bluuebunny/crossref_metadata_2025 huggingface dataset:
Thermally activated delayed fluorescence of co-deposited copper(i) complexes: cost-effective emitters for highly efficient organic light-emitting diodes
Authors: Wang Zixing , Zhu Jun , Liu Zhiwei , Wu Peng , Wang Hedan , Zhang Zhen , Wei Bin
Published: June 2017

TADF copper(i) complexes were made by co-depositing carboline derivatives and copper iodide. δ-Carboline derivative-based OLEDs showed 6 times higher efficiency than α-carboline derivative-based ones.
Efficient solid-state perovskite solar cells based on nanostructured zinc oxide designed by strategic low temperature water oxidation
Authors: Pelicano Christian Mark , Yanagi Hisao
Published: June 2017

A facile and energy saving method to produce high quality ZnO nanostructures in ultrapure water for efficient perovskite solar cells.
Luminescence-/morphology-modulation of organic microcrystals by a protonation process
Authors: Li Zhi-Zhou , Wang Xue-Dong , Liao Liang-Sheng
Published: June 2017

Organic nano/microcrystals with desirable optical/electrical properties and a regular morphology are extensively applied in various optoelectronic devices at the microscale, but the morphology/luminescence-modulation of organic microstructures remains to be a great challenge.
All-silicone elastic composites with counter-intuitive piezoelectric response, designed for electromechanical applications
Authors: Racles Carmen , Dascalu Mihaela , Bele Adrian , Tiron Vasile , Asandulesa Mihai , Tugui Codrin , Vasiliu Ana-Lavinia , Cazacu Maria
Published: June 2017

PDMS-based stretchable elastomeric composites with cross-linked polar silicone particles as fillers exhibit piezoresponse, improved dielectric properties and tunable mechanical behaviour.
Assessment on cadmium and lead in soil based on a rhizosphere microbial community
Authors: Zhang Xu , Yang Huanhuan , Cui Zhaojie
Published: June 2017

The soil ecosystem is easily polluted by heavy metals.
Metabolic disturbances of non-alcoholic fatty liver resemble the alterations typical for type 2 diabetes
Authors: Brouwers Bram , Schrauwen-Hinderling Vera B. , Jelenik Tomas , Gemmink Anne , Havekes Bas , Bruls Yvonne , Dahlmans Dennis , Roden Michael , Hesselink Matthijs K.C. , Schrauwen Patrick
Published: June 2017

Non-alcoholic fatty liver (NAFL) is an independent risk factor for the development of type 2 diabetes (T2DM). We examined metabolic perturbations in patients with NAFL, patients with T2DM, and control (CON) subjects with normal intrahepatic lipid (IHL) content.

A two-step (10 mU/m2 /min; 40 mU/m2/min) hyperinsulinemic–euglycemic clamp was performed in 11 NAFL, 13 T2DM, and 11 CON subjects, all matched for BMI, and aerobic fitness. IHL content was measured using proton magnetic resonance spectroscopy. Because of high IHL content variability in T2DM patients, this group was separated into a high IHL content group (IHL ≥ 5.0%, T2DM+NAFL) and a normal IHL content group (IHL < 5.0%, T2DM-non-NAFL) for further analysis.

IHL content was increased in NAFL and T2DM+NAFL subjects (P<0.050 versus CON and T2DM-non-NAFL subjects). Adipose tissue insulin sensitivity index (Adipo-IRi) was higher in NAFL (P<0.050 versus CON and T2DM-non-NAFL subjects) and in T2DM+NAFL subjects (P=0.055 versus CON subjects, P<0.050 versus T2DM-non-NAFL subjects). Suppression of plasma-free fatty acids (P=0.046) was lower in NAFL compared with CON subjects, with intermediate values for T2DM-non-NAFL, and T2DM+NAFL subjects. Suppression of endogenous glucose production (EGP) and insulin-stimulated glucose disposal (ΔRd) was comparable between NAFL, T2DM-non-NAFL, and T2DM+NAFL subjects (all P>0.05), and was lower in comparison with CON subjects (all P<0.01). Metabolic flexibility was lower in T2DM-non-NAFL subjects (P=0.047) and NAFL subjects (P=0.059) compared with CON subjects. Adipo-IRi (r=0.652, P<0.001), hepatic insulin resistance index (HIRi) (r=0.576, P=0.001), and ΔRd (r=−0.653, P<0.001) correlated with IHL content.

Individuals with NAFL suffer from metabolic perturbations to a similar degree as T2DM patients. NAFL is an important feature leading to severe insulin resistance and should be viewed as a serious health threat for the development of T2DM. ClinicalTrials.gov: NCT01317576
Evaluation of Quality of life, Physical Activity and Nutritional Profile of Postmenopausal Women with and without Vitamin D Deficiency
Authors: Delchiaro Adriele , Oliveira Flávia de Jesus , Bonacordi Camila Lopez , Chedid Bruna Libanori , Annicchino Giuliana , Fernandes Cesar Eduardo , Strufaldi Rodolfo , Pompei Luciano M. , Steiner Marcelo Luis
Published: June 2017

Introduction Vitamin D deficiency is associated with various diseases. Prevalent in Brazil, it can result from inadequate lifestyle habits.

Objective To demonstrate that postmenopausal women with vitamin D deficiency have worse quality of health, expressed as worse quality of life, lower levels of physical activity, and worse nutritional profile.

