating disorders (EDs) may lead to reduced treatment seeking. We aimed to estimate the prevalence of stigmatizing trends and beliefs related to anorexia nervosa (AN) and bulimia nervosa (BN), and the associations with the experiential knowledge of the problem, in a large sample of Italian undergraduates. A total of 2109 participants completed an online survey including questionnaires related to stigmatizing beliefs toward AN and BN, and personal contacts with people with EDs. Undergraduates reported almost overlapping low levels of stigmatizing trends for AN and BN, apart from personal responsibility and social distance. Those aged 18 to 25 and living with family held higher stigmatizing attitudes. Stigma was lower in underweight participants and in those (12%) reporting a previous ED diagnosis. Although not improving stigmatizing attitudes, 83% of the sample was familiar with people with an ED. Antistigma actions to increase awareness on EDs and to improve treatment-seeking behaviors are needed.
Why Do Women Not Use Preconception Care? A Systematic Review On Barriers And Facilitators
Authors: Poels Marjolein , Koster Maria P. H. , Boeije Hennie R. , Franx Arie , van Stel Henk F.
Published: October 2016

Importance

Preconception care (PCC) has the potential to optimize pregnancy outcomes. However, awareness of PCC among the target population is generally limited, and the use of PCC remains low.

Importance

The objective of this study was to review the literature on women's perceptions regarding barriers and facilitators for the use of PCC.

Evidence Acquisition

A systematic search was conducted in MEDLINE, Embase, CINAHL, and PsycINFO for published studies until February 2015. Original qualitative and quantitative peer-reviewed studies from Western countries in English, holding women's perceptions regarding barriers and facilitators for the use of PCC. Data extraction and analysis were performed using NVivo version 10 software. A coding frame was derived from the findings and applied by 2 authors. Thematic analysis was used to identify key topics and themes.

Results

Twenty-one good-quality articles were included, of which 10 qualitative and 11 quantitative studies. Seven main themes were identified: preconditions, emotions and beliefs, perceived need, knowledge and experience, social structure, accessibility, and provider characteristics. “Not (fully) planning pregnancy”, “perceived absence of risks”, “lack of awareness”, and “pregnancy experiences” were the most frequently identified barriers and “believing in the benefits” and “availability of PCC” the most frequently identified facilitators for PCC use.

Conclusions and Relevance

Women perceive more barriers than facilitators related to PCC uptake, which explains why the use of PCC remains low. Our results provide a starting point to refocus interventions and strategies, aiming on enlarging the awareness, perceived importance, and accessibility of PCC to improve its uptake.

Target Audience

Obstetricians and gynecologists, family physicians.

Learning Objectives

After completing this activity, the learner should be better able to (1) appraise the recent literature on barriers and facilitators that affect the uptake rates of preconception care; (2) discuss which perceptions women hold regarding the use of preconception care; and (3) take these factors into account while designing preconception care interventions and strategies.
Graft and Mesh Use in Transvaginal Prolapse Repair: A Systematic Review
Authors: Schimpf Megan O. , Abed Husam , Sanses Tatiana , White Amanda B. , Lowenstein Lior , Ward Renée M. , Sung Vivian W. , Balk Ethan M. , Murphy Miles
Published: October 2016

(Abstracted from Obstet Gynecol 2016;128:81–91)

In 2008, the US Food and Drug Administration (FDA) issued the first safety communication regarding serious complications associated with the use of transvaginal mesh for pelvic organ prolapse (POP) repair. Since this first safety communication, there have been increasing reports of debilitating mesh complications such as erosion, chronic pain, and dyspareunia, as well as high recurrence rates.
PROSE Treatment in Atypical Ocular Graft-Versus-Host Disease
Authors: Chiu Gloria B. , Theophanous Christos , Irvine John A.
Published: October 2016

Purpose

To report a case of persistent epithelial defects in a patient with ocular chronic graft-versus-host disease that required coordinated modulation of systemic immunosuppressive treatment and overnight wear of Prosthetic Replacement of the Ocular Surface Ecosystem (BostonSight PROSE, Needham, MA) devices to achieve ocular surface healing.

Case Report

The case of a 38-year-old male patient who presented with a 2-year history of ocular chronic graft-versus-host disease, ocular burning, pain, light sensitivity, and a 3-week history of bilateral corneal epithelial defects is presented. Standard therapies and an initial PROSE treatment utilizing customized scleral lenses were unsuccessful in resolving his ocular complications. A second trial of PROSE treatment involving overnight wear of the devices in combination with increased systemic immunosuppressant therapy ultimately allowed ocular surface healing and improved his discomfort, vision, and quality of life.

Conclusions

Sight-threatening complications of ocular chronic graft-versus-host disease often require a multidisciplinary approach. Persistent corneal epithelial defects may require increased systemic immunosuppression and extension of PROSE treatment to overnight wear.