bluuebunny/crossref_metadata_2025 huggingface dataset:
The Trump Effect: With No Peer Review, How Do We Know What to Really Believe on Social Media?
Authors: Brady Justin , Kelly Molly , Stein Sharon
Published: September 2017

Social media is a source of news and information for an increasing portion of the general public and physicians. The recent political election was a vivid example of how social media can be used for the rapid spread of “fake news” and that posts on social media are not subject to fact-checking or editorial review. The medical field is susceptible to propagation of misinformation, with poor differentiation between authenticated and erroneous information. Due to the presence of social “bubbles,” surgeons may not be aware of the misinformation that patients are reading, and thus, it may be difficult to counteract the false information that is seen by the general public. Medical professionals may also be prone to unrecognized spread of misinformation and must be diligent to ensure the information they share is accurate.
New Treatment Approaches to Arteriovenous Malformations
Authors: Gilbert Patrick , Dubois Josée , Giroux Marie , Soulez Gilles
Published: September 2017

Arteriovenous malformations (AVMs) are high-flow vascular anomalies that have demonstrated a very high recurrence rate after endovascular treatment, surgical treatment, or a combination of both. Surgical treatments have shown good response when they are small and well localized but a poor response when diffuse. A better understanding of the nature of the lesion has led to a better response rate and a safer treatment for these patients. This has been accomplished through a detailed understanding of the angioarchitecture of the lesion, enabling a tailored approach in reaching and targeting the nidus of the AVM with different liquid embolic agents, more specifically ethanol. Flow reduction techniques help in exposing the nidus to sclerosant agents. A clinical classification, the Schobinger classification, will help determine the appropriate time to start or to pursue therapy.
Sudden Sensorineural Hearing Loss: Comparative Study of Different Treatment Modalities
Authors: Khater Ahmed , El-Anwar Mohammad , Nofal Ahmad , Elbahrawy Atef
Published: September 2017

Introduction Idiopathic sudden sensorineural hearing loss (ISSNHL) is hearing loss of at least 30 dB in at least 3 contiguous frequencies within at least 72 hours. There are many different theories to explain it, and many different modalities are used for its management, such as: systemic steroids (SSs), intratympanic steroid injection (ITSI), hyperbaric oxygen therapy (HOT), antiviral drugs, and vasodilators or vasoactive substances.

Objectives This study aims to evaluate the efficacy of the combination of the most common treatment modalities of ISSNHL and to compare the results if HOT was not one of the treatment modalities administered.

Methods The study was conducted with 22 ISSNHL patients with ages ranging from 34 to 58 years. The patients were divided into 2 groups; group A included 11 patients managed by SSs, ITSI, antiviral therapy, and HOT simultaneously, and group B included 11 patients exposed to the aforementioned modalities, with the exception of HOT.

Results After one month, all of the patients in group A showed total improvement in hearing in all frequencies, with pure tone average (PTA) of 18.1 ± 2.2, while in group B, 5/11 (45.5%) patients showed total improvement, and 6 /11 (54.5%) patients showed partial improvement, with a total mean PTA of 28.1 ± 8.7.

Conclusion The early administration of HOT in combination with other clinically approved modalities (SSs, ITSI, antiviral therapy) provides better results than the administration of the same modalities, with the exception of HOT, in the treatment of ISSNHL.
Transfusion Approaches and Mortality in Trauma Patients: A Narrative Review
Authors: Innerhofer Petra , Spahn Donat , Fries Dietmar
Published: September 2017

Trauma is one of the leading causes of mortality in the world, accounting for millions of deaths per year. One of the most frequent causes of death in trauma patients is hemorrhage. The presence of a coagulopathy in trauma patients more than doubles the expected mortality. Coagulation management is a key aspect of care for bleeding trauma patients and has been investigated in many studies. However, it is unclear whether a particular approach to coagulation management is associated with a reduction in mortality. Treatment may be guided (e.g., viscoelastic test-guided administration of coagulation factor concentrates) or nonguided (e.g., treatment with a fixed ratio of plasma:red blood cells). This review aimed to assess the published literature regarding coagulation management technique and mortality rate. From the 41 articles obtained in the literature search, there appeared to be a trend toward lower mortality in studies utilizing a guided approach, despite a higher injury severity score in these patients. There were many methodological variations across studies including coagulation management approaches, inclusion criteria, time and type of measurements, use of early fast coagulation monitoring and damage control surgery principles, additional products to those under study, and potential regional differences. It is essential that controlled trials are performed to ascertain optimal transfusion approaches in trauma patients.
Birth Order and Maternal Age for Reported Cases of Severe Prenatal Cortical Hyperostosis (Caffey–Silverman Disease)
Authors: Engel Rolf , Cifuentes Raul
Published: September 2017

The spectrum of prenatal cortical hyperostosis includes a mild phenotype that typically presents after 35 weeks of gestation, and a severe form that presents earlier. The skeletal and systemic manifestations of the severe phenotype remain unexplained. A review of reported cases indicates that older mothers and firstborn infants are overrepresented. This combination suggests decreased fertility. Fourteen years after the birth of the present case, his mother presented with renal failure from multiple myeloma raising the possibility that a maternal antibody may play a role in the etiology of severe prenatal Caffey disease. The present case report is also intended to alert clinicians to potential difficulties with tracheal intubation secondary to micrognathia from mandibular involvement during a critical growth period.
Optische Rehabilitation nach Limbusstammzellinsuffizienz: aktuelle Behandlungsmöglichkeiten und Entwicklungen
Authors: Thomasen Henning , Steuhl Klaus , Meller Daniel
Published: September 2017

