bluuebunny/crossref_metadata_2025 huggingface dataset:
Enzymatic burn wound debridement with NexoBrid®: Cost simulations and investigations on cost
efficiency
Authors: Kern Monika A. , Depka Norbert von , Schackert Christian , Henkel Wolfgang , Hirche Christoph R.
Published: May 2017

Aim Removal of eschar (debridement) is an essential and early step in the treatment of deep burns. Enzymatic debridement by
NexoBrid® is a relatively new non-surgical tool for early, individualized and selective debridement which adds some advantages
compared to surgical standard techniques known as standard of care (SOC). Nevertheless, until now it is not represented and
calculated in the pricing system for German hospitals (G-DRG system), and an own operative procedure key (OPS) is lacking. The
objective of this empiric cost study was to compare treatment cost of enzymatic debridement by NexoBrid® and SOC based procedures
and to analyse the impact of improved burn wound care using NexoBrid® on total treatment costs of burn patients.

Method The analysis is based on two different cost simulation models, the Average Outcome Model and the Defined Patient
Model. Based on the results of a randomized phase III trial and treatment costs specified in the pricing system for German
hospitals (G-DRG system), total costs of NexoBrid® based treatments were compared to those of SOC to determine cost saving
potentials (Average outcome model). In addition, distinct burn wound treatment pathways common in clinical practice were assigned
to actual treatment costs to allow economic considerations (Defined Patient Model).

Results Using NexoBrid® cost savings are inversely related to the treated total burned surface area (1–15% TBSA) and
directly related to the savings in burn centre stay (up to 6.5 days) (Average Outcome Model). Based on quantitative and
qualitative aspects, three quarter of all cases in the range of 5% to 15% TBSA burned are in favour of NexoBrid®. Main cost
drivers are LOS and ICU stay (45–80% of total costs). NexoBrid® becomes a more powerful cost driver with increasing TBSA treated.
If NexoBrid® completely substitutes for SOC, the total cost per patient can be reduced by nearly 30% (treatment of 5% TBSA) or are
in the range of SOC costs (treatment of 15% TBSA) (Defined Patient Model). Highest costs are generated when enzymatic and surgical
methods for debridement are combined and an increased LOS or ICU stay is indicated.

Conclusion Cost advantages of enzymatic debridement by NexoBrid® may emerge in cases with low or medium burned and treated
surface area when costs for enzymatic debridement remain below the costs for SOC (excision plus autografting). Even in more severe
cases (15% TBSA burned) total costs of basic NexoBrid®-based treatment pathways do not exceed costs of comparable SOC pathways. In
addition, enzymatic debridement by NexoBrid® can be successfully applied as a strategic tool in order to reduce surgical procedure
time and OR room capacity and making use of the redundant capacity for further surgical cases reimbursement. Beside these
quantitative aspects that may improve overall economic efficiency, qualitative improvements of burn wound care must be considered
separately from this analysis.
Laser-driven proton acceleration enhancement by the optimized intense short laser pulse shape
Authors: Souri S. , Amrollahi R. , Sadighi-Bonabi R.
Published: May 2017

Interactions of two distinct shapes of the pulses namely positive/negative chirped pulse and fast/slow rising-edge pulse with plasma are studied using particle-in-cell simulation. It is found that, for a pulse duration of 34 fs and intensity a0 = 12, proton acceleration could be enhanced by asymmetric pulses with either pulse envelope or pulse frequency modification. The number of accelerated protons, as well as the proton energy cut-off, is increased by asymmetric pulses. In this work, for positive chirped pulse, electrostatic field at the rear side of the target is improved by about 30%, which in turns leads to an increase in the proton energy cut-off more than 40%. Moreover, in contrary to the fast pulses, the slow one could enhance the proton energy cut-off up to 65% for 34 fs pulse with 20 fs rising-edge.
Refractive index matched scanning and detection of soft particles
Authors: Dijksman Joshua A. , Brodu Nicolas , Behringer Robert P.
Published: May 2017

We describe here how to apply the three-dimensional imaging technique of refractive index matched scanning to hydrogel spheres. Hydrogels are water based materials with a low refractive index, which allows for index matching with water-based solvent mixtures. We discuss here various experimental techniques required to handle specifically hydrogel spheres as opposed to other transparent materials. The deformability of hydrogel spheres makes their identification in three-dimensional images non-trivial. We will also discuss numerical techniques that can be used in general to detect contacting, non-spherical particles in a three-dimensional image. The experimental and numerical techniques presented here give experimental access to the stress tensor of a packing of deformed particles.
Size-dependent structural, magnetic, and optical properties of MnCo2O4 nanocrystallites
Authors: Singh S. , Pramanik P. , Sangaraju S. , Mallick A. , Giebeler L. , Thota S.
Published: May 2017

