bluuebunny/crossref_metadata_2025 huggingface dataset:
Ferromagnetism in α-Mn nanorods
Authors: Tiwary Chandra Sekhar , Bhowmick Somnath , Prakash Abhinav , Chakrabarti Ramananda , Biswas Krishanu , Chattopadhyay Kamanio
Published: February 2017

The present investigation reports the first experimental evidence of ferromagnetism in the cryomilled pure α-Mn nano-rods. Cryomilling of Mn powder at liquid nitrogen temperature leads to the formation of long nanorods of α-Mn. The detailed electron microscopy reveals that the nanorods grow along [11¯2] directions with surfaces bounded by {110} planes of FCC α-Mn. The magnetic measurements indicate ferromagnetic hysteresis loops, suggesting typical ferromagnetic order. The ab-initio density functional theory calculations indicate that the ferromagnetic response originates from the under coordinated surface atoms.
A small-signal theory for the radial-line relativistic klystron amplifier
Authors: Dang Fangchao , Zhang Xiaoping , Zhong Huihuang , Zhang Jun , Ju Jinchuan
Published: February 2017

A small-signal theory describing the electron beam modulation in the radial-line relativistic klystron amplifier (RL-RKA) is developed in this paper. We first derive theoretically the space-charge limited current, the dispersion relation of space-charge waves on the radial-radiated electron beam, and the beam coupling coefficient for the radial-line electromagnetic structure. Then, a small-signal theory is established to analyze the beam current bunching during the initial modulation period. With particle-in-cell simulations, the theoretical analysis is verified through observing the fundamental harmonic current of an input cavity in a previous Ku-band RL-RKA. More importantly, the presented small-signal theory can provide a theoretical guidance for the RL-RKA design.
Low noise all-oxide magnetic tunnel junctions based on a La0.7Sr0.3MnO3/Nb:SrTiO3 interface
Authors: Kurij G. , Solignac A. , Maroutian T. , Agnus G. , Guerrero R. , Calvet L. E. , Pannetier-Lecoeur M. , Lecoeur Ph.
Published: February 2017

All-oxide magnetic tunnel junctions with a semiconducting barrier, formed by the half-metallic ferromagnet La0.7Sr0.3MnO3 and n-type semiconductor SrTi0.8Nb0.2O3, were designed, fabricated, and investigated in terms of their magneto-transport properties as a function of applied bias and temperature. We found that the use of the heavily Nb-doped SrTiO3 as a barrier results in significant improvement in the reproducibility of results, i.e., of large tunnel magnetoresistance (TMR) ratios, and a spectral noise density reduced by three orders of magnitude at low temperature. We attribute this finding to a considerably decreased amount of point defects in SrTi0.8Nb0.2O3, especially oxygen vacancies, compared with the conventional insulating SrTiO3 barrier.
Ordered visibility graph average aggregation operator: An application in produced water management
Authors: Jiang Wen , Wei Boya , Tang Yongchuan , Zhou Deyun
Published: February 2017

Complex networks are widely used in modeling complex system. How to aggregate data in complex systems is still an open issue. In this paper, an ordered visibility graph average aggregation operator is proposed which is inspired by the complex network theory and Newton's law of universal gravitation. First of all, the argument values are ordered in descending order. Then a new support function is proposed to measure the relationship among values in a visibility graph. After that, a weighted network is constructed to determine the weight of each value. Compared with the other operators, the new operator fully takes into account not only the information of orders but also the correlation degree between the values. Finally, an application of produced water management is illustrated to show the efficiency of the proposed method. The new method provides a universal way to aggregate data in complex systems.
Phase-amplitude reduction of transient dynamics far from attractors for limit-cycling systems
Authors: Shirasaka Sho , Kurebayashi Wataru , Nakao Hiroya
Published: February 2017

Phase reduction framework for limit-cycling systems based on isochrons has been used as a powerful tool for analyzing the rhythmic phenomena. Recently, the notion of isostables, which complements the isochrons by characterizing amplitudes of the system state, i.e., deviations from the limit-cycle attractor, has been introduced to describe the transient dynamics around the limit cycle [Wilson and Moehlis, Phys. Rev. E 94, 052213 (2016)]. In this study, we introduce a framework for a reduced phase-amplitude description of transient dynamics of stable limit-cycling systems. In contrast to the preceding study, the isostables are treated in a fully consistent way with the Koopman operator analysis, which enables us to avoid discontinuities of the isostables and to apply the framework to system states far from the limit cycle. We also propose a new, convenient bi-orthogonalization method to obtain the response functions of the amplitudes, which can be interpreted as an extension of the adjoint covariant Lyapunov vector to transient dynamics in limit-cycling systems. We illustrate the utility of the proposed reduction framework by estimating the optimal injection timing of external input that efficiently suppresses deviations of the system state from the limit cycle in a model of a biochemical oscillator.
Improved power efficiency in phosphorus doped n-a-SiNxOy/p-Si heterojunction light emitting diode
Authors: Lin Zewen , Chen Kunji , Zhang Pengzhan , Xu Jun , Li Wei , Yang Huafeng , Huang Xinfan
Published: February 2017