Die Behandlung der Limbusstammzellinsuffizienz (LSZI) stellt eine Herausforderung in der Augenheilkunde dar. Es handelt sich um eine Störung der Augenoberfläche, die durch eine nicht funktionale Regeneration des kornealen Epithels entsteht. Die LSZI wird sowohl von hereditären als auch erworbenen Grunderkrankungen verursacht. Je nach Ausprägung unterscheidet man dabei zwischen einer partiellen oder totalen LSZI sowie zwischen uni- oder bilateralen Fällen. Die Behandlung richtet sich nach der Ätiologie der Erkrankung. Es stehen zu diesem Zweck eine Reihe von Techniken zur Verfügung, darunter fallen die Anwendung von Amniontransplantationen, die Transplantation von Limbusgewebe oder die Anwendung von ex vivo expandierten Zellen. In dieser Übersichtsarbeit werden die aktuellen Behandlungsoptionen für die LSZI zusammengefasst sowie neue Entwicklungen auf diesem Gebiet vorgestellt.
Eating Frequency and Carbohydrate Intake in Adolescents with Type 1 Diabetes Differ from Those in Their Peers and are Associated with Glycemic Control
Authors: Baechle Christina , Hoyer Annika , Castillo-Reinado Katty , Stahl-Pehe Anna , Kuss Oliver , Holl Reinhard , Kersting Mathilde , Rosenbauer Joachim ,   In cooperation with the German Pediatric Surveillance Unit (ESPED) and the DPV-Science initiative, supported by the German Center for Diabetes Research (DZD)
Published: September 2017

Aim The diet of people with type 1 diabetes may differ from that of healthy peers due to disease-related factors that may affect the course of diabetes. This cross-sectional study sought to compare meal and snacking frequency and corresponding carbohydrate intake among adolescents with intensively-treated type 1 diabetes and healthy peers and to analyze their association with glycemic control among diabetes patients.

Methods Nutritional data of 712 11- to <19-year-olds from a nationwide population-based survey on early-onset type 1 diabetes (52.7% boys/men, mean age 15.6 years) were compared with 949 food records of 296 healthy participants in the DONALD cohort study (49.7% boys, mean age 14.4 years) using linear mixed models. Furthermore, the association between eating frequency and/or carbohydrate intake with glycemic control (HbA1c) was analyzed with multiple linear regression models.

Results After comprehensive adjustment, diabetes patients had, on average, 4.6 [95% confidence interval 3.6, 5.5] more meals or snacks/week but consumed 75.9 [64.5, 87.3] fewer grams of carbohydrates/day than the comparison group. Diabetes subjects also consumed breakfast, lunch, dinner, and snacks more frequently but ate fewer carbohydrates at all eating occasions. Total carbohydrate intake and carbohydrate intake at breakfast were associated with higher HbA1c levels, while increased breakfast frequency was associated with lower HbA1c levels.

Conclusion Eating frequency and carbohydrate intake differed between adolescents with early-onset type 1 diabetes and non-diabetic peers. The observed associations with glycemic control challenge the concept of a completely unregulated eating frequency and carbohydrate intake for people on intensified insulin therapy.
Sciatic Nerve Conductivity is Impaired by Hamstring Strain Injuries
Authors: Kouzaki Karina , Nakazato Koichi , Mizuno Masuhiko , Yonechi Tooru , Higo Yusuke , Kubo Yoshiaki , Kono Tokuyoshi , Hiranuma Kenji
Published: September 2017

The aim of this study was to assess sciatic nerve conductivity in athletes with a history of hamstring strain injuries. Twenty-seven athletes with a history of hamstring strain injuries were included in the injured group. The control group consisted of 16 uninjured participants. We measured the proximal and distal latencies and calculated the sciatic nerve conduction velocity to evaluate neuronal conductivity. The results were expressed as median values and interquartile ranges. Both proximal latency and distal latency of the injured limb in the injured group were significantly longer than those of the uninjured limb (p<0.05). The nerve conduction velocity of the injured limb in the injured group was significantly lower than that of the uninjured limb (p<0.05). There were no significant side-to-side differences in the control group. Sciatic nerve conductivity impairments may exist in athletes with a history of hamstring strain injuries.
The Application of SUDOSCAN for Screening Diabetic Peripheral Neuropathy in Chinese Population
Authors: Jin Jiewen , Wang Weimin , Gu Tianwei , Chen Wei , Lu Jing , Bi Yan , Zhu Dalong
Published: September 2017

Purpose Diabetic peripheral neuropathies are the common chronic complications of diabetes, but the diagnosis is insensitive by physical examination in busy outpatients. Here we evaluated the performance of SUDOSCAN in screening diabetic peripheral neuropathies in Chinese type 2 diabetic patients.

Methods The study enrolled 180 patients for annually screening. All patients underwent neurological symptoms assessment, clinical examination, nerve conduction studies and cardiovascular autonomic reflex tests. SUDOSCAN was tested and evaluated with electrochemical skin conductance in hands and feet, asymmetry ratio in hands and feet and predicted cardiac neuropathy.

Results Patients enrolled had an average age of 56.1 years, 9.8 years of diabetic duration. Patients with diabetic sensorimotor polyneuropathy showed significantly lower electrochemical skin conductance in feet and higher asymmetry ratio in feet compared with those without. Sensitivity and specificity of asymmetry ratio in feet for diagnosing diabetic sensorimotor polyneuropathy were 88.2% and 46.9% and area under ROC curve was 0.713. Patients with cardiovascular autonomic neuropathy showed significantly lower electrochemical skin conductance in hands and feet, and higher asymmetry ratio in feet and predicted cardiac neuropathy compared with those without. Sensitivity and specificity of electrochemical skin conductance in feet in diagnosing cardiovascular autonomic neuropathy were 85.6% and 76.1% with an area under ROC curve of 0.859.

