bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of rectangular beam folded waveguide traveling-wave tube for terahertz radiation
Authors: Lu Fengying , Zhang Changqing , Grieser Manfred , Wang Yong , Lü Suye , Zhao Guohui
Published: October 2017

To gain higher power with a lower cathode current density and a simpler structure, a novel rectangular beam folded waveguide traveling-wave tube (RB-FW-TWT) operating at 220 GHz is proposed and analyzed in this paper and compared with the normal circular beam (CB) FW TWT. The dispersion characteristic was investigated based on an equivalent circuit model. The interaction impedance and the S-parameter of a RB-FW traveling-wave tube were analyzed by numerical simulations. A 3-D particle-in-cell code CST particle studio was introduced to analyze the performance of RB-FW TWT. The influence of the initial electron energy, frequency, input power, guiding magnetic field, and aspect ratio of the RB tunnel on the circuit performance was observed, and physical explanations were given. It reveals that the output power of RB-FW can reach 51.1 dBm, 8.4% dBm higher than a CB-FW, with a 3 dB bandwidth of 35 GHz when the beam voltage and current are set to 14.25 kV and 140 mA, respectively. An aspect ratio of 0.4 is recommended to optimize the high-frequency properties and circuit performance.
Excitation variance matching with limited configuration interaction expansions in variational Monte Carlo
Authors: Robinson Paul J. , Pineda Flores Sergio D. , Neuscamman Eric
Published: October 2017

In the regime where traditional approaches to electronic structure cannot afford to achieve accurate energy differences via exhaustive wave function flexibility, rigorous approaches to balancing different states’ accuracies become desirable. As a direct measure of a wave function’s accuracy, the energy variance offers one route to achieving such a balance. Here, we develop and test a variance matching approach for predicting excitation energies within the context of variational Monte Carlo and selective configuration interaction. In a series of tests on small but difficult molecules, we demonstrate that the approach is effective at delivering accurate excitation energies when the wave function is far from the exhaustive flexibility limit. Results in C3, where we combine this approach with variational Monte Carlo orbital optimization, are especially encouraging.
A spinner magnetometer for large Apollo lunar samples
Authors: Uehara M. , Gattacceca J. , Quesnel Y. , Lepaulard C. , Lima E. A. , Manfredi M. , Rochette P.
Published: October 2017

We developed a spinner magnetometer to measure the natural remanent magnetization of large Apollo lunar rocks in the storage vault of the Lunar Sample Laboratory Facility (LSLF) of NASA. The magnetometer mainly consists of a commercially available three-axial fluxgate sensor and a hand-rotating sample table with an optical encoder recording the rotation angles. The distance between the sample and the sensor is adjustable according to the sample size and magnetization intensity. The sensor and the sample are placed in a two-layer mu-metal shield to measure the sample natural remanent magnetization. The magnetic signals are acquired together with the rotation angle to obtain stacking of the measured signals over multiple revolutions. The developed magnetometer has a sensitivity of 5 × 10−7 Am2 at the standard sensor-to-sample distance of 15 cm. This sensitivity is sufficient to measure the natural remanent magnetization of almost all the lunar basalt and breccia samples with mass above 10 g in the LSLF vault.
Semiconducting carbon nanotube network thin-film transistors with enhanced inkjet-printed source and drain contact interfaces
Authors: Lee Yongwoo , Yoon Jinsu , Choi Bongsik , Lee Heesung , Park Jinhee , Jeon Minsu , Han Jungmin , Lee Jieun , Kim Yeamin , Kim Dae Hwan , Kim Dong Myong , Choi Sung-Jin
Published: October 2017

Carbon nanotubes (CNTs) are emerging materials for semiconducting channels in high-performance thin-film transistor (TFT) technology. However, there are concerns regarding the contact resistance (Rcontact) in CNT-TFTs, which limits the ultimate performance, especially the CNT-TFTs with the inkjet-printed source/drain (S/D) electrodes. Thus, the contact interfaces comprising the overlap between CNTs and metal S/D electrodes play a particularly dominant role in determining the performances and degree of variability in the CNT-TFTs with inkjet-printed S/D electrodes. In this work, the CNT-TFTs with improved device performance are demonstrated to enhance contact interfaces by controlling the CNT density at the network channel and underneath the inkjet-printed S/D electrodes during the formation of a CNT network channel. The origin of the improved device performance was systematically investigated by extracting Rcontact in the CNT-TFTs with the enhanced contact interfaces by depositing a high density of CNTs underneath the S/D electrodes, resulting in a 59% reduction in Rcontact; hence, the key performance metrics were correspondingly improved without sacrificing any other device metrics.
Spin transport through a junction entirely consisting of molecules from first principles
Authors: Wang Huan , Zhou Jia , Liu Xiaojie , Yao Chengbao , Li Hua , Niu Li , Wang Yin , Yin Haitao
Published: October 2017

