bluuebunny/crossref_metadata_2025 huggingface dataset:
HWFusion: Holoentropy and SP‐Whale optimisation‐based fusion model for magnetic resonance imaging multimodal image fusion
Authors: Venkatrao Patil Hanmant , Damodar Shirbahadurkar Suresh
Published: November 2017

Image fusion is becoming a promising technique for obtaining a more informative image by combining various source images captured by multimodal imaging systems. The technique finds application in several fields, such as medical imaging, material analysis, satellite imaging, including defence and civilian sectors. This study presents a model, named holoentropy‐whale fusion (HWFusion), for the image fusion. Two different multimodal images from magnetic resonance imaging (T1, T1C, T2, FLAIR) are fed into the wavelet transform to convert the images into four subbands. The wavelet coefficients are then fused using a weighted coefficient that utilises two factors, entropy and whale fusion factor, which are calculated using holoentropy and the proposed SP‐Whale optimiser, respectively. SP‐Whale is an algorithm designed by modifying whale optimisation algorithm with self‐adaptive learning particle swarm optimisation and is used for the optimal selection of whale fusion factor. Inverse wavelet transform converts the fused wavelet coefficients obtained by the averaging of fusion factors into fused image. In a comparative analysis, the performance of HWFusion is compared with that of four existing techniques using, mutual information, peak signal‐to‐noise ratio, and root mean‐squared error (RMSE), where it could attain mutual information of 1.8015, RMSE of 1.1701, and peak signal‐to‐noise ratio of 40.6575.
Dual‐frequency microstrip antenna at S and X bands with higher‐order mode suppression technique
Authors: Mathur Pratigya , Kumar Girish
Published: November 2017

In this study, a higher‐order mode suppression technique in single‐ and dual‐frequency microstrip antennas is proposed. The technique integrates a microstrip filter within the microstrip antenna, thereby simplifying the transmitter/receiver chain by eliminating the need of a separate filter. This technique gives higher‐order mode suppression of 8 dB using a low‐pass microstrip filter without any effect on the resonance frequency and the gain of the antenna. A dual‐frequency antenna for S and X bands is designed using this technique to obtain measured bandwidth of 7% and gain of 8 dBi at the S‐band and measured bandwidth of 10.5% and gain of 11.5 dBi at the X‐band. This antenna can be used for satellite applications.
Efficient millimetre‐wave imaging structure for detecting axially rotated objects
Authors: Farsaee Amir Ashkan , Kavehvash Zahra , Shabany Mahdi
Published: November 2017

An efficient multi‐static millimetre‐wave (MMW) imaging system is proposed with the aim of obtaining the information of an axially tilted object. It is known that a multi‐static structure performs better than a mono‐static array in detecting the reflected signal from axially tilted surfaces due to the specular reflection. Still, no efficient multi‐static structure for the purpose of imaging tilted objects in view of the computational time, cost and image quality is proposed till now. The authors propose an efficient multi‐static MMW imaging system tackle this issue with the minimum number of antennae. Furthermore, the small number of antennae in the proposed design and the proposed fast reconstruction method considerably decrease the overall imaging time compared to conventional multi‐static structures, making it the technology of the choice for real‐time applications. Experimental results prove 2× and 1.4× improvement in the image quality (in terms of digital‐image‐correlation metric) compared to mono‐static and conventional multi‐static structures, respectively, and yet a great enhancement in the axial information, insofar as rotated targets are concerned.
Research and implementation of outage plan system for reliability and clean energy consumptive power constraint
Authors: Peijun Li , Xiaoyu Zheng , Jiali Zhang , Lihua Liu , Xiaotian Zhang , Min Li
Published: November 2017

The authors have studied the connotation of the outage plan management system, explored the application framework and key technology to realise the outage plan system for power grid reliability and clean energy consumptive consideration; combined the outage plan management process and status and designed and realised the outage plan system for reliability and clean energy consumptive power constraint, to improve the safety and reliability of power grid and clean energy consumptive level. The practical result confirmed the effectiveness of the designed system.
Richness of compact radio sources in NGC 6334D to F
Authors: Medina S.-N. X. , Dzib S. A. , Tapia M. , Rodríguez L. F. , Loinard L.
Published: November 2017

Context. The presence and properties of compact radio sources embedded in massive star forming regions can reveal important physical properties about these regions and the processes occurring within them. The NGC 6334 complex, a massive star forming region, has been studied extensively. Nevertheless, none of these studies has focused in its content in compact radio sources.

Aims. Our goal here is to report on a systematic census of the compact radio sources toward NGC 6334, and their characteristics. This will be used to attempt to define their very nature.

Methods. We used the VLA C band (4–8 GHz) archive data with 0.̋36 (500 AU) of spatial resolution and noise level of 50 μJy bm−1 to carry out a systematic search for compact radio sources within NGC 6334. We also searched for infrared counterparts to provide some constraints on the nature of the detected radio sources.

Results. A total of 83 compact sources and three slightly resolved sources were detected. Most of them are here reported for the first time. We found that 29 of these 86 sources have infrared counterparts and three are highly variable. Region D contains 18 of these sources. The compact source toward the center, in projection, of region E is also detected.