Methods Postmenopausal women answered questionnaires about physical activity and quality of life, provided a 24-hour food record, and had serum vitamin D levels measured.

Results Among the more active women, those who perform a daily average of one hour of physical activity had vitamin D levels above 20 ng/mL (76.9%), and those, which expose themselves to sunlight, had vitamin D levels above 30 ng/mL (34.6%). Meanwhile the percentages for the women who are less physically active and less exposed to sunlight were 42.2% and 8.9% respectively. Being more active and more exposed to sunlight resulted in a lower fat percentage. Serum vitamin D levels were not correlated with quality of life.

Conclusion Walking and gardening increased serum vitamin D levels and decreased the percentage of body fat. The limitations of the study prevented the impact of 25-hidroxyvitamin D on the quality of life and nutritional aspects of the women from being evaluated.
Identifying key nodes in multilayer networks based on tensor decomposition
Authors: Wang Dingjie , Wang Haitao , Zou Xiufen
Published: June 2017

The identification of essential agents in multilayer networks characterized by different types of interactions is a crucial and challenging topic, one that is essential for understanding the topological structure and dynamic processes of multilayer networks. In this paper, we use the fourth-order tensor to represent multilayer networks and propose a novel method to identify essential nodes based on CANDECOMP/PARAFAC (CP) tensor decomposition, referred to as the EDCPTD centrality. This method is based on the perspective of multilayer networked structures, which integrate the information of edges among nodes and links between different layers to quantify the importance of nodes in multilayer networks. Three real-world multilayer biological networks are used to evaluate the performance of the EDCPTD centrality. The bar chart and ROC curves of these multilayer networks indicate that the proposed approach is a good alternative index to identify real important nodes. Meanwhile, by comparing the behavior of both the proposed method and the aggregated single-layer methods, we demonstrate that neglecting the multiple relationships between nodes may lead to incorrect identification of the most versatile nodes. Furthermore, the Gene Ontology functional annotation demonstrates that the identified top nodes based on the proposed approach play a significant role in many vital biological processes. Finally, we have implemented many centrality methods of multilayer networks (including our method and the published methods) and created a visual software based on the MATLAB GUI, called ENMNFinder, which can be used by other researchers.
The effect of an InP cap layer on the photoluminescence of an InxGa1–xAs1–yPy/InzAl1– zAs quantum well heterostructure
Authors: Esmaielpour Hamidreza , Whiteside Vincent R. , Hirst Louise C. , Tischler Joseph G. , Walters Robert J. , Sellers Ian R.
Published: June 2017

The effect of an InP cap on the photoluminescence (PL) spectrum of an InGaAsP/InAlAs quantum well (QW) is investigated using excitation power and temperature dependent PL. An as-grown sample with the InP cap layer shows an inverted interface created between InP and InAlAs that has a transition energy very close to the transition energy of the QW; consequently, there is an overlap between them. On the other hand, the QW sample with the cap layer etched away does not have a feature due to the inverted interface; even at very low power, the only observed feature is due to the QW transition.
Multifractal temporally weighted detrended cross-correlation analysis to quantify power-law cross-correlation and its application to stock markets
Authors: Wei Yun-Lan , Yu Zu-Guo , Zou Hai-Long , Anh Vo
Published: June 2017

A new method—multifractal temporally weighted detrended cross-correlation analysis (MF-TWXDFA)—is proposed to investigate multifractal cross-correlations in this paper. This new method is based on multifractal temporally weighted detrended fluctuation analysis and multifractal cross-correlation analysis (MFCCA). An innovation of the method is applying geographically weighted regression to estimate local trends in the nonstationary time series. We also take into consideration the sign of the fluctuations in computing the corresponding detrended cross-covariance function. To test the performance of the MF-TWXDFA algorithm, we apply it and the MFCCA method on simulated and actual series. Numerical tests on artificially simulated series demonstrate that our method can accurately detect long-range cross-correlations for two simultaneously recorded series. To further show the utility of MF-TWXDFA, we apply it on time series from stock markets and find that power-law cross-correlation between stock returns is significantly multifractal. A new coefficient, MF-TWXDFA cross-correlation coefficient, is also defined to quantify the levels of cross-correlation between two time series.
On- and off-axis spectral emission features from laser-produced gas breakdown plasmas
Authors: Harilal S. S. , Skrodzki P. J. , Miloshevsky A. , Brumfield B. E. , Phillips M. C. , Miloshevsky G.
Published: June 2017