The higher up to 60% internal quantum efficiency of photoluminescence (PL) from amorphous silicon oxynitride (a-SiNxOy) films has been reported in our previous work. In present work, the improved power efficiency visible light emitting diode (LED) has been realized based on phosphorus doped n-a-SiNxOy/p-Si heterojunction structure, which is at least three times higher than that of ITO/a-SiNxOy/p-Si (called MIS) LED. The n-a-SiNxOy films were doped by using phosphine (PH3) gas during the deposition by plasma enhanced chemical vapor deposition technique and the electron concentration is about 2.4 × 1015 cm−3 at room temperature obtained from Hall-effect measurements. The light emitting (electroluminescence (EL)) peak energy is coincided with that of PL of a-SiNxOy, which suggests that the EL emission is also originated from the radiative recombination via N-Si-O bonding defect states in n-a-SiNxOy layers. The transport mechanism and optical performance of the device have been investigated with the characteristics of current-voltage (I-V) and light output-voltage (L-V), in terms of the energy band diagram of n-a-SiNxOy/p-Si heterojunction structure. The power law like L ∼ Im of light output-current (L ∼ I) characteristic in n-a-SiNxOy/p-Si heterojunction has also been observed, which exhibits a superlinear behaviour with a slope of 1.35 in the low current range and becomes almost linear with a slope of 1.05 in the high current range, due to the saturation of nonradiative recombination centers.
Dzyaloshinskii-Moriya interaction in Pt/Co/Pt films prepared by chemical vapor deposition with various substrate temperatures
Authors: Quinsat M. , Ootera Y. , Shimada T. , Kado M. , Hashimoto S. , Morise H. , Nakamura S. , Kondo T.
Published: February 2017

We deposited perpendicularly magnetized Co(∼1nm)/Pt(6nm) bilayers by thermal chemical vapor deposition (CVD) on top of 3nm thick Pt layer using various deposition temperature. Observed Ms increased with the increase of deposition temperature Ts, and reached the value of pure-Co at Ts = 500°C. We measured a (left-handed) negative Dzyaloshinskii-Moriya interaction in CVD films indicating a dominant role of the bottom Pt/Co interface.
Suppression of ITI by array head reading and 2D-equalization
Authors: Nakamura Y. , Suzuto R. , Osawa H. , Okamoto Y. , Kanai Y. , Muraoka H.
Published: February 2017

Two-dimensional magnetic recording (TDMR) by shingled magnetic recording (SMR) draws attention as a next generation technology to increase the recording density in hard disk drive (HDD). It is shown that the two-dimensional finite impulse response (2D-FIR) filter provides gain the reproducing waveforms from an array head with 3 readers in the TDMR under a specification of 4 Tbit/inch.2 We evaluate the effect of the intertrack interference (ITI) reduction by 2D-FIR using the correlation between the real FIR filter output and the partial response class-I (PR1) signal corresponding to recording sequence by the computer simulation. The results show that the 2D-FIR filter is effective to mitigate ITI and improves the signal-to-noise ratio at the discriminate point by about 0.6 dB.
Temperature dependence of magnetic hysteresis scaling for cubic Fe3O4 nanoparticles
Authors: Sato Takuma , Nagaoka Kaori , Kobayashi Satoru , Manjanna Jayappa , Murakami Takeshi
Published: February 2017

We have examined magnetic hysteresis scaling of minor loops for cubic Fe3O4 nanoparticles with particle diameter of 265 nm in order to seek a possible application of the method for characterization of magnetic nanoparticles. While the conventional Steinmetz law fails, a power-law scaling with an exponent of 1.3±0.1 was found to universally hold true between the remanence and hysteresis loss of minor loops below and above the Verwey temperature of ∼ 100 K. A minor-loop coefficient obtained from the power law exhibits a sudden increase with an onset of Verwey transition, followed by a steep increase with decreasing temperature. The increase of the coefficient at Verwey transition is by 390%, being much higher than 260% for major-loop coercivity. There observations demonstrate that a magnetic hysteresis scaling using symmetrical minor loops can be a possible technique for characterizing magnetic nanoparticles due to its sensitivity to materials intrinsic properties and low measurement fields below 1 kOe.
Alternative friction stir welding technology for titanium–6Al–4V propellant tanks within the space industry
Authors: Brassington W. D. P. , Colegrove P. A.
Published: February 2017

Friction stir welding (FSW) offers an appealing solid state joining alternative to traditional fusion welding techniques for titanium alloys because it reduces problems associated with high temperature processing. Propellant tanks are a critical component of every spacecraft and contain several weld seams and a prime candidate for this innovative technology. This paper reviews the current technological maturity of FSW relative to titanium alloys and considers the application with respect to a pressure vessel. FSW is currently in a period of significant investment by large engineering companies and international research institutions. The technology is advancing and evolving to cater for high temperature alloys. Stationary shoulder FSW and hybrid techniques show promising potential with respect to Ti–6Al–4V. The tool material and limited process window for this material are restrictive factors at present but can be overcome with future development.
VHL promotes immune response against renal cell carcinoma via NF-κB–dependent regulation of VCAM-1
Authors: Labrousse-Arias David , Martínez-Alonso Emma , Corral-Escariz María , Bienes-Martínez Raquel , Berridy Jaime , Serrano-Oviedo Leticia , Conde Elisa , García-Bermejo María-Laura , Giménez-Bachs José M. , Salinas-Sánchez Antonio S. , Sánchez-Prieto Ricardo , Yao Masahiro , Lasa Marina , Calzada María J.
Published: February 2017