Conclusions. From statistical analyses, we suggest that the 83 reported compact sources are real and most of them are related to NGC 6334 itself. A stellar nature for 27 of them is confirmed by their IR emission. Compared with Orion, region D suffers a deficit of compact radio sources. The infrared nebulosities around two of the slightly resolved sources are suggested to be warm dust, and we argue that the associated radio sources trace free-free emission from ionized material. We confirm the thermal radio emission of the compact source in region E. However, its detection at infrared wavelengths implies that it is located in the foreground of the molecular cloud. Finally, three strongly variable sources are suggested to be magnetically active young stars.
High speed displacement measurement based on electro-magnetic induction applied to electromagnetically driven ring expansion
Authors: Han Xiaotao , Wu Jiawei , Huang Lantao , Qiu Lei , Chen Qi , Cao Quanliang , Herlach Fritz , Li Liang
Published: November 2017

Investigating the mechanism of electromagnetic forming (EMF) becomes a hot topic in the field of metal forming. The high speed up to 200 m/s in EMF makes it a real challenge to capture the forming process. To this end, a new method for measuring displacement at high speed based on electromagnetic induction has been developed. Specifically this is used to measure the displacement of an expanding metal ring driven by a pulsed magnetic field; this is one of the basic EMF processes. The new method is simple and practical, and it combines high-speed response with adequate precision. The new measurement system consists of a printed circuit board (PCB) and a Rogowski probe. Eleven coaxial annular detecting probes are arranged in the PCB plate to acquire induced voltage at different positions, and a Rogowski probe is used to measure the current in the driving coil. The displacement of the ring is deduced by analyzing the output voltages of the detecting probes and the Rogowski probe. The feasibility of the method is verified by comparing the results with pictures from a high speed camera taken simultaneously.
Small scale stand-alone photovoltaic pumping system with brushless DC motor for irrigation in agriculture
Authors: Kapica Jacek
Published: November 2017

This paper presents a case study analysis of a solar photovoltaic-powered pumping system with a brushless DC motor. Four circuit configurations are considered: direct coupling of the pump set with a photovoltaic generator, generator with a maximum power point tracking device and with a supercapacitor which stores energy from the low irradiation periods which otherwise would be lost as the power is too low to start the motor. A setup with a supercapacitor and a maximum power point tracking device is also considered. The system is analysed in the Matlab/Simulink environment. The purpose of this study was to determine the impact of the chosen setup on the volume of water pumped. The results show that the systems with maximum power point tracking usually outweigh other configurations.
Burst synchronization transition of intracellular Ca2+ oscillations in coupled cell systems
Authors: Ji Quanbao , Zuo Hongkun , Meng Pan
Published: November 2017

Considering four coupled identical and non-identical bursters with different topological types, both of the different synchronization transition paths and influence of the oscillatory patterns on synchronization are studied. Our results reveal that the phenomena of multi-time scale, phase-locking, chaos and anti-phase synchronization transitions can be separately found in the coupled systems by varying the coupling strength. The above analysis of synchronization transition could provide us with a further clue for better understanding the mechanism of intracellular Ca2+ signaling.
Wideband terahertz absorber based on Mie resonance metasurface
Authors: Wang Qingmin , Zhou Ruilin , Wang Xuying , Guo Yunsheng , Hao Yanan , Lei Ming , Bi Ke
Published: November 2017

Terahertz absorber has attracted much attention. However, most of them have complex structures and narrow bandwidth. Here, a wideband terahertz metasurface absorber based on Mie resonance is demonstrated. The metasurface absorber is prepared by combining four dielectric resonators with different permittivity values into a single unit cell. The absorption of the wideband metasurface absorber goes beyond 80% from 8.37 to 8.60 THz, showing wideband absorption performance. In addition, the center frequency of the wideband metasurface absorber can be tuned by the size and permittivity of the dielectric resonators, which makes the proposed absorber suitable for applications in wideband terahertz devices.
Volatility of the catalytic hydrogenation products of 1,4 bis(phenylethynyl)benzene
Authors: Sharma Hom N. , Sangalang Elizabeth A. , Saw Cheng K. , Cairns Gareth A. , McLean William , Maxwell Robert S. , Dinh Long N.
Published: November 2017

Measurements of equilibrium vapor pressures by effusion thermogravimetry and melting points by differential scanning calorimetry reveal that the melting temperature and equilibrium vapor pressures of 1,4-bis(phenylethynyl)benzene (DEB) do not vary monotonically with the hydrogenation extent. Contrary to intuition which suggests increasing volatility with hydrogenation, results indicate decreasing volatility for the first two hydrogenation steps before a non-monotonic upward trend, in which trans-isomers are less volatile. Insights on structural packing and functional groups were obtained from x-ray diffraction and infrared studies to shed light on the observed variation in the volatility of DEB with hydrogenation. Density functional theory calculations were performed to obtain molecular level information and to establish the thermodynamics of DEB hydrogenation reactions. A major factor influencing the observed melting points and volatility of the hydrogenated intermediate species is identified as the local attractive or repulsive carbon-hydrogen (CH) dipole interactions among the getter molecules in their respective crystal structures. Such collective CH dipole interactions can be used to predict the trends in the volatilities of catalytic hydrogenation processes.
Electric field formation in three different plasmas: A fusion reactor, arc discharge, and the ionosphere
Authors: Lee Kwan Chul
Published: November 2017