Using first-principles calculations based on density functional theory combined with the nonequilibrium Green's function formalism, we studied the spin transport through a single molecular junction which consists of a single 1,4-benzenedithiolate (BDT) molecule and two ferromagnetic electrodes [(Ge5)Fe]∞. A large magnetoresistance ratio (MR) of 21100% was found in the [(Ge5)Fe]∞-BDT-[(Ge5)Fe]∞ molecular junction at small bias voltage, and the MR value decreased with the increase in the applied bias voltage. For the parallel magnetization configuration, the molecular junction showed outstanding spin injection effects. Negative differential resistance was observed for the antiparallel magnetization configuration. Spin dependent transmission spectra at different bias voltages were used to explain the calculated results.
Mapping-by-sequencing enabled fast forward genetics in crops with complex genomes.
Authors: Zhu QianHao Zhu QianHao , Wilson I. , Llewellyn D.
Published: October 2017

Forward genetics is an approach that applies mutants to identify genes responsible for a mutant phenotype, and is traditionally achieved using map-based cloning, a time-consuming multistep procedure, particularly for crops with complex genomes that usually lack high-quality genetic maps with high-density markers. Next-generation sequencing (NGS) technologies are now providing tools for the identification of an unprecedented number of genetic markers to overcome this limitation. In combination with bulk segregant analysis, NGS-based strategies are able to identify causal mutations in a single step that combines together marker identification and mutation mapping. Since the first report on gene identification using this mapping-by-sequencing (MBS) approach in Arabidopsis, MBS has been expanded to many other plant species to identify not only point mutations, but also deletion mutations thanks to the development and application of novel strategies. Here, we summarize the most recent progress on MBS-based fine-mapping and identification of causal mutations in plants, with a focus on crops with large and complex genomes.
IPM for tropical crops: rice.
Authors: Heinrichs E. A. , Rangaswamy Muniappan Rangaswamy Muniappan
Published: October 2017

Rice is a staple food and the foundation of national stability and economic growth in many developing countries. Rice pests are major biotic constraints limiting rice production globally. This review discusses the biology, ecology, global distribution and plant damage and yield losses caused by insect pests, plant diseases, nematodes, rats and weeds. The interactions among insects, weeds and diseases are discussed. A proposed conceptual framework for arthropod pest management in organic crop production is explained. In this framework, arthropod pest management strategies are classified into four 'phases'. The framework prioritizes pest management options that will prevent damaging levels of pests (phase 1 and 2) and minimize the need for curative actions (phases 3 and 4). We adopt and modify this conceptual framework to structure a discussion on various rice pest management options in rice ecosystems. A detailed package of practices for managing rice pests is given. The relative efficiencies of the Farmers Field Schools and mass media campaigns in transferring IPM technology to rice farmers are discussed.
Agriculture in the Fertile Crescent: continuity and change under climate change.
Authors: Jaradat A. A.
Published: October 2017

The Fertile Crescent (FC) is a high biodiversity region where most temperate-zone agricultural species originated and were first domesticated. A favourable environment, a special plant community and an adaptive population combined to initiate the transition from a hunter-gatherer economy to one based on agriculture and food production in the Fertile Crescent. However, over time, valuable plant genetic resources of the region are being eroded through degradation of natural habitats, intensification of the cultivation of arable lands, expansion of cultivation into marginal areas, replacement of diverse and widely adapted landraces by new cultivars based on a narrow genetic base, and over-exploitation of natural pastures and grazing lands. There is a serious risk that much of the inherent biodiversity will be lost unless a holistic approach to the management of ecosystems, based on sustainable agriculture and sustainable development, is implemented. Water scarcity is the key environmental factor and a major constraint to economic and social development in the Fertile Crescent. Inefficient and inequitable use of water is at the root of many problems in the region, and yet, effective solutions remain elusive. With 75% of water demand covered by virtual water imports, this region became the world's fastest in its dependence on imported food; such imports will remain, for the foreseeable future, the main option for adaptation to climate change. Climate change is expected to further reduce water availability; while water quality is a growing concern due to chemical pollution and soil salinity in irrigated lands. As the ancient FC was a cultural forerunner in solving the management problems of affluent agricultural societies, it might become a testing ground for managing water scarcity and depleted natural resources. Possible reorientation of agriculture, although very important but not a trivial challenge, will shape the welfare of its people for generations.
Microstructures and ion-irradiation behaviour of friction stir welded 12Cr-ODS steel
Authors: Guo Y. H. , Chang Y. Q. , Zhang J. , Li J. Z. , Ukai S. , Wan F. R.
Published: October 2017

12Cr oxide dispersion strengthened steel was successfully joined by friction stir welding (FSW), and the joints were irradiated with 3 MeV Au ions at 500°C. The morphology of grains, dislocations, sizes and distributions of nano-sized oxide particles (NPs) in different zones of the FSW joints were analysed. It was found severe plastic deformation occurred and fine equixed grains were formed in stir zone (SZ). The NPs coarsen obviously in thermal-mechanically affected zone (TMAZ) on advancing side (AS) due to the relative movements of plastic materials with high-velocity gradient. The size distributions of the NPs in base metal (BM), heat affected zone (HAZ) and RS-TMAZ are concentrated in a smaller range than those in SZ and AS-TMAZ. Finer grains and high density of dislocations result in hardness increasing obviously in SZ. Irradiation introduced higher hardening in HAZ because of its less grain boundaries and dislocation density compared with SZ and BM.
Promises, lies and the accountability trap. Evidence from a survey experiment in Armenia and Georgia
Authors: Turmanidze Koba
Published: October 2017

