bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of natural radioactivity levels and the associated radiological hazards in some building materials from Mayo-Kebbi region, Chad
Authors: Penabei S. , Bongue D. , Maleka P. , Dlamini T. , Saïdou  , Guembou Shouop C.J. , Halawlaw Y.I. , Ngwa Ebongue A. , Kwato Njock M.G.
Published: October 2018

In order to assess the levels of natural radioactivity and the associated radiological hazards in some building materials of the Mayo-Kebbi region (Chad), a total of nineteen samples were collected on the field. Using a high resolution γ-ray spectrometry system, the activity concentrations of radium (226Ra), thorium (232Th) and potassium (40K) in these samples have been determined. The measured average activity concentrations range from 0.56 ± 0.37 Bq kg−1 to 435 ± 7 Bq kg−1, 1.3 ± 0.6 Bq kg−1 to 50.6 ± 1.1 Bq kg−1 and 4.3 ± 2.0 Bq kg−1 to 840 ± 9 Bq kg−1, for 226Ra, 232Th and 40K, respectively. The highest 226Ra average activities is found in soil brick samples of Zabili. The highest mean value of 232Th and 40K concentrations are found in soil brick samples of Madajang. The activity concentration and the radium equivalent activity (Raeq) have been compared to other studies done elsewhere in the world. Their average values are lower than most of those of countries with which the comparison has been made. Were also evaluated, the external radiation hazard index, the internal radiation hazard index, the indoor air absorbed dose rate, the outdoor air absorbed dose rate, the activity utilization index, the annual effective dose, the annual gonadal dose equivalent, the representative level index, as well as, the excess lifetime cancer risk. In accordance with the criterion of the Organization for Economic Cooperation and Development, our results show that soil brick samples of Zabili and Madajang increases the risk of radiation exposure, thereby the possibility of developing cancer by people living in this environment. Based on these findings, brick samples from Zabili and Madajang are not recommended for construction purposes. All other sample materials have properties that are acceptable for use as building materials in terms of radiation hazard.
Wartelistenführung und Organvermittlung zur Lungentransplantation 2018 – Aktuelles für den Pneumologen
Authors: Kümmel A. , Witt C. , Schramm R. , Wenker M. , Buhl R. , Gottlieb J.
Published: October 2018

Die gesetzliche Grundlage der Allokation und Wartelistenführung zur Lungentransplantation wurde 2017 novelliert. Durch die aktuelle Richtlinie ergeben sich für die Transplantationszentren wichtige Änderungen. Wesentliche Neuerungen der Richtlinie betreffen die Transplantationskonferenz, die Indikationen zum Verfahren und die Führung der Warteliste zur Organtransplantation. In bestimmten klinischen Konstellationen ist die Aufnahme von Patienten nun beschränkt, und es gibt neue Regeln zur Größenkompatibilität von Spenderlunge und Empfänger. Zudem wird im Detail beschrieben, wie die Parameter, die dem Lung Allocation Score (LAS) zugrunde liegen, definiert sind inkl. der Durchführung der hierfür notwendigen Untersuchungen. Darüber hinaus gibt der vorliegende Artikel einen Überblick über die Organzuteilung durch die Vermittlungsstelle.
Oophoropexy to the Round Ligament after Recurrent Adnexal Torsion
Authors: Gonçalves Inês Sarmento , Sampaio Joana , Félix Joana , Silva Ana Catarina , Fornelos Gisela , Silva Pedro Tiago
Published: October 2018

Recurrent adnexal torsion is a rare gynecological emergency. We report a case of recurrent ipsilateral adnexal torsion in a woman with polycystic ovaries, previously submitted to a laparoscopic plication of the utero-ovarian ligament. Due to the recurrence after the plication of the utero-ovarian ligament, the authors performed a laparoscopic oophoropexy to the round ligament, which is an underreported procedure. The patient was asymptomatic for 1 year, after which she had a new recurrence and needed a unilateral laparoscopic adnexectomy. Since then, she regained the quality of life without any gynecological symptoms.

Oophoropexy to the round ligament may be considered when other techniques fail or, perhaps, as a first option in selected cases of adnexal torsion, as it may allow the prevention of recurrence without increasing morbidity while preserving the adnexa.
Anatomopathological Assessment of the Diaphragm in Formalin-Fixed, Paraffin-Embedded Sections
Authors: Nucci Ricardo , Jacob-Filho Wilson , Busse Alexandre , Maifrino Laura , de Souza Romeu
Published: October 2018

Introduction The analysis of frozen muscle biopsies has become a routine method in the evaluation of muscle structure in health and disease. However, the technique for frozen muscle specimens is not widely available in countries with limited medical facilities. The present study aimed to elucidate a reproducible formalin-fixed and paraffin-embedded (FFPE) method for this type of analysis in postmortem muscles.

Methods Diaphragm muscle was obtained within 1 hour of sudden death. Diaphragm strips were washed in saline solution, fixed in 10% formalin, frozen at 4°C in a refrigerator, and stored for 24 hours. Then, the tissue samples were processed into paraffin-embedded blocks. Transversal sections were cut from each paraffin block and stained with hematoxylin and eosin, Picrosirius red, Verhoeff-Van Gieson, and Congo red for the qualitative analysis.

Results Our analysis indicated a well-preserved muscle.