Conclusions SUDOSCAN is a sensitive test to detect diabetic peripheral neuropathy in China and could be an effective screening tool in in busy outpatients and primary health care.
Anti-Hyperglycaemic Effect of Cleome Rutidosperma in Alloxan-Induced Diabetic Albino Rats
Authors: Oridupa Olayinka , Ovwighose Naomi , Saba Adebowale
Published: September 2017

The hypoglycaemic and antihyperglycaemic effects of methanol extract of leaves of Cleome rutidosperma (Cr) DC (Family: Capparidaceae) was investigated in Wistar rats. Fifty normoglycaemic male rats (120 g–200 g) were divided into groups A (hypoglycaemic study; n=20) and B (antihyperglycaemic study; n=30). Each experiment had one control group and three groups administered with Cr (100, 200 or 400 mg/kg) respectively. Group B had two additional groups of diabetic-untreated rats and glibenclamide-treated diabetic rats. Diabetes was induced in Group B rats (except control) fasted overnight for 12 h by intraperitoneal injection of Alloxan (100 mg/kg). Fasting blood glucose levels (FBGL) were determined and alloxan-treated rats with BGL >200 mg/dl 48 h post-induction were considered diabetic. Data obtained were analyzed using One-way ANOVA and Duncan Multiple Range Test (p<0.05). Cr-treated rats showed significant decline in BGL with noteworthy decline by day 3 post-treatment at the dose of 200 mg/kg (236.40±14.72 mg/dl) from 336.40±21.06 mg/dl. Cr at the dose of 200 mg/kg (72.20±6.18 mg/dl, 69.20±7.81 mg/dl, 137.80±7.15 mg/dl and 70.60±10.66 mg/dl) showed better glycemic control compared to glibenclamide (194.50±7.75 mg/dl, 253.75±7.20 mg/dl, 284.25±10.56 mg/dl and 156.00±10.80 mg/dl). Cr-treated rats also showed progressive weight gain through the course of the study. This study demonstrated Cr has antihyperglycemic effect with more rapid onset of action and better glycemic control compared to glibenclamide.
Exsudative AMD in der OCT-Angiografie
Authors: Farecki Marie-Louise , Gutfleisch Matthias , Faatz Henrik , Rothaus Kai , Lommatzsch Albrecht , Pauleikhoff Daniel
Published: September 2017

Die OCT-Angiografie bietet eine Kombination aus vaskulärer und struktureller Information und kann im Gegensatz zur konventionellen Fluoresceinangiografie nichtinvasiv und ohne Farbstoff choroidale Neovaskularisationen darstellen. Derzeit existiert noch keine gültige OCT-angiografische Klassifikation der AMD, obwohl verschiedene Muster und Aktivitätskriterien von Neovaskularisationen beobachtet werden konnten. Die OCT-Angiografie könnte so in Zukunft zu einem besseren Verständnis pathophysiologischer Mechanismen und therapeutischer Strategien beitragen.
OCT-Angiografie bei RPE-Einrissen im Rahmen einer exsudativen AMD: morphologische Analysen der Choriokapillaris und des RPE
Authors: Gutfleisch Matthias , Rothaus Kai , Farecki Marie-Louise , Faatz Henrik , Heimes-Bussmann Britta , Gunnemann Frederic , Ziegler Martin , Papapostolou Ioannis , Lommatzsch Albrecht , Pauleikhoff Daniel
Published: September 2017

Hintergrund Ein Riss des retinalen Pigmentepithels (RPE) ist eine typische Komplikation vaskularisierter Pigmentepithelabhebungen im Rahmen einer exsudativen AMD. Unter einer proaktiven intensiven Anti-VEGF-Therapie kann es zu einer funktionellen Stabilisierung oder sogar Verbesserung kommen. Durch die neue Methode der OCT-Angiografie (OCT-A) können die retinalen Gefäße dargestellt und die Perfusionsdichte quantifiziert werden. Die vorliegende Pilotstudie untersucht die Veränderungen der Choriokapillaris (CC) im Areal mit wieder zunehmender Fundusautofluoreszenz (FAF) nach der Entstehung eines RPE-Risses mittels OCT-A.

Material und Methoden Bei 6 Augen mit einem RPE-Riss wurde prospektiv initial und alle 3 Monate eine multimodale Bildgebung inklusive einer FAF (HRA2, Heidelberg Engineering, Heidelberg, Deutschland) und OCT-A (RTVue XR Avanti, SSDA-Modus, Angiovue, Optovue, Freemont, CA, USA) durchgeführt. Durch ein interaktives MATLAB-Programm (MATLAB, MathWorks, Natick, MA, USA) wurden FAF und OCT-A geometrisch überlagert. Unter Zuhilfenahme der Software Fiji (National Institutes of Health, Bethesda, MD, USA) wurde in Arealen mit zunehmender FAF die Flussdichte in der OCT-A mit Choriokapillarissegmentierung in einem Nachbeobachtungszeitraum von durchschnittlich 12 Monaten gemessen.

Ergebnisse Es konnte eine Verkleinerung des RPE-freien Areals durch Zunahme von autofluoreszenten Gewebe im Randbereich des RPE-Einrisses im Mittel von 2,94 mm2 (SD 2,1 mm2; 42,1% des initialen RPE-freien Areals) beobachtet werden. Am Ende der unterschiedlichen Nachbeobachtungszeit zeigten einige Patienten im Areal mit regenerierter Autofluoreszenz eine gegenüber dem Initialbefund verringerte Flussdichte, während andere eine gleiche oder sogar vergrößerte Flussdichte aufwiesen.