Lie a little or promise a lot is a question many politicians face when campaigning before elections. This paper examines whether voters support ambiguous pre-election promises in Armenia and Georgia using an experimental design and if so, what it tells us about accountability mechanisms and a potential accountability trap. The accountability trap emerges when voters cannot hold their elected officials accountable for their promises due to their ambiguity and become disillusioned with political participation. This paper looks at how voters’ expected political behaviour changes in response to randomly assigned types of electoral promises from a hypothetical party. I find a positive effect of ambiguity: if a party makes an ambiguous promise, it will do significantly better in Georgia and at least not worse in Armenia than a party promising a specific policy option. The effect of ambiguity partially explains why parties have been poor at putting forward coherent electoral programmes in Armenia and Georgia. More broadly, my findings contribute to understanding the problem of accountability in hybrid regimes, which may lead to representation crises.
A Sentence That Shaped the Modern World
Authors: Urban Greg
Published: October 2017

Tracking a single sentence as it moved around the globe, through space and across time, this essay examines the transformations it underwent, seeking to understand the motive force behind that movement and those transformations. The sentence in its various incarnations forms part of the constitutions of the majority of recognized nations on the planet. It encodes a key idea about the nature of the modern nation as a distinctive type of polity. At the same time, the motive force behind the movement may not be the power of that idea alone. Instead, the words in which it is encoded take on a thing-like quality, undergoing replication as they travel but also modification, such that the words become in effect emblems of a distinctive nation. The essay proposes that a “totemic force” impels this kind of motion, with the interest in being on a par with other nations stimulating recognizable similarities in wording, and the desire for distinctiveness vis-à-vis other nations simultaneously inspiring differences in wording.
Money Talk and Conduct from Cowries to Bitcoin
Authors: Agha Asif
Published: October 2017

What role do forms of money play in social life? What kinds of sociocultural variation do they exhibit? What variety of things do people do with varieties of money? How are activities involving money differentiated into registers of money conduct in specific times and places? How are specific forms of money conduct recognized and differentiated from other cultural routines by those who encounter them? It has long been understood that money is intimately linked to varied forms of discursive semiosis through which distinct forms of money are created and endowed with distinct use characteristics; that specific forms of money are readily linked to (or appropriated by) group-specific interests or ideologies; and that differences in types of money conduct readily differentiate social roles and relationships among persons and groups in social history. Yet the role of discursive semiosis in the existence and use of money is not well understood, a lacuna that links most descriptions of “money” to voicing structures (or discursive positionalities) that are not grasped for what they are by those who offer such descriptions (e.g., “speaking like the State” without knowing it). This article clarifies the role of discursive semiosis in the social life of money. It shows that such clarification is a prerequisite on ethnographic answers to the questions listed at the beginning of this abstract. It presents a comparative framework for reasoning about forms of money in forms of life.
Chronotopic Realignments and the Shifting Semiotics and Politics of Visibility in Brazilian Candomblé Activism
Authors: Hartikainen Elina I.
Published: October 2017

This article examines the shifting semiotics and politics of visibility in Brazilian Candomblé activism in the late 2000s in the city of Salvador. It analyses how the use of publicly salient discourses and signs of peace and antiviolence activism by activists from the African diasporic religion Candomblé reconfigured the religion’s practitioners public image from that of politically passive practitioners of “black magic” and self-sacrificing “black mothers” to that of politically active peace and antiviolence activists. I argue that this transformation was effected by a realignment of the general public’s chronotopic orientation toward the religion and its practitioners from a chronotope of concealment to one of political visibility. This shift in chronotopic orientation not only aligned Candomblé practitioners with the social persona of the politically engaged peace activist but also produced a new social persona of a religiously motivated “black mother of peace.”
Evaluation of Educational Offerings Associated with the 2014 Farm Bill
Authors: Ellison Brenna , Paulson Nicholas D , Taylor Mykel R , Tonsor Glynn T , Coppess Jonathan , Schnitkey Gary D
Published: October 2017

The 2014 Farm Bill required farmers and landowners to make a set of one‐time, irrevocable decisions lasting for the duration of the farm bill. The decisions included the choice between three program alternatives with uncertain payments. To aid in making those decisions, the farm bill funded two key educational efforts: (a) the development of two online decision tools and (b) additional funding to support land grant institutions and extension systems to educate farmers through more traditional extension mediums, particularly in‐person meetings. This paper provides an evaluation of both types of farm bill education through two case studies.
On control strategies for avoiding loss of information in non-destructive testing
Authors: Destuynder Philippe , Fabre Caroline
Published: October 2017

This study takes place in the framework of non-destructive testing. Based on energy invariants, one can derive boundary quantities which could help to detect damages in a structure. Since only a small part of a structure is equipped with sensors, a lot of information may be lost through the boundary where there is no sensor. In this article, we study several control strategies in order to focus most of the information contained in the energy invariant used, to the sensors.
Spontaneous chondroma formation in CD2-Cre-driven Erk-deficient mice
Authors: Shiokawa Moe , Lu Xiuyuan , Miyake Yasunobu , Ishikawa Eri , Pagès Gilles , Pouysségur Jacques , Ogata Masato , Yamasaki Sho
Published: October 2017