Conclusion In summary, we demonstrate a simple technique for a reproducible FFPE method in postmortem muscle tissues.
Fetal Noncompaction Cardiomyopathy and Histologic Diagnosis of Spongy Myocardium: Case Report and Review of the Literature
Authors: Nappi Luigi , Vasciaveo Lorenzo , Sorrentino Felice , Scutiero Gennaro , Iannone Piergiorgio , Greco Pantaleo
Published: October 2018

Noncompaction cardiomyopathy (NCCM) and left ventricular noncompaction (LVNC), in their isolated form, are rare cardiomyopathies. They are characterized by a thickened myocardium due to the presence of deep trabeculae recesses, and to thick trabeculae. This condition is associated with a variable clinical phenotype including heart failure, thromboembolism, and sudden death. We report a case of LVNC at 26 weeks and 4 days of gestation revised on the basis of what is currently reported in the literature. A review of the literature was performed to better describe this rare condition. Left ventricular noncompaction is a rare fetal condition and it should be suspected in case of cardiomyopathy.
Measurement of apparent ion temperature using the magnetic recoil spectrometer at the OMEGA laser facility
Authors: Gatu Johnson M. , Katz J. , Forrest C. , Frenje J. A. , Glebov V. Yu. , Li C. K. , Paguio R. , Parker C. E. , Robillard C. , Sangster T. C. , Schoff M. , Séguin F. H. , Stoeckl C. , Petrasso R. D.
Published: October 2018

The Magnetic Recoil neutron Spectrometer (MRS) at the OMEGA laser facility has been routinely used to measure deuterium-tritium (DT) yield and areal density in cryogenically layered implosions since 2008. Recently, operation of the OMEGA MRS in higher-resolution mode with a new smaller, thinner (4 cm2, 57 μm thick) CD2 conversion foil has also enabled inference of the apparent DT ion temperature (Tion) from MRS data. MRS-inferred Tion compares well with Tion as measured using neutron time-of-flight spectrometers, which is important as it demonstrates good understanding of the very different systematics associated with the two independent measurements. The MRS resolution in this configuration, ΔEMRS = 0.91 MeV FWHM, is still higher than that required for a high-precision Tion measurement. We show how fielding a smaller foil closer to the target chamber center and redesigning the MRS detector array could bring the resolution to ΔEMRS = 0.45 MeV, reducing the systematic Tion uncertainty by more than a factor of 4.
Is dynamic desaturation better than a static index to quantify the mortality risk in heart failure patients with Cheyne-Stokes respiration?
Authors: Granitza Philine , Kraemer Jan F. , Schoebel Christoph , Penzel Thomas , Kurths Jürgen , Wessel Niels
Published: October 2018

Cheyne-Stokes respiration (CSR) is a periodic, highly dynamic, respiratory pattern and a known comorbidity in congestive heart failure (CHF) patients. It is generally seen as an indicator for a negative prognosis, even if no distinction in degree is known or understood. This paper aims to improve on existing attempts by creating a quantification of the behavior of the dynamic desaturation process of oxygen in the blood. We performed this work on a cohort of 11 subjects with CHF, reduced left ventricular ejection fraction, and CSR. The dynamic desaturation process was evaluated according to changes to peripheral capillary oxygenation SpO2 resulting from highly nonlinear relationships in the ventilatory system perturbed by periodic breathing. Hypoxaemic burden expressed as a static index T90 was compared to a novel relative desaturation index RDI, developed in this paper. While T90 represents a single value calculated using a static cut-off value of 90% SpO2, the RDI is more sensitive to dynamic influences as it uses the specific maximum change in saturation for each CSR episode. The threshold of T90=22minper night as suggested by Oldenburg et al. could not be confirmed to predict survival, but all central apneas resulting in a relative desaturation of SpO2 above a cut-off value of 8% were a 100% positive predictor of mortality. The RDI proved sufficiently stable in intraindividual measurements across CSR epochs. Across the cohort, it showed a bimodal distribution for the deceased group, indicative of a possible aetiological difference. Hence, it is our conclusion that a dynamic approach to analyse desaturation of oxygen during Cheyne-Stokes respiration is to be strongly favoured over a static approach to analysis.
Nonlinear transition from convective to absolute Raman instability with trapped electrons and inflationary growth of reflectivity
Authors: Wang Y. X. , Wang Q. , Zheng C. Y. , Liu Z. J. , Liu C. S. , He X. T.
Published: October 2018

We propose a nonlinear mechanism for transition from convective to absolute in stimulated Raman backscattering instability due to the effect of trapped particles in the plasma wave. Convective instability saturates at the low level, yet it is sufficient to trap electrons near the plasma phase velocity. The trapped electrons tend to flatten the distribution function. With spatial averaging over the trapped region, we find that the flattened distribution function reduces the damping rate due to bounce resonance of the plasma wave and then decreases the threshold for absolute instability. So the transition from a weak, convective instability to a strong, absolute instability can occur, leading to exponential growth everywhere and inflation of reflectivity of several orders of magnitude as observed in the experiment, once the threshold is exceeded.
Gate leakage mechanisms in normally off p-GaN/AlGaN/GaN high electron mobility transistors
Authors: Xu Ning , Hao Ronghui , Chen Fu , Zhang Xiaodong , Zhang Hui , Zhang Peipei , Ding Xiaoyu , Song Liang , Yu Guohao , Cheng Kai , Cai Yong , Zhang Baoshun
Published: October 2018