Schlussfolgerung In der vorliegenden Pilotstudie wird die OCT-A zur Analyse der CC-Struktur in Arealen regenerierender FAF nach einem RPE-Einriss getestet. Mit einer externen Bildbearbeitung wurden FAF und OCT-A im Verlauf verglichen. Hiermit konnte beobachtet werden, dass scheinbar zunächst eine Regression der CC im genannten Areal eintritt, die mit längerer Nachbeobachtungszeit und Ausbildung von autofluoreszentem SHT (Subretinal hyperreflective Tissue) sich ebenso wie die FAF bis zum CC-Ausgangsbefund regeneriert.
Methamphetaminkonsum in Mitteldeutschland: Eine qualitative Studie zu Konsumentengruppen und -motiven aus Expertensicht
Authors: Hoffmann Laura , Schumann Nadine , Richter Matthias
Published: September 2017

Hintergrund Methamphetamin gehört zu den meist konsumierten illegalen Drogen weltweit. In Deutschland weist der Konsum in den letzten Jahren hohe Steigerungsraten im Vergleich zu anderen Suchtmitteln auf. Insbesondere Mitteldeutschland ist von einem starken Konsumanstieg betroffen. Internationale Studien zeigen, dass beim Methamphetaminkonsum keine Begrenzung auf bestimmte Personengruppen feststellbar ist und riskante Konsummuster in verschiedenen sozialen Gruppen zu finden sind. Ziel der vorliegenden Studie ist es, zu explorieren, mit welchen Konsumentengruppen und -motiven von Methamphetamin die Experten der verschiedenen Beratungs- und Behandlungseinrichtungen konfrontiert sind und worin sie sich von anderen Suchterkrankten unterscheiden.

Methode Die empirische Datenerhebung erfolgte in einem konsekutiven, 2-stufigen Verfahren. Zunächst wurden in 39 semi-strukturierten Einzelinterviews die Erfahrungen und Perspektiven der befragten Experten aus unterschiedlichen Versorgungsbereichen exploriert. Anschließend wurden die Ergebnisse der Einzelinterviews in 2 professionsübergreifenden Fokusgruppen diskutiert und validiert. Alle Interviews und Fokusgruppendiskussionen wurden digital aufgezeichnet, transkribiert und mithilfe des Auswertungsverfahrens nach Meuser & Nagel analysiert.

Ergebnisse Es konnten 3 prägnante Konsumentengruppen identifiziert werden: (1) Eltern mit Kindern, Schwangere und Frauen, (2) junge Konsumenten bzw. „Früheinsteiger“ sowie (3) ältere Konsumenten bzw. „Späteinsteiger“. Als Hauptmotiv für den Methamphetaminkonsum beschreiben die Experten die Leistungssteigerung. Weitere Konsummotive sind z. B. die Bewältigung verschiedenster Belastungssituationen, das Ermöglichen bzw. Verbessern von sexuellen Erlebnissen, die Selbstwertsteigerung, Krisen- und Traumabewältigung, Selbstmedikation, der Konsum aus Neugierde sowie zur Freizeitgestaltung.

Diskussion/Schlussfolgerung Übereinstimmend mit internationalen Befunden zeigen die vorliegenden Ergebnisse, dass es unter den Crystal Meth Konsumenten verschiedene soziale Gruppen und breit gefächerte Motivlagen gibt, die sich teils von Konsumenten anderer illegaler Substanzen unterscheiden. So kommen z. B. junge, alleinerziehende Mütter sowie Schwangere vergleichsweise häufig vor. Für die Beratungs- und Behandlungsangebote bedeutet dies, sich künftig diesen Konsumgruppen und -motiven anzupassen und Versorgungsangebote bedarfsorientiert auszubauen, z. B. mit mehr familienorientierten Maßnahmen für suchterkrankte Eltern. Zudem gilt es, die Erreichbarkeit der Betroffenen künftig zu verbessern, u. a. mittels flexiblerer Beratungszeiten im ambulanten Bereich.
Relationship between Oxidative Stress, Inflammation and Dyslipidemia with Fatty Liver Index in Patients with Type 2 Diabetes Mellitus
Authors: Klisic Aleksandra , Isakovic Aleksandra , Kocic Gordana , Kavaric Nebojsa , Jovanovic Milovan , Zvrko Elvir , Skerovic Verica , Ninic Ana
Published: September 2017

Introduction/Aim Considering the high prevalence of non-alcoholic fatty liver disease (NAFLD) in individuals with type 2 diabetes mellitus (DM2), we aimed to investigate the potential benefit of determining markers of oxidative stress, inflammation and dyslipidemia for prediction of NAFLD, as estimated with fatty liver index (FLI) in individuals with DM2.

Methods A total of 139 individuals with DM2 (of them 49.9% females) were enrolled in cross-sectional study. Anthropometric and biochemical parameters, as well as blood pressure were obtained. A FLI was calculated.

Results Multivariate logistic regression analysis showed that high density lipoprotein cholesterol (HDL-c) and malondialdehyde (MDA) were independent predictors of higher FLI [Odds ratio (OR)=0.056, p=0.029; and OR=1.105, p=0.016, respectively]. In Receiver Operating Characteristic curve analysis, the addition of fatty liver risk factors (e. g., age, gender, body height, smoking status, diabetes duration and drugs metabolized in liver) to each analysed biochemical parameter [HDL-c, non-HDL-c, high sensitivity C-reactive protein (hsCRP), MDA and advanced oxidant protein products (AOPP)] in Model 1, increased the ability to discriminate patients with and without fatty liver [Area under the curve (AUC)=0.832, AUC=0.808, AUC=0.798, AUC=0.824 and AUC=0.743, respectively]. Model 2 (which included all five examined predictors, e. g., HDL-c, non-HDL-c, hsCRP, MDA, AOPP, and fatty liver risk factors) improved discriminative abilities for fatty liver status (AUC=0.909). Even more, Model 2 had the highest sensitivity and specificity (89.3% and 87.5%, respectively) together than each predictor in Model 1.