Three examples of electric field formation in the plasma are analyzed based on a new mechanism driven by ion-neutral collisions. The Gyro-Center Shift analysis uses the iteration of three equations including perpendicular current induced by the momentum exchange between ions and neutrals when there is asymmetry over the gyro-motion. This method includes non-zero divergence of current that leads the solution of time dependent state. The first example is radial electric field formation at the boundary of the nuclear fusion device, which is a key factor in the high-confinement mode operation of future fusion reactors. The second example is the reversed rotation of the arc discharge cathode spot, which has been a mysterious subject for more than one hundred years. The third example is electric field formations in the earth's ionosphere, which are important components of the equatorial electrojet and black aurora. The use of one method that explains various examples from different plasmas is reported, along with a discussion of the applications.
Enhanced photoelectrochemical properties of copper-assisted catalyzed etching black silicon by electrodepositing cobalt
Authors: Cai Weidong , Xiong Haiying , Su Xiaodong , Zhou Hao , Shen Mingrong , Fang Liang
Published: November 2017

Black silicon (Si) photoelectrodes are promising for improving the performance of photoelectrochemical (PEC) water splitting. Here, we report the fabrication of p-black Si and n+p-black Si photocathodes via a controllable copper-assisted catalyzed etching method. The etching process affects only the topmost less than 200 nm of Si and is independent of the surface doping. The synergistic effects of the excellent light harvesting of the black Si and the improved charge transfer properties of the p-n junction boost the production and utilization of photogenerated carriers. The mean reflectance of the pristine Si samples is about 10% from 400 to 950 nm, while that of the black Si samples is reduced as low as 5%. In addition, the PEC properties of the n+p-black Si photocathode can be further enhanced by depositing a cobalt (Co) layer. Compared with the p-Si sample, the onset potential of the Co/n+p-black Si photocathode is positively shifted by 560 mV to 0.33 V vs. reversible hydrogen electrode and the saturation photocurrent density is increased from 22.7 to 32.6 mA/cm2. The design of the Co/n+p-black Si photocathode offers an efficient strategy for preparing PEC solar energy conversion devices.
Electronic structure of monolayer 1T′-MoTe2 grown by molecular beam epitaxy
Authors: Tang Shujie , Zhang Chaofan , Jia Chunjing , Ryu Hyejin , Hwang Choongyu , Hashimoto Makoto , Lu Donghui , Liu Zhi , Devereaux Thomas P. , Shen Zhi-Xun , Mo Sung-Kwan
Published: November 2017

Monolayer transition metal dichalcogenides (TMDCs) in the 1T′ structural phase have drawn a great deal of attention due to the prediction of quantum spin Hall insulator states. The band inversion and the concomitant changes in the band topology induced by the structural distortion from 1T to 1T′ phases are well established. However, the bandgap opening due to the strong spin-orbit coupling (SOC) is only verified for 1T′-WTe2 recently and still debated for other TMDCs. Here we report a successful growth of high-quality monolayer 1T′-MoTe2 on a bilayer graphene substrate through molecular beam epitaxy. Using in situ angle-resolved photoemission spectroscopy (ARPES), we have investigated the low-energy electronic structure and Fermi surface topology. The SOC-induced breaking of the band degeneracy points between the valence and conduction bands is clearly observed by ARPES. However, the strength of SOC is found to be insufficient to open a bandgap, which makes monolayer 1T′-MoTe2 on bilayer graphene a semimetal.
Modeling of intense pulsed ion beam heated masked targets for extreme materials characterization
Authors: Barnard John J. , Schenkel Thomas
Published: November 2017

Intense, pulsed ion beams locally heat materials and deliver dense electronic excitations that can induce material modifications and phase transitions. Material properties can potentially be stabilized by rapid quenching. Pulsed ion beams with pulse lengths of order ns have recently become available for materials processing. Here, we optimize mask geometries for local modification of materials by intense ion pulses. The goal is to rapidly excite targets volumetrically to the point where a phase transition or local lattice reconstruction is induced followed by rapid cooling that stabilizes desired material's properties fast enough before the target is altered or damaged by, e.g., hydrodynamic expansion. By using a mask, the longitudinal dimension can be large compared to the transverse dimension, allowing the possibility of rapid transverse cooling. We performed HYDRA simulations that calculate peak temperatures for a series of excitation conditions and cooling rates of silicon targets with micro-structured masks and compare these to a simple analytical model. The model gives scaling laws that can guide the design of targets over a wide range of pulsed ion beam parameters.
Can the mother plant age of Acacia melanoxylon (Leguminosae) modulate the germinative response to fire?
Authors: Cruz Oscar , García-Duro Juan , Casal Mercedes , Reyes Otilia
Published: November 2017

Acacia melanoxylon R.Br. (Leguminosae) is one of the most widely distributed tree species in the world. It has significant commercial use but can be a danger to natural ecosystems as an invader species. For these reasons it is necessary to have a deep knowledge about its germinative response to fire and the role the mother plant age plays in that response. In this work we assessed the effects of the interaction of the mother plant age with the main fire agents (smoke, charcoal, ash and heat) on the germinative response of A. melanoxylon. To reach this aim, germination tests were conducted with seeds from young, intermediate and mature mother plants, with 20 treatments each applied. Results show that fire can act as a great stimulator of the germination of A. melanoxylon but it can also strongly inhibit it. The mother plant age does not modify the final germination values, but it influences the time in which the first germinations occur after fire. This trait can be more important than the final germination percentage when looking at the success of post-fire regeneration. These results have important implications for A. melanoxylon management, for both species control and ecological restoration purposes.
Peri-conception and first trimester diet modifies reproductive development in bulls
Authors: Copping K. J. , Ruiz-Diaz M. D. , Rutland C. S. , Mongan N. P. , Callaghan M. J. , McMillen I. C. , Rodgers R. J. , Perry V. E. A.
Published: November 2017