In this letter, gate leakage mechanisms in different gate contact normally off p-GaN/AlGaN/GaN high electron mobility transistors (HEMTs) have been studied by the temperature-dependent current-voltage (IG-VG) measurement. It is found that two-dimensional variable range hopping is responsible for gate leakage current at the reverse gate bias and low forward gate bias in both high-leakage and low-leakage Schottky gate contact devices. At high forward gate bias, in the case of high-leakage Schottky contact, the dominant current conduction mechanism is found to be thermionic field emission while it is Poole–Frenkle emission (PFE) for the case of low-leakage Schottky contact and the activation energy of trap states for PFE current is derived as 0.6 eV. Besides, related models are also proposed to describe the gate leakage current in p-GaN gate HEMTs and they match well with the experimental gate leakage current within a wide range of temperatures and gate biases.
A thermoacoustic imaging system with variable curvature and multi-dimensional detection adapted to breast tumor screening
Authors: Zhao Yan , Ji Zhong , Qin Baohua , Xing Da
Published: October 2018

Microwave-induced thermoacoustic (TA) imaging is efficient in detecting anomalous absorption areas, especially breast tumors. The operation of previous imaging systems has generally suffered from complexity, and early-stage tumors could be missed because of signal loss. In this paper, we report a variable-curvature and multi-dimensional screening method realized by combining a redesigned adaptive algorithm and an integrated TA breast screening system (ITBCS) comprising a flexible detector and a traction device designed for multi-axis rotation. In contrast to conventional TA imaging systems, the proposed system improves the ability to identify early-stage breast tumors, with a simplified system and operational process. Variable curvature is achieved by the flexible characteristics of the detector, which achieves good shape adaptation between the tissue and the detector. Moreover, multi-dimensional scanning is achieved by the multi-axis traction device and meets the requirements for angle transformation and dynamic imaging. The experimental results indicate that ITBCS exhibits a good performance in detecting breast tumors. Faster screening makes inspection more efficient, thereby improving clinical applicability and providing a convenient facility for large-scale physical examination.
Carbon nanotube/zirconia composite-coated separator for a high-performance rechargeable lithium–sulfur battery
Authors: Liu Bin , Wang Shan , Wu Xiaomeng , Liu Zhikang , Gao Zhaodongfang , Li Chuanbin , Yang Quanling , Hu Guo-Hua , Xiong Chuanxi
Published: October 2018

The shuttle effect caused by polysulfides remains a major issue hindering the application of lithium–sulfur (Li-S) batteries. In this work, a composite of organically modified carbon nanotube (CNT) and zirconia (ZrO2) nanoparticles is synthesized and used as a surface coating on a commercial Celgard separator to restrain the shuttle effect and improve battery performance. Electrolyte uptake and water contact angle measurements show that the CNT/ZrO2 composite-coated separator has an enhanced electrolyte wettability. Thermal shrinkage results reveal an improvement in the stability of the coated separators, especially at high temperatures. Electrochemical measurements also show the effectiveness of the CNT/ZrO2 composite-coated separator in a Li–S battery. The initial discharge capacity is improved after coating, as is the capacity retention rate. In addition, a battery with a CNT/ZrO2 composite-coated separator attains an impressive capacity reversibility as high as 91.7% in a rate performance test from 0.1 to 2 C. The composite coating restrains the shuttle effect effectively and improves the thermal shrinkage properties of the separator. Thus, the use of a CNT/ZrO2 composite-coated separator should improve the prospects for practical application of Li–S batteries.
Ewald sum for hydrodynamic interactions of rigid spherical microswimmers
Authors: Adhyapak Tapan Chandra , Jabbari-Farouji Sara
Published: October 2018

We derive the Ewald sum decomposition of the grand mobility tensor which captures the hydrodynamic interactions in an infinite suspension of rigid spherical microswimmers. The grand mobility tensor connects the motion of an individual swimmer to the active and passive forces and torques acting on all the swimmers, and it is calculated based on a minimal microswimmer model incorporating the swimmers’ finite body size. Our results have direct applications to the Stokesian dynamics simulations of an infinite suspension of rigid-bodied microswimmers. They also provide a platform to develop more advanced methods such as particle-mesh-Ewald-sum and accelerated Stokesian dynamics simulations.
Superconductivity at 3.5 K and/or 7.2 K in potassium-doped triphenylbismuth
Authors: Wang Ren-Shu , Cheng Jia , Wu Xiao-Lin , Yang Hui , Chen Xiao-Jia , Gao Yun , Huang Zhong-Bing
Published: October 2018

We develop a two-step synthesis method—ultrasound treatment and low temperature annealing to explore superconductivity in potassium-doped triphenylbismuth, which is composed of one bismuth atom and three phenyl rings. The combination of dc and ac magnetic measurements reveals that one hundred percent of synthesized samples exhibit superconductivity at 3.5 K and/or 7.2 K at ambient pressure. The magnetization hysteresis loops provide a strong piece of evidence of type-II superconductors. It is found that the doped materials crystallize into the triclinic P1 structure, with a mole ratio of 4:1 between potassium and triphenylbismuth. Both the calculated electronic structure and measured Raman spectra indicate that superconductivity is realized by transferring electrons from the K-4s to C-2p orbital. Our study opens an encouraging window for the search of organic superconductors in organometallic molecules.
Distance readout of Al content with naked eyes on a cotton thread
Authors: Xu Chunxiu , Huang Wanjie , Zhu Shunying , Li Ziqi , Cai Longfei , Zhong Minghua
Published: October 2018