Lineage-specific Cre Tg mice are widely used to delineate the functions of genes in a tissue-specific manner. Several T-cell-specific promoter cassettes have been developed; however, the activities of those promoters in non-T cells have not been investigated extensively. Here, we report that CD2-Cre-mediated deletion of Erk proteins by generating CD2-Cre × Erk1–/–Erk2flox/flox (Erk∆CD2-Cre) mice results in abnormal cartilage hyperplasia. Histological analysis revealed that this abnormality is caused by aberrant hyperplasia of chondrocytes. The presence of Erk-deficient T cells is not required for this chondroma formation, as it was similarly observed in the absence of T cells in a CD3ε-deficient background. In addition, adoptive transfer of bone marrow cells from Erk∆CD2-Cre mice to wild-type recipients did not cause chondroma formation, suggesting that Erk-deficient non-immune cells are responsible for this abnormality. By tracing Cre-expressed tissues using a ROSA26-STOP-RFP allele, we found that the chondroma emitted RFP fluorescence, indicating that functional Cre is expressed in hyperplastic chondrocytes in Erk∆CD2-Cre mice. Furthermore, RFP+ chondrocytes were also found in an Erk-sufficient background, albeit without aberrant growth. These results suggest that unexpected expression of CD2-driven Cre in chondrocytes generates Erk-deficient chondrocytes, resulting in hyperplastic cartilage formation. Recently, two independent reports showed that CD4-Cre-mediated Ras-Erk signaling ablation led to similar abnormal cartilage formation (Guittard, G., Gallardo, D. L., Li, W. et al. 2017. Unexpected cartilage phenotype in CD4-Cre-conditional SOS-deficient mice. Front. Immunol. 8:343; Wehenkel, M., Corr, M., Guy, C. S. et al. 2017. Extracellular signal-regulated kinase signaling in CD4-expressing cells inhibits osteochondromas. Front. Immunol. 8:482). Together with these reports, our study suggests that an unexpected link exists between T-like cell and chondrocyte lineages during ontogeny.
A Staged Protocol for Circumferential Minimally Invasive Surgical Correction of Adult Spinal Deformity
Authors: Anand Neel , Kong Christopher , Fessler Richard G
Published: October 2017

BACKGROUND

Minimally invasive surgery (MIS) techniques used for management of adult spinal deformity (ASD) aim to decrease the physiological demand on patients and minimize postoperative complications. A circumferential MIS (cMIS) protocol offers the potential to maximize this advantage over standard open approaches, through the concurrent use of multiple MIS techniques.

OBJECTIVE

To demonstrate through a case example the execution of a cMIS protocol for management of an ASD patient with severe deformity.

METHODS

Thorough preoperative assessment, surgical planning, and medical optimization were completed. Deformity correction was performed over 2 stages. During the first stage, interbody fusion was performed via an oblique lateral approach at all levels of the lumbar spine intended to be included in the final construct. The patient was kept as an inpatient and mobilized postoperatively. They were then re-imaged with standing films. The second stage occurred after 3 d and involved percutaneous instrumentation of all levels. Posterior fusion of the thoracic levels was achieved through decortication of pars and facets. These areas were accessed through the intermuscular plane established by the percutaneous screws. The patient was mobilizing on their first postoperative day.

RESULTS

In a 66-yr-old female with severe sagittal imbalance and debilitating back pain, effective use of this cMIS protocol allowed for correction of the Cobb angle from 52° to 4° correction of spinopelvic parameters and 13 cm of sagittal vertical axis improvement. No complications were identified by 2 yr postoperative.

CONCLUSION

As a systematization of multiple MIS techniques combined, in a specific and staged manner, this cMIS protocol could provide a safe and effective approach to the management of ASD.
The Effect of Surgical Start Time on Complications Associated With Neurological Surgeries
Authors: Linzey Joseph R , Burke James F , Sabbagh M Amr , Sullivan Stephen , Thompson B Gregory , Muraszko Karin M , Pandey Aditya S
Published: October 2017

BACKGROUND

Neurosurgical procedures are necessary at all times of day. Other surgical specialties have examined the effect of surgical start time (SST) on morbidity and mortality; however, a similar study has not been performed for neurosurgical procedures.

OBJECTIVE

To perform a retrospective cohort study describing the association between SST and operative morbidity.

METHODS

We analyzed all patients undergoing neurological surgery between January 1, 2007 and August 1, 2014 at our institution. This study included 15 807 patients. A total of 785 complications were identified through the self-reported morbidity and mortality reports created by faculty and resident neurosurgeons. We used multilevel logistic regression to investigate the association of SST with morbidity.

RESULTS

In multilevel logistic regression, our Baseline model demonstrated that the odds of complication increased by more than 50% for start times between 21:01 and 07:00 (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.03-2.29, P = .04). When accounting for the length of the surgery, the odds of a complication were even greater for later time periods 21:01 to 07:00 (OR 2.16, 95% CI 1.44-3.23, P < .001). The only statistically significant factor that predicted severity of the complication was if the operation was emergent compared to elective (OR 1.70, 95% CI 1.11-2.60, P = .02). An SST between 21:01 and 07:00 substantially contributed when severe complications were isolated (OR 1.61, 95% CI 1.50-2.90, P = .08).