Finite-size (d = 5.4–112 nm) and surface effects on the structural, optical, and magnetic properties of ferrimagnetic inverse-spinel MnCo2O4 are reported. For d ≥ 87 nm, partial tetragonal distortion of the inverse spinel-lattice was observed. The Curie temperature TC of MnCo2O4 nanostructures, as determined by dc-magnetic susceptibility (χ) measurements, follows a finite-size scaling relation TC(d) = TC(∞)[1−(ξ0/d)λ] with a shift exponent λ = 0.75 ± 0.15 and microscopic correlation length ξ0 = 1.4 ± 0.3 nm, which is consistent with the mean field theory. For T > TC, χ(T) fits Néel's expression for the two-sublattice model with antiferromagnetic molecular field (exchange) constants NBB ∼ 85.16 (JBB ∼ 2.94 × 10−22 J), NAB ∼ 110.96 (JAB ∼ 1.91 × 10−22 J), and NAA ∼ 43.8 (JAA ∼ 1.13 × 10−22 J) and asymptotic Curie temperature Ta ∼ 717.63 K. The optical energy bandgap Eg, evaluated from the Kubelka-Munk function ([F(R∞)ℏω]2 = C2(ℏω - Eg)) is blueshifted to 2.4 eV (d ∼ 5.4 nm) from 1.73 eV (d ∼ 112 nm) due to the quantum confinement and non-stoichiometry. The role of tetragonal distortion and grain-size-effects in the intensity of crystal field transitions and variation in the magnetic ordering are further discussed and compared with Co3O4 nanostructures.
Uncertainty quantification and propagation of errors of the Lennard-Jones 12-6 parameters forn-alkanes
Authors: Messerly Richard A. , Knotts Thomas A. , Wilding W. Vincent
Published: May 2017

Molecular simulation has the ability to predict various physical properties that are difficult to obtain experimentally. For example, we implement molecular simulation to predict the critical constants (i.e., critical temperature, critical density, critical pressure, and critical compressibility factor) for large n-alkanes that thermally decompose experimentally (as large as C48). Historically, molecular simulation has been viewed as a tool that is limited to providing qualitative insight. One key reason for this perceived weakness in molecular simulation is the difficulty to quantify the uncertainty in the results. This is because molecular simulations have many sources of uncertainty that propagate and are difficult to quantify. We investigate one of the most important sources of uncertainty, namely, the intermolecular force field parameters. Specifically, we quantify the uncertainty in the Lennard-Jones (LJ) 12-6 parameters for the CH4, CH3, and CH2 united-atom interaction sites. We then demonstrate how the uncertainties in the parameters lead to uncertainties in the saturated liquid density and critical constant values obtained from Gibbs Ensemble Monte Carlo simulation. Our results suggest that the uncertainties attributed to the LJ 12-6 parameters are small enough that quantitatively useful estimates of the saturated liquid density and the critical constants can be obtained from molecular simulation.
Development of low angle grain boundaries in lightly deformed superconducting niobium and their influence on hydride distribution and flux perturbation
Authors: Sung Z.-H. , Wang M. , Polyanskii A. A. , Santosh C. , Balachandran S. , Compton C. , Larbalestier D. C. , Bieler T. R. , Lee P. J.
Published: May 2017

This study shows that low angle grain boundaries (LAGBs) can be created by small 5% strains in high purity (residual resistivity ratio ≥ 200) superconducting radio frequency (SRF)-grade single crystalline niobium (Nb) and that these boundaries act as hydrogen traps as indicated by the distribution of niobium hydrides (Nb1-xHx). Nb1-xHx is detrimental to SRF Nb cavities due to its normal conducting properties at cavity operating temperatures. By designing a single crystal tensile sample extracted from a large grain (>5 cm) Nb ingot slice for preferred slip on one slip plane, LAGBs and dense dislocation boundaries developed. With chemical surface treatments following standard SRF cavity fabrication practice, Nb1-xHx phases were densely precipitated at the LAGBs upon cryogenic cooling (8–10 K/min). Micro-crystallographic analysis confirmed heterogeneous hydride precipitation, which included significant hydrogen atom accumulation in LAGBs. Magneto-optical imaging analysis showed that these sites can then act as sites for both premature flux penetration and eventually flux trapping. However, this hydrogen related degradation at LAGBs did not completely disappear even after an 800 °C/2 h anneal typically used for hydrogen removal in SRF Nb cavities. These findings suggest that hydride precipitation at an LAGB is facilitated by a non-equilibrium concentration of vacancy-hydrogen (H) complexes aided by mechanical deformation and the hydride phase interferes with the recovery process under 800 °C annealing.
Variable-length analog of Stavskaya process: A new example of misleading simulation
Authors: Ramos A. D. , Silva F. S. G. , Sousa C. S. , Toom A.
Published: May 2017

This article presents a new example intended to showcase limitations of computer simulations in the study of random processes with local interaction. For this purpose, we examine a new version of the well-known Stavskaya process, which is a discrete-time analog of the well-known contact processes. Like the bulk of random processes studied till now, the Stavskaya process is constant-length, that is, its components do not appear or disappear in the course of its functioning. The process, which we study here and call Variable Stavskaya, VS, is similar to Stavskaya; it is discrete-time; its states are bi-infinite sequences, whose terms take only two values (denoted here as “minus” and “plus”), and the measure concentrated in the configuration “all pluses” is invariant. However, it is a variable length, which means that its components, also called particles, may appear and disappear under its action. The operator VS is a composition of the following two operators. The first operator, called “birth,” depends on a real parameter β; it creates a new component in the state “plus” between every two neighboring components with probability β independently from what happens at other places. The second operator, called “murder,” depends on a real parameter α and acts in the following way: whenever a plus is a left neighbor of a minus, this plus disappears (as if murdered by that minus which is its right neighbor) with probability α independently from what happens to other particles. We prove for any α<1 and any β>0 and any initial measure μ that the sequence μ(𝖵𝖲)t (the result of t iterative applications of VS to μ) tends to the measure δ⊕ (concentrated in “all pluses”) as t→∞. Such a behavior is often called ergodic. However, the Monte Carlo simulations and mean-field approximations, which we performed, behaved as if μ(𝖵𝖲)t tended to δ⊕ much slower for some α,β,μ than for some others. Based on these numerical results, we conjecture that 𝖵𝖲 has phases, but not in that simple sense as the classical Stavskaya process.
Linear stochastic Schrödinger equations in terms of quantum Bernoulli noises
Authors: Chen Jinshu , Wang Caishi
Published: May 2017