Vascular cell adhesion molecule 1 (VCAM-1) is an adhesion molecule assigned to the activated endothelium mediating immune cells adhesion and extravasation. However, its expression in renal carcinomas inversely correlates with tumor malignancy. Our experiments in clear cell renal cell carcinoma (ccRCC) cell lines demonstrated that von Hippel Lindau (VHL) loss, hypoxia, or PHD (for prolyl hydroxylase domain–containing proteins) inactivation decreased VCAM-1 levels through a transcriptional mechanism that was independent of the hypoxia-inducible factor and dependent on the nuclear factor κB signaling pathway. Conversely, VHL expression leads to high VCAM-1 levels in ccRCC, which in turn leads to better outcomes, possibly by favoring antitumor immunity through VCAM-1 interaction with the α4β1 integrin expressed in immune cells. Remarkably, in ccRCC human samples with VHL nonmissense mutations, we observed a negative correlation between VCAM-1 levels and ccRCC stage, microvascular invasion, and symptom presentation, pointing out the clinical value of VCAM-1 levels as a marker of ccRCC progression.
Human centromeric CENP-A chromatin is a homotypic, octameric nucleosome at all cell cycle points
Authors: Nechemia-Arbely Yael , Fachinetti Daniele , Miga Karen H. , Sekulic Nikolina , Soni Gautam V. , Kim Dong Hyun , Wong Adeline K. , Lee Ah Young , Nguyen Kristen , Dekker Cees , Ren Bing , Black Ben E. , Cleveland Don W.
Published: February 2017

Chromatin assembled with centromere protein A (CENP-A) is the epigenetic mark of centromere identity. Using new reference models, we now identify sites of CENP-A and histone H3.1 binding within the megabase, α-satellite repeat–containing centromeres of 23 human chromosomes. The overwhelming majority (97%) of α-satellite DNA is found to be assembled with histone H3.1–containing nucleosomes with wrapped DNA termini. In both G1 and G2 cell cycle phases, the 2–4% of α-satellite assembled with CENP-A protects DNA lengths centered on 133 bp, consistent with octameric nucleosomes with DNA unwrapping at entry and exit. CENP-A chromatin is shown to contain equimolar amounts of CENP-A and histones H2A, H2B, and H4, with no H3. Solid-state nanopore analyses show it to be nucleosomal in size. Thus, in contrast to models for hemisomes that briefly transition to octameric nucleosomes at specific cell cycle points or heterotypic nucleosomes containing both CENP-A and histone H3, human CENP-A chromatin complexes are octameric nucleosomes with two molecules of CENP-A at all cell cycle phases.
A game of musical chairs: Pro- and anti-resection factors compete for TOPBP1 binding after DNA damage
Authors: Shimada Kenji , Gasser Susan M.
Published: February 2017

DNA double strand breaks (DSBs) are generally repaired through nonhomologous end joining or homologous recombination. In this issue, Liu et al. (2017. J. Cell Biol. https://doi.org/10.1083/jcb.201607031) report that the conserved scaffold protein TOPBP1Dpb11 provides binding sites for both pro- and anti-resection factors at DSBs, providing insights into repair pathway regulation.
Erin Goley: Catching the bug for studying the cytoskeleton
Authors: O’Donnell Marie Anne
Published: February 2017

Erin Goley investigates how the microbial cytoskeleton controls cell growth and division.
On the enumeration of interval graphs
Authors: Yang Joyce , Pippenger Nicholas
Published: February 2017

We present upper and lower bounds for the number

i
n

i_n

of interval graphs on

n
n

vertices. Answering a question posed by Hanlon, we show that the ordinary generating function

I
(
x
)
=

∑

n
≥
0

i
n

x
n

I(x) = \sum _{n\ge 0} i_n\,x^n

for the number

i
n

i_n

of

n
n

-vertex interval graphs has radius of convergence zero. We also show that the exponential generating function

J
(
x
)
=

∑

n
≥
0

i
n

x
n

/

n
!

J(x) = \sum _{n\ge 0} i_n\,x^n/n!

has radius of convergence at least

1

/

2

1/2

.
Capturing a Value‐Added Niche Market: Articulation of Local Organic Grain
Authors: Baker Brian P. , Russell June A.
Published: February 2017

The market for organic and locally‐grown products continues to expand as consumer preferences demand them. One category that has been relatively underserved has been the market for local and organic small grains, such as wheat. Small grains provide multiple benefits to organic farms, but are underutilized because of their relatively low economic value compared to other organic crops. Small‐ and medium‐scale producers in the northeastern region of the United States have faced challenges to produce and profitably market small grains for a whole host of reasons. Policy initiatives by New York State and GrowNYC's Greenmarket have expanded the market for local and organic grains and fueled the revival of small grain production in the Northeast. To meet demand, it was necessary to create the full value chain including the necessary infrastructure to handle relatively small amounts of a crop ordinarily sold as a commodity and processed at an industrial scale. This case study examines the articulation of a value chain with independent—but interdependent—enterprises connected by innovative agreements and strategic partnerships. The value chain includes the owner‐operator of a farm located in the Finger Lakes region of New York, a milling enterprise started as a partnership with another farmer, and a community‐supported bakery, where the farmer is also a partner. The case study also demonstrates how institutions and policies can help establish new markets to meet consumer demand, how farmers and entrepreneurs can identify market opportunities, and shows the articulation of a value chain on a micro‐scale.
Spatial‐Dynamic Complexities of Climate Challenge for Rural Areas: Integrating Resource and Regional Economic Insights
Authors: Epanchin‐Niell Rebecca , Kuwayama Yusuke , Walls Margaret
Published: February 2017