CONCLUSION

Patients with SSTs between 21:01 and 07:00 are at an increased risk of developing morbidity compared to patients with an SST earlier in the day.
Recovery Kinetics of Radiographic and Implant-Related Revision Patients Following Adult Spinal Deformity Surgery
Authors: Passias Peter G , Jalai Cyrus M , Lafage Virginie , Poorman Gregory W , Vira Shaleen , Horn Samantha R , Scheer Justin K , Hamilton D Kojo , Line Breton G , Bess Shay , Schwab Frank J , Ames Christopher P , Burton Douglas C , Hart Robert A , Klineberg Eric O
Published: October 2017

BACKGROUND

Prior studies have observed similar health-related quality of life (HRQL) in revisions and nonrevision (NR) patients following adult spinal deformity (ASD) correction. However, a novel comparison approach may allow better comparisons in spine outcomes groups.

OBJECTIVE

To determine if ASD revisions for radiographic and implant-related complications undergo a different recovery than NR patients.

METHODS

Inclusion: ASD patients with complete HRQL (Oswestry Disability Index, Short-Form-36 version 2 (SF-36), Scoliosis Research Society [SRS]-22) at baseline, 6 wk, 1 yr, 2 yr. Generated revision groups: nonrevision (NR), revised-complete data (RC; with follow-up 2 yr after revision), and revised-incomplete data (RI; without 2-yr follow-up after revision). In a traditional analysis, analysis of variance (ANOVA) compared baseline HRQLs to follow-up changes. In a novel approach, integrated health state was normalized at baseline using area under curve analysis before ANOVA t-tests compared follow-up statuses.

RESULTS

Two hundred fifty-eight patients were included with 50 undergoing reoperations (19.4%). Rod fractures (n = 15) and proximal joint kyphosis (n = 9) were most common. In standard HRQL analysis, comparing RC index surgery and RC revision surgery HRQLS revealed no significant differences throughout the 2-yr follow-up from either the initial index or revision procedure. Using normalized HRQL/integrated health state, RI displayed worse scores in SF-36 Physical Component Score, SRS activity, and SRS appearance relative to NR (P < .05), indicating less improvement over the 2-yr period. RC were significantly worse than RI in SF-36 Mental Component Score, SRS mental, SRS satisfaction, and SRS total (P < .05).

CONCLUSION

ASD patients indicated for revisions for radiographic and implant-related complications differ significantly in their overall 2-yr recovery compared to NR, using a normalized integrated health state method. Traditional methods for analyzing revision patients' recovery kinetics may overlook delayed improvements.
Head and Neck: Skull Base Imaging
Authors: Hudgins Patricia A , Baugnon Kristen L
Published: October 2017

There are a myriad of head and neck pathologies that extend from the extracranial to the intracranial compartment, traversing the skull base, and knowledge of the imaging appearance of this pathology is critical to practicing neurosurgeons. This article reviews some of the important inflammatory or acquired head and neck pathology along the skull base, neoplastic skull base lesions, and the intracranial extension of head and neck malignancy. Focus will be on the relevant anatomy, appropriate imaging protocols to evaluate these processes, as well as the differentiating imaging findings on computed tomography and magnetic resonance imaging.
Novel Findings in Obstetric Brachial Plexus Palsy: A Study of Corpus Callosum Volumetry and Resting-State Functional Magnetic Resonance Imaging of Sensorimotor Network
Authors: Kislay Kishore , Devi Bhagavatula Indira , Bhat Dhananjaya Ishwar , Shukla Dhaval Prem , Gupta Arun Kumar , Panda Rajanikant
Published: October 2017

BACKGROUND

The response of the brain to obstetric brachial plexus palsy (OBPP) is not clearly understood. We propose that even a peripheral insult at the developmental stage may result in changes in the volume of white matter of the brain, which we studied using corpus callosum volumetry and resting-state functional magnetic resonance imaging (rsfMRI) of sensorimotor network.

OBJECTIVE

To study the central neural effects in OBPP.

METHODS

We performed an MRI study on a cohort of 14 children who had OBPP and 14 healthy controls. The mean age of the test subjects was 10.07 ± 1.22 yr (95% confidence interval). Corpus callosum volumetry was compared with that of age-matched healthy subjects. Hofer and Frahm segmentation was used. Resting-state fMRI data were analyzed using the FSL software (FMRIB Software Library v5.0, Oxford, United Kingdom), and group analysis of the sensorimotor network was performed.

RESULTS

Statistical analysis of corpus callosum volume revealed significant differences between the OBPP cohort and healthy controls, especially in the motor association areas. Independent t-test revealed statistically significant volume loss in segments I (prefrontal), II (premotor), and IV (primary sensory area). rsfMRI of sensorimotor network showed decreased activation in the test hemisphere (the side contralateral to the injured brachial plexus) and also decreased activation in the ipsilateral hemisphere, when compared with healthy controls.