We described a facile method for distance-based detection of aluminum on a thread based on the adsorption of formed complex onto thread. Chrome azurol S (CAS) containing Cetyltrimethylammonium Bromide (CTMAB) were used as chromogenic reagent, which reacts with aluminum to form AL-CAS-CTMAB complex on a thread. The complex was adsorbed onto thread to generate a colored band. Aluminum contents could be quantified by measuring the length of colored band on the thread using a ruler, thereby eliminating the need for electronic readout devices and trained personnel. This instrument-free method has features of low cost, easy to operation, fast analysis speed, disposability and low reagents/sample consumption. Moreover, considering that the thread fiber has adsorption capability to various molecules such as metal-ligand complexes and biomolecules, we believe that this technique holds the potentials to be widely adaptable to distance-based chemical and biochemical analysis.
High energy storage performances in lead-free BaBi3.9Pr0.1Ti4O15 relaxor ferroelectric films
Authors: Chen Jieyu , Tang Zhehong , Yang Bo , Zhao Shifeng
Published: October 2018

Lead-free BaBi4-xPrxTi4O15 (BBPT) relaxor ferroelectric films were prepared by the sol−gel method. A giant recoverable energy storage density of 47.8 J/cm3 and a high efficiency of 66.45% are obtained in BaBi3.9Pr0.1Ti4O15 (BBPT10) films. Specifically, the energy utilization ratio reaches as high as 0.0373. After 1 × 109 cycles, both the energy storage density and the efficiency can still be perfectly maintained. Moreover, BBPT10 capacitors possess outstanding thermal stability of energy storage performance over a wide temperature range of −20 °C to 120 °C. The breakdown strength reaches 1285 kV/cm. Such superb energy storage performances are mainly attributable to strong relaxation behaviors of the layered perovskite structure derived from the lattice distortion and structural transformation. BBPT based films provide a exploring area of lead-free ferroelectric materials widely applicable in energy storage devices.
The multi-spectral imaging diagnostic
Authors: Linehan B. L. , Mumgaard R. T. , Wensing M. , Verhaegh K. , Andrebe Y. , Harrison J. R. , Duval B. P. , Theiler C. ,   TCV Team
Published: October 2018

The Multi-Spectral Imaging system is a new diagnostic that captures simultaneous spectrally filtered images from a common line of sight while maintaining a large étendue and high throughput. Imaging several atomic line intensities simultaneously may enable numerous measurement techniques. By making a novel modification of a polychromator layout, the MSI sequentially filters and focuses images onto commercial CMOS cameras while exhibiting minimal vignetting and aberrations. A four-wavelength system was initially installed and tested on Alcator C-Mod and subsequently moved to TCV. The images are absolutely calibrated and spatially registered enabling 2D mappings of atomic line ratios and absolute line intensities. The spectral transmission of the optical system was calibrated using an integrating sphere of known radiance. The images are inverted by cross-referencing points on TCV with a computer-aided design (CAD) model.
Thermodynamic favorability and pathway yield as evolutionary tradeoffs in biosynthetic pathway choice
Authors: Du Bin , Zielinski Daniel C. , Monk Jonathan M. , Palsson Bernhard O.
Published: October 2018

Significance

The metabolic diversity across the tree of life has become increasingly apparent with the growing availability of sequenced genomes and annotations. The basis for such metabolic diversity in organisms is not understood. Here, we evaluate alternative pathways in amino acid biosynthesis from a standpoint of tradeoff between thermodynamic favorability and cofactor-use efficiency. Using 5,203 sequenced genomes and available metabolic network reconstructions, we found evidence that this tradeoff affects pathway choice, which can be related to organism lifestyle. Given the fundamental importance of metabolism on organism survival and adaptation, such choices help us reveal the impact of selection pressures and may ultimately have fundamental implications for our understanding of the phylogenetic tree.
Re-reading Anscombe on ‘I’
Authors: Stainton Robert J.
Published: October 2018

According to a ‘Straight’ reading of Elizabeth Anscombe’s (1975) ‘The First Person’, she holds a radically non-referring view of ‘I’. Specifically, ‘I’ is analogous to the expletive ‘it’ in ‘It’s raining’. I argue that this is not her conclusion. Her substantive view, rather is that if what you mean by ‘reference’ is a certain rich and recherché notion tracing to Frege, then ‘I’ is not a referring term. Her methodological point is that one shouldn’t be ‘bewitched by language’ into thinking that ‘I’, because of its syntax, must exhibit ‘reference’ in this sense.
Increasing the representation of women in JGP to reduce bias and sexual harassment
Authors: Gordon Sharona E.
Published: October 2018

Sexual harassment has plagued academic science with too little progress over the last decades. A new report from the National Academies of Science, Engineering, and Medicine provides data and guidance for making real advances.
Energy Ecological Footprint Changes and Its Influencing Factors at the Provincial Scale in China
Authors: Wang Tao
Published: October 2018

The energy ecological footprint is an important theory and method for quantitative measurement of the coordinated development of the socio-economic-ecological environment. This research indicated the following: (1) the energy ecological footprints of China and the provinces showed significant linear increases (except Beijing). China’s economy developed rapidly over 1999-2015, but the economic development had a high dependence on energy consumption, which induced an increase in the energy ecological footprint. Optimizing industrial structure and reducing energy consumption are effective ways to reduce the energy ecological footprint. (2) Forest land was the most important land use type for per capita energy ecological footprint capacity, accounting for 50% or more of the total. The energy ecological footprints of China and the provinces were mainly in a state of deficit, and only Sichuan, Qinghai, Guangxi, Shaanxi, Inner Mongolia and Xinjiang were in surplus. In addition, the ecological pressure in the eastern developed provinces was higher than in the central provinces, and the lowest pressure was in the west. (3) The energy ecological footprint of China and the provinces was mainly affected by the secondary industry output value, followed by population, total investment in fixed assets, and then the tertiary and primary industry output values. The results showed that reduction of industrial energy consumption is still the main issue for addressing carbon emissions in China.
The GABA Developmental Shift Is Abolished by Maternal Immune Activation Already at Birth
Authors: Fernandez Amandine , Dumon Camille , Guimond Damien , Tyzio Roman , Bonifazi Paolo , Lozovaya Natalia , Burnashev Nail , Ferrari Diana C , Ben-Ari Yehezkel
Published: October 2018