Research questions in resource economics increasingly have incorporated both the field's traditional dynamic considerations and the spatial concerns that often are the focus of regional economics. Spatial heterogeneity in costs, benefits, or connectivity often interact with intertemporal change in contexts such as fisheries management, water allocation, invasive species control, and land use change, making spatially‐ or temporally‐uniform polices less likely to be efficient. In this article, we examine how climate change is likely to enhance the need to incorporate spatial‐dynamic approaches to address natural resource challenges. We focus our discussion on rural areas, which are typically highly dependent on natural resources and particularly vulnerable to climate change. Following a brief review of existing spatial‐dynamic models in natural resource economics and the insights derived from them, we describe how climate change can bring new spatial or temporal aspects to resource management problems, or exacerbate existing resource challenges that are best characterized as spatial‐dynamic processes. We conclude with three case studies that highlight how integrating resource and regional economics through spatial‐dynamic modeling may improve the analysis of climate change impacts in rural areas, considering the effects on rangeland management, groundwater policy, and land use management in floodplains and coastal areas.
Long-Term Mortality of Patients with an Alcohol-Related Wernicke–Korsakoff Syndrome
Authors: Sanvisens Arantza , Zuluaga Paola , Fuster Daniel , Rivas Inmaculada , Tor Jordi , Marcos Miguel , Chamorro Antonio J. , Muga Roberto
Published: February 2017

Aims

To characterize a series of contemporary patients with alcohol-related Wernicke's encephalopathy (WE) or Korsakoff's syndrome (KS) and to update the current prognosis of disease.

Methods

Retrospective and prospective study of patients diagnosed with an alcohol-related WE or KS between 2002 and 2011 in a tertiary hospital. Socio-demographic, alcohol use characteristics, signs and symptoms, co-morbidity and blood parameters were obtained at admission. Patients were followed up until 2013 and causes of death were ascertained through the review of charts.

Results

Sixty-one patients were included (51 with WE and 10 with KS). Among patients with WE, 78% were men and age at diagnosis was 57 years (interquartile range (IQR): 49–66). Twenty-three percent fulfilled the classic WE triad. Regarding Caine's criteria for WE, 70.6% presented with at least two out of four signs or symptoms. Median follow-up of patients with WE syndrome was 5.3 years (IQR: 2.6–8.8), the cumulated mortality was 45% and death rate of 7.4 × 100 person-years (95% confidence interval (CI): 4.8–10.9). Overall, 50% of patients would be expected to die within 8 years of WE episode and main causes of death included serious bacterial infections (44.5%) and cancer (33.3%).

Conclusions

Survival of patients with an alcohol-related Wernicke–Korsakoff syndrome is poor; pursuing treatment of alcohol use disorder and early diagnosis of thiamine deficiency is a priority for improving clinical outcomes.
Using Fishermen’s Ecological Knowledge to map Atlantic cod spawning grounds on Georges Bank
Authors: DeCelles Gregory R. , Martins David , Zemeckis Douglas R. , Cadrin Steven X.
Published: February 2017

The spawning dynamics of Atlantic cod (Gadus morhua) on Georges Bank and Nantucket Shoals are not well understood. To address this uncertainty, we combined Fishermen’s Ecological Knowledge (FEK) with traditional scientific data to develop a more holistic understanding of cod spawning on Georges Bank. Data from historical reports, trawl surveys, fisheries observers, and ichthyoplankton surveys were used to describe the spatial and temporal distribution of cod spawning activity. We also collected FEK regarding cod spawning dynamics through semi-structured interviews (n = 40). The fishermen had detailed knowledge of the spatial and temporal distribution of cod spawning, and identified persistent fine-scale (i.e. <50 km2) spawning grounds that were often associated with specific habitat features, including spawning grounds that were previously unreported in the scientific literature. The spawning seasons and locations identified by fishermen generally agreed with information from traditional scientific data, but it was evident that seasonal scientific surveys lack the spatial and temporal resolution needed to fully characterize the distribution of cod spawning activity. Our results will help inform management measures designed to promote the rebuilding of Georges Bank cod, and also provide a basis for further investigations of cod spawning dynamics and stock structure.
Learning from errors: analysis of medication order voiding in CPOE systems
Authors: Kannampallil Thomas G , Abraham Joanna , Solotskaya Anna , Philip Sneha G , Lambert Bruce L , Schiff Gordon D , Wright Adam , Galanter William L
Published: February 2017

Objective: Medication order voiding allows clinicians to indicate that an existing order was placed in error. We explored whether the order voiding function could be used to record and study medication ordering errors.

Materials and Methods: We examined medication orders from an academic medical center for a 6-year period (2006–2011; n = 5 804 150). We categorized orders based on status (void, not void) and clinician-provided reasons for voiding. We used multivariable logistic regression to investigate the association between order voiding and clinician, patient, and order characteristics. We conducted chart reviews on a random sample of voided orders (n = 198) to investigate the rate of medication ordering errors among voided orders, and the accuracy of clinician-provided reasons for voiding.

Results: We found that 0.49% of all orders were voided. Order voiding was associated with clinician type (physician, pharmacist, nurse, student, other) and order type (inpatient, prescription, home medications by history). An estimated 70 ± 10% of voided orders were due to medication ordering errors. Clinician-provided reasons for voiding were reasonably predictive of the actual cause of error for duplicate orders (72%), but not for other reasons.