Laser-heated gas breakdown plasmas or sparks emit profoundly in the ultraviolet and visible region of the electromagnetic spectrum with contributions from ionic, atomic, and molecular species. Laser created kernels expand into a cold ambient with high velocities during their early lifetime followed by confinement of the plasma kernel and eventually collapse. However, the plasma kernels produced during laser breakdown of gases are also capable of exciting and ionizing the surrounding ambient medium. Two mechanisms can be responsible for excitation and ionization of the surrounding ambient: photoexcitation and ionization by intense ultraviolet emission from the sparks produced during the early times of their creation and/or heating by strong shocks generated by the kernel during its expansion into the ambient. In this study, an investigation is made on the spectral features of on- and off-axis emission of laser-induced plasma breakdown kernels generated in atmospheric pressure conditions with an aim to elucidate the mechanisms leading to ambient excitation and emission. Pulses from an Nd:YAG laser emitting at 1064 nm with a pulse duration of 6 ns are used to generate plasma kernels. Laser sparks were generated in air, argon, and helium gases to provide different physical properties of expansion dynamics and plasma chemistry considering the differences in laser absorption properties, mass density, and speciation. Point shadowgraphy and time-resolved imaging were used to evaluate the shock wave and spark self-emission morphology at early and late times, while space and time resolved spectroscopy is used for evaluating the emission features and for inferring plasma physical conditions at on- and off-axis positions. The structure and dynamics of the plasma kernel obtained using imaging techniques are also compared to numerical simulations using the computational fluid dynamics code. The emission from the kernel showed that spectral features from ions, atoms, and molecules are separated in time with early time temperatures and densities in excess of 35 000 K and 4 × 1018/cm3 with an existence of thermal equilibrium. However, the emission from the off-kernel positions from the breakdown plasmas showed enhanced ultraviolet radiation with the presence of N2 bands and is represented by non-local thermodynamic equilibrium (non-LTE) conditions. Our results also highlight that the ultraviolet radiation emitted during the early time of spark evolution is the predominant source of the photo-excitation of the surrounding medium.
Experimental observation of electron-acoustic wave propagation in laboratory plasma
Authors: Chowdhury Satyajit , Biswas Subir , Chakrabarti Nikhil , Pal Rabindranath
Published: June 2017

In the field of fundamental plasma waves, the direct observation of electron-acoustic wave (EAW) propagation in laboratory plasmas remains a challenging problem, mainly because of heavy damping. In the Magnetized Plasma Linear Experimental device, the wave is observed and seen to propagate with the phase velocity ∼1.8 times the electron thermal velocity. A small amount of cold, drifting electrons, with the moderate bulk to cold temperature ratio (≈2−3), is present in the device. It plays a crucial role in reducing the damping. Our calculation reveals that the drift relaxes the stringent condition on the temperature ratio for wave destabilization. Growth rate becomes positive above a certain drift velocity even if the temperature ratio is moderate. The observed phase velocity agrees well with the theoretical estimate. Experimental realization of the mode may open up a new avenue in the EAW research.
Influence of expanding and contracting magnetic field configurations on detached plasma formation in a linear plasma device
Authors: Hayashi Y. , Ohno N. , Kajita S. , Tanaka H.
Published: June 2017

We investigated the effects of magnetic field structure on detached plasma formation by simulating magnetically expanding and contracting plasma in a linear plasma device. The present study helps to characterize the geometries of a conventional poloidal divertor and advanced divertors, e.g., super-X divertor. The total ion particle flux measured with a large-diameter target plate dramatically changed under the detached plasma condition compared to that in attached plasma. Under the detached plasma condition, the magnetically expanding plasma clearly exhibited a significant influence on the degradation of detached plasma formation. Further, the magnetically contracting plasma slightly enhanced the electron-ion recombination (EIR) processes. By changing the magnetic field structure from contraction to expansion, the electron density (ne) decreased and the electron temperature (Te) increased upstream from the recombination front, leading to the degradation of the EIR processes. The effect of the decrease in parallel flow velocity under the magnetically contracting plasma on the plasma detachment was not observed because the driven flow due to pressure gradient compensated the effect.
Structure of superconducting layers in bronze-processed and internal-tin Nb3Sn-based wires of various designs
Authors: Deryagina I. , Popova E. , Patrakov E. , Valova-Zaharevskaya E.
Published: June 2017

The microstructure of Nb3Sn layers in multifilamentary composites manufactured by bronze technology and the internal-tin (IT) method differing in the strand design has been studied. The IT strands of International Thermonuclear Experimental Reactor (ITER) type and high-Jc type are characterized by both the higher Sn concentration and the higher fraction of equiaxed grains than bronze-route composites. In all the samples under study, the fraction of equiaxed grains correlates with the average concentration of Sn in Nb3Sn layers. The Ti doping of the bronze matrix in the bronze-processed wires results in the reduction in average grain sizes of Nb3Sn grains and in a higher fraction of equiaxed grains with a higher Sn concentration, which leads to a higher non-Cu Jc (calculated as a ratio of critical current Ic to a cross-sectional area of a strand without stabilizing Cu), 997 A/mm2 at 12 T, 4.2 K, compared to a composite of the same design with artificially Ti-doped Nb filaments. The ITER type IT strand demonstrates a somewhat higher fraction of equiaxed Nb3Sn grains with much larger average grain sizes (120 nm). The grain coarsening in this IT strand results in a decrease in Jc compared to other ITER type strands studied. The highest values of Jc are ensured in the high-Jc type of IT wires with 7 extended tin sources by the highest fraction (92%) of equiaxed Nb3Sn grains despite their coarser sizes (92 nm).
Surface localization of the Er-related optical active centers in Er doped zinc oxide films
Authors: Azad Fahad , Luo Caiqin , Su Shichen , Younas Muhammad , Azeem Waqar , Kuznetsov Andrej , Azarov Alexander , Shih Kaimin , Liao Changzhong , Maqsood Asghari , Ling Francis Chi-Chung
Published: June 2017

Er-doped ZnO films were grown on c-plane sapphire by employing the pulsed laser deposition method. In accordance with the previously reported literature studies, post-growth annealing was required to activate the optical emission originated from the intra-shell transitions of the Er atoms. Importantly, the present systematic studies revealed that the thermal activation of the optical activity is due to the atomistic rearrangements occurring only in the vicinity of the film surface. The processes exhibit a distinct signature of changing oxygen coordination with the Er atom, as observed by the x-ray photoemission study.
Vacuolar convolution: possible mechanisms and role of phosphatidylinositol 3,5-bisphosphate
Authors: Pérez Koldenkova Vadim , Hatsugai Noriyuki
Published: June 2017