Quantum Bernoulli noises (QBN) are the family of annihilation and creation operators acting on Bernoulli functionals, which satisfy a canonical anti-commutation relation. In this paper, we study linear stochastic Schrödinger equations (LSSEs) associated with QBN in the space of square integrable complex-valued Bernoulli functionals. We first rigorously prove a formula concerning the number operator N on Bernoulli functionals. And then, by using this formula as well as Mora and Rebolledo’s results on a general LSSE [C. M. Mora and R. Rebolledo, Infinite. Dimens. Anal. Quantum Probab. Relat. Top. 10, 237–259 (2007)], we obtain an easily checking condition for a LSSE associated with QBN to have a unique Nr-strong solution of mean square norm conservation for given r≥0. Finally, as an application of this condition, we examine a special class of LSSEs associated with QBN and some further results are proven.
Fisher information and topological pressure
Authors: Godó B. , Nagy Á.
Published: May 2017

The relationship between the Fisher information and the topological pressure is explored. The new concept of topological Fisher information is introduced and the relation between the topological pressure and the topological Fisher information is derived. In the special case of expanding maps, a relation between the topological and the dimensional Fisher information is obtained. Relations between the Legendre transforms of the topological and the dimensional Fisher information are also formulated.
Single-molecule spin orientation control by an electric field
Authors: Zhang Yachao
Published: May 2017

We report the effects of an electric field E on the spin orientations of nickelocene (Nc) deposited on the Cu surfaces by means of first-principles calculations. We employ the Hubbard-U corrected van der Waals density functional to take into account the strong correlation effects of the localized 3d electrons and the non-covalent binding involved in the molecule-surface coupling. We show that the deposited Nc molecule can switch between in-plane (in small E-field) and perpendicular magnetization (in large E-field). We find that the significant charge transfer between the molecule and the metallic surface plays a dominant role in the spin reorientation transition. From an electronic structure perspective, the shift in the Fermi level enhances the coupling between the occupied and unoccupied Ni-3d states of different spin states, which tends to facilitate the perpendicular magnetic anisotropy. These findings shed some light on the electrical control of the magnetic anisotropies of single-molecule magnets on metal surfaces.
Modulation of the electroluminescence emission from ZnO/Si NCs/p-Si light-emitting devices via pulsed excitation
Authors: López-Vidrier J. , Gutsch S. , Blázquez O. , Hiller D. , Laube J. , Kaur R. , Hernández S. , Garrido B. , Zacharias M.
Published: May 2017

In this work, the electroluminescence (EL) emission of zinc oxide (ZnO)/Si nanocrystals (NCs)-based light-emitting devices was studied under pulsed electrical excitation. Both Si NCs and deep-level ZnO defects were found to contribute to the observed EL. Symmetric square voltage pulses (50-μs period) were found to notably enhance EL emission by about one order of magnitude. In addition, the control of the pulse parameters (accumulation and inversion times) was found to modify the emission lineshape, long inversion times (i.e., short accumulation times) suppressing ZnO defects contribution. The EL results were discussed in terms of the recombination dynamics taking place within the ZnO/Si NCs heterostructure, suggesting the excitation mechanism of the luminescent centers via a combination of electron impact, bipolar injection, and sequential carrier injection within their respective conduction regimes.
Predicting solid solubility in CoCrFeNiMx (M = 4d transition metal) high-entropy alloys
Authors: Sheikh Saad , Mao Huahai , Guo Sheng
Published: May 2017

CoCrFeMnNi is a prototype fcc-structured high-entropy alloy. Numerous efforts have been paid to strengthen CoCrFeMnNi, by replacing Mn with other elements for an enhancement of the solid solution strengthening. 4d transition metals, including Zr, Nb, and Mo, are of interest for this purpose, since they have much larger atomic radii than that of Mn. However, Nb and Mo are known to have a low solid solubility in fcc-structured CoCrFeNi. Compared to Nb and Mo, Zr has an even larger atomic radius. The solid solubility of Zr in fcc-structured CoCrFeNi was investigated in this work, combining both experimental studies and thermodynamic calculations. In addition, based on previous results and new results obtained here, methods to predict the solid solubility in CoCrFeNiMx (M = Zr, Nb, and Mo) alloys were developed. Particularly, the average d-orbital energy level, Md, was re-evaluated in the present work, for an improved predictability of the solid solubility in fcc-structured high entropy alloys containing 4d transition metals.
Circularly polarized magnetic field generated by two microfabricated crossed coplanar waveguides
Authors: Kan I. , Soeno Y. , Roppongi T. , Nozaki Y.
Published: May 2017