CONCLUSION

OBPP occurs in an immature brain and causes central cortical changes. There is secondary corpus callosum atrophy which may be due to retrograde transneuronal degeneration. This in turn may result in disruption of interhemispheric coactivation and consequent reduction in activation of sensorimotor network even in the ipsilateral hemisphere.
Current State of the Surgical Treatment of Terminal Neuromas
Authors: Ives Graham C , Kung Theodore A , Nghiem Bao Tram , Ursu Daniel C , Brown David L , Cederna Paul S , Kemp Stephen W P
Published: October 2017

Painful terminal neuromas resulting from nerve injury following amputation are common. However, there is currently no universally accepted gold standard of treatment for this condition. A comprehensive literature review is presented on the treatment of terminal neuromas. Four categories of terminal neuroma surgical procedures are assessed: epineurial closure; nerve transposition with implantation; neurorrhaphy, and alternate target reinnervation. Significant patient and case studies are highlighted in each section, focusing on surgical technique and patient outcome metrics. Studies presented consisted of a PubMed search for “terminal neuromas,” without year limitation. The current available research supports the use of implantation into muscle for the surgical treatment of terminal neuromas. However, this technique has several fundamental flaws that limit its utility, as it does not address the underlying physiology behind neuroma formation. Regenerative peripheral nerve interfaces and targeted muscle reinnervation are 2 techniques that seem to offer the most promise in preventing and treating terminal neuroma formation. Both techniques are also capable of generating control signals which can be used for both motor and sensory prosthetic control. Such technology has the potential to lead to the future restoration of lost limb function in amputees. Further clinical research employing larger patient groups with high-quality control groups and reproducible outcome measures is needed to determine the most effective and beneficial surgical treatment for terminal neuromas. Primary focus should be placed on investigating techniques that most closely approximate the theoretically ideal neuroma treatment, including targeted muscle reinnervation and regenerative peripheral nerve interfaces.
Postmortem Autopsy-Confirmation of Antemortem [F-18]FDDNP-PET Scans in a Football Player With Chronic Traumatic Encephalopathy
Authors: Omalu Bennet , Small Gary W , Bailes Julian , Ercoli Linda M , Merrill David A , Wong Koon-Pong , Huang Sung-Cheng , Satyamurthy Nagichettiar , Hammers Jennifer L , Lee John , Fitzsimmons Robert P , Barrio Jorge R
Published: October 2017

Currently, only presumptive diagnosis of chronic traumatic encephalopathy (CTE) can be made in living patients. We present a modality that may be instrumental to the definitive diagnosis of CTE in living patients based on brain autopsy confirmation of [F-18]FDDNP-PET findings in an American football player with CTE. [F-18]FDDNP-PET imaging was performed 52 mo before the subject's death. Relative distribution volume parametric images and binding values were determined for cortical and subcortical regions of interest. Upon death, the brain was examined to identify the topographic distribution of neurodegenerative changes. Correlation between neuropathology and [F-18]FDDNP-PET binding patterns was performed using Spearman rank-order correlation. Mood, behavioral, motor, and cognitive changes were consistent with chronic traumatic myeloencephalopathy with a 22-yr lifetime risk exposure to American football. There were tau, amyloid, and TDP-43 neuropathological substrates in the brain with a differential topographically selective distribution. [F-18]FDDNP-PET binding levels correlated with brain tau deposition (rs = 0.59, P = .02), with highest relative distribution volumes in the parasagittal and paraventricular regions of the brain and the brain stem. No correlation with amyloid or TDP-43 deposition was observed. [F-18]FDDNP-PET signals may be consistent with neuropathological patterns of tau deposition in CTE, involving areas that receive the maximal shearing, angular–rotational acceleration–deceleration forces in American football players, consistent with distinctive and differential topographic vulnerability and selectivity of CTE beyond brain cortices, also involving midbrain and limbic areas. Future studies are warranted to determine whether differential and selective [F-18]FDDNP-PET may be useful in establishing a diagnosis of CTE in at-risk patients.
Management of Odontoid Fractures in the Elderly: A Review of the Literature and an Evidence-Based Treatment Algorithm
Authors: Iyer Sravisht , Hurlbert R John , Albert Todd J
Published: October 2017

Odontoid fractures are the most common fracture of the axis and the most common cervical spine fracture in patients over 65. Despite their frequency, there is considerable ambiguity regarding optimal management strategies for these fractures in the elderly. Poor bone health and medical comorbidities contribute to increased surgical risk in this population; however, nonoperative management is associated with a risk of nonunion or fibrous union. We provide a review of the existing literature and discuss the classification and evaluation of odontoid fractures. The merits of operative vs nonoperative management, fibrous union, and the choice of operative approach in elderly patients are discussed. A treatment algorithm is presented based on the available literature. We believe that type I and type III odontoid fractures can be managed in a collar in most cases. Type II fractures with any additonal risk factors for nonunion (displacement, comminution, etc) should be considered for surgical management. However, the risks of surgery in an elderly population must be carefully considered on a case-by-case basis. In a frail elderly patient, a fibrous nonunion with close follow-up is an acceptable outcome. If operative management is chosen, a posterior approach is should be chosen when fracture- or patient-related factors make an anterior approach challenging. The high levels of morbidity and mortality associated with odontoid fractures should encourage all providers to pursue medical co-management and optimization of bone health following diagnosis.
Reliable Identification of Benign Clinical Course in Aneurysmal Subarachnoid Hemorrhage: A Simple and Qualitative Algorithm
Authors: Duan Yifei , Wright James , Wright Christina , Shammassian Berje , Tatsuoka Curtis , Bambakidis Nicholas
Published: October 2017

BACKGROUND

A reliable method to specifically identify low vasospasm risk in aneurysmal subarachnoid hemorrhage (aSAH) patients has not been previously proposed.