Nutritional perturbation during gestation alters male reproductive development in rodents and sheep. In cattle both the developmental trajectory of the feto–placental unit and its response to dietary perturbations is dissimilar to that of these species. This study examined the effects of dietary protein perturbation during the peri-conception and first trimester periods upon reproductive development in bulls. Nulliparous heifers (n = 360) were individually fed a high- or low-protein diet (HPeri and LPeri) from 60 days before conception. From 24 until 98 days post conception, half of each treatment group changed to the alternative post-conception high- or low-protein diet (HPost and LPost) yielding four treatment groups in a 2 × 2 factorial design. A subset of male fetuses (n = 25) was excised at 98 days post conception and fetal testis development was assessed. Reproductive development of singleton male progeny (n = 40) was assessed until slaughter at 598 days of age, when adult testicular cytology was evaluated. Low peri-conception diet delayed reproductive development: sperm quality was lowered during pubertal development with a concomitant delay in reaching puberty. These effects were subsequent to lower FSH concentrations at 330 and 438 days of age. In the fetus, the low peri-conception diet increased the proportion of seminiferous tubules and decreased blood vessel area in the testis, whereas low first trimester diet increased blood vessel number in the adult testis. We conclude that maternal dietary protein perturbation during conception and early gestation may alter male testis development and delay puberty in bulls.
Changes in bone turnover and calcium homeostasis during pregnancy and lactation in mammals: a meta-analysis
Authors: Torres Diego A. , Freitas Mariella B. , Gonçalves Reggiani V.
Published: November 2017

Large amounts of calcium are required during pregnancy and lactation to support fetal and neonatal bone growth and calcification. An inadequate supply of calcium during these stages can lead to unsuccessful reproduction or impaired offspring fitness. During reproduction, female mammals undergo numerous physiological changes, including adaptations to allow an adequate supply of calcium. The lack of quantitative studies analysing these physiological changes from a comparative perspective limits our ability to explain and understand these adaptations. Herein, we present our meta-analysis of studies reporting changes in bone turnover and calcium homeostasis during pregnancy and lactation in 14 species of mammals. Our meta-analysis of 60 studies showed that all species have a similar pattern of physiological changes during pregnancy and lactation, which include: (1) decreased serum calcium concentrations; (2) bone tissue loss; (3) decreased serum calcitonin and parathyroid hormone concentrations; and (4) increased serum calcitriol concentration, regardless of changes in parathyroid hormone concentrations. In addition, we found a negative relationship between: (1) serum calcium concentrations and the number of teats; and (2) serum parathyroid hormone concentrations and litter mass.
Liming improves soil microbial growth, but trash blanket placement increases labile carbon and nitrogen availability in a sugarcane soil of subtropical Australia
Authors: Liu X. Y. , Rashti M. Rezaei , Esfandbod M. , Powell B. , Chen C. R.
Published: November 2017

Liming has been widely used to decrease soil acidity, but its effects on soil nitrogen (N) availability and microbial processes in sugarcane fields are largely unknown. Adjacent sugarcane soils at 26 months after liming (26ML), 14 months after liming (14ML) and with no lime amendment (CK) in Bundaberg, Australia, were selected to investigate the effect of liming on soil N bioavailability and microbial activity in a long-term subtropical sugarcane cropping system. Liming in both 14ML and 26ML treatments significantly increased soil pH (by 1.2–1.4 units) and exchangeable Ca2+ (>2-fold) compared with the CK treatment. The lower concentrations of hot water extractable organic carbon (C) and total N and ammonium-N in the 14ML, compared with the CK and 26ML treatments, can be attributed to the absence of trash blanket placement in the former. Enhanced microbial immobilisation due to improved soil pH by liming (14ML and 26ML treatments) led to increased soil microbial biomass C and N, particularly in the presence of a trash blanket (26 ML treatment), but decreased soil respiration and metabolic quotient indicated that acidic stress conditions were alleviated in the liming treatments. Soil pH was the main factor governing soil enzyme activities, with an overall decrease in all enzyme activities in response to liming. Overall, liming and trash blanket practices improved sugarcane soil fertility. Further study is warranted to investigate the shifts in soil microbial community composition and the diversity and abundance of N-associated functional genes in response to liming in sugarcane fields.
Trophic interactions between a native Catfish (Trichomycteridae) and a non-native species, the Rainbow Trout, in an Andean stream, San Juan, Argentina
Authors: Garcia M. I. , Acosta J. C. , García M. L.
Published: November 2017