Conclusion Multimarker approach, including biomarkers of oxidative stress, dyslipidemia and inflammation, could be of benefit in identifying patients with diabetes being at high risk of fatty liver disease.
Editorial
Authors: Saftoiu Adrian
Published: September 2017

Dear colleagues,

It is my great pleasure and honor to introduce the September 2017 Issue of Ultrasound International Open (UIO), already in its eight number from the initial appearance of the journal in 2015. Recently, UIO has reached the antechamber of journals applying for Impact Factor, being accepted in ESCI (Emerging Sources Citation Index). Consequently, UIO will soon appear in the Web of Science, a major step forward for the journal. The enthusiasm and hard work of the editors, as well as of the entire Thieme support team was invaluable for this endeavor! Three landmark papers are published in the issue, along with 4 case presentations and 1 letter to the editor.
Interaction between air plasma-produced aqueous 1O2 and the spin trap DMPO in electron spin resonance
Authors: Chen Chen , Li Fanying , Chen Hai-Lan , Kong Michael G.
Published: September 2017

A series of electron spin resonance (ESR) experiments is done to quantitatively measure the concentrations of aqueous 1O2 and ̇OH produced by a surface micro-discharge air plasma device. 1O2 is tested to be existed in the plasma treated solution by using the spin trap of TEMP. However, the unexpected DMPOX spectrum is observed in measuring ̇OH by the spin trap of 5,5-Dimethyl-1-Pyrroline-N-Oxide (DMPO). With more chemical scavenger experiments, it is found that removal of aqueous 1O2 leads to the disappearance of DMPOX in ESR. Therefore, the generation of DMPOX is directly related to the oxidation of DMPO by plasma-produced aqueous 1O2. This oxidation process and interactions between DMPO and chemical scavengers used in experiments can all be well explained by a proposed reaction mechanism. The revelation of interactions between aqueous 1O2 and the spin trap DMPO shows that the observation of spectra of DMPOX in the ESR measurement can be regarded as a marker of high concentrations of plasma-produced 1O2 in liquid. These results also prove the existence of interactions between spin traps and non-targeted plasma-produced reactive species in ESR experiments. Also, these results have offered a better understanding of the use of spin traps such as DMPO in the plasma-induced highly oxidative aqueous environment.
Diffusion in energy materials: Governing dynamics from atomistic modelling
Authors: Parfitt D. , Kordatos A. , Filippatos P. P. , Chroneos A.
Published: September 2017

Understanding diffusion in energy materials is critical to optimising the performance of solid oxide fuel cells (SOFCs) and batteries both of which are of great technological interest as they offer high efficiency for cleaner energy conversion and storage. In the present review, we highlight the insights offered by atomistic modelling of the ionic diffusion mechanisms in SOFCs and batteries and how the growing predictive capability of high-throughput modelling, together with our new ability to control compositions and microstructures, will produce advanced materials that are designed rather than chosen for a given application. The first part of the review focuses on the oxygen diffusion mechanisms in cathode and electrolyte materials for SOFCs and in particular, doped ceria and perovskite-related phases with anisotropic structures. The second part focuses on disordered oxides and two-dimensional materials as these are very promising systems for battery applications.
The propulsion of two flapping foils with tandem configuration and vortex interactions
Authors: Xu G. D. , Duan W. Y. , Xu W. H.
Published: September 2017

The propulsive performance of two flapping foils with the tandem configuration has been analysed. The trajectories of the foils are prescribed with typical propulsive motions. The hind foil performs oscillatory motion in the wake of the fore foil. The local flow around the hind foil and the effective attack angle have been changed by the vortex street. The velocity potential theory and the boundary element method are introduced to study the interactions of the vortices and the foils. The propulsive performance of the tandem flapping foils is affected significantly when various longitudinal distances and phase differences are adopted. The typical vortex interaction modes are investigated in terms of global phase shift. The thrust coefficient and the propulsive efficiency of tandem NACA0012 foils at typical global phases are analysed. The optimal global phase shifts for the highest thrust and highest efficiency have been found.
Successful mangrove establishment along an artificially created tidal creek at Port Hedland, Western Australia
Authors: Erftemeijer Paul L. A. , Wylie Nicole , Hooper Garnet J.
Published: September 2017

There is growing interest in innovative ways to minimise the environmental footprint of port developments. Herein we present results of a mangrove planting trial along an artificial tidal creek at Port Hedland, Western Australia. A 75 m-long tidal creek with exposed sloping and terraced banks was constructed, creating ~1000m2 of intertidal area in which 800 nursery-raised seedlings of four mangrove species (Avicennia marina, Rhizophora stylosa, Ceriops australis and Aegiceras corniculatum) were transplanted. Planting followed a randomised block design to test seedling performance against tidal elevation, bank design and erosion protection. After 3 years, 142 seedlings (18%) had survived. Another 1171 mangrove seedlings, dominated by A. corniculatum (75%) and Aegitialis annulata (15%), had recruited naturally into the site. Performance and survival of planted and recruited seedlings was significantly affected by tidal elevation (P=0.002), but not by bank design or erosion protection. A. marina showed highest survival (46%), followed by R. stylosa (18%). These results demonstrate that by creating appropriate environmental conditions conducive to mangrove growth, seedlings will recruit and establish naturally. Owing to the slow growth typical of semi-arid mangroves, it may take well over a decade before vegetation at this site is comparable to adjacent natural creeks.
Atmospheric evidence for a global secular increase in carbon isotopic discrimination of land photosynthesis
Authors: Keeling Ralph F. , Graven Heather D. , Welp Lisa R. , Resplandy Laure , Bi Jian , Piper Stephen C. , Sun Ying , Bollenbacher Alane , Meijer Harro A. J.
Published: September 2017