We generate a circularly polarized (CP) magnetic field using two crossed coplanar waveguides (TCCWs). By using the CP field, we selectively excite a ferromagnetic resonance between positively and negatively magnetized Co/Ni multilayers. The CP field arises from a superposition of Ampere fields generated by microwaves orthogonally propagating along the crossed arms of the TCCWs. The polarity of the magnetic field can be tuned continuously from circular to linear by exploiting a phase delay between the orthogonal microwaves. From a local measurement of the magneto-optical Kerr effect, we also find that the ellipticity of the CP field is distributed over the intersection of the TCCWs. These results indicate that TCCWs have great potential as CP-field generators that can be integrated into micron-scale electrical devices.
Variable-temperature inelastic light scattering spectroscopy of nickel oxide: Disentangling phonons and magnons
Authors: Lacerda M. M. , Kargar F. , Aytan E. , Samnakay R. , Debnath B. , Li J. X. , Khitun A. , Lake R. K. , Shi J. , Balandin A. A.
Published: May 2017

We report the results of an investigation of the temperature dependence of the magnon and phonon frequencies in NiO. A combination of Brillouin-Mandelstam and Raman spectroscopies allowed us to elucidate the evolution of the phonon and magnon spectral signatures from the Brillouin zone center (GHz range) to the second-order peaks from the zone boundary (THz range). The temperature-dependent behavior of the magnon and phonon bands in the NiO spectrum indicates the presence of antiferromagnetic (AF) order fluctuation or a persistent AF state at temperatures substantially above the Néel temperature (TN=523 K). Tuning the intensity of the excitation laser provides a method for disentangling the features of magnons from acoustic phonons in AF materials without the application of a magnetic field. Our results are useful for the interpretation of the inelastic-light scattering spectrum of NiO and add to the knowledge of its magnon properties important for THz spintronic devices.
Structural and dynamic insights into the role of conformational switching in the nuclease activity of the Xanthomonas albilineans Cas2 in CRISPR-mediated adaptive immunity
Authors: Ka Donghyun , Hong Suji , Jeong Ugeene , Jeong Migyeong , Suh Nayoung , Suh Jeong-Yong , Bae Euiyoung
Published: May 2017

Clustered regularly interspaced short palindromic repeats (CRISPRs) and CRISPR-associated (Cas) proteins constitute a microbial, adaptive immune system countering invading nucleic acids. Cas2 is a universal Cas protein found in all types of CRISPR-Cas systems, and its role is implicated in new spacer acquisition into CRISPR loci. In subtype I-C CRISPR-Cas systems, Cas2 proteins are metal-dependent double-stranded DNA (dsDNA) nucleases, and a pH-dependent conformational transition has been proposed as a prerequisite for catalytic action. Here, we report the crystal structure of Xanthomonas albilineans Cas2 (XaCas2) and provide experimental evidence of a pH-dependent conformational change during functional activation. XaCas2 crystallized at an acidic pH represented a catalytically inactive conformational state in which two Asp8 residues were too far apart to coordinate a single catalytic metal ion. Consistently, XaCas2 exhibited dsDNA nuclease activity only under neutral and basic conditions. Despite the overall structural similarity of the two protomers, significant conformational heterogeneity was evident in the putative hinge regions, suggesting that XaCas2 engages in hinge-bending conformational switching. The presence of a Trp residue in the hinge region enabled the investigation of hinge dynamics by fluorescence spectroscopy. The pH dependence of the fluorescence intensity overlapped precisely with that of nuclease activity. Mutational analyses further suggested that conformational activation proceeded via a rigid-body hinge-bending motion as both D8E and hinge mutations significantly reduced nuclease activity. Together, our results reveal strong correlations between the conformational states, catalytic activity, and hinge dynamics of XaCas2, and provide structural and dynamic insights into the conformational activation of the nuclease function of Cas2.
Phylogenetic Variation of Chelonid Alphaherpesvirus 5 (ChHV5) in Populations of Green Turtles Chelonia mydas along the Queensland Coast, Australia
Authors: Ariel E. , Nainu F. , Jones K. , Juntunen K. , Bell I. , Gaston J. , Scott J. , Trocini S. , Burgess G. W.
Published: May 2017

Sea turtle fibropapillomatosis (FP) is a disease marked by the proliferation of benign but debilitating cutaneous and occasional visceral tumors, likely to be caused by chelonid alphaherpesvirus 5 (ChHV5). This study presents a phylogeny of ChHV5 strains found on the east coast of Queensland, Australia, and a validation for previously unused primers. Two different primer sets (gB-1534 and gB-813) were designed to target a region including part of the UL27 glycoprotein B (gB) gene and part of UL28 of ChHV5. Sequences obtained from FP tumors found on juvenile green turtles Chelonia mydas (<65 cm curved carapace length) had substantial homology with published ChHV5 sequences, while a skin biopsy from a turtle without FP failed to react in the PCRs used in this study. The resulting sequences were used to generate a neighbor-joining tree from which three clusters of ChHV5 from Australian waters were identified: north Australian, north Queensland, and Queensland clusters. The clusters reflect the collection sites on the east coast of Queensland with a definitive north–south trend.