Epidemiological and experimental studies suggest that maternal immune activation (MIA) leads to developmental brain disorders, but whether the pathogenic mechanism impacts neurons already at birth is not known. We now report that MIA abolishes in mice the oxytocin-mediated delivery γ-aminobutyric acid (GABA) shift from depolarizing to hyperpolarizing in CA3 pyramidal neurons, and this is restored by the NKCC1 chloride importer antagonist bumetanide. Furthermore, MIA hippocampal pyramidal neurons at birth have a more exuberant apical arbor organization and increased apical dendritic length than age-matched controls. The frequency of spontaneous glutamatergic postsynaptic currents is also increased in MIA offspring, as well as the pairwise correlation of the synchronized firing of active cells in CA3. These alterations produced by MIA persist, since at P14–15 GABA action remains depolarizing, produces excitatory action, and network activity remains elevated with a higher frequency of spontaneous glutamatergic postsynaptic currents. Therefore, the pathogenic actions of MIA lead to important morphophysiological and network alterations in the hippocampus already at birth.
Integrated, Co-located, Telemedicine-based Treatment Approaches for Hepatitis C Virus Management in Opioid Use Disorder Patients on Methadone
Authors: Talal Andrew H , Andrews Phyllis , Mcleod Anthony , Chen Yang , Sylvester Clewert , Markatou Marianthi , Brown Lawrence S
Published: October 2018

Background

Despite high hepatitis C virus (HCV) prevalence, opioid use disorder (OUD) patients on methadone rarely engage in HCV treatment. We investigated the effectiveness of HCV management via telemedicine in an opioid substitution therapy (OST) program.

Methods

OUD patients on methadone underwent biweekly telemedicine sessions between a hepatologist and physician assistant during the entire HCV treatment course. All pretreatment labs (HCV RNA, genotype, and noninvasive fibrosis assessments) were obtained onsite and direct-acting antivirals were coadministered with methadone using modified directly observed therapy. We used multiple correspondence analysis, least absolute shrinkage and selection operator, and logistic regression to identify variables associated with pursuit of HCV care.

Results

Sixty-two HCV RNA–positive patients (24% human immunodeficiency virus [HIV] infected, 61% male, 61% African American, 25.8% Hispanic) were evaluated. All patients were stabilized on methadone and all except 4 were HCV genotype 1 infected. Advanced fibrosis/cirrhosis was present in 34.5% of patients. Of the 45 treated patients, 42 (93.3%) achieved viral eradication. Of 17 evaluated patients who were not treated, 5 were discontinued from the drug treatment program or did not follow up after the evaluation, 2 had HIV adherence issues, and 10 had insurance authorization issues. Marriage and a mental health diagnosis other than depression were the strongest positive predictors of treatment pursuit, whereas being divorced, separated, or widowed was the strongest negative predictor.

Conclusions

HCV management via telemedicine integrated into an OST program is a feasible model with excellent virologic effectiveness. Psychosocial and demographic variables can assist in identification of subgroups with a propensity or aversion to pursue HCV treatment.
Advanced Glycation End Product Accumulation Is Associated With Low Skeletal Muscle Mass, Weak Muscle Strength, and Reduced Bone Density: The Nagahama Study
Authors: Tabara Yasuharu , Ikezoe Tome , Yamanaka Mikihiro , Setoh Kazuya , Segawa Hiroaki , Kawaguchi Takahisa , Kosugi Shinji , Nakayama Takeo , Ichihashi Noriaki , Tsuboyama Tadao , Matsuda Fumihiko ,   The Nagahama Study Group
Published: October 2018

Background

The accumulation of advanced glycation end product (AGE) might exert deleterious effects on musculoskeletal properties. Our study aims to clarify this possible association in a large general population.

Methods

This study investigated a general population of 9,203 patients (mean age, 57.8 years). Skeletal muscle mass was measured by bioelectrical impedance analysis, whereas accumulation of AGEs was assessed by skin autofluorescence (SAF-AGE). The muscle strength of upper and lower limbs and usual gait speed were measured in a portion of older (≥60 years of age) participants (n = 1,934). The speed of sound (SOS) in the calcaneal bone was assessed via a quantitative ultrasound technique.

Results

In the total population, the frequency of low skeletal muscle mass linearly increased with the SAF-AGE quartiles (Q1: 14.2%, Q2: 16.1%, Q3: 21.1%, Q4: 24.8%; p < .001), and this association was independent of covariates including glycemic traits (Q4: odds ratio [OR] = 1.48, p < .001). The association between the highest SAF-AGE quartile and low skeletal muscle mass remained significant in the older subpopulation (OR = 1.85, p = .002). A similar but weak association was observed for low SOS (Q1: 8.9%, Q2: 8.3%, Q3: 10.4%, Q4: 12.2%; p < .001). Similar inverse associations were also observed with grip strength (OR = 1.98, p = .003), hip flexion strength (OR = 1.50, p = .012), and hip abduction strength (OR = 1.78, p = .001), but not with usual gait speed.