Significance

Climate change and rising CO2are altering the behavior of land plants in ways that influence how much biomass they produce relative to how much water they need for growth. This study shows that it is possible to detect changes occurring in plants using long-term measurements of the isotopic composition of atmospheric CO2. These measurements imply that plants have globally increased their water use efficiency at the leaf level in proportion to the rise in atmospheric CO2over the past few decades. While the full implications remain to be explored, the results help to quantify the extent to which the biosphere has become less constrained by water stress globally.
Gut microbiota from multiple sclerosis patients enables spontaneous autoimmune encephalomyelitis in mice
Authors: Berer Kerstin , Gerdes Lisa Ann , Cekanaviciute Egle , Jia Xiaoming , Xiao Liang , Xia Zhongkui , Liu Chuan , Klotz Luisa , Stauffer Uta , Baranzini Sergio E. , Kümpfel Tania , Hohlfeld Reinhard , Krishnamoorthy Gurumoorthy , Wekerle Hartmut
Published: September 2017

Significance

Studies using experimental models have indicated that multiple sclerosis (MS)-like disease can be triggered in the gut following interactions of brain autoimmune T lymphocytes with local microbiota. Here we studied the gut microbiota from monozygotic human twin pairs discordant for multiple sclerosis. When we transferred human-derived microbiota into transgenic mice expressing a myelin autoantigen-specific T cell receptor, we found that gut microbiota from multiple sclerosis-affected twins induced CNS-specific autoimmunity at a higher incidence than microbiota from healthy co-twins. Our results offer functional evidence that human microbiome components contribute to CNS-specific autoimmunity.
Double-Crested Cormorants: Too Much of a Good Thing?
Authors: Dorr Brian S. , Fielder David G.
Published: September 2017

For centuries, people have viewed double-crested cormorants Phalacrocorax auritus negatively, and human persecution coupled with environmental contamination severely reduced numbers of cormorants throughout North America. Shifts in paradigms for management of our natural resources resulted in reductions in environmental contaminants and regulatory protection of cormorants, allowing for an amazing population resurgence of this adaptable fish-eating bird. However, for cormorants, as with some other native wildlife species the populations of which have rebounded due to conservation efforts, there have been cormorant-societal conflicts with respect to commercial and natural resources such as aquaculture and sport fisheries. Increasing resource conflicts caused cormorants to be a priority with agencies responsible for their management, resulting in development of policy to facilitate addressing stakeholder concerns. Subsequent research and management in regard to cormorant issues have been subject to considerable challenges and debate. In this feature, we discuss the primary resource damage issues associated with cormorants, management efforts and outcomes, what we have learned, and the future with regard to cormorant management.
Two-Way Trap and Haul as a Conservation Strategy for Anadromous Salmonids
Authors: Lusardi Robert A. , Moyle Peter B.
Published: September 2017

Dams are ubiquitous in the United States and have disconnected migratory fishes from important historical habitat. Trapping fish and moving them around dams (trap and haul) is a common strategy to manage Pacific coast salmonids. Usually, juveniles or adults are moved in one direction, but there is growing interest in two-way trap and haul (TH2), where both adults and out-migrating juveniles are captured and transported over dams. Despite recent technological advances, no TH2 program is an unequivocal success. Our review indicates that uncertainties associated with TH2 programs exist and include delayed effects from transportation, maintenance of above-dam populations, out-migrant capture efficiency, and the role of hatchery supplementation. Two-way trap and haul programs should (1) clearly define measurable and objective success metrics, such as the 10 we provide; (2) proceed experimentally under an adaptive management framework to determine risk–benefit trade-offs; and (3) be part of comprehensive conservation strategies that consider the entire life cycle of each species. Two-way trap and haul is proposed as a high-priority recovery strategy for Chinook Salmon Oncorhynchus tshawytscha populations in California. Our findings indicate that any such TH2 program should proceed with extreme caution.
Resistance spot welding aluminium to magnesium using nanoparticle reinforced eutectic forming interlayers
Authors: Cooke Kavian O. , Khan Tahir I.
Published: September 2017

Successful joining of dissimilar metals such as Al and Mg can provide significant advantages to the automotive industry in the fabrication of vehicle bodies and other important components. This study explores dissimilar joining of Al–Mg using a resistance spot welding process to produce microstructurally sound lap joints and evaluates the impact of interlayer composition on microstructural evolution and the formation of intermetallic compounds within the weld nugget. The results indicated that mechanically sound joints can be produced, with fine equiaxed and columnar dendrites within the weld nugget. The presence of intermetallic compounds was also confirmed by the variation in the microhardness values recorded across the weld zone.
Mitochondrial fission facilitates the selective mitophagy of protein aggregates
Authors: Burman Jonathon L. , Pickles Sarah , Wang Chunxin , Sekine Shiori , Vargas Jose Norberto S. , Zhang Zhe , Youle Alice M. , Nezich Catherine L. , Wu Xufeng , Hammer John A. , Youle Richard J.
Published: September 2017