Received October 22, 2016; accepted May 7, 2017 Published online July 26, 2017
Microstructure and mechanical properties of high-energy shot-peened Mg/Ti weldments
Authors: Xu Chuan , Sheng Guangmin , Sun Yongqiang , Yuan Xinjian , Jiao Yingjun
Published: May 2017

In the present work, high-energy shot-peening treatment was applied to the tungsten inert gas welded–brazed Mg/Ti weldments. The surface characteristics, residual stress distribution, microstructures and mechanical properties of HESP-treated Mg/Ti weldments were investigated. Results revealed that with the optimised peening time of 60 s and the peening pressure of 0.15 MPa, the elimination of surface voids and cracks, high compressive residual stress and surface strain strengthening of joint were introduced in the HESP-treated Mg/Ti weldments. The average tensile strength increased 24.5% to 241 MPa over the joints without HESP treatment (193.5 MPa) and fracture even occurred in the Mg alloy base metal.
Effects of stereoscopic disparity on early ERP components during classification of three-dimensional objects
Authors: Pegna Alan J , Darque Alexandra , Roberts Mark V , Leek E Charles
Published: May 2017

This study investigates the effects of stereo disparity on the perception of three-dimensional (3D) object shape. We tested the hypothesis that stereo input modulates the brain activity related to perceptual analyses of 3D shape configuration during image classification. High-density (256-channel) electroencephalogram (EEG) was used to record the temporal dynamics of visual shape processing under conditions of two-dimensional (2D) and 3D visual presentation. On each trial, observers made image classification judgements (‘Same’/’Different’) to two briefly presented, multi-part, novel objects. On different-object trials, stimuli could either share volumetric parts but not the global 3D shape configuration and have different parts but the same global 3D shape configuration or differ on both aspects. Analyses using mass univariate contrasts showed that the earliest sensitivity to 2D versus 3D viewing appeared as a negative deflection over posterior locations on the N1 component between 160 and 220 ms post-stimulus onset. Subsequently, event-related potential (ERP) modulations during the N2 time window between 240 and 370 ms were linked to image classification. N2 activity reflected two distinct components – an early N2 (240-290 ms) and a late N2 (290-370 ms) – that showed different patterns of responses to 2D and 3D input and differential sensitivity to 3D object structure. The results revealed that stereo input modulates the neural correlates of 3D object shape. We suggest that this reflects differential perceptual processing of object shape under conditions of stereo or mono input. These findings challenge current theories that attribute no functional role for stereo input during 3D shape perception.
A Review of public private partnerships around girls' education in developing countries: flicking gender equality on and off
Authors: Unterhalter Elaine
Published: May 2017

The article reviews the literature on Public Private Partnerships (PPPs) and policy on girls’ schooling in developing countries. It considers the ways in which aims around gender equality and women's rights are positioned in policy texts concerned with girls’ education PPPs. The argument made is that these documents exemplify an oscillation, using a multipolar register, between pragmatic initiatives that recognise existing sites of power, and attempts to develop a political project that dissolves differences between public and private constituencies, who share an interest in getting girls into school. The potential and limits of this approach to support integrated policy around rights and equalities is considered using the case of DFID'sGirls’ Education Challenge. An analytical framework is sketched that maps a political and epistemological process termed dispersal, which is used to consider some ways to investigate the effects of PPPs as a mechanism to address intersecting inequalities.
IL-2high tissue-resident T cells in the human liver: Sentinels for hepatotropic infection
Authors: Pallett Laura J. , Davies Jessica , Colbeck Emily J. , Robertson Francis , Hansi Navjyot , Easom Nicholas J.W. , Burton Alice R. , Stegmann Kerstin A. , Schurich Anna , Swadling Leo , Gill Upkar S. , Male Victoria , Luong TuVinh , Gander Amir , Davidson Brian R. , Kennedy Patrick T.F. , Maini Mala K.
Published: May 2017

The liver provides a tolerogenic immune niche exploited by several highly prevalent pathogens as well as by primary and metastatic tumors. We have sampled healthy and hepatitis B virus (HBV)–infected human livers to probe for a subset of T cells specialized to overcome local constraints and mediate immunity. We characterize a population of T-betloEomesloBlimp-1hiHobitlo T cells found within the intrahepatic but not the circulating memory CD8 T cell pool expressing liver-homing/retention markers (CD69+CD103+ CXCR6+CXCR3+). These tissue-resident memory T cells (TRM) are preferentially expanded in patients with partial immune control of HBV infection and can remain in the liver after the resolution of infection, including compartmentalized responses against epitopes within all major HBV proteins. Sequential IL-15 or antigen exposure followed by TGFβ induces liver-adapted TRM, including their signature high expression of exhaustion markers PD-1 and CD39. We suggest that these inhibitory molecules, together with paradoxically robust, rapid, cell-autonomous IL-2 and IFNγ production, equip liver CD8 TRM to survive while exerting local noncytolytic hepatic immunosurveillance.
A Dictionary of Business and Management in India
Authors: Enderwick Peter
Published: May 2017

Over 200 entries

This authoritative dictionary contains entries on all aspects of business and management in India, covering commercial vocabulary in broad terms. Topics such as finance, economics, management, culture, commercial law, and competition terms are covered, as well as key Indian commercial legislation and institutions.

Entries cover the unique business system of India in relation to international trade, foreign direct investment, and offshore sourcing. The dictionary complements other business and management titles, by defining more general terms within an Indian business context.

