bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidermal growth factor receptor and ligand family expression and activity in glioblastoma
Authors: von Achenbach Caroline , Weller Michael , Szabo Emese
Published: June 2018

Epidermal growth factor family of receptor tyrosine kinases (ERBB) family cell surface receptors, including epidermal growth factor receptor (EGFR/ERBB1), are phosphorylated upon binding by various EGF family ligands and signal via multiple kinase pathways. EGFR signaling is enhanced because of mutational activation of EGFR in almost half of glioblastomas, the most common malignant primary brain tumor. Therapeutic targeting of EGFR in glioblastoma has remained largely unsuccessful. Here, we profiled nine long‐term (LTC) and five glioma‐initiating (GIC) cell lines for expression and activation of ERBB family receptors and expression of their ligands. Receptors and ligands were abundantly expressed, with patterns overall similar to glioblastoma expression profiles in vivo as deposited in The Cancer Genome Atlas database. No differences between LTC and GIC emerged. Irrespective of ligand or receptor expression, neither an EGFR antibody, erbitux, nor an EGFR tyrosine kinase inhibitor, gefitinib, were particularly active against LTC or GIC at clinically relevant concentrations. Self‐renewal capacity of GIC was severely compromised by epidermal growth factor (EGF) withdrawal, but rescued by transforming growth factor alpha (TGF‐α), although not by neuregulin‐1 (NRG‐1). Subcellular fractionation indicated high levels of nuclear phosphorylated EGFR in all LTC and GIC. In LN‐229 cells, pERBB2 and pERBB3 were also detected in the nucleus. Nuclear pERBB2 was less sensitive, whereas pERBB3 was induced, in response to gefitinib. This study provides an extensive characterization of human glioma cell models, including stem‐like models, with regard to ERBB receptor/ligand expression and signaling. Redundant signaling involving multiple ERBB family ligands and receptors may contribute to the challenges of developing more effective EGFR‐targeted therapies for glioblastoma.

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Effects of dietary phytoncides extracted from Korean pine (Pinus koraiensis) cone on performance, egg quality, gut microflora, and immune response in laying hens
Authors: Kim Min‐Jeong , Jung U‐Suk , Lee Jae‐Sung , Jeon Seung‐Woo , Kim Won‐Seob , An Byoung‐Ki , Kim Eun‐Jib , Wang Tao , Kim Bae‐Young , Im Jin‐Taek , Lee Hong‐Gu
Published: June 2018

This study was conducted to evaluate the effects of dietary phytoncides extracted from discarded Korean pine cones (Pinus koraiensis) on the performance, egg quality, immune response and gut microflora in laying hens. A total of 400 Hy‐Line brown laying hens (50‐week old) were allotted into four dietary treatments including a control diet or a diet supplemented with phytoncides at 0.002%, 0.004% and 0.008%. During the 6 weeks of experimental feeding, 0.008% of dietary phytoncides improved egg production, feed conversion ratio (p < 0.05), but not feed intake, egg weight or feed efficiency. Although dietary phytoncides had no effect on egg quality, decreases in Haugh units depending on storage periods were improved by 0.008% of dietary phytoncides (p < 0.05). To investigate the roles of dietary phytoncides on the alteration of the immune response during inflammation, lipopolysaccharide (LPS) or saline was intraperitoneally injected into 10 hens per diet group on the end date of the experimental feeding period. Serum immunoglobulins and splenic cytokine expression at mRNA levels were then measured at 4 hr postinjection. Although the levels of IgA were decreased by LPS injection in all dietary groups, dietary phytoncides at 0.008% showed a higher level of IgA by LPS (p < 0.05). Interestingly, although LPS injection resulted in an enhanced expression of proinflammatory cytokines such as IL‐1β and IL‐6, dietary phytoncides at 0.008% showed less increased levels of them (p < 0.05). Gut microflora was examined from 10 hens per diet group at the end of the experimental period. While the number of Lactobacillus spp. was increased (p < 0.05), Escherichia coli counts in the cecal contents were decreased by 0.008% of dietary phytoncides. Taken together, these results demonstrate that dietary supplementation of 0.008% phytoncides improved the egg production, immune responses during inflammation and gut microflora in laying hens.
Vogt–Koyanagi–Harada case accompanied by polyneuropathy
Authors: Tsunoda Keiichiro , Ohta Yasuyuki , Tadokoro Koh , Sasaki Ryo , Takahashi Yoshiaki , Sato Kota , Nomura Emi , Takemoto Mami , Hishikawa Nozomi , Yamashita Toru , Kajita Ai , Abe Koji
Published: June 2018