The trophic relationship between Torrent Catfish (Hatcheria macraei) and Rainbow Trout (Oncorhynchus mykiss) was studied in a lotic Andean system of Argentina to examine whether these fish compete for the same food resources. Fishes were sampled seasonally, in autumn, spring, and summer. Hatcheria macraei and O. mykiss presented a carnivorous generalist feeding strategy. Trout diet was dominated by aquatic macroinvertebrates, and terrestrial invertebrates were an important component in summer. Large-sized Rainbow Trout fed on Catfish, which in turn preyed mainly on Chironomidae and Elmidae larvae. During flood periods, the Trout diet, as well as that of the Catfish, was mainly composed of clingers (Elmidae and Chironomidae) and particularly in the case of Catfish, burrowers (Oligochaeta) were found. We found an elevated dietary overlap between Trout and Catfish with seasonal changes. Our results suggest that coexistence of Trout and Catfish depends on input of terrestrial invertebrates, and the feeding of Catfish on small prey.
Applying a decision tree framework in support of an ecosystem approach to fisheries: IndiSeas indicators in the North Sea
Authors: Lockerbie Emma M , Lynam Christopher P , Shannon Lynne J , Jarre Astrid
Published: November 2017

As one of the most economically important marine ecosystems, the North Sea has been impacted by numerous anthropogenic activities. A move towards an ecosystem approach to fisheries is key in developing sustainable fisheries in marine ecosystems. The application of a previously tested decision tree framework that employs a suite of indicators suggested in the IndiSeas project with additional indicators of environmental variability has been used in this study. Trends in indicators were used to identify ecosystem trends across three periods: 1983–1992, 1993–2003, and 2004–2010. A score-based approach was adopted, assigning scores to indicators based on direction and significance of trends. Ecological indicator scores were adjusted to account for impacts of fishing and environmental variability. Overall ecosystem scores assigned the ecosystem into one of five possible categories: improving, possibly improving, no improvement/deterioration, possibly deteriorating or deteriorating. Results indicated no improvement or deterioration over Period 1 (1983–1992); whereas Periods 2 (1993–2003) and 3 (2004–2010) showed a possible improvement of the ecosystem. Use of a structured decision tree framework, including extensive literature reviews and knowledge from ecosystem experts, allows the determination of ecosystem trends in a way consistent with ecological theory.
Effectiveness of Virtual Reality in Children With Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Chen Yuping , Fanchiang HsinChen D , Howard Ayanna
Published: November 2017

Background

Researchers recently investigated the effectiveness of virtual reality (VR) in helping children with cerebral palsy (CP) to improve motor function. A systematic review of randomized controlled trials (RCTs) using a meta-analytic method to examine the effectiveness of VR in children with CP was thus needed.

Purpose

The purpose of this study was to update the current evidence about VR by systematically examining the research literature.

Data Sources

A systematic literature search of PubMed, CINAHL, Cochrane Central Register of Controlled Trials, ERIC, PsycINFO, and Web of Science up to December 2016 was conducted.

Study Selection

Studies with an RCT design, children with CP, comparisons of VR with other interventions, and movement-related outcomes were included.

Data Extraction

A template was created to systematically code the demographic, methodological, and miscellaneous variables of each RCT. The Physiotherapy Evidence Database (PEDro) scale was used to evaluate the study quality. Effect size was computed and combined using meta-analysis software. Moderator analyses were also used to explain the heterogeneity of the effect sizes in all RCTs.

Data Synthesis

. The literature search yielded 19 RCT studies with fair to good methodological quality. Overall, VR provided a large effect size (d = 0.861) when compared with other interventions. A large effect of VR on arm function (d = 0.835) and postural control (d = 1.003) and a medium effect on ambulation (d = 0.755) were also found. Only the VR type affected the overall VR effect: an engineer-built system was more effective than a commercial system.

Limitations

The RCTs included in this study were of fair to good quality, had a high level of heterogeneity and small sample sizes, and used various intervention protocols.

Conclusions

Then compared with other interventions, VR seems to be an effective intervention for improving motor function in children with CP.
Toward a Common Language for Measuring Patient Mobility in the Hospital: Reliability and Construct Validity of Interprofessional Mobility Measures
Authors: Hoyer Erik H , Young Daniel L , Klein Lisa M , Kreif Julie , Shumock Kara , Hiser Stephanie , Friedman Michael , Lavezza Annette , Jette Alan , Chan Kitty S , Needham Dale M
Published: November 2017

Background

The lack of common language among interprofessional inpatient clinical teams is an important barrier to achieving inpatient mobilization. In The Johns Hopkins Hospital, the Activity Measure for Post-Acute Care (AM-PAC) Inpatient Mobility Short Form (IMSF), also called “6-Clicks,” and the Johns Hopkins Highest Level of Mobility (JH-HLM) are part of routine clinical practice. The measurement characteristics of these tools when used by both nurses and physical therapists for interprofessional communication or assessment are unknown.

Objective

The purposes of this study were to evaluate the reliability and minimal detectable change of AM-PAC IMSF and JH-HLM when completed by nurses and physical therapists and to evaluate the construct validity of both measures when used by nurses.

Design

A prospective evaluation of a convenience sample was used.

Methods

The test-retest reliability and the interrater reliability of AM-PAC IMSF and JH-HLM for inpatients in the neuroscience department (n = 118) of an academic medical center were evaluated. Each participant was independently scored twice by a team of 2 nurses and 1 physical therapist; a total of 4 physical therapists and 8 nurses participated in reliability testing. In a separate inpatient study protocol (n = 69), construct validity was evaluated via an assessment of convergent validity with other measures of function (grip strength, Katz Activities of Daily Living Scale, 2-minute walk test, 5-times sit-to-stand test) used by 5 nurses.