Discussion and Conclusion: Medication safety initiatives require availability of error data to create repositories for learning and training. The voiding function is available in several electronic health record systems, so order voiding could provide a low-effort mechanism for self-reporting of medication ordering errors. Additional clinician training could help increase the quality of such reporting.
Low-pressure Hydrocephalus in Children: A Case Series and Review of the Literature
Authors: Smalley Zachary S. , Venable Garrett T. , Einhaus Stephanie , Klimo Paul
Published: February 2017

BACKGROUND: Low-pressure hydrocephalus (LPH) is a rare phenomenon characterized by a clinical picture consistent with elevated intracranial pressure (ICP) and ventricular enlargement, but also a well-functioning shunt and low or negative ICP.

OBJECTIVE: To report our experience in evaluating this challenging problem.

METHODS: Patients with LPH were identified from several sources, including institutional procedural databases and personal case logs. Electronic medical records were reviewed to collect demographic, clinical, surgical, and radiographic data to determine the presence of LPH. Each patient's clinical course, including presentation, management, and outcome, is reported.

RESULTS: Thirty instances of LPH were identified in 29 patients. Eleven cases (37.9%) of LPH were after lumbar puncture (LP), and 19 cases (62.1%) occurred without any preceding spinal procedure. Among the post-LP patients, conservative measures alone were successful in 3 cases (27%); lumbar blood patch was successful in 2 cases (18%); and 6 cases (55%) required external cerebrospinal fluid (CSF) drainage. Of the spontaneous cases, 5 patients did not receive the full spectrum of treatment because of terminal prognosis. Of the remaining 14 patients, 11 (78.6%) required external CSF drainage. Post-LP patients required fewer days of external CSF drainage (median, 4 [range, 0-12] vs median, 11 [range, 0-90]) and had a shorter hospital stay (median, 2 [range, 2-16] vs median, 8 [range, 0-26]).

CONCLUSION: This study represents the largest series of LPH. Although its pathophysiology remains a mystery, there are a variety of management options. Multiple procedures and a protracted hospital stay are often required to successfully treat LPH.
Transsylvian Selective Amygdalohippocampectomy for Mesiotemporal Epilepsy: Experience with 162 Procedures
Authors: Schmeiser Barbara , Wagner Kathrin , Schulze-Bonhage Andreas , Elger Christian Erich , Steinhoff Bernhard Jochen , Wendling Anne-Sophie , Mader Irina , Prinz Marco , Scheiwe Christian , Zentner Josef
Published: February 2017

BACKGROUND:Mesial temporal lobe epilepsy (MTLE) is one of the most common forms of epilepsy refractory to medical therapy. Among different surgical approaches, selective amygdalohippocampectomy has gained increasing interest for its rationale of isolated removal of the epileptogenic mesiotemporal area.

OBJECTIVE:To summarize our experience with surgical treatment of MTLE in 162 patients using the transsylvian approach and to analyze possible effects of length of hippocampal resection and postoperative gliosis on seizure and cognitive outcome.

METHODS:Clinical, radiological, histopathological and neuropsychological findings of 162 patients with MTLE who were operated by the senior author between 1993 and 2012 were retrospectively evaluated. Postoperative follow-up mounted up to 240 months (59 ± 56 months). Seizure outcome was available in 156 patients with minimum follow-up of 3 months. Extent of hippocampal resection was evaluated in 70 and postoperative gliosis in 62 of the 92 patients. Results were then correlated with seizure and cognitive outcome.

RESULTS:Of 134 patients with a follow-up of at least 1 year, 85 (63.4%) remained completely seizure free (Engel Ia) and 118 (88.0%) had a worthwhile improvement after surgery (Engel I+II). There was no perioperative death. Permanent morbidity was encountered in 4 patients (2.5%). Neither the extent of hippocampal resection nor postoperative gliosis correlated with seizure outcome or postoperative memory performance.

CONCLUSION:Transsylvian selective amygdalohippocampectomy can be recommended as an adequate procedure for the surgical treatment of mesiotemporal epilepsy with favorable epileptological results and acceptable morbidity.
Neuropsychological Function in Patients With Acute Tetraplegia and Sleep Disordered Breathing
Authors: Schembri Rachel , Spong Jo , Graco Marnie , Berlowitz David. J. ,   COSAQ study team
Published: February 2017

Sleep disordered breathing is highly prevalent following spinal cord injury and likely caused by the injury. Beyond the devastating physical consequences of spinal cord injury, neuropsychological dysfunction is also common. In both the able-bodied and chronic spinal cord injury patients, sleep disordered breathing impairs many areas of neuropsychological function. However, this has not been investigated in patients with acute injury.

Study objectives:

To investigate the relationship between apnea severity and neuropsychological function in patients with acute-onset tetraplegia and sleep disordered breathing.

Methods:

Polysomnography and neuropsychological testing were performed on 104 participants (age M = 45.60, SD = 16.38; 10 female) across 11 international sites, 2 months postinjury (M = 60.70 days, SD = 39.48). Neuropsychological tests assessed attention, information processing, executive function, memory, learning, mood, and quality of life.

Results:

More severe sleep apnea was associated with poorer attention, information processing, and immediate recall. Deficits did not extend to memory. Higher preinjury intelligence and being younger reduced the associations with sleep disordered breathing; however, these protective factors were insufficient to counter the damage to attention, immediate recall, and information processing associated with sleep disordered breathing.