Within the mitochondrial matrix, protein aggregation activates the mitochondrial unfolded protein response and PINK1–Parkin-mediated mitophagy to mitigate proteotoxicity. We explore how autophagy eliminates protein aggregates from within mitochondria and the role of mitochondrial fission in mitophagy. We show that PINK1 recruits Parkin onto mitochondrial subdomains after actinonin-induced mitochondrial proteotoxicity and that PINK1 recruits Parkin proximal to focal misfolded aggregates of the mitochondrial-localized mutant ornithine transcarbamylase (ΔOTC). Parkin colocalizes on polarized mitochondria harboring misfolded proteins in foci with ubiquitin, optineurin, and LC3. Although inhibiting Drp1-mediated mitochondrial fission suppresses the segregation of mitochondrial subdomains containing ΔOTC, it does not decrease the rate of ΔOTC clearance. Instead, loss of Drp1 enhances the recruitment of Parkin to fused mitochondrial networks and the rate of mitophagy as well as decreases the selectivity for ΔOTC during mitophagy. These results are consistent with a new model that, instead of promoting mitophagy, fission protects healthy mitochondrial domains from elimination by unchecked PINK1–Parkin activity.
Accounting for Selectivity Bias and Correlation Across the Sequence From Elevated Blood Pressure to Hypertension Diagnosis and Treatment
Authors: Gordon-Larsen Penny , Attard Samantha M , Howard Annie Green , Popkin Barry M , Zhang Bing , Du Shufa , Guilkey David K
Published: September 2017

BACKGROUND

It is unknown whether efforts to reduce hypertension burden in countries with very high prevalence, would be more effective if directed at hypertension diagnosis vs. treatment. Most analyses do not address bias and correlation across the sequence from elevated blood pressure (BP) to hypertension diagnosis and treatment, leading to potentially misleading findings.

METHODS

Using data spanning 18 years of the China Health and Nutrition Survey (n = 18,926; ages 18–75 years), we used an innovative 3-step, integrated system of equations to predict the sequence from: (i) elevated BP (systolic/diastolic BP ≥ 140/90 mm Hg) to (ii) diagnosed hypertension conditional on elevated BP, and to (iii) treatment (medication use) conditional on diagnosis, accounting for measured and unmeasured individual- and community-level confounders at each of the 3 steps. We compared results to separate traditional logistic regression models without control for unmeasured confounding.

RESULTS

Using our 3-step model, elevated BP increased from 12.6% and 8.5% (1991) to 36.8% and 29% (2009) in men and women, respectively, but diagnosis remained under 50%. We found widening disparities in hypertension diagnosis (higher hypertension at lower vs. higher education (difference of 2% in 1991 that widened to 5% in 2009)) and narrowing disparities in education (difference of 6% in 1991 to 4% in 2009) and insurance status (difference of 7% in 1991 to 2% in 2009) for treatment.

CONCLUSIONS

Our 3-step model improved model fit over traditionally used models. Our findings highlight serious barriers to hypertension diagnosis in Chinese adults, particularly among men and individuals of low attained education.
NavMol 3.0: enabling the representation of metabolic reactions by blind users
Authors: Binev Yuri , Peixoto Daniela , Pereira Florbela , Rodrigues Ian , Cavaco Sofia , Lobo Ana M , Aires-de-Sousa João
Published: September 2017

The representation of metabolic reactions strongly relies on visualization, which is a major barrier for blind users. The NavMol software renders the communication and interpretation of molecular structures and reactions accessible by integrating chemoinformatics and assistive technology. NavMol 3.0 provides a molecular editor for metabolic reactions. The user can start with templates of reactions and build from such cores. Atom-to-atom mapping enables changes in the reactants to be reflected in the products (and vice-versa) and the reaction centres to be automatically identified. Blind users can easily interact with the software using the keyboard and text-to-speech technology.

Availability and implementation

NavMol 3.0 is free and open source under the GNU general public license (GPLv3), and can be downloaded at http://sourceforge.net/projects/navmol as a JAR file.
The formation of massive molecular filaments and massive stars triggered by a magnetohydrodynamic shock wave
Authors: Inoue Tsuyoshi , Hennebelle Patrick , Fukui Yasuo , Matsumoto Tomoaki , Iwasaki Kazunari , Inutsuka Shu-ichiro
Published: September 2017

Recent observations suggest an that intensive molecular cloud collision can trigger massive star/cluster formation. The most important physical process caused by the collision is a shock compression. In this paper, the influence of a shock wave on the evolution of a molecular cloud is studied numerically by using isothermal magnetohydrodynamics simulations with the effect of self-gravity. Adaptive mesh refinement and sink particle techniques are used to follow the long-time evolution of the shocked cloud. We find that the shock compression of a turbulent inhomogeneous molecular cloud creates massive filaments, which lie perpendicularly to the background magnetic field, as we have pointed out in a previous paper. The massive filament shows global collapse along the filament, which feeds a sink particle located at the collapse center. We observe a high accretion rate $\dot{M}_{\rm acc}> 10^{-4}\, M_{\odot }\:$yr−1 that is high enough to allow the formation of even O-type stars. The most massive sink particle achieves M > 50 M$_{\odot }$ in a few times 105 yr after the onset of the filament collapse.
Governing Academic Medical Center Systems: Evaluating and Choosing Among Alternative Governance Approaches
Authors: Chari Ramya , O’Hanlon Claire , Chen Peggy , Leuschner Kristin , Nelson Christopher
Published: September 2017