Results

The test-retest reliability values (intraclass correlation coefficients) for physical therapists and nurses were 0.91 and 0.97, respectively, for AM-PAC IMSF and 0.94 and 0.95, respectively, for JH-HLM. The interrater reliability values (intraclass correlation coefficients) between physical therapists and nurses were 0.96 for AM-PAC IMSF and 0.99 for JH-HLM. Construct validity (Spearman correlations) ranged from 0.25 between JH-HLM and right-hand grip strength to 0.80 between AM-PAC IMSF and the Katz Activities of Daily Living Scale.

Limitations

The results were obtained from inpatients in the neuroscience department of a single hospital.

Conclusions

The AM-PAC IMSF and JH-HLM had excellent interrater reliability and test-retest reliability for both physical therapists and nurses. The evaluation of convergent validity suggested that AM-PAC IMSF and JH-HLM measured constructs of patient mobility and physical functioning.
Pathological Movements of the Pelvis and Trunk During Gait in Children With Cerebral Palsy: A Cross-Sectional Study With 3-Dimensional Kinematics and Lower Lumbar Spinal Loading
Authors: Kiernan Damien , O’Sullivan Rory , Malone Ailish , O’Brien Timothy , Simms Ciaran K
Published: November 2017

Background

Increased loading at the lumbar spine, particularly in the coronal plane, has been reported in children with cerebral palsy (CP). As pelvic and trunk movements associated with Trendelenburg and Duchenne type gait are most significant in the coronal plane, the potential exists for lower lumbar spinal loading to be negatively affected in children with CP and these types of movement patterns.

Objective

The objective of this study was to assess trunk and pelvic kinematics and lower lumbar spinal loading patterns in children with CP and Trendelenburg and Duchenne type gait.

Design

This was a cross-sectional study.

Methods

Three-dimensional kinematic (lower limb and thorax) and L5-S1 kinetic data were recorded. Children were divided according to clinical presentation of Trendelenburg or Duchenne type gait. Several discrete kinematic and kinetic parameters were assessed between groups.

Results

Three distinct pelvic and trunk movement patterns were identified for children with CP: Trendelenburg, Duchenne, and complex Trendelenburg–Duchenne. Peak L5-S1 lateral bending moments were increased by 62% in children with CP and Duchenne type gait. Children with CP and complex Trendelenburg-Duchenne gait demonstrated the largest deviations from normal, with increased peak ipsilateral and contralateral directed moments of 69% and 54%, respectively, compared with children with typical development.

Limitations

A test-retest reliability analysis or measure of minimal detectable change was not conducted as part of this study. Results suggest that measures of minimal detectable change may be high for some of the reported variables. In addition, the inverse dynamic approach determines only the net intersegmental reactive forces that reflect the effect of external loads. Previous studies have shown that spinal loads may be larger than the net intersegmental force.

Conclusions

Trendelenburg and Duchenne type movements were not always distinct, and a third type of movement, a combination of the two, was the most common in this study. Clinicians should be aware that children with CP and the Duchenne type or the complex Trendelenburg-Duchenne type of gait pattern experience abnormal loading that may have significant implications for the lower spine in the long term.
Assessing Specimens of Devitalized Tissue in Chronic Sacral Pressure Ulcers: A Pilot Study
Authors: Lino Gomes Silva Juliany , Coope Andressa , Pereira de Araújo Eliana , Velloso Licio A. , Saad Mário José A. , Melo Lima Maria Helena
Published: November 2017

Pressure ulcers (PrUs)* are chronic wounds caused by a combination of factors, such as repetitive ischemia perfusion injury, bacterial colonization of the wound bed, local tissue hypoxia, or an altered cellular and systemic stress response. The objectives of this study were to analyze fragments of devitalized tissue of Stages III and IV PrUs and compare them with healthy tissue to evaluate the expression of the genes involved in wound inflammation. Samples of healthy skin from patients undergoing plastic surgery (n = 3) were collected, as well as from patients with devitalized tissue from Stages III and IV PrUs (n = 3) by means of sharp debridement. Gene expression analysis identified 5 up-regulated genes and 6 down-regulated genes in the devitalized tissue. Fibroblast cultures treated with devitalized tissue extract showed less attraction and cellular growth compared with the control group. Western blotting analysis showed a tendency of 3 particular genes to decrease in cell cultures treated with devitalized tissue extract. This study demonstrates that all of these mediators stimulate and promote inflammation in the wound bed and that a better understanding of the mechanisms of chronic wound development could lead to novel therapeutic strategies.
Pyoderma Gangrenosum: A Critical Appraisal
Authors: Shavit Eran , Alavi Afsaneh , Sibbald R. Gary
Published: November 2017

GENERAL PURPOSE:

To provide information about pyoderma gangrenosum (PG), including pathophysiology, diagnostic criteria, and treatment.