Vogt–Koyanagi–Harada disease (VKHD) is a systemic autoimmune disease that targets melanocyte‐rich tissues such as eye, central nervous system, inner ear, and skin. Here, we report a case of VKHD accompanied by polyneuropathy. After VKHD was diagnosed, depending on the involvement of bilateral ocular, auditory, and central nervous systems, he expressed muscle weakness, pain, and numbness in bilateral lower extremities. Nerve conduction studies suggested sensorimotor polyneuropathy, while a skin, muscle, and nerve biopsy suggested vasculitis. Steroid therapy improved his symptoms. The present case might suggest a relationship between VKHD and polyneuropathy.
Origins of Specialization: The CeramicChaîne Opératoireand Technological Take‐Off at Vinča‐Belo Brdo, Serbia
Authors: Spataro Michela
Published: June 2018

This paper presents scientific analyses of Neolithic pottery from Miloje Vasić’s–34 excavations at Vinča‐Belo Brdo, which has long been a key site in south‐eastern European prehistory. Results show a series of changes in the chaîne opératoire of pottery production, both between the early Neolithic Starčevo and middle–late Neolithic Vinča periods, and between Vinča A and Vinča B phases. Unlike in Starčevo assemblages, Vinča pottery fabrics probably served specific functions, but cult objects (an anthropomorphic figurine and several prosopomorphic lids) were made locally using the same raw materials and technology used to make Vinča fine ware. In contrast to the uniformity of Starčevo pottery technology, Vinča pottery production was geographically diverse and evolved over time. Higher firing temperatures of Vinča pottery apparently preceded the development of metallurgy by more than a century.
Congenital nevus comedonicus complicated by a hidradenitis suppurativa‐like lesion: Report of a childhood case
Authors: Ravaioli Giulia Maria , Neri Iria , Zannetti Guido , Patrizi Annalisa
Published: June 2018

Nevus comedonicus is a rare, benign hamartoma of the pilosebaceous unit that may be isolated or part of the nevus comedonicus syndrome. Although rare in children, complication by hidradenitis suppurativa‐like lesions has been described. We present a report of a 9‐year‐old girl in whom surgical excision was curative, with a review of the relevant literature.
Storytelling as Adaptive Collective Sensemaking
Authors: Bietti Lucas M. , Tilston Ottilie , Bangerter Adrian
Published: June 2018

Storytelling represents a key element in the creation and propagation of culture. Three main accounts of the adaptive function of storytelling include (a) manipulating the behavior of the audience to enhance the fitness of the narrator, (b) transmitting survival‐relevant information while avoiding the costs involved in the first‐hand acquisition of that information, and (c) maintaining social bonds or group‐level cooperation. We assess the substantial evidence collected in experimental and ethnographic studies for each account. These accounts do not always appeal to the specific features of storytelling above and beyond language use in general. We propose that the specific adaptive value of storytelling lies in making sense of non‐routine, uncertain, or novel situations, thereby enabling the collaborative development of previously acquired skills and knowledge, but also promoting social cohesion by strengthening intragroup identity and clarifying intergroup relations.
Computational Simulation of Biventricular Pacing in an Asymptomatic Human Heart
Authors: Murphey Corey L. , Wong Jonathan , Kuhl Ellen
Published: June 2018

Cardiac resynchronization therapy (CRT) through biventricular stimulation was first used in the early 1990s as a treatment option for patients with systolic heart failure, intraventricular conduction delay, and other cardiac arrhythmias [1]. CRT, also known as biventricular pacing (BiVP), is an alternative to right ventricular stimulation, which induces dyssynchronous ventricular contraction. In BiVP, three pacing leads are usually placed on the myocardium of the right atrium, the right ventricle, and the left ventricle in the distal cardiac vein. Because there are no standardized loci for lead placement in BiVP, physicians rely on trial and error when inserting pacemaker leads and use electrocardiograms (ECG) to determine the effectiveness of the BiVP lead placement. The ECG measures the electrical conduction, contraction pacing, and projections of the anatomy of the myocardium. Abnormalities in the sinusoidal waves of the ECG reveal problems. Therefore, the ECG can depict a quantitative representation of the effectiveness of biventricular pacing lead placement.
Design and Validation of a Novel Bioreactor to Expose Aortic Valve Leaflets to Side-Specific Shear Stress
Authors: Sun Ling , Rajamannan Nalini M. , Sucosky Philippe
Published: June 2018