Conclusions:

These data suggest that new spinal cord injury may function as a model of “acute sleep apnea” and that more widespread sleep apnea–related deficits, including memory, may only be seen with longer exposure to apnea. These findings have important implications for functioning and skill acquisition during rehabilitation and, as such, highlight the importance of sleep health following tetraplegia.
Heterologous Complementation Reveals a Specialized Activity for BacA in the Medicago–Sinorhizobium meliloti Symbiosis
Authors: diCenzo George C. , Zamani Maryam , Ludwig Hannah N. , Finan Turlough M.
Published: February 2017

The bacterium Sinorhizobium meliloti Rm2011 forms N2-fixing root nodules on alfalfa and other leguminous plants. The pSymB chromid contains a 110-kb region (the ETR region) showing high synteny to a chromosomally located region in Sinorhizobium fredii NGR234 and related rhizobia. We recently introduced the ETR region from S. fredii NGR234 into the S. meliloti chromosome. Here, we report that, unexpectedly, the S. fredii NGR234 ETR region did not complement deletion of the S. meliloti ETR region in symbiosis with Medicago sativa. This phenotype was due to the bacA gene of NGR234 not being functionally interchangeable with the S. meliloti bacA gene during M. sativa symbiosis. Further analysis revealed that, whereas bacA genes from S. fredii or Rhizobium leguminosarum bv. viciae 3841 failed to complement the Fix− phenotype of a S. meliloti bacA mutant with M. sativa, they allowed for further developmental progression prior to a loss of viability. In contrast, with Melilotus alba, bacA from S. fredii and R. leguminosarum supported N2 fixation by a S. meliloti bacA mutant. Additionally, the S. meliloti bacA gene can support N2 fixation of a R. leguminosarum bacA mutant during symbiosis with Pisum sativum. A phylogeny of BacA proteins illustrated that S. meliloti BacA has rapidly diverged from most rhizobia and has converged toward the sequence of pathogenic genera Brucella and Escherichia. These data suggest that the S. meliloti BacA has evolved toward a specific interaction with Medicago and highlights the limitations of using a single model system for the study of complex biological topics.
Evaluating the Association Between Acute and Chronic Pain After Surgery
Authors: Gilron Ian , Vandenkerkhof Elizabeth , Katz Joel , Kehlet Henrik , Carley Meg
Published: February 2017

Aim/Objectives/Background:

There is a need to predict chronic (Z3mo) postsurgical pain (CPSP). Acute (<7 d) pain is a predictor, that is, more severe pain is associated with higher CPSP risk. However, reported associations vary widely.

Methods:

Using a systematic search, we examined associations between 2 acute pain measures (pain at rest [PAR] and movement-evoked pain [MEP]) and CPSP outcomes (considering severity vs. any “nonzero” pain only) in 22 studies.

Results:

Seven studies reported the relationship between CPSP and both PAR and MEP. Of these, 2/7 reported no association, 3/7 reported significant associations for both PAR and MEP, 1/7 reported an association for PAR only, and 1/7 reported an association for MEP only. Six of another 7 studies reporting only the association for MEP found a significant relationship. Three of the 5 studies that did not specify whether acute pain outcomes were PAR or MEP reported a significant relationship. Another 3 studies reporting a relationship with CPSP did not specify whether this was for PAR, MEP, or both. All investigations incorporating severity of CPSP in their analyses (n=7) demonstrated a significant relationship, whereas only 10 of the 15 studies that dichotomized CPSP outcome as “no pain” versus “any”/“nonzero pain” were positive.

Conclusions:

Overall, evidence for an association between acute and chronic pain is moderate at best. However, closer attention to pain measurement methods will clarify the relationships between acute pain and CPSP. We propose that future CPSP predictor studies assess both PAR and MEP acutely and also incorporate CPSP severity in their analyses.
A Three-arm Randomized Clinical Trial Comparing Continuous Femoral Plus Single-injection Sciatic Peripheral Nerve Blocks versus Periarticular Injection with Ropivacaine or Liposomal Bupivacaine for Patients Undergoing Total Knee Arthroplasty
Authors: Amundson Adam W. , Johnson Rebecca L. , Abdel Matthew P. , Mantilla Carlos B. , Panchamia Jason K. , Taunton Michael J. , Kralovec Michael E. , Hebl James R. , Schroeder Darrell R. , Pagnano Mark W. , Kopp Sandra L.
Published: February 2017

Background

Multimodal analgesia is standard practice for total knee arthroplasty; however, the role of regional techniques in improved perioperative outcomes remains unknown. The authors hypothesized that peripheral nerve blockade would result in lower pain scores and opioid consumption than two competing periarticular injection solutions.

Methods

This three-arm, nonblinded trial randomized 165 adults undergoing unilateral primary total knee arthroplasty to receive (1) femoral catheter plus sciatic nerve blocks, (2) ropivacaine-based periarticular injection, or (3) liposomal bupivacaine-based periarticular injection. Primary outcome was maximal pain during postoperative day 1 (0 to 10, numerical pain rating scale) in intention-to-treat analysis. Additional outcomes included pain scores and opioid consumption for postoperative days 0 to 2 and 3 months.