TARGET AUDIENCE:

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES:

After participating in this educational activity, the participant should be better able to:

Pyoderma gangrenosum (PG) is an uncommon cutaneous disease, presenting with recurrent painful ulcerations most commonly on the lower extremities. The diagnosis is made according to a typical presentation, skin lesion morphology, skin biopsy, histopathology, and the exclusion of other etiologies. Classically, PG presents with painful ulcers with well-defined violaceous borders; other variants including bullous, pustular, and vegetative/granulomatous can also occur. Treatment of PG involves a combination of topical and systemic anti-inflammatory and immunosuppressive medications, wound care, antimicrobial agents for secondary infections, and treatment of the underlying etiology. This article is a continuing education review of the literature with a focus on the clinical application of the pathophysiology, diagnosis, and treatment of this challenging disease.
Disruption of Biofilms and Neutralization of Bacteria Using Hypochlorous Acid Solution: An In Vivo and In Vitro Evaluation
Authors: Day Anna , Alkhalil Abdulnaser , Carney Bonnie C. , Hoffman Hilary N. , Moffatt Lauren T. , Shupp Jeffrey W.
Published: November 2017

OBJECTIVES:

The aims of this study were to assess the effectiveness of a hypochlorous acid–based wound cleanser (Vashe Wound Solution [VWS], SteadMed Medical, Fort Worth, Texas) in disrupting methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa biofilms relative to other cleansers using an in vitro collagen biofilm model and to evaluate cleansers’ cytotoxicity. The bioburden reduction of venous stasis wounds by VWS and another cleanser was evaluated.

METHODS:

Plates coated with collagen films incubated with active bacteria cultures to yield biofilm mimics were treated with VWS, 1% and 10% povidone-iodine (PI), 0.05% chlorhexidine wound solution (CWS), or normal saline for 3 or 10 minutes. Biofilms were then analyzed for biomass density using a crystal violet assay, quantitative cultures, and fluorescent microscopy. Cytotoxicity was measured using neutral red uptake by primary human dermal fibroblasts. Pre- and postcleansing exudates and swab samples obtained from venous stasis wounds of patients were processed and plated on a series of selective agar plates for bacteria typing and quantification.

RESULTS:

All agents tested significantly neutralized methicillin-resistant S aureus and P aeruginosa biofilms compared with saline control as assessed by crystal violet assay and fluorescent microscopy assays. Undiluted VWS was significantly less cytotoxic compared with 1% PI, CWS, and 10% PI (in increasing order of cytotoxicity). There was no significant difference in bacterial reduction in wounds after treatment with VWS or CWS for any type of bacteria examined using selective media. In wounds that were treated with VWS or CWS, there was a similar percentage reduction in bacterial colony-forming units from precleansing levels when plated on tryptic soy agar, MacConkey, streptococcal, and mannitol salt agar plates. Plates treated with CWS trended toward higher bacterial reduction on nonselective and gram-negative agars, whereas VWS trended toward higher bacterial reduction in Streptococcus-selective agars.

CONCLUSIONS:

These findings support the use of VWS in the treatment of wounds with biofilms and to reduce the bioburden of venous stasis ulcers. While VWS-treated biofilms had higher biomass than CWS- and saline-treated biofilms, most of the cellular component was not viable. Ultimately, VWS had a similar effectiveness to CWS in eliminating bacteria but with lower cytotoxicity.
Lithium Use in Pregnancy and the Risk of Cardiac Malformations
Authors: Patorno Elisabetta , Huybrechts Krista F. , Bateman Brian T. , Cohen Jacqueline M. , Desai Rishi J. , Mogun Helen , Cohen Lee S. , Hernandez-Diaz Sonia
Published: November 2017

(Abstracted from N Engl J Med 2017;376:2245–2254)

Lithium is a first-line treatment for women of reproductive age with bipolar disorder. However, concerns persist that exposure increases the risk of congenital cardiac defects including Ebstein anomaly, a right ventricular outflow tract obstruction defect.
Prevalence and clinical characteristics of local allergic rhinitis to house dust mites
Authors: Shin Yoo Seob , Jung Chang-Gyu , Park Hae-Sim
Published: November 2017

Purpose of review

Local allergic rhinitis (LAR) is a recently classified subtype of rhinitis defined by a nasal allergic response in patients without systemic evidence of atopy. Recent studies have reported the prevalence, clinical course, culprit allergens, diagnostic methods and treatment outcomes of LAR. The purpose of this review is to summarize the most relevant and updated scientific evidence for LAR, especially focusing on its prevalence and clinical characteristics.

Recent findings

LAR is found in a significant proportion (3.7–61.9%) of patients previously diagnosed with nonallergic rhinitis, but the prevalence may differ among ethnic groups and countries. Common allergens of LAR are similar to those of allergic rhinitis, in which house dust mites are the most common cause, followed by grass pollen, tree pollen, weed pollen and animal dander confirmed by provocation tests. Although the nasal provocation test to a single allergen is considered the gold standard method, the detection of allergen-specific IgE and other inflammatory mediators from nasal secretions and the basophil activation test can assist in the diagnosis of LAR. Conjunctivitis and asthma are the most common comorbid conditions, and the occurrence rate of asthma increases over period. However, the conversion rate to allergic rhinitis was not significantly different between LAR and healthy controls.

LAR is a well-differentiated entity of rhinitis, which should be considered in patients with persistent and severe symptoms without any systemic evidence of atopy. Further research is needed to investigate the long-term outcome, and geographic and ethnic differences of LAR.
Payer Policy Behavior Towards Opioid Pharmacotherapy Treatment in Ohio
Authors: Molfenter Todd , Sherbeck Carol , Starr Sandy , Kim Jee-Seon , Zehner Mark , Quanbeck Andrew , Jacobson Nora , McCarty Dennis
Published: November 2017

Objective:

Few studies examine how payers address the need for improved access to pharmacotherapy for opioid use disorders and the influence of environmental variables on access to opioid agonist and antagonist medications.