Calcific aortic valve disease (CAVD), the most common aortic valve disorder, is characterized by an accumulation of calcium on the valve leaflets that contributes to the obstruction of the left ventricular outflow and progressive heart failure. CAVD follows an active process presumably triggered by atherogenic risk factors and hemodynamic cues1,2. Resulting from the relative motion between the deforming leaflets and the surrounding blood flow, fluid shear stress is an important component of the valve hemodynamic environment. The ventricular surface of the leaflets is exposed to a unidirectional pulsatile shear stress, while the aortic surface experiences a bidirectional oscillatory shear stress3. The characterization of the effects of shear stress on valvular pathogenesis, which requires the replication of the native valvular shear stress in the laboratory setting, has been hampered by this hemodynamic complexity. In an effort to address this challenge, the goal of this study was to design and validate a novel apparatus capable of exposing simultaneously but independently both surfaces of aortic valve leaflets to native side-specific shear stress. The device based on a cone-and-plate geometry was validated with respect to its ability to expose each surface of aortic valve leaflets to its native, time-varying shear stress waveform, while maintaining the tissue under sterile conditions for 96 hours.
Wrist Kinematics and Ultrasound Measures of the Median Nerve During Computer Keyboarding
Authors: Toosi Kevin K. , Boninger Michael L.
Published: June 2018

Carpal tunnel syndrome (CTS) is a common, costly problem in the general population and particularly in manual workers [1–3], with as many as 3 million individuals experiencing its symptoms and signs, including pain, tingling, numbness, fatigue and weakness in the hands and fingers [4]. Treatment of CTS is estimated to cost over one billion dollars a year [5]. The most prevalent theory for the pathogenesis of CTS is compression of median nerve in the carpal tunnel [6]. Although this theory is widely accepted, the cause of the compression in the carpal tunnel is not fully understood. Epidemiological research has identified several occupational risk factors associated with the development of CTS in general industry including: force, repetition, awkward/static postures, localized mechanical compression, and vibration [7]. Several studies have found greater prevalence of carpal tunnel syndrome in workers with highly repetitive manual jobs [8]. Keyboarding is a highly repetitive daily task, and its association with musculoskeletal disorders of the upper extremity has been a public health concern since the 1980s [1]. However, there are controversial results regarding the association between computer keyboarding and CTS which indicate that we have an insufficient understanding of an association between keyboarding and upper limb neuropathy. Using ultrasonographic techniques, our laboratory was able to explore acute changes in the median nerve following a one-hour keyboarding task [9].
The Direction of Cyclic Stretch-Induced Stress Fiber Orientation Depends on Matrix Rigidity
Authors: Tondon Abhishek , Hsu Hui-Ju , Kaunas Roland
Published: June 2018

Mechanical properties of the cellular environment such as elastic rigidity have been shown to play an important role in the regulation of important cellular processes such as proliferation, differentiation and apoptosis (1–3). Intracellular tension decreases with decreasing matrix rigidity (1). Actin stress fibers (SFs), the major structural element in cells bearing tension, are also less prevalent on soft vs. rigid matrices (4). We have developed a theoretical model of stretch-induced SFs that predicts SFs reorient perpendicular to the direction of cyclic stretch in order to maintain SF tension at a homeostatic level (5). A theoretical model developed by the Safran group (6) predicts that cells will also align perpendicular to cyclic stretch on soft substrates. To test these predictions, we subjected cells to cyclic uniaxial stretch on soft collagen hydrogels. Interestingly, the cells and their SFs aligned parallel to the direction of stretch without co-alignment of collagen fibrils, indicating the need for a new model to describe the effects of cyclic stretch on SF reorganization on soft matrices.
Influence of Vehicle Restraint System Design on the Kinematics and Neck Forces of a Rear Seat Small Occupant
Authors: Burke Donald S. , Bidez Martha W. , Mergl Kathryn M.
Published: June 2018

In 2008, motor vehicle collisions resulted in 968 child occupant fatalities and 193,000 seriously injured children, ages 14 years old and younger, according to the most recent data provided by the National Highway Traffic Safety Administration (NHTSA) [1]. In fact, motor vehicle collisions are the leading cause of death for all children ages 3 to 14 years old living in the United States [1]. As children grow older they require size-appropriate restraint types to fit their body at each developmental level. For older children, booster seats are not a total solution for child safety as they are often dependent on the design of the vehicle seat belt system (2). Additionally, there is no federal standard that requires vehicle manufacturers to dynamically test the performance of child seats of any type in their vehicles.
Modulation of Traction Forces of Isolated Tenocytes by Substrate Stiffness
Authors: Sugimoto Megumi , Maeda Eijiro , Ohashi Toshiro
Published: June 2018

Mechanical stimuli are important to maintenance of homeostasis in many connective tissues including tendons and ligaments. Application of cyclic tensile loading in a physiological range has been demonstrated to possess anabolic and anti-catabolic effects on tenocyte metabolism [1,2], whereas the loading falling outside the range induced upregulations of tenocyte catabolism [3]. One of mechanotransduction signaling pathways of tenocytes is mediated via cytoskeletal elements [4]. It has been demonstrated that cytoskeletal tension within tenocytes regulated anabolic and catabolic gene expressions in a reciprocal manner [4]. However, the precise relationship between cell metabolism and internal tension within cytoskeletons has not been studied.
Characterization of the Poroelastic Material Properties of Skeletal Repair Tissues Using Microindentation
Authors: Sperry M. M. , Hayward L. N. M. , Miller G. J. , Morgan E. F.
Published: June 2018