The central or lytic vacuole is the largest intracellular organelle in plant cells, but we know unacceptably little about the mechanisms regulating its function in vivo. The underlying reasons are related to difficulties in accessing this organelle without disrupting the cellular integrity and to the dynamic morphology of the vacuole, which lacks a defined structure. Among such morphological changes, vacuolar convolution is probably the most commonly observed event, reflected in the (reversible) transformation of a large central vacuole into a structure consisting of interconnected bubbles of a smaller size. Such behaviour is observed in plant cells subjected to hyperosmotic stress but also takes place in physiological conditions (e.g. during stomatal closure). Although vacuolar convolution is a relatively common phenomenon in plants, studies aimed at elucidating its execution mechanisms are rather scarce. In the present review, we analyse the available evidence on the participation of the cellular cytoskeleton and ion transporters in vacuolar morphology dynamics, putting special emphasis on the available evidence of the role played by phosphatidylinositol 3,5-bisphosphate in this process.
Exploring Medical Students’ Conceptions of Substance Use: A Follow-Up Evaluation
Authors: Lindsay Dawn L. , Hagle Holly , Lincoln Piper , Williams Jessica , Luongo Peter F.
Published: June 2017

Background

Despite the devastating impact of alcohol and other drug involvement and misuse within society, medical students still receive very limited exposure to these issues. The Scaife Advanced Medical Student Fellowship in Alcohol and Other Drug Dependency, offered by the Institute for Research, Education and Training in Addictions for over 10 years, offers a unique, 3-week intensive educational experience, including didactic, observation, and experiential learning in these topics to first-year medical students. The goal of this project was to evaluate the impact of the Scaife Fellowship on medical students’ attitudes toward patients with alcohol and other drug involvement 1 to 5 years after completion of the experience.

Methods

Past Scaife students and individuals who applied but did not attend were located and recruited to participate in an online attitude survey.

Results

Results indicated that Scaife Fellowship students largely retain their sense of role security around working with patients with alcohol and other drug involvement at the follow-up time point. Although therapeutic commitment or the motivation to work with these patients decreased for drug use, the decrease was smaller than that typically noted in the literature. The group of comparison students showed lower scores on both subscales at the evaluation time point compared with Scaife students.

Conclusions

A three-week experiential program significantly improved medical students’ Role Security and Therapeutic Commitment toward working with patients with substance use disorders. Moreover, the positive effects gained from the program were sustained over time.
Mixed 3-manifolds are virtually special
Authors: Przytycki Piotr , Wise Daniel
Published: June 2017

Let

M
M

be a compact oriented irreducible

3
3

-manifold which is neither a graph manifold nor a hyperbolic manifold. We prove that

π
1

M

\pi _1M

is virtually special.
Air Pollution and Cardiometabolic Disease: An Update and Call for Clinical Trials
Authors: Brook Robert D , Newby David E , Rajagopalan Sanjay
Published: June 2017

Fine particulate matter <2.5 µm (PM2.5) air pollution is a leading cause of global morbidity and mortality. The largest portion of deaths is now known to be due to cardiovascular disorders. Several air pollutants can trigger acute events (e.g., myocardial infarctions, strokes, heart failure). However, mounting evidence additionally supports that longer-term exposures pose a greater magnified risk to cardiovascular health. One explanation may be that PM2.5 has proven capable of promoting the development of chronic cardiometabolic conditions including atherosclerosis, hypertension, and diabetes mellitus. Here, we provide an updated overview of recent major studies regarding the impact of PM2.5 on cardiometabolic health and outline key remaining scientific questions. We discuss the relevance of emerging trials evaluating personal-level strategies (e.g., facemasks) to prevent the harmful effects of PM2.5, and close with a call for large-scale outcome trials to allow for the promulgation of formal evidence-base recommendations regarding their appropriate usage in the global battle against air pollution.
Implementing prescription drug monitoring and other clinical decision support for opioid risk mitigation in a military health care setting: a qualitative feasibility study
Authors: Finley Erin P , Schneegans Suyen , Tami Claudina , Pugh Mary Jo , McGeary Don , Penney Lauren , Sharpe Potter Jennifer
Published: June 2017

Objective

Chronic noncancer pain is a highly prevalent condition among service members returning from deployment overseas. The US Army has a higher rate of opioid misuse than the civilian population. Although most states and many health care systems have implemented prescription drug monitoring programs (PDMPs) or other clinician decision support (CDS) to aid providers in delivering guideline-recommended opioid therapy, similar tools are lacking in military health settings.

Materials and Methods

We conducted a pre-implementation feasibility and needs assessment guided by the Promoting Action Research in Health Services framework. Twenty-six semistructured interviews were conducted with providers from a large military health system (MHS) to assess baseline knowledge and practices in opioid risk mitigation and providers’ preferences and needs for a military-based PDMP or other CDS.

Results

Military health care providers reported complex decision-making around opioid prescribing and monitoring, varied knowledge and use of existing clinical informatics, and concerns about the feasibility of implementing a military-based PDMP in their context. However, providers indicated a need for training and CDS to support opioid risk mitigation for their patients.