Method:

The 52 Ohio Addiction Drug Abuse and Mental Health Services (ADAMHS) Boards that disburse funds for treatment services for the uninsured and underinsured were surveyed to assess coverage for opioid agonist and antagonist treatment medications. Analyses examined public health data on regional opioid addiction patterns, characteristics of the local health insurance market, and their associations with coverage for opioid addiction pharmacotherapy.

Results:

Most (70%) of the 44 participating ADAMHS Boards paid for opioid treatment medications. For payment policy, all Boards required behavioral therapy to be provided in conjunction with opioid agonist or opioid antagonist therapy, and 27% of the Boards limited length of a buprenorphine therapy regimen. Higher local opioid treatment admission rates were associated with higher rates of Board funding for opioid treatment pharmacotherapy. Environmental variables (eg, overdose fatality rates or the behaviors of private insurance payers) were not associated with ADAMHS support for opioid agonist or antagonist medication.

Conclusions:

The analysis highlights the policy preferences of these payers. Follow-up studies should examine the payer decision-making processes, preferences, and attitudes that affect support for pharmacotherapy for opioid dependence.
Purinergic P2X7 receptor functional genetic polymorphisms are associated with the susceptibility to obesity in Chinese postmenopausal women
Authors: Liu Xingzi , Rao Shenqiang , Gong Chengxin , Li Tao , Ding Lu , Wang Shuo , Zhong Peipei , Wang Jihong , Zhao Jiani , Zhou Yuru , Xiong Chaopeng , Tu Yunming , Liang Shangdong , Xu Hong
Published: November 2017

Objective:

We conducted a case-control study to investigate the associations of functional single-nucleotide polymorphisms in the purinergic P2X7 receptor (P2X7R) gene (rs2393799, rs7958311, rs1718119, rs2230911, and rs3751143) with obesity and overweight in a population of Chinese postmenopausal women.

Methods:

Our study included 180 obese women, 179 overweight women, and 204 controls. All participants were genotyped at the P2X7R rs2393799, rs7958311, rs1718119, rs2230911, and rs3751143 loci via allele-specific polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism procedures. The relationships between P2X7R genetic polymorphisms and their associated haplotypes with obesity (body mass index [BMI] ≥30 kg/m2] and overweight (25 kg/m2 ≤ BMI < 30 kg/m2) were evaluated.

Results:

Our results showed that P2X7R rs2230911G and rs1718119A were associated with an increased risk of obesity; in particular, both carriers of the rs2230911G allele and GG/(CG + GG) genotypes (G vs C, P < 0.001, odds ratio [OR] 2.87, 95% confidence interval [CI] 1.98-4.16; GG vs CC, P < 0.001, OR 8.76, 95% CI 3.29-23.35; CG + GG vs CC, P < 0.001, OR 2.54, 95% CI 1.63-3.95) and carriers of the rs17181191A allele and GA/(GA + AA) genotypes (A vs G, P < 0.001, OR 2.97, 95% CI 1.86-4.74; GA vs GG, P = 0.001, OR 2.72, 95% CI 1.55-4.79; GA + AA vs GG, P < 0.001, OR 3.05, 95% CI 1.79-5.19) were at a higher risk of obesity. No association with obesity or overweight was observed for the other three P2X7R polymorphisms (rs2393799, rs7958311, and rs3751143). Haplotype analysis indicated that P2X7R rs1718119A-rs2230911G-rs3751143C appeared to be a significant risk haplotype with obesity (P = 0.0005, OR 2.37, 95% CI 1.45-3.90).

Conclusions:

P2X7R functional genetic polymorphisms and their estimated haplotypes are associated with obesity in Chinese postmenopausal women.
Meaningful weight loss in obese postmenopausal women: a pilot study of high-intensity interval training and wearable technology
Authors: Grossman Joan A. , Arigo Danielle , Bachman Jessica L.
Published: November 2017

Objective:

Postmenopausal women cite lack of time as their primary barrier to exercise and related weight control behaviors. The purpose of this study was to address this barrier via testing the feasibility and initial outcomes of a short-duration/high-intensity interval training (HIIT)-based weight loss program among obese postmenopausal women, with descriptive comparison to an endurance-focused exercise program.

Methods:

A 16-week behavioral program incorporated (1) HIIT to limit time necessary to produce health benefits of exercise, and (2) wearable activity sensors to facilitate self-monitoring exercise. Participants (n = 11; M
Age = 59 ± 5.33; M
BMI = 32.0 ± 2.53 kg/m2) were randomly assigned to HIIT or endurance exercise. Both groups followed a calorie-restricted diet, attended monthly in-person meetings, weekly weigh-ins and electronic check-ins to review behavioral skills, and monitored their exercise with a Fitbit ChargeHR. Adherence to exercise programs, assessed with the Fitbit sensor, was used to determine feasibility.

Results:

Participants in the HIIT group (6/6) adhered to their program, whereas 3 of 5 adhered to the Endurance program. Participants in the HIIT group lost twice as much weight as those in the Endurance group (8.7% vs 4.3% of initial body weight), and lost an additional 6 in. of body mass. In addition, only the HIIT group significantly changed fat mass, body mass index, and fat-free mass (Ps < 0.04).

Conclusions:

These findings support the feasibility and potential effectiveness of HIIT for weight loss and body composition changes in obese postmenopausal women, and indicate that additional investigation of this approach is warranted to reduce postmenopausal chronic disease risk.