This is an essential work for students and practitioners of business who require knowledge of business in this emerging market.
Distinct responses of sympatric migrant and resident Atlantic cod phenotypes to substrate and temperature at a remote Gulf of Maine seamount
Authors: Conroy Christian W , Calvert Jay , Sherwood Graham D , Grabowski Jonathan H
Published: May 2017

Life-history strategies often vary within motile marine species, affecting morphometry, growth, diet, and fecundity. Atlantic cod (Gadus morhua) in the Gulf of Maine display marked variation in a number of life-history traits, exemplified by differences in body colour. Migratory behaviours are suspected to differ among these colour types, but have yet to be shown definitively. Here, we used the combination of an acoustic telemetry system and fine-scale benthic habitat maps to reveal that the red phenotype cod adhered to an isolated kelp forest covering <2 km2 of a seamount in the central Gulf of Maine. Meanwhile, the olive phenotype cod adopted diel vertical migratory behaviour, possibly in response to a temperature gradient. Use of shallow, structured habitat was influenced by temperature and may be enabled by dynamic conditions related to internal waves that persist throughout the summer and early fall. Detections decreased in response to changing thermal conditions, although phenotypes reacted to these changes in distinct ways: the olive phenotype abandoned shallow habitat prior to peak summer temperatures, while the red phenotype remained until mid-fall when temperatures and temperature variability declined. Our findings support a link between morphometry, colour, behavioural strategies, and habitat preferences that may be widespread in Atlantic cod.
Degree of Vascular Encasement in Sphenoid Wing Meningiomas Predicts Postoperative Ischemic Complications
Authors: McCracken D. Jay , Higginbotham Raymond A. , Boulter Jason H. , Liu Yuan , Wells John A. , Halani Sameer H. , Saindane Amit M. , Oyesiku Nelson M. , Barrow Daniel L. , Olson Jeffrey J.
Published: May 2017

BACKGROUND: Sphenoid wing meningiomas (SWMs) can encase arteries of the circle of Willis, increasing their susceptibility to intraoperative vascular injury and severe ischemic complications.

OBJECTIVE: To demonstrate the effect of circumferential vascular encasement in SWM on postoperative ischemia.

METHODS: A retrospective review of 75 patients surgically treated for SWM from 2009 to 2015 was undertaken to determine the degree of circumferential vascular encasement (0°-360°) as assessed by preoperative magnetic resonance imaging (MRI). A novel grading system describing “maximum” and “total” arterial encasement scores was created. Postoperative MRIs were reviewed for total ischemia volume measured on sequential diffusion-weighted images.

RESULTS: Of the 75 patients, 89.3% had some degree of vascular involvement with a median maximum encasement score of 3.0 (2.0-3.0) in the internal carotid artery (ICA), M1, M2, and A1 segments; 76% of patients had some degree of ischemia with median infarct volume of 3.75 cm3 (0.81-9.3 cm3). Univariate analysis determined risk factors associated with larger infarction volume, which were encasement of the supraclinoid ICA (P < .001), M1 segment (P < .001), A1 segment (P = .015), and diabetes (P = .019). As the maximum encasement score increased from 1 to 5 in each of the significant arterial segments, so did mean and median infarction volume (P < .001). Risk for devastating ischemic injury >62 cm3 was found when the ICA, M1, and A1 vessels all had ≥360° involvement (P = .001). Residual tumor was associated with smaller infarct volumes (P = .022). As infarction volume increased, so did modified Rankin Score at discharge (P = .025).

CONCLUSION: Subtotal resection should be considered in SWM with significant vascular encasement of proximal arteries to limit postoperative ischemic complications.
Step-cut Valgus Osteotomy of Proximal Femur
Authors: Muhamad Effendi Ferdhany , Shin Chang Ho , Park Moon Seok , Yoo Won Joon , Choi In Ho , Cho Tae-Joon
Published: May 2017

Proximal femur valgus osteotomy aims to improve hip mechanics and achieve better hip joint congruity in a deformed proximal femur and/or aspherical femoral head. We describe a novel technique in performing proximal valgus osteotomy by using a step-cut at the distal osteotomy fragment. This technique was successfully performed in 24 hips with an average of 24.7 degrees of valgization. All osteotomies healed and no perioperative complications were noted.
Dehydrated Human Amnion/Chorion Membrane (dHACM) Allografts as a Therapy for Orthopedic Tissue Repair
Authors: Lei Jennifer , Priddy Lauren B. , Lim Jeremy J. , Koob Thomas J.
Published: May 2017

The amniotic membrane is a placental tissue that supports the development of the fetus during pregnancy. It is composed of extracellular matrix components such as collagen, fibronectin, and laminin, and contains many different growth factors and cytokines. Amniotic membrane can be PURION® Processed to produce dehydrated human amnion/chorion membrane (dHACM, Epifix, Amniofix; MiMedx Group Inc.) allografts. This tissue has been shown in randomized clinical trials to be effective for healing chronic foot and leg ulcers, and has demonstrated the ability to promote the migration of stem cells in vitro and to recruit stem cells to a wound site in vivo. Owing to its regenerative properties, amniotic membrane and dHACM allografts have more recently been implicated as an alternative or supplemental therapy in the treatment of orthopedic tissue injuries such as plantar fasciitis, tendinopathy, and vertebral fusion procedures. In this review, the basic structure, function, and components of dHACM are discussed, and its current in vitro, in vivo, and clinical usages in orthopedic tissue repair applications are summarized.
Acute Demyelinating Polyneuropathy as Presentation of Hereditary Neuropathy With Liability to Pressure Palsies in a Patient Who Exercised Regularly in the Army
Authors: Perugula Malathi , Uppal Gulshan , Chuquilin Miguel
Published: May 2017

Acute generalized neuropathy as the presenting manifestation of hereditary neuropathy with liability to pressure palsies (HNPP) is rare. We report a 19-year-old Army recruit who exercised regularly for 9 months and presented with 2 weeks of numbness, tingling, and weakness in both upper and lower extremities, starting 2 weeks after influenza vaccination and 1 day after vigorous exercise. Based on acute onset, clinical examination and electrophysiological findings, Guillain–Barre syndrome was diagnosed, and intravenous immunoglobulin was administered with minimal improvement. The presence of high foot arches and scapular winging raised suspicion of HNPP, confirmed by genetic testing. The role of the influenza vaccine in the development of symptoms is discussed. This case highlights the fact that HNPP can present as an acute generalized neuropathy even in people who train regularly. Careful history, physical examination, and evidence of entrapment neuropathies in nerve conduction study can aid in the diagnosis.
A Man With Distal Asymmetric Leg Weakness
Authors: Bello Rey , Bertorini Tulio
Published: May 2017

Educational objectives:

To discuss a case of adult-onset asymmetric distal leg weakness in a patient who presented with weakness and atrophy of the posterior compartment of the left leg.