Discussion

This article describes providers’ knowledge and behaviors around opioid risk mitigation in the MHS, and views on the potential usefulness of a military-based PDMP or other CDS. This pre-implementation study provides a model for using qualitative methods to assess feasibility and inform planning and development of CDS in complex health care settings.

Conclusion

Military providers were skeptical regarding the feasibility of MHS-based PDMP implementation, but provided important recommendations for CDS to support safe and appropriate opioid prescribing in military health care.
Detection of the Northeastern African Rift Valley Fever Virus Lineage During the 2015 Outbreak in Mauritania
Authors: Bob Ndeye Sakha , Bâ Hampâté , Fall Gamou , Ishagh Elkhalil , Diallo Mamadou Y. , Sow Abdourahmane , Sembene Pape Mbacké , Faye Ousmane , El Kouri Brahim , Sidi Mohamed Lemine , Sall Amadou Alpha
Published: June 2017

Background

Rift Valley fever (RVF) is an acute viral anthropozoonosis that causes epizootics and epidemics among livestock population and humans. Multiple emergences and reemergences of the virus have occurred in Mauritania over the last decade. This article describes the outbreak that occurred in 2015 in Mauritania and reports the results of serological and molecular investigations of blood samples collected from suspected RVF patients.

Methods

An RVF outbreak was reported from 14 September to 26 November 2015 in Mauritania. Overall, 184 suspected cases from different localities were identified by 26 health facilities. Blood samples were collected and tested by enzyme-linked immunosorbent assay (ELISA) and real-time reverse-transcription polymerase chain reaction (RT-PCR) at the Institut Pasteur de Dakar (IPD). Sequencing of partial genomes and phylogenetic analyses were performed on RT-PCR–positive samples. As part of routine surveillance at IPD, samples were also screened for dengue, yellow fever, West Nile, Crimean Congo hemorrhagic fever, Zika, and Chikungunya viruses by ELISA and RT-PCR.

Results

Of the 184 suspected cases, there were 57 confirmed cases and 12 deaths. Phylogenetic analysis of the sequences indicated an emergence of a virus that originated from Northeastern Africa. Our results show co-circulation of other arboviruses in Mauritania—dengue, Crimean Congo hemorrhagic fever, and West Nile viruses.

Conclusion

The Northeastern Africa lineage of RVF was responsible for the outbreak in Mauritania in 2015. Co-circulation of multiples arboviruses was detected. This calls for systematic differential diagnosis and highlights the need to strengthen arbovirus surveillance in Africa.
Bilateral HPV Positive Squamous Cell Carcinoma In Situ of Conjunctiva
Authors: George Rebecca S. , Lewis Darrell R. , Archibald Curtis W. , Heathcote Godfrey
Published: June 2017

A 45 year-old woman presented with blurred vision and irritation of the left eye. Clinical examination revealed a superior palpebral conjunctival lesion consistent with a diagnosis of papilloma. She was lost to follow up despite repeated attempts to schedule a biopsy, and presented again after an extended period with bilateral disease. Subsequent biopsy confirmed bilateral squamous cell carcinoma in situ which was human papilloma virus-16 positive by molecular testing. She declined further treatment; during the subsequent year, the lesions extended across the bulbar conjunctiva bilaterally.
A Clinical Framework for Functional Recovery in a Person With Chronic Traumatic Brain Injury: A Case Study
Authors: McCain Karen , Shearin Staci
Published: June 2017

Background and Purpose:

This case study describes a task-specific training program for gait walking and functional recovery in a young man with severe chronic traumatic brain injury.

Case Description:

The individual was a 26-year-old man 4 years post–traumatic brain injury with severe motor impairments who had not walked outside of therapy since his injury. He had received extensive gait training prior to initiation of services. His goal was to recover the ability to walk.

Intervention:

The primary focus of the interventions was the restoration of walking. A variety of interventions were used, including locomotor treadmill training, electrical stimulation, orthoses, and specialized assistive devices. A total of 79 treatments were delivered over a period of 62 weeks.

Outcomes:

At the conclusion of therapy, the client was able to walk independently with a gait trainer for approximately 1km (over 3000 ft) and walked in the community with the assistance of his mother using a rocker bottom crutch for distances of 100m (330 ft).

Discussion:

Specific interventions were intentionally selected in the development of the treatment plan. The program emphasized structured practice of the salient task, that is, walking, with adequate intensity and frequency. Given the chronicity of this individual's injury, the magnitude of his functional improvements was unexpected.

Video Abstract available for additional insights from the Authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A175).
Understanding the Effects of Forced Sex on Sexually Transmitted Disease Acquisition and Sexually Transmitted Disease Care: Findings From the National Survey of Family Growth (2011–2013)
Authors: Brookmeyer Kathryn A. , Beltran Oscar , Abad Neetu
Published: June 2017

Background

Although there is evidence for heightened sexually transmitted disease (STD) acquisition among women who experienced sexual violence, little is known about their patterns of STD testing, STD diagnosis, and STD treatment.

Methods

Data was drawn from cycle eight of the National Survey of Family Growth (2011–2013). Logistic regression analyses used SUDAAN to examine the link between forced sex and risky sexual behavior as well as forced sex and STD testing, diagnoses, treatment, and connection to care.