Results

One hundred fifty-seven study patients received peripheral nerve block (n = 50), ropivacaine (n = 55), or liposomal bupivacaine (n = 52) and reported median maximal pain scores on postoperative day 1 of 3, 4, and 4.5 and on postoperative day 0 of 1, 4, and 5, respectively (average pain scores for postoperative day 0: 0.6, 1.7, and 2.4 and postoperative day 1: 2.5, 3.5, and 3.7). Postoperative day 1 median maximal pain scores were significantly lower for peripheral nerve blockade compared to liposomal bupivacaine-based periarticular injection (P = 0.016; Hodges–Lehmann median difference [95% CI] = −1 [−2 to 0]). After postanesthesia care unit discharge, postoperative day 0 median maximal and average pain scores were significantly lower for peripheral nerve block compared to both periarticular injections (ropivacaine: maximal −2 [−3 to −1]; P < 0.001; average −0.8 [−1.3 to −0.2]; P = 0.003; and liposomal bupivacaine: maximal −3 [−4 to −2]; P < 0.001; average −1.4 [−2.0 to −0.8]; P < 0.001).

Conclusions

Ropivacaine-based periarticular injections provide pain control comparable on postoperative days 1 and 2 to a femoral catheter and single-injection sciatic nerve block. This study did not demonstrate an advantage of liposomal bupivacaine over ropivacaine in periarticular injections for total knee arthroplasty.
A Longitudinal Investigation of the Home Literacy Environment and Shared Book Reading in Young Children With Hearing Loss
Authors: DesJardin Jean L. , Stika Carren J. , Eisenberg Laurie S. , Johnson Karen C. , Hammes Ganguly Dianne M. , Henning Shirley C. , Colson Bethany G.
Published: February 2017

Objectives:

The principle goal of this longitudinal study was to examine parent perceptions of home literacy environment (e.g., frequency of book reading, ease of book reading with child) and observed behaviors during shared book reading (SBR) interactions between parents and their children with hearing loss (HL) as compared with parents and their children with normal hearing (NH) across 3 time points (12, 24, and 36 months old). Relationships were also explored among home literacy environment factors and SBR behaviors and later language outcomes, across all three time points for parents of children with and without HL.

Design:

Participants were a group of parents and their children with HL (N = 17) and typically developing children with NH (N = 34). Parent perceptions about the home literacy environment were captured through a questionnaire. Observed parent behaviors and their use of facilitative language techniques were coded during videotaped SBR interactions. Children’s oral language skills were assessed using a standardized language measure at each time point.

Results:

No significant differences emerged between groups of parents (HL and NH) in terms of perceived home literacy environment at 12 and 36 months. However, significant group differences were evident for parent perceived ease of reading to their child at 24 months. Group differences also emerged for parental SBR behaviors for literacy strategies and interactive reading at 12 months and for engagement and interactive reading at 36 months, with parents of children with HL scoring lower in all factors. No significant relationships emerged between early home literacy factors and SBR behaviors at 12 months and oral language skills at 36 months for parents of children with NH. However, significant positive relationships were evident between early home literacy environment factors at 12 months and oral language skills at 36 months for parents and their children with HL.

Conclusions:

Although both groups of parents increased their frequency of SBR behaviors over time, parents of children with HL may need additional support to optimize SBR experiences to better guide their toddlers’ and preschoolers’ language skills. Early intervention efforts that focus on SBR interactions that are mutually enjoyed and incorporate specific ways to encourage parent–child conversations will be essential as children with HL acquire language.
Possible Compartmental Cytokine Release Syndrome in a Patient With Recurrent Ovarian Cancer After Treatment With Mesothelin-targeted CAR-T Cells
Authors: Tanyi Janos L. , Stashwick Caitlin , Plesa Gabriela , Morgan Mark A. , Porter David , Maus Marcela V. , June Carl H.
Published: February 2017

Cytokine release syndrome (CRS) is a potentially severe systemic toxicity seen after adoptive T-cell therapy and caused by T-cell activation and proliferation and is associated with elevated circulating levels of cytokines such as C-reactive protein, interleukin-6 (IL-6), and interferon-γ and has previously been described as a systemic response in hematologic malignancies. A 52-year-old woman with BRCA 1 mutation positive heavily pretreated advanced recurrent serous ovarian cancer was treated under a compassionate use protocol with autologous mesothelin-redirected chimeric antigen receptor T cells (CART-meso). Autologous T cells were transduced to express a receptor composed of an extracellular antimesothelin single-chain variable fragment fused to 4-1BB and TCR-zeta signaling domain. This patient was infused with 3×107 CART-meso T cells/m2 without lymphodepletion and developed compartmental CRS confined to the pleural cavities. The compartmental CRS was evidenced by an increase in IL-6 and accumulation of CART-meso T cells in pleural fluid compared with peripheral blood and was successfully treated the anti-IL6 receptor antagonist tocilizumab on D21 after the T-cell infusion. This is the first description of a compartmental CRS in a patient with solid malignancy. This response could be due to malignant pleural fluid creating an environment where T cells could interact with tumor cells and suggests localized on-target CAR-T-cell activation.
Myasthenia Gravis After Nivolumab Therapy for Squamous Cell Carcinoma of the Bladder
Authors: Chang Elaine , Sabichi Anita L. , Sada Yvonne H.
Published: February 2017