OBJECTIVE

To develop a clinical algorithm using admission aSAH clinical severity and subarachnoid blood distribution to identify patients at low risk of clinical vasospasm.

METHODS

Clinical severities, admission noncontrasted head computerized tomography (CT) scan, and incidences of vasospasm among 291 aSAH patients treated at our institution were evaluated. Admission head CTs were assessed for distributions of cisternal and ventricular blood. Patients with the following 4 criteria experienced considerably lower risk of vasospasm: (1) Hunt Hess grade 1 to 2, (2) Lack of thick subarachnoid blood filling 2 adjacent cisterns, (3) Lack of thick interhemispheric blood, and (4) Lack of biventricular intraventricular hemorrhage.

RESULTS

One hundred thirty-three patients (45.7%) developed cerebral vasospasm. Hunt Hess grade greater than 2 (odds ratio [OR] 4.52, 95% confidence interval [CI] 2.74-7.46), adjacent cistern blood (OR 4.1, 95% CI 2.51-6.7), interhemispheric thick blood (OR 5.72, 95% CI 3.41-9.59), and biventricular intraventricular hemorrhage (OR 1.92, 95% CI 1.19-3.02) were significant risk factors. Application of our algorithm yielded a sensitivity of 29%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 54.5%, which was superior compared to metrics from current institutional practice criteria. Inter-rater agreement was substantial at mean kappa = 0.75.

CONCLUSION

Application of our novel clinical algorithm produced successful identification of aSAH patients who experience zero risk of clinical vasospasm. Our algorithm is simple to apply with high reliability and is superior to currently available clinical and radiographic metrics.
Meta-Analytic Modeling of the Decline in Performance of Fungicides for Managing Soybean Rust after a Decade of Use in Brazil
Authors: Dalla Lana Felipe , Paul Pierce A. , Godoy Claudia V. , Utiamada Carlos M. , da Silva Luís Henrique C. P. , Siqueri Fabiano V. , Forcelini Carlos A. , Jaccoud-Filho David de Souza , Miguel-Wruck Dulândula S. , Borges Edson P. , Juliatti Fernando C. , Campos Hercules D. , Nunes José , Carneiro Luciana C. , Canteri Marcelo G. , Ito Margarida F. , Meyer Maurício C. , Martins Mônica C. , Balardin Ricardo S. , Furlan Silvânia H. , Carlin Valtemir J. , Del Ponte Emerson M.
Published: October 2017

An apparent decline of fungicide performance for the control of soybean rust in Brazil has been reported but the rate at which it has occurred has not been formally quantified. Control efficacy and yield response to three fungicides applied as single active ingredients (a.i.)—azoxystrobin (AZOX), cyproconazole (CYPR), and tebuconazole (TEBU)—and four applied as mixtures—AZOX+CYPR, picoxystrobin + CYPR, pyraclostrobin + epoxiconazole, and trifloxystrobin + prothioconazole (TRIF+PROT)—were summarized using network meta-analytic models fitted to mean severity and yield data from 250 trials (10-year period). The effect of year was tested on both variables in a meta-regression model. Overall control efficacy ranged from 56 to 84%; the three single-a.i. fungicides performed the poorest (56 to 62%). Yield increase for single-a.i. fungicides was as low as 30% but ranged from 47 to 65% for the premixes. Significant declines in both variables were detected for all fungicides except TRIF+PROT. For TEBU, control efficacy (yield response) declined the most: 78% (18%) to 54% (8%) from 2004–05 to 2013–14. The recent surge of resistant populations of Phakopsora pachyrhizi to both demethylation inhibitor and quinone outside inhibitor fungicides is likely the driving force behind a significant decline after 4 years of fungicide use.
The Pain Course
Authors: Dear Blake F. , Courtney Catherine , Khor Kok Eng , McDonald Sarah , Ricciardi Tahlia , Gandy Milena , Fogliati Vincent J. , Titov Nick
Published: October 2017

Background:

This study examined the acceptability and preliminary outcomes of an internet-delivered pain management program, the Pain Course, when offered by a specialist pain management clinic in a large public hospital.

Methods:

A single-group feasibility open-trial design was used and 39 patients participated in the program, which ran for 8 weeks. Participants were supported through the program with weekly contact from a Clinical Psychologist at the clinic.

Results:

All participants provided data at posttreatment and >90% of participants completed all 5 lessons of the course. High levels of satisfaction were observed and relatively little clinician time (M=71.99 min/participant; SD=32.82 min) was required to support patients through the program. Preliminary evidence of clinical improvements in depression symptoms (avg. improvement=38%; Cohen d=0.74), but not disability levels or anxiety symptoms, was observed in the overall sample. However, evidence of improvements was observed across all the primary outcomes among patients who had clinical levels of difficulties with disability (n=20; avg. improvement=11%; Cohen d=0.64), depression (n=17; avg. improvement=35%; Cohen d=1.24) and anxiety (n=8; avg. improvement=29%; Cohen d=0.57).