Results

Women who experienced forced sex were more likely to have risky sex (adjusted odds ratio [AOR], 1.56; 95% confidence interval [CI], 1.08–2.24), risky partners (AOR, 1.90; 95% CI, 1.11–3.23), and report substance abuse (AOR, 1.80; 95% CI, 1.28–2.53) than women who never experienced forced sex. Women who reported forced sex were more likely to be tested for an STD (AOR, 1.67; 95% CI, 1.34–2.09), and be diagnosed with herpes (AOR, 1.94; 95% CI, 1.13–3.32), genital warts (AOR, 2.55; 95% CI, 1.90–3.41), and chlamydia (AOR, 1.83; 95% CI, 1.03–3.25) than those who have never had forced sex. Results indicated a direct relationship between particular STD diagnoses and treatment in the past 12 months (AOR, 6.81; 95% CI, 4.50–10.31). Further analyses indicate that forced sex moderated the link between STD diagnoses and STD treatment (AOR, 0.43; 95% CI, 0.19–0.98).

Conclusions

Results indicate that women who reported experiencing forced sex were more likely to be diagnosed with chlamydia, herpes, and genital warts than women who never had forced sex. There may be a need to pay particular attention to women who experienced forced sex and a history of STDs to ensure that they are retained in care.
Provider Adherence to Syphilis Testing Recommendations for Women Delivering a Stillbirth
Authors: Patel Chirag G. , Huppert Jill S. , Tao Guoyu
Published: June 2017

Objective

To assess overall adherence to Centers for Disease Control and Prevention and American College of Obstetrics and Gynecology recommended guidelines for syphilis testing among women who delivered a stillbirth and compare it with other tests recommended for stillbirth evaluation.

Methods

We used MarketScan claims data with 40 million commercially insured and 8 million Medicaid enrollees annually to estimate prenatal care and follow-up testing among women who had stillbirths between January 1, 2013, and December 24, 2013. Stillbirth was identified if women had any International Classification of Disease, Ninth Revision codes related to a stillbirth outcome. Among women with stillbirths, we estimated the proportions of women who received prenatal care and prenatal syphilis testing within 280 days before stillbirth, and testing at the time of stillbirth (syphilis testing, complete blood count, placental examination and autopsy) using Physician’s Current Procedural Terminology codes.

Results

We identified 3672 Medicaid-insured women and 6023 commercially insured women with stillbirths in 2013. Approximately, 61.7% of Medicaid-insured women and 66.0% of commercially insured women had claims data indicating prenatal syphilis testing. At the time of stillbirth, Medicaid-insured and commercially insured women had similar rates of syphilis testing (6.5% vs 9.3%), placental examination (61.6% vs 57.8%), and complete blood count (31.9% vs 37.6%). Autopsies were too infrequent to be reported. Approximately, 34.6% of Medicaid-insured women and 29.7% of commercially insured women had no syphilis testing either prenatally or at the time of stillbirth.

Conclusions

Syphilis testing among women after stillbirth was less than 10%, illustrating limited adherence to Centers for Disease Control and Prevention and American College of Obstetrics and Gynecology recommendations. Such low prenatal and delivery syphilis testing rates may impact the number of stillbirth cases identified as congenital syphilis cases and reported to the national surveillance system. Our results emphasize the need to improve syphilis testing to improve diagnosis of syphilitic stillbirths, identify women with syphilis infection, and provide treatment to these women to avoid syphilis-related adverse outcomes.
TRIAD IX: Can a Patient Testimonial Safely Help Ensure Prehospital Appropriate Critical Versus End-of-Life Care?
Authors: Mirarchi Ferdinando , Cammarata Christopher , Cooney Timothy E. , Juhasz Kristin , Terman Stanley A.
Published: June 2017

Objective

The present study sought to assess the clarity of Physician Orders for Life-Sustaining Treatment (POLST) or Living Will (LW) documents alone or in combination with a video message/testimonial (VM).

Methods

Emergency medical services (EMS) personnel responded to survey questions about the meaning of stand-alone POLST and LW documents and those used in conjunction with emergent care scenarios. Personnel were randomized to receive documents only or documents with VM. Questions sought a code status for each scenario and a resuscitation decision. Code status responses were analyzed for consensus (95% response rate), resuscitation responses for correct treatment decisions.

Results

The survey response rate was 85%. Approximately half of emergency medical technician (EMT) respondents were EMT basic, and half EMT respondents were paramedic, with an average age of 42 years. Less than half had previous POLST/LW training averaging 2 hours. Consensus failed to be reached for stand-alone documents. For clinical scenarios, responses to POLST documents specifying do not resuscitate/comfort measures only or cardiopulmonary resuscitation/full treatment exceeded 80% for code status designation and correct resuscitation decisions. Other POLST resuscitation/treatment combinations showed more disparate responses, and most benefited from VM with changes in responses of 20% or more (P ≤ 0.025). Code status responses to LW-based scenarios evidenced a nonconsensus majority (79%–83%) that was significantly affected with VMs (≥12%, P ≤ 0.004); half evidenced large changes in resuscitation decisions (49%, P < 0.001).