Key Questions:

1. What is the differential diagnosis of asymmetric distal leg weakness?

2. How would a clinician approach diagnostic testing for such a patient?

3. What is the final diagnosis for this patient?

4. How to treat this patient?
Locomotor and discriminative stimulus effects of four novel hallucinogens in rodents
Authors: Gatch Michael B. , Dolan Sean B. , Forster Michael J.
Published: May 2017

There has been increasing use of novel synthetic hallucinogenic compounds, 2-(4-bromo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine hydrochloride (25B-NBOMe), 2-(4-chloro-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine hydrochloride (25C-NBOMe), 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine hydrochloride (25I-NBOMe), and N,N-diallyl-5-methoxy tryptamine (5-MeO-DALT), which have been associated with severe toxicities. These four compounds were tested for discriminative stimulus effects similar to a prototypical hallucinogen (−)-2,5-dimethoxy-4-methylamphetamine (DOM) and the entactogen (±)-3,4-methylenedioxymethamphetamine (MDMA). Locomotor activity in mice was tested to obtain dose range and time-course information. 25B-NBOMe, 25C-NBOMe, and 25I-NBOMe decreased locomotor activity. 5-MeO-DALT dose dependently increased locomotor activity, with a peak at 10 mg/kg. A higher dose (25 mg/kg) suppressed activity. 25B-NBOMe fully substituted (≥80%) in both DOM-trained and MDMA-trained rats at 0.5 mg/kg. However, higher doses produced much lower levels of drug-appropriate responding in both DOM-trained and MDMA-trained rats. 25C-NBOMe fully substituted in DOM-trained rats, but produced only 67% drug-appropriate responding in MDMA-trained rats at doses that suppressed responding. 25I-NBOMe produced 74–78% drug-appropriate responding in DOM-trained and MDMA-trained rats at doses that suppressed responding. 5-MeO-DALT fully substituted for DOM, but produced few or no MDMA-like effects. All of the compounds, except 25I-NBOMe, fully substituted for DOM, whereas only 25B-NBOMe fully substituted for MDMA. However, the failure of 25I-NBOMe to fully substitute for either MDMA or DOM was more likely because of its substantial rate-depressant effects than weak discriminative stimulus effects. All of the compounds are likely to attract recreational users for their hallucinogenic properties, but probably of much less interest as substitutes for MDMA. Although no acute adverse effects were observed at the doses tested, the substantial toxicities reported in humans, coupled with the high likelihood for illicit use, suggests that these compounds have the same potential for abuse as other, currently scheduled compounds.
BETTER PROGNOSIS FOR EYES WITH PRESERVED FOVEAL DEPRESSION AFTER INTRAVITREAL RANIBIZUMAB INJECTION FOR MACULAR EDEMA SECONDARY TO CENTRAL RETINAL VEIN OCCLUSION
Authors: Kitagawa Shuta , Yasuda Shunsuke , Ito Yasuki , Ueno Shinji , Iwase Takeshi , Terasaki Hiroko
Published: May 2017

Purpose:

To determine the prognosis of eyes with central retinal vein occlusion that had a preserved foveal depression at the baseline and were treated by intravitreal ranibizumab injections (IRIs).

Methods:

The authors reviewed the medical records of 23 eyes of 23 consecutive treatment-naive patients who received IRIs to treat the macular edema due to central retinal vein occlusion. Eyes were classified by the pre-IRI presence or absence of a foveal depression. A foveal depression was defined as a central foveal thickness that was <50 μm thinner than the average thickness at 200 μm temporal and nasal to the central fovea. The characteristics of the two groups were compared.

Results:

Seven of 23 eyes had a preserved foveal depression before the IRI. The mean number of injections within 12 months after the initial IRI was significantly fewer (P < 0.001) in eyes with foveal depression (1.6 ± 0.5) than in eyes without foveal depression (4.3 ± 1.3). The mean best-corrected visual acuity at 12 months after the initial IRI was significantly better (P = 0.003) in eyes with foveal depression (0.10 ± 0.17 logarithm of the minimum angle of resolution [logMAR] units; 20/25 Snellen units) than in eyes without foveal depression (0.77 ± 0.54 logMAR units; 20/118 Snellen units).

Conclusion:

These results indicate that the prognosis is better for eyes with a foveal depression before the IRI treatment for a macular edema secondary to central retinal vein occlusion.
Cardiovascular Disease in Korean Americans
Authors: Shin Cha-Nam , Keller Colleen , An Kyungeh , Sim Jeongha
Published: May 2017

Background:

Despite Korean Americans being one of the fastest growing immigrant groups in the United States, little is known about their cardiovascular health or cardiovascular disease risk factors.

Purpose:

The purpose of this report is to describe the prevalence of cardiovascular disease risks and their contributing factors in Korean Americans and recommend future directions for the development of cardiovascular disease prevention or management research to meet the unique needs of this ethnic group.