Conclusion

Accumulation of AGEs might be a deleterious factor for musculoskeletal properties.
Do universities generate spatial spillovers? Evidence from US counties between 1930 and 2010
Authors: Cermeño Alexandra L
Published: October 2018

This paper explores the impact of new universities established in the USA between 1931 and 1980 on population density, GDP and market size measured from 1930 to 2010. The analysis is based on differences in differences on counties selected through propensity score matching, as well as an instrumental variable approach. The evidence suggests that counties hosting a university for the first time grew by between 1% and 3% annually on top of the general trends of population density and GDP growth, and that this effect expanded to neighboring counties. Controlling for research intensity and interstate road infrastructure shows that the potential gains from these new universities were severely constrained by the ease of access, which eventually resulted in higher congestion costs. These results point to a situation where new universities create spillover effects that eventually fade away if not accompanied by additional investments.
Identification of Functioning Domains in the Presurgical Period and Their Relationships with Opioid Use and Pain Catastrophizing
Authors: Travaglini Letitia E , Highland Krista B , Rojas Winifred , Buckenmaier Chester C , Kent Michael
Published: October 2018

Objectives

The National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) is a multidimensional screening system evaluating biopsychosocial factors affecting pain and functioning. Using a military sample, the current study 1) examined the structure and domains of the PROMIS, the Defense and Veterans Pain Rating Scale 2.0 (DVPRS), and the Pain Catastrophizing Scale (PCS) within a presurgical setting and 2) examined the relationship of these variables to pre- and postsurgical opioid use.

Methods

This cross-sectional study included 279 adult patients scheduled for surgery at the Walter Reed National Military Medical Center and a validation sample of 79 additional patients from the Naval Medical Center, San Diego. PROMIS, DVPRS, PCS, and opioid use data were collected before surgery. Exploratory factor analysis and confirmatory factor analysis identified the latent structure for the measures. A structural equation model (SEM) examined their relationship to pre- and postsurgical opioid use.

Results

Two latent factors represented Psychosocial Functioning (PROMIS Depression, PROMIS Anxiety, and PROMIS Social Isolation) and Pain Impact (DVPRS, PROMIS Pain Interference, PROMIS Physical Functioning). The remaining PROMIS scales did not load onto a single factor. In the SEM, the two latent factors and PCS were significantly related to pre- and postsurgical opioid use.

Conclusions

This study highlights the utility and relative ease of using a convenient multidimensional assessment in presurgical settings. Using such an assessment can help provide targeted interventions for individuals who may be at greatest risk for negative postsurgical outcomes.
Factors Influencing Rust (Melampsora apocyni) Intensity on Cultivated and Wild Apocynum venetum in Altay Prefecture, China
Authors: Gao P. , Nan Z. B. , Christensen M. J. , Barbetti M. J. , Duan T. Y. , Liu Q. T. , Meng F. J. , Huang J. F.
Published: October 2018

Rust (Melampsora apocyni) on Apocynum venetum is the major constraint to the commercial development of this medicinal herb. To determine the factors influencing rust intensity (maximum disease index [DImax]), rust was investigated from 2011 to 2015 in both cultivated and wild A. venetum plants. Partial least squares path modeling (PLS-PM) was used to analyze the paths and extent of the factors related to pathogen, environment, and host that affect rust intensity. DImax exhibited considerable variations across years and study sites, with variations linked to various factors fostering disease development. PLS-PM explained 80.0 and 70.1% of variations in DImax in cultivated and wild plants, respectively. Precipitation was the key factor determining DImax in both cultivated and wild plants (path coefficient [PC] = 0.313 and 0.544, respectively). In addition, the topsoil water content in cultivated plants and the total vegetation coverage in wild plants were also critical determinants of DImax via their effects on the microclimatic factor (contribution coefficients [CC] = 0.681 and 0.989, respectively; PC = 0.831 and 0.231, respectively). In both cultivated and wild plants, host factors were mainly dominated by A. venetum density (CC = 0.989 and 0.894, respectively), and their effect on DImax via the microclimatic factor (PC = 0.841 and 0.862, respectively) exceeded that via the inoculum factor (PC = 0.705 and 0.130, respectively). However, the indirect effects led to DImax variation, while the dilution effect on host (CC = 0.154) from weed in wild plants led to the indirect effect size in wild plants of 0.200, which was lower than −0.699 in cultivated plants.
The Ponseti method of clubfoot treatment in walking age children: is it effective? A study of 56 children from 1 to 10 years of age
Authors: Shah Avi , Mehta Rujuta , Aroojis Alaric
Published: October 2018

The Ponseti method is well-established for the treatment of clubfoot in younger babies; however, its effectiveness in older children is still unclear. The aim of our study was to report our results of the ‘traditional’ Ponseti method in the management of clubfoot in children of walking age. A total of 56 (81 clubfeet) children with a mean age of 3.16±2.35 years (1–10 years) were divided into two groups: group I consisted of 12 (18 clubfeet) patients with a mean age of 3.36±2.7 years (range: 1–8.4 years) who presented with an untreated clubfoot whereas group II consisted of 44 (63 clubfeet) patients with a mean age of 3.19±2.34 years (range: 1–10 years) who presented with a recurrent clubfoot. All children underwent the standard manipulation and casting technique described by Ponseti, including a percutaneous tenotomy of the Tendo Achilles. The bracing protocol was modified appropriately. All feet corrected with a mean of 7.36 (3–17) casts in group I and 4.49 (1–12) casts in group II. All children in group I and 70.45% in group II underwent a percutaneous Tendo Achilles tenotomy. There was a statistically significant change between the pretreatment and post-treatment Pirani scores in both groups. Nineteen (30.86%) patients underwent relapse at a mean follow-up of 2.84±1.25 years (1.2–5.4 years), who were treated by re-casting, bracing and tibialis anterior tendon transfer. The Ponseti method is effective even in walking age children upto the age of 10 years with a good success rate, although approximately one-third of the clubfeet relapsed and needed further treatment. No modifications to the standard casting protocol are required. Despite a high relapse rate, a supple, plantigrade and pain-free foot is achievable without the need for extensive soft-tissue surgeries or bony procedures. The Ponseti method lends itself well to developing a nation-wide program for clubfoot treatment in countries with limited resources. Level of Evidence: Level III.
Clinical Diagnosis of Sacroiliac Joint Pain
Authors: Laslett Mark
Published: October 2018