Conclusions

Document clarity, judged by consensus response, was rarely evidenced. video message/testimonial seems to be a helpful aid to both POLST and LWs. Standardized education and training reveal opportunities to improve patient safety to ensure patient wishes.
A Retrospective Study of Pimavanserin Use in a Movement Disorders Clinic
Authors: Friedman Joseph H.
Published: June 2017

Pimavanserin, a 5-HT2A inverse agonist, was commercially released in the United States in April 2016 for the treatment of Parkinson disease psychosis. No “naturalistic” treatment results have yet been published. Charts from the movement disorders clinic were reviewed for all patients who received this drug as treatment for psychosis associated with primary parkinsonism due to α-synucleinopathies. Data of 10 patients with idiopathic Parkinson disease, including 1 with a long history of schizophrenia, 4 with dementia with Lewy bodies, and 1 with multiple-system atrophy, were reviewed. There were no adverse events reported. Ten patients improved and continue on the drug, whereas 5 stopped because of lack of benefit.
Serotonin Syndrome Following Combined Administration of Dopaminergic and Noradrenergic Agents in a Patient With Akinetic Mutism After Frontal Intracerebral Hemorrhage: A Case Report
Authors: Jeon Dae Geun , Kim Yong Wook , Kim Na Young , Park Jung Hyun
Published: June 2017

Background

Serotonin syndrome (SS) is a potentially life-threatening condition that can be caused by use of proserotonergic drugs. Several studies have reported that combined administration of various medications may induce SS. We report a case of SS in a patient who was being treated with dopaminergic and noradrenergic drugs.

Case Presentation

A 55-year-old man with a right frontal intracerebral hemorrhage extending to the left cerebral hemisphere presented with clinical features of akinetic mutism. Three months after onset, dopaminergic (methylphenidate, levodopa/benserazide) and noradrenergic (atomoxetine) drugs were administered to enhance his cognitive function. His cognitive function gradually improved during 8 weeks of dose escalation. One day after the dose of atomoxetine was increased from 40 mg/d to 60 mg/d, the patient developed inducible clonus, rigidity, diarrhea, tachycardia, and hyperthermia, in keeping with a diagnosis of SS. The symptoms and signs suggestive of SS resolved on the day following cessation of all dopaminergic and noradrenergic drugs.

Conclusions

This case demonstrates that medications generally known as dopaminergic or noradrenergic agents could have serotonergic effects via a mechanism that is yet to be fully elucidated. The clinical manifestations of SS can be diverse, ranging from mild to severe and potentially fatal symptoms. When administering a combination of catecholaminergic agents, clinicians should carefully monitor the patient’s neurologic status for unexpected adverse reactions.
Effect of Excessive Coffee Consumption on the Clinical Course of a Patient With Bipolar Disorder: A Case Report and Literature Review
Authors: Kunitake Yutaka , Mizoguchi Yoshito , Sogawa Rintaro , Matsushima Jun , Kato Takahiro A. , Kawashima Toshiro , Monji Akira
Published: June 2017

Objective

The aim of this study was to examine the impact of excessive caffeine consumption on therapeutic outcomes in bipolar disorder.

Methods and Results

We report on a case of a patient with bipolar disorder whose psychiatric symptoms were ameliorated with the elevation of lithium concentrations after the reduction of excessive daily coffee consumption, and we review the relevant literatures.

Conclusions

Excessive coffee consumption may exacerbate the therapeutic course of bipolar disorder through its effects on the mechanisms underlying bipolar disorder itself, as well as by affecting the blood concentration of lithium.
Bupropion Augmentation in a Case of Compulsive Buying Disorder
Authors: Sepede Gianna , Di Iorio Giuseppe , Sarchione Fabiola , Fiori Federica , Di Giannantonio Massimo
Published: June 2017

Background

Compulsive buying disorder (CBD) is a condition characterized by excessive preoccupations, impulses, and behaviors regarding buying, resulting in serious psychological, social, and financial problems. Even though it has not been included in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, “behavioral addictions” section, CBD is a hot topic in current clinical psychiatry, because of its relevant prevalence (at least 5% in adult populations) and severe effect on quality of life.

The CBD shares some clinical features with substance-related and behavioral addictions, impulse control disorders, and obsessive compulsive disorder, and it is often comorbid with other psychiatric illnesses (especially depressive and anxiety disorders). The treatment of CBD is therefore difficult, and clear therapeutic guidelines are not yet available. Treating the comorbid disorders as the first-line approach, or combining drugs with different pharmacodynamic profiles, has been suggested to address this challenging condition.

Case

A 60-year-old woman affected by a severe form of CBD with comorbid major depressive disorder, resistant/intolerant to previous selective serotonin reuptake inhibitor treatments and only partially responder to mirtazapine, achieved a good clinical improvement adding bupropion.

Conclusions

Combining 2 agents with different pharmacological profiles and mechanisms of action, such as bupropion and mirtazapine, could be a useful strategy in the management of complex CBD cases.
Straight round the twist: frustration and chirality in smectics-A
Authors: Matsumoto Elisabetta A. , Kamien Randall D. , Alexander Gareth P.
Published: June 2017

Frustration is a powerful mechanism in condensed matter systems, driving both order and complexity. In smectics, the frustration between macroscopic chirality and equally spaced layers generates textures characterized by a proliferation of defects. In this article, we study several different ground states of the chiral Landau–de Gennes free energy for a smectic liquid crystal. The standard theory finds the twist grain boundary (TGB) phase to be the ground state for chiral type II smectics. However, for very highly chiral systems, the hierarchical helical nanofilament phase can form and is stable over the TGB.
Circularly polarized reflection from the scarab beetleChalcothea smaragdina: light scattering by a dual photonic structure
Authors: McDonald Luke T. , Finlayson Ewan D. , Wilts Bodo D. , Vukusic Pete
Published: June 2017