Conclusions:

These findings highlight the potential value of internet-delivered programs when provided by specialist pain management clinics as a part of their services and the value of larger scale studies in this area.
Internet-Delivered Exposure Therapy for Fibromyalgia
Authors: Hedman-Lagerlöf Maria , Hedman-Lagerlöf Erik , Axelsson Erland , Ljótsson Brjánn , Engelbrektsson Johanna , Hultkrantz Sofia , Lundbäck Karolina , Björkander Daniel , Wicksell Rikard K. , Flink Ida , Andersson Erik
Published: October 2017

Background:

Fibromyalgia (FM) is a common and disabling chronic pain disorder, for which existing pharmacological and psychological treatments have yet yielded insufficient effects. Previous literature has shown that exposure therapy may be an effective treatment for chronic pain. This study constitutes the first randomized controlled trial evaluating exposure therapy for FM.

Methods:

A total of 140 participants with diagnosed FM were randomized to a 10-week Internet-delivered exposure treatment (iExp; n=70) or a waitlist control condition (WLC; n=70). Primary outcome measure were FM symptoms and impact, and secondary outcome measures were fatigue, disability, quality of life, pain-related distress and avoidance behaviors, insomnia, depression, and anxiety.

Results:

Data retention was high (100% data completion at posttreatment for primary outcome, 96% at 6-month follow-up and 94% at 12-month follow-up). Results showed that participants in the iExp group made large and superior improvements compared with WLC on FM symptoms and impact (B, −1.93; z, −10.14; P<0.001, between-group Cohen d=0.90), as well as all secondary outcomes (between-group Cohen d ranging from 0.44 to 1.38) with sustained results.

Conclusions:

We conclude that iExp seems to be an efficacious treatment for FM compared with no treatment, and the results also highlight the potential increase of accessibility by using the Internet format to deliver psychological treatments for these patients. Future trials with active control conditions are warranted.
Systematic Changes to Help Parentsof Medically Complex Infants Manage Medical Expenses
Authors: Carter Judith , Dwyer Noel , Roselund Julie , Cote Karen , Chase Phoebe , Martorana Kathleen , Gustafson Kathryn , Bergling Emily , Kamalia Radhika , DeGrazia Michele
Published: October 2017

Background:

Financial obligations serve as an added source of stress and burden for parents of medically complex infants that have extended hospitalizations in the neonatal intensive care unit. Financial resources and support personnel are available to assist parents, but systems must be in place to help access these services. When neonatal intensive care unit nurses work collaboratively with financial support personnel, they improve families' access to financial resources.

Purpose:

The purpose of this quality improvement initiative was to increase and facilitate timely parent referrals to health benefits coordinators (HBCs).

Methods/Search Strategy:

Utilizing the Plan-Do-Study Act framework, the hospital's current system for HBC referrals was revised utilizing 3 Plan-Do-Study Act cycles.

Findings/Results:

A substantial increase in the percentage of HBC referrals, from preimplementation of less than 5% to a sustained average of 90% was observed.

Implications for Practice:

A simple, sustainable screening process was successfully created to identify families with primary health insurance who qualified for coordination of benefits. This resulted in a significant increase in the number of HBC referrals. Minimal time is now required for the multidisciplinary team to ensure that parents, eligible for referral, are identified as soon as possible. Early identification and timely referral to the HBC may lessen the financial burden for families caring for children with medically complex long-term care needs by securing secondary insurance and other resources.

Implications for Research:

Research focused on the financial impact of the HBC role is needed.
Correlation of Functional Outcomes and Sagittal Alignment After Long Instrumented Fusion for Degenerative Thoracolumbar Spinal Disease
Authors: Yeh Kuang-Ting , Lee Ru-Ping , Chen Ing-Ho , Yu Tzai-Chiu , Liu Kuan-Lin , Peng Cheng-Huan , Wang Jen-Hung , Wu Wen-Tien
Published: October 2017

Study Design.

A retrospective function and radiography study of the patients who have received long instrumented thoracolumbar fusion.

Objective.

To investigate the correlation between the sagittal spinopelvic alignment and the functional outcomes after long instrumented fusion for degenerative thoracolumbar spinal disease.

Summary of Background Data.

Restoring better sagittal alignment is known as a key factor to spine fusion surgeries. The relationship between function and radiographic results in the elderly group is barely known.

Methods.

Between 2009 and 2013, data of 120 patients with multilevel degenerative thoracolumbar spinal disease who underwent long instrumented fusion were collected retrospectively. Perioperative radiographic and functional parameters were measured and analyzed for their correlations. Receiver operating characteristic (ROC) method was used to define ideal cutoff points of postoperative spinopelvic alignment to avoid poor outcome.

Results.

Oswestry disability index (ODI) more than or equal to 20 or Visual analogue scale (VAS) more than or equal to 4 were defined as poor functional outcomes. The optimal cutoff points of the radiographic parameters were found as below: the mismatch between pelvic incidence and lumbar lordosis was 16.2°, sagittal vertical axis was 38.5 mm, and pelvic tilt was 23.4°. Poor functional outcomes were significantly correlated with bad sagittal alignment, older age, and poor preoperative function.

Conclusion.

Postoperative functional outcomes were highly impacted by the spinopelvic sagittal alignment.

Level of Evidence: 4