There is a need to establish a standardized clinical examination, based on best available evidence, that identifies those patients with persistent back and buttock pain whose symptoms arise from the sacroiliac joint. This clinical examination is the first step in the selection of patients for controlled and guided diagnostic intra-articular block (the reference standard). This in turn is the prerequisite for selection of patients for minimally invasive therapies such as intra-articular steroid injection or for surgical fusion. The use of pain location and results from pain provocation tests is described within the context of a clinical reasoning algorithm. A cluster of at least 2, preferably 3 provocation tests in the absence of any clear diagnosis of a pain source other than the sacroiliac joint, has a sensitivity of 91% and specificity of 89%. The clinical examination described is reliable, requires no special equipment, and is available from trained clinicians in most developed countries.
Peripartum Anesthesia Considerations for Placenta Accreta
Authors: WARRICK CHRISTINE M. , ROLLINS MARK D.
Published: October 2018

Placenta accreta spectrum is becoming more common and is the most frequent indication for peripartum hysterectomy. Management of cesarean delivery in the setting of a morbidly adherent placenta has potential for massive hemorrhage, coagulopathies, and other morbidities. Anesthetic management of placenta accreta spectrum presents many challenges including optimizing surgical conditions, providing a safe and satisfying maternal delivery experience, preparing for massive hemorrhage and transfusion, preventing coagulopathies, and optimizing postoperative pain control. Balancing these challenging goals requires meticulous preparation with a thorough preoperative evaluation of the parturient and a well-coordinated multidisciplinary approach in order to optimize outcomes for the mother and fetus.
Effects of Sex Hormones on Ocular Blood Flow and Intraocular Pressure in Primary Open-angle Glaucoma: A Review
Authors: Patel Pooja , Harris Alon , Toris Carol , Tobe Leslie , Lang Matthew , Belamkar Aditya , Ng Adrienne , Verticchio Vercellin Alice C. , Mathew Sunu , Siesky Brent
Published: October 2018

Primary open-angle glaucoma (POAG) is a multifactorial optic neuropathy characterized by progressive retinal ganglion cell death and visual field loss. Some speculate that sex plays a role in the risk of developing POAG and that the physiological differences between men and women may be attributed to the variable effects of sex hormones on intraocular pressure, ocular blood flow, and/or neuroprotection. Estrogen, in the form of premenopausal status, pregnancy, and postmenopausal hormone therapy is associated with an increase in ocular blood flow, decrease in intraocular pressure and neuroprotective properties. The vasodilation caused by estrogen and its effects on aqueous humor outflow may contribute. In contrast, although testosterone may have known effects in the cardiovascular and cerebrovascular systems, there is no consensus as to its effects in ocular health or POAG. With a better understanding of sex hormones in POAG, sex hormone–derived preventative and therapeutic considerations in disease management may provide for improved sex-specific patient care.
Epidemiological Trends of Anterior Cruciate Ligament Reconstruction in a Canadian Province
Authors: Zhang Yiyang , McCammon James , Martin Richard Kyle , Prior Heather J. , Leiter Jeff , MacDonald Peter B.
Published: October 2018

Objective:

To determine epidemiological trends of anterior cruciate ligament reconstruction (ACL-R) in a Canadian province, estimate the national incidence, and compare with internationally published data.

Design:

Retrospective review.

Setting:

All hospitals that performed ACL reconstructions in Manitoba between 1980 and 2015.

Participant:

All patients that underwent ACL-R in Manitoba between 1980 and 2015.

Intervention:

This is a retrospective review looking at deidentified, individual-level administrative records of health services used for the entire population of Manitoba (approximately 1.3 million). Codes for ACL and cruciate ligament reconstruction were searched from 1980 to 2015. Patient demographics included age, sex, geographic area of residence, and neighborhood income quintile.

Main Outcome Measures:

Trends of ACL reconstructions from 1980 to 2015.

Results:

A total of 10 114 ACL-R were performed during the 36-year study period and patients were predominantly male (63.1%). The mean age at ACL-R was 29.5 years (SD 10.0) for males and 28.5 years (SD 11.9) for females, whereas age younger than 40 years accounted for 81.7% of all ACL-R. The incidence of ACL-R increased from 7.56/100 000 inhabitants in 1980 to 48.45/100 000 in 2015. The proportion of females undergoing ACL-R has increased from 29.3% in 1980% to 41.9% in 2015, and female patients now comprise the majority of ACL-R in the under-20 age category.

Conclusion:

The incidence of ACL-R has significantly increased since 1980; female patients now make up a greater proportion than males of the ACL-R population younger than 20 years. This information can be used to guide resource allocation planning and focus injury prevention initiatives.
Smaller Inguinal Hernias are Independent Risk Factors for Developing Chronic Postoperative Inguinal Pain (CPIP)
Authors: Hoffmann Henry , Walther Daniela , Bittner Reinhard , Köckerling Ferdinand , Adolf Daniela , Kirchhoff Philipp
Published: October 2018

Objective:

Impact of inguinal hernia defect size as stratified by the European Hernia Society (EHS) classification I to III on the rate of chronic postoperative inguinal pain (CPIP).