The ability of academic medical centers (AMCs) to fulfill their triple mission of patient care, medical education, and research is increasingly being threatened by rising financial pressures and resource constraints. Many AMCs are, therefore, looking to expand into academic medical systems, increasing their scale through consolidation or affiliation with other health care systems. As clinical operations grow, though, the need for effective governance becomes even more critical to ensure that the business of patient care does not compromise the rest of the triple mission. Multi-AMC systems, a model in which multiple AMCs are governed by a single body, pose a particular challenge in balancing unity with the needs of component AMCs, and therefore offer lessons for designing AMC governance approaches. This article describes the development and application of a set of criteria to evaluate governance options for one multi-AMC system—the University of California (UC) and its five AMCs. Based on a literature review and key informant interviews, the authors identified criteria for evaluating governance approaches (structures and processes), assessed current governance approaches using the criteria, identified alternative governance options, and assessed each option using the identified criteria. The assessment aided UC in streamlining governance operations to enhance their ability to respond efficiently to change and to act collectively. Although designed for UC and a multi-AMC model, the criteria may provide a systematic way for any AMC to assess the strengths and weaknesses of its governance approaches.
Impact of Public Reporting of 30-day Mortality on Timing of Death after Coronary Artery Bypass Graft Surgery
Authors: Hua May , Scales Damon C. , Cooper Zara , Pinto Ruxandra , Moitra Vivek , Wunsch Hannah
Published: September 2017

Background

Recent reports have raised concerns that public reporting of 30-day mortality after cardiac surgery may delay decisions to withdraw life-sustaining therapies for some patients. The authors sought to examine whether timing of mortality after coronary artery bypass graft surgery significantly increases after day 30 in Massachusetts, a state that reports 30-day mortality. The authors used New York as a comparator state, which reports combined 30-day and all in-hospital mortality, irrespective of time since surgery.

Methods

The authors conducted a retrospective cohort study of patients who underwent coronary artery bypass graft surgery in hospitals in Massachusetts and New York between 2008 and 2013. The authors calculated the empiric daily hazard of in-hospital death without censoring on hospital discharge, and they used joinpoint regression to identify significant changes in the daily hazard over time.

Results

In Massachusetts and New York, 24,864 and 63,323 patients underwent coronary artery bypass graft surgery, respectively. In-hospital mortality was low, with 524 deaths (2.1%) in Massachusetts and 1,398 (2.2%) in New York. Joinpoint regression did not identify a change in the daily hazard of in-hospital death at day 30 or 31 in either state; significant joinpoints were identified on day 10 (95% CI, 7 to 15) for Massachusetts and days 2 (95% CI, 2 to 3) and 12 (95% CI, 8 to 15) for New York.

Conclusions

: In Massachusetts, a state with a long history of publicly reporting cardiac surgery outcomes at day 30, the authors found no evidence of increased mortality occurring immediately after day 30 for patients who underwent coronary artery bypass graft surgery. These findings suggest that delays in withdrawal of life-sustaining therapy do not routinely occur as an unintended consequence of this type of public reporting.
Impact of Missing Physiologic Data on Performance of the Simplified Acute Physiology Score 3 Risk-Prediction Model*
Authors: Engerström Lars , Nolin Thomas , Mårdh Caroline , Sjöberg Folke , Karlström Göran , Fredrikson Mats , Walther Sten M.
Published: September 2017

Objectives:

The Simplified Acute Physiology 3 outcome prediction model has a narrow time window for recording physiologic measurements. Our objective was to examine the prevalence and impact of missing physiologic data on the Simplified Acute Physiology 3 model’s performance.

Design:

Retrospective analysis of prospectively collected data.

Setting:

Sixty-three ICUs in the Swedish Intensive Care Registry.

Patients:

Patients admitted during 2011–2014 (n = 107,310).

Interventions:

None.

Measurements and Main Results:

Model performance was analyzed using the area under the receiver operating curve, scaled Brier’s score, and standardized mortality rate. We used a recalibrated Simplified Acute Physiology 3 model and examined model performance in the original dataset and in a dataset of complete records where missing data were generated (simulated dataset). One or more data were missing in 40.9% of the admissions, more common in survivors and low-risk admissions than in nonsurvivors and high-risk admissions. Discrimination did not decrease with one to two missing variables, but accuracy was highest with no missing data. Calibration was best in the original dataset with a mix of full records and records with some missing values (area under the receiver operating curve was 0.85, scaled Brier 27%, and standardized mortality rate 0.99). With zero, one, and two data missing, the scaled Brier was 31%, 26%, and 21%; area under the receiver operating curve was 0.84, 0.87, and 0.89; and standardized mortality rate was 0.92, 1.05 and 1.10, respectively. Datasets where the missing data were simulated for oxygenation or oxygenation and hydrogen ion concentration together performed worse than datasets with these data originally missing.

Conclusions:

There is a coupling between missing physiologic data, admission type, low risk, and survival. Increased loss of physiologic data reduced model performance and will deflate mortality risk, resulting in falsely high standardized mortality rates.
Myoelectric versus Body-Powered Upper-Limb Prostheses: A Clinical Perspective
Authors: Uellendahl Jack
Published: September 2017

The major considerations in upper-limb prosthetic rehabilitation can be characterized as cosmesis, comfort, and control. Although these proceedings were focused largely on control, this single consideration must not occur at the exclusion of the other two. The indications, benefits, contraindications, and drawbacks associated with the major control variants of myoelectric, body-powered, and hybrid prostheses will be discussed from the perspective of the clinical prosthetist. Although centered on the care of the individual with unilateral transradial amputation, considerations in the management for more proximal amputations levels will be presented. In addition, those obstacles that may interfere with the procurement of the most appropriate control option are presented.