Methods:

We conducted a systematic review using databases of PubMed, CINAHL, PsycINFO, Web of Science, and the Cochrane Database of Systematic Reviews and identified 27 studies that reported the prevalence of cardiovascular disease or its risk factors in Korean Americans, published in English between 2000 and 2016.

Results:

We found high rates of unhealthy behaviors (eg, consumption of a high-sodium diet, physical inactivity, smoking) and risk factors (eg, hypertension, diabetes) for cardiovascular disease. Moreover, they were less likely to receive counseling about their diseases from healthcare providers and modify their lifestyle (eg, reduce their diet sodium intake, control their weight) to manage their diseases than were other ethnic populations. Individual-, interpersonal-, community-, and societal-level influences contributed to the high prevalence of cardiovascular risk factors.

Conclusions:

Data on subgroups of Asian Americans indicate that Korean Americans have significant lifestyle-related cardiovascular disease risks, which could be a critical agenda for researchers and clinicians to better understand cardiovascular health disparities in the United States.
Anogenital and Physical Injuries in Adolescent Sexual Assault Patients: The Role of Victim–Offender Relationship, Alcohol Use, and Memory Impairment
Authors: Feeney Hannah , Chiaramonte Danielle , Campbell Rebecca , Greeson Megan R. , Fehler-Cabral Giannina
Published: May 2017

Prior research has documented high rates of anogenital and physical injuries among adolescent sexual assault patients. Although a number of factors related to rates of injury detection in adolescents have been identified, there may be additional features of the assault that are disclosed in the patient history that could be important indicators of injury risk. The purpose of the current study was to expand this literature by examining whether factors that are salient in sexual assaults committed against adolescents—victim–offender relationship, substance use, and memory impairment—are associated with documented anogenital and physical injury rates. Results indicated that victim–offender relationship, substance use, and assault memory are significantly related to the number of anogenital injuries and, particularly, the number of physical injuries detected in adolescent sexual assault patients. These results highlight the importance of a comprehensive patient history, including assessment of alcohol and drug use and memory impairment, to guide the medical forensic examination.
If Background Lung Abnormalities Do Not Affect the Presentation of Spontaneous Pneumothorax, Is Lung Resection Always Justified?
Authors: Bilancia Rocco , Sharkey Annabel J. , Paik Amit , Waller David A.
Published: May 2017

Background:

The suggestion that spontaneous pneumothorax (SP) may result from diffuse porosity rather than discrete anatomic abnormality challenges the practice of targeted bullectomy. We assessed whether underlying pulmonary abnormalities are correlated or could be predicted from the mode of presentation, with potential implications for treatment.

Methods:

We analyzed 192 consecutive video-assisted thoracoscopic surgery resections for SP (139 primary, 53 secondary) in 171 patients (115 male, age 36, range, 16 to 81). Presentation was categorized as: recurrent never drained (RND), recurrent drained, persistent air leak (PAL). Resected lung pathology was categorized as: no bleb/bulla, ruptured bleb/bulla, unruptured bleb/bulla.

Results:

No correlation between presentation and resected lung pathology was observed for primary (P=0.608) or secondary SP (P=0.597). A similar proportion of patients in each pathologic group presented with PAL or RND; ruptured bleb/bulla or no bleb/bulla was equally noted in PAL and RND group.

Conclusions:

There is lack of association between resected lung pathology and mode of presentation. This suggests that discrete anatomic abnormalities may not be responsible for the air leak leading to pneumothorax. In conjunction with favorable reported outcomes from medical thoracoscopy and talc pleurodesis alone, these findings challenge the current practice of routine video-assisted thoracoscopic surgery lung resection in these patients.
Assessing Frailty in Patients Undergoing Destination Therapy Left Ventricular Assist Device: Observations from Interagency Registry for Mechanically Assisted Circulatory Support
Authors: Cooper Lauren B. , Hammill Bradley G. , Allen Larry A. , Lindenfeld JoAnn , Mentz Robert J. , Rogers Joseph G. , Milano Carmelo A. , Patel Chetan B. , Alexander Karen P. , Hernandez Adrian F.
Published: May 2017

Frailty and heart failure share common pathways with symptoms that often coexist. Assessment of frailty may inform patient selection for left ventricular assist device (LVAD) therapy. Using Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) data of destination therapy (DT) LVAD patients from January 1, 2012, to March 31, 2014, we examined preimplantation provider-assessed frailty and gait speed testing and the association with 1 year postimplantation outcomes. Of 2,469 patients, 227 (9.2%) had provider-assessed frailty. Only 320 (13.0%) completed gait speed testing, whereas 1,047 (42.4%) were “too sick” to perform the test. Provider-assessed frail and nonfrail patients had similar distributions of INTERMACS profiles and similar median gait speeds. One year mortality was higher for patients with provider-assessed frailty versus nonfrail (24.6% vs. 18.9%; p = 0.01) and for those too sick to complete gait speed testing versus completed testing (22.0% vs. 15.9%). There was an association between provider-assessed frailty and mortality, although it was not clinically significant after adjustment (hazard ratio [HR]: 1.38 [95% confidence interval {CI}: 0.97–1.95]). Useful information regarding frailty on postimplant mortality is gained from provider assessment of frailty or knowing gait speed could not be performed. Development of frailty measures better suited for DT LVAD candidates may help in distinguishing between a frailty phenotype and a more reversible from heart failure–related vulnerability.