Helicoidal architectures comprising various polysaccharides, such as chitin and cellulose, have been reported in biological systems. In some cases, these architectures exhibit stunning optical properties analogous to ordered cholesteric liquid crystal phases. In this work, we characterize the circularly polarized reflectance and optical scattering from the cuticle of the beetleChalcothea smaragdina(Coleoptera: Scarabaeidae: Cetoniinae) using optical experiments, simulations and structural analysis. The selective reflection of left-handed circularly polarized light is attributed to a Bouligand-type helicoidal morphology within the beetle's exocuticle. Using electron microscopy to inform electromagnetic simulations of this anisotropic stratified medium, the inextricable connection between the colour appearance ofC. smaragdinaand the periodicity of its helicoidal rotation is shown. A close agreement between the model and the measured reflectance spectra is obtained. In addition, the elytral surface ofC. smaragdinapossesses a blazed diffraction grating-like surface structure, which affects the diffuse appearance of the beetle's reflected colour, and therefore potentially enhances crypsis among the dense foliage of its rainforest habitat.
Optimal packings of three-arm star polyphiles: from tricontinuous to quasi-uniformly striped bicontinuous forms
Authors: de Campo Liliana , Castle Toen , Hyde Stephen T.
Published: June 2017

Star-shaped molecules with three mutually immiscible arms self-assemble to form a variety of novel structures, with conformations that attempt to minimize interfacial area between the domains composed of the different arms. The geometric frustration caused by the joining of these arms at a common centre limits the size and shape of each domain, encouraging the creation of complex and interesting solutions. Some solutions are tricontinuous, and these solutions (and others) share aspects of bicontinuous structures with amphiphilic assemblies as similar molecular segregation factors are at work. We describe both highly symmetric and balanced structures, as well as unbalanced solutions that take the form of intricately striped amphiphilic membranes. All these patterns can result in chiral assemblies with multiple networks.
Scaling properties of ageing orientation fluctuations in stripe phases
Authors: Riesch Christian , Radons Günter , Magerle Robert
Published: June 2017

We investigate the non-equilibrium dynamics of an ordered stripe-forming system free of topological defects. In particular, we study the ageing and the coarsening of orientation fluctuations parallel and perpendicular to the stripes via computer simulations based on a minimal phase-field model (model B with Coulomb interactions). Under the influence of noise, the stripe orientation field develops fluctuations parallel to the stripes, with the dominant modulation length λ*∥increasing with timetas λ*∥∼t1/4and the correlation length perpendicular to the stripesξ⊥θincreasing asξ⊥θ∼t1/2. We explain these anisotropic coarsening dynamics with an analytic theory based on the linear elastic model for stripe displacements first introduced by Landau and Peierls. We thus obtain the scaling forms and the scaling exponents characterizing the correlation functions and the structure factor of the stripe orientation field. Our results reveal how the coarsening of orientation fluctuations prevents a periodically modulated phase free of topological defects from reaching equilibrium.
Non-lamellar lipid assembly at interfaces: controlling layer structure by responsive nanogel particles
Authors: Dabkowska Aleksandra P. , Valldeperas Maria , Hirst Christopher , Montis Costanza , Pálsson Gunnar K. , Wang Meina , Nöjd Sofi , Gentile Luigi , Barauskas Justas , Steinke Nina-Juliane , Schroeder-Turk Gerd E. , George Sebastian , Skoda Maximilian W. A. , Nylander Tommy
Published: June 2017

Biological membranes do not only occur as planar bilayer structures, but depending on the lipid composition, can also curve into intriguing three-dimensional structures. In order to fully understand the biological implications as well as to reveal the full potential for applications, e.g. for drug delivery and other biomedical devices, of such structures, well-defined model systems are required. Here, we discuss the formation of lipid non-lamellar liquid crystalline (LC) surface layers spin-coated from the constituting lipids followed by hydration of the lipid layer. We demonstrate that hybrid lipid polymer films can be formed with different properties compared with the neat lipid LC layers. The nanostructure and morphologies of the lipid films formed reflect those in the bulk. Most notably, mixed lipid layers, which are composed of glycerol monooleate and diglycerol monooleate with poly(
N
-isopropylacrylamide) nanogels, can form films of reverse cubic phases that are capable of responding to temperature stimulus. Owing to the presence of the nanogel particles, changing the temperature not only regulates the hydration of the cubic phase lipid films, but also the lateral organization of the lipid domains within the lipid self-assembled film. This opens up the possibility for new nanostructured materials based on lipid–polymer responsive layers.
Imaging optical scattering of butterfly wing scales with a microscope
Authors: Fu Jinxin , Yoon Beom-Jin , Park Jung Ok , Srinivasarao Mohan
Published: June 2017

A new optical method is proposed to investigate the reflectance of structurally coloured objects, such as
Morpho
butterfly wing scales and cholesteric liquid crystals. Using a reflected-light microscope and a digital single-lens reflex (DSLR) camera, we have successfully measured the two-dimensional reflection pattern of individual wing scales of
Morpho
butterflies. We demonstrate that this method enables us to measure the bidirectional reflectance distribution function (BRDF). The scattering image observed in the back focal plane of the objective is projected onto the camera sensor by inserting a Bertrand lens in the optical path of the microscope. With monochromatic light illumination, we quantify the angle-dependent reflectance spectra from the wing scales of
Morpho rhetenor
by retrieving the raw signal from the digital camera sensor. We also demonstrate that the polarization-dependent reflection of individual wing scales is readily observed using this method, using the individual wing scales of
Morpho cypris
. In an effort to show the generality of the method, we used a chiral nematic fluid to illustrate the angle-dependent reflectance as seen by this method.