Checkpoint inhibitors have become standard therapy for multiple cancers, and their use will increase in the next year as regulatory approvals for additional indications are expected. It is essential for clinicians to be aware of the potential for rare immune-related adverse effects. Here, we report the case of a new diagnosis of myasthenia gravis (MG) after the use of nivolumab for squamous cell carcinoma of the bladder. A review the literature identified 10 cases of MG diagnosed after programmed cell death protein 1 inhibitor therapy. This is the first case, to our knowledge, reported in association with bladder cancer. The precise diagnosis of MG has important implications on management, as treatment with steroids can transiently worsen myasthenia in nearly 50% of cases.
Scalp melanoma is associated with high mitotic rate and is a poor prognostic factor for recurrence and outcome
Authors: Tas Faruk , Erturk Kayhan
Published: February 2017

A small subset of head and neck melanoma, scalp melanoma comprises 3–5% of all cutaneous melanomas. So far, small numbers of researches on scalp melanoma have yielded controversial results. In this trial, we aimed to define the histopathological and clinical features specific to scalp melanoma and to compare them with melanomas that occurred on other sites by using a large group of patients from a single institution. The data of 93 patients with scalp melanoma and 1076 patients with melanomas on other sites were analyzed retrospectively. The median age of the patients was 53 (range 18–83) years. The scalp melanomas were found more frequently in male patients (79.6 vs. 52.0%, P=0.001) and they tended to have nodular histology (41.1 vs. 29.2%, P=0.01), with a higher mitotic rate (>3/mm2) (56.9 vs. 40.9%, P=0.01). However, the scalp melanoma was not significantly associated with other histopathological parameters, for example, age, Clark invasion level, Breslow thickness, ulceration, regression, lymphovascular invasion, neurotropism, tumor-infiltrating lymphocyte, and BRAF mutation analysis. Besides, no correlation was found between scalp localization and either nodal involvement or metastasis (P>0.05). The scalp patients had poorer survivals compared with those with other sites. The median survival time and 5-year recurrence-free survival rates for scalp and other sites in patients were 15.6 months and 45.1% versus 23.5 months and 63.6%, respectively (P=0.001). Similarly, the median overall survival times and 5-year overall survival rates in scalp and other sites in patients were 25.6 months and 44.1% versus 28.7 months and 62.9%, respectively (P=0.0001). In conclusion, scalp melanoma patients correlate with a high mitotic rate and are associated with poorer survival than patients with melanomas on other sites.
Radial Peripapillary Capillary Density Measurement Using Optical Coherence Tomography Angiography in Early Glaucoma
Authors: Mansoori Tarannum , Sivaswamy Jayanthi , Gamalapati Jahnavi Sai , Balakrishna Nagalla
Published: February 2017

Purpose:

The purpose of the study was to compare radial peripapillary capillary (RPC) density between normal subjects and patients with early primary open-angle glaucoma (POAG) using optical coherence tomography angiography (OCT-A).

Materials and Methods:

A total of 24 patients with early POAG and age-matched 52 normal subjects underwent scanning with OCT-A imaging (RTVue XR-100, Avanti OCT). The enface angioflow images obtained were analyzed qualitatively for the RPC network, and RPC capillary density (CD) was measured in 8 sectors within a 3.45-mm-diameter circle around the optic disc, using the Bar-Selective Combination of Shifted Filter Responses (B-COSFIRE) method. CD and retinal nerve fiber layer (RNFL) thickness were compared between corresponding sectors with the Mann-Whitney U test. Correlations between CD and Humphrey visual field parameters and optic disc structural parameters were calculated by linear regression analysis.

Results:

In the normal eyes, RPC bed was clearly visible on OCT-A as a dense microvascular network around the optic disc, whereas in POAG patients it was focally attenuated. RPC CD was lower in the inferotemporal (P=0.002) and superotemporal (P=0.008) sectors with corresponding focal RNFL defect in POAG patients when compared with normal controls. The average CD correlated with visual field mean deviation (P=0.01) and pattern standard deviation (P=0.02) in glaucomatous eyes.

Conclusions:

OCT-A demonstrated reproducible, focal loss of RPCs in patients with early POAG when compared with normal controls. The results of our study suggest that the RPC density measurements may have a value in the diagnosis and monitoring of glaucoma.
Effect of Surgical Intraocular Pressure Lowering on Peripapillary and Macular Vessel Density in Glaucoma Patients: An Optical Coherence Tomography Angiography Study
Authors: Zéboulon Pierre , Lévêque Pierre-Maxime , Brasnu Emmanuelle , Aragno Vittoria , Hamard Pascale , Baudouin Christophe , Labbé Antoine
Published: February 2017

Purpose:

To measure the influence of surgically induced intraocular pressure lowering on peripapillary and macular vessel density in glaucoma patients using optical coherence tomography angiography.

Methods:

Twenty-one eyes of 21 patients with open-angle glaucoma scheduled for filtering surgery were enrolled prospectively. Using optical coherence tomography angiography, vessel density was quantified within the peripapillary and macular regions, before and 1 month after filtering surgery. Change in vessel density was calculated for all analyzed areas.

Results:

One month after surgery, the mean intraocular pressure reduction was 44.2%±4.8% (range, 15.2% to 77.1%). The mean change in vessel density for the whole peripapillary area was 0.065±0.88% (P=0.788). In the macular region, the mean change in vessel density was −0.022%±0.691% (P=0.405) with significant changes only within the inferotemporal area of patients with predominantly superior visual field defects (−1.86%±1.43%, P=0.024).

Conclusions:

Optical coherence tomography angiography allowed very limited measurement of intraocular pressure lowering-induced changes on the vessel density of the peripapillary and macular regions in glaucoma patients.