Background:

CPIP is the most important complication after inguinal hernia repair. The impact of hernia defect size according to the EHS classification on CPIP is unknown.

Methods:

In total, 57,999 male patients from the Herniamed registry undergoing primary unilateral inguinal hernia repair including a 1-year follow-up were selected between September 1, 2009 and November 30, 2016. Using multivariable analysis, the impact of EHS inguinal hernia classification (EHS I vs EHS II vs EHS III and/or scrotal) on developing CPIP was investigated.

Results:

Multivariable analysis revealed for smaller inguinal hernias a significant higher rate of pain at rest [EHS I vs EHS II: odds ratio, OR = 1.350 (1.180–1.543), P < 0.001; EHS I vs EHS III and/or scrotal: OR = 1.839 (1.504–2.249), P < 0.001; EHS II vs EHS III and/or scrotal: OR = 1.363 (1.125–1.650), P = 0.002], pain on exertion [EHS I vs EHS II: OR = 1.342 (1.223–1.473), P < 0.001; EHS I vs EHS III and/or scrotal: OR = 2.002 (1.727–2.321), P < 0.001; EHS II vs EHS III and/or scrotal: OR = 1.492 (1.296; 1.717), P < 0.001], and pain requiring treatment [EHS I vs EHS II: OR = 1.594 (1.357–1.874), P < 0.001; EHS I vs EHS III and/or scrotal: OR = 2.254 (1.774–2.865), P < 0.001; EHS II vs EHS III and/or scrotal: OR = 1.414 (1.121–1.783), P = 0.003] at 1-year follow-up. Younger patients (<55 y) revealed higher rates of pain at rest, pain on exertion, and pain requiring treatment (each P < 0.001) with a significantly trend toward higher rates of pain in smaller hernias.

Conclusions:

Smaller inguinal hernias have been identified as an independent patient-related risk factor for developing CPIP.
On the Concurrent Use of Self-System Therapy and Functional Magnetic Resonance Imaging–Guided Transcranial Magnetic Stimulation as Treatment for Depression
Authors: Neacsiu Andrada D. , Luber Bruce M. , Davis Simon W. , Bernhardt Elisabeth , Strauman Timothy J. , Lisanby Sarah H.
Published: October 2018

Objectives

Despite the growing use of repetitive transcranial magnetic stimulation (rTMS) as a treatment for unipolar depression, its typical effect sizes have been modest, and methodological and conceptual challenges remain regarding how to optimize its efficacy. Linking rTMS to a model of the neurocircuitry underlying depression and applying such a model to personalize the site of stimulation may improve the efficacy of rTMS. Recent developments in the psychology and neurobiology of self-regulation offer a conceptual framework for identifying mechanisms of action in rTMS for depression, as well as for developing guidelines for individualized rTMS treatment. We applied this framework to develop a multimodal treatment for depression by pairing self-system therapy (SST) with simultaneously administered rTMS delivered to an individually targeted region of dorsolateral prefrontal cortex identified via functional magnetic resonance imaging (fMRI).

Methods

In this proof-of-concept study, we examined the acceptability, feasibility, and preliminary efficacy of combining individually fMRI-targeted rTMS with SST. Using the format of a cognitive paired associative stimulation paradigm, the treatment was administered to 5 adults with unipolar depression in an open-label trial.

Results

The rTMS/SST combination was well tolerated, feasible, and acceptable. Preliminary evidence of efficacy also was promising. We hypothesized that both treatment modalities were targeting the same neural circuitry through cognitive paired associative stimulation, and observed changes in task-based fMRI were consistent with our model. These neural changes were directly related to improvements in depression severity.

Conclusions

The new combination treatment represents a promising exemplar for theory-based, individually targeted, multimodal intervention in mood disorders.
Genomic epidemiology of clinical Campylobacter spp. at a single health trust site
Authors: Dunn Steven J. , Pascoe Ben , Turton James , Fleming Vicki , Diggle Mathew , Sheppard Samuel K. , McNally Alan , Manning Georgina
Published: October 2018

Campylobacter is the leading cause of bacterial enteritis in the developed world, and infections with the organism are largely sporadic in nature. Links between sporadic cases have not been established, with the majority of infections thought to be caused by genetically distinct isolates. Using a read-mapping approach, 158 clinical isolates collected during 2014 from the greater Nottinghamshire area were analysed to assess the local population structure and investigate potential case linkages between sporadic cases of campylobacteriosis. Four instances (2.5 %) of case linkage were observed across the dataset. This study demonstrates that case linkage does occur between sporadic Campylobacter infections, and provides evidence that a dual multi-locus sequence typing/within-lineage single nucleotide polymorphism typing approach to Campylobacter genomic epidemiology provides a benefit to public-health investigations.
The design and evaluation of a Bayesian system for detecting and characterizing outbreaks of influenza
Authors: Millett Nicholas E. , Aronis John M. , Wagner Michael M. , Tsui Fuchiang , Ye Ye , Ferraro Jeffrey P. , Haug Peter J. , Gesteland Per H. , Cooper Gregory F.
Published: October 2018

1

The prediction and characterization of outbreaks of infectious diseases such as influenza remains an open and important problem. This paper describes a framework for detecting and characterizing outbreaks of influenza and the results of testing it on data from ten outbreaks collected from two locations over five years. We model outbreaks with compartment models and explicitly model non-influenza influenza-like illnesses.