Nearly 10% of the approximately six million fractures that occur each year in the United States do not heal, causing lasting pain and repetitive injury [1]. Although the causes of poor healing are unknown in many cases, the sensitivity of the repair process to mechanical factors is well established. In an effort to understand how mechanical factors such as axial and shear micromotion at the fracture site affect healing, prior studies have sought to characterize the local mechanical environment using finite element (FE) analysis (e.g., [2,3]). However, a key set of inputs for the FE analyses is the distribution of material properties of the various tissues that comprise the fracture callus. Recent studies using nano- and microindentation have estimated these properties by approximating the tissues as linear elastic [4,5]. As a next step in this line of inquiry, the overall goal of this study was to estimate the linear, poroelastic material properties of callus tissues. The specific objectives were: 1) to develop an FE model for use in simulating microindentation experiments; and 2) to compare the results of the simulation to experimental microindentation data in order to derive the mechanical properties of the healing tissues.
A Multi-Physics Finite Element Model of the Traction Forces in a Three-Dimensional Smooth Muscle Cell
Authors: Rodriguez Marita L. , Han Sangyoon J. , Sniadecki Nathan J.
Published: June 2018

Vascular smooth muscle cells (VSM) modulate cardiac output, maintain vascular pressure, and regulate blood flow via contraction. This contraction is generated by a mechanochemical interaction of actin-myosin cross-bridges within each cell and is governed by the biochemical and mechanical state of the cell [1]. When this state is disturbed, VSM cells can respond with excessive constriction (which can lead to hypertension) or weakened residual stresses (which can result in aortic aneurysms); both of which are considered to be symptoms of cardiovascular diseases [2]. Furthermore, disruption in the state of VSM cells can cause their migration into the intimal layer of the artery, which is a precursor to atherosclerosis.
Suppression of vocal responses to auditory perturbation with real-time visual feedback
Authors: Ning Li-Hsin , Loucks Torrey M. , Shih Chilin
Published: June 2018

Speakers can adjust pitch using auditory feedback through a short-latency corrective response known as the pitch-shift response (PSR). Suppression of the PSR denotes on-line stabilization of pitch. In this paper, the hypothesis that pitch-shift responses can be suppressed with real-time visual feedback of vocal F0 is investigated. Mandarin speakers and naive speakers without tonal language experience were instructed to produce the sustained vowel /a/ and Mandarin tone /ma1/ in an audio-only condition and a separate audio-visual condition. Both Mandarin speakers and naive speakers suppressed pitch-shift responses in the audio-visual condition, regardless of task (/a/ or /ma1/) and stimulus magnitude (25 cents or 200 cents). These findings suggest that multisensory feedback (audio-visual) can improve the stability of voice F0. The benefit of audio-visual integration is independent of language experience.
Using Devices to Assess Physical Activity and Sedentary Behavior in a Large Cohort Study: The Women’s Health Study
Authors: Lee I-Min , Shiroma Eric J. , Evenson Kelly R. , Kamada Masamitsu , LaCroix Andrea Z. , Buring Julie E.
Published: June 2018

In recent years, it has become feasible to use devices for assessing physical activity and sedentary behavior among large numbers of participants in epidemiologic studies, allowing for more precise assessments of these behaviors and quantification of their associations with health outcomes. Between 2011–2015, the Women’s Health Study (WHS) used the Actigraph GT3X+ device to measure physical activity and sedentary behavior over seven days, during waking hours, among 17,708 women (Mage, 72 years) living throughout the United States. Devices were sent to and returned by participants via mail. We describe here the methods used to collect and process the accelerometer data for epidemiologic data analyses. We also provide metrics that describe the quality of the accelerometer data collected, as well as expanded findings regarding previously published associations of physical activity or sedentary behavior with all-cause mortality during an average follow-up of 2.3 years (207 deaths). The WHS is one of the earliest “next generation” epidemiologic studies of physical activity, utilizing wearable devices, in which long-term follow-up of participants for various health outcomes is anticipated. It therefore serves as a useful case study in which to discuss unique challenges and issues faced.
Agricultural advances draw opposition that blunts innovation
Authors: Hoy Anne Q.
Published: June 2018

Evidence-free challenges increase public misconceptions and feed the world of “parallel science”
Beyond epigenetics
Extended Heredity: A New Understanding of Inheritance and Evolution
Russell Bonduriansky and Troy Day
Princeton University Press, 2018. 302 pp.
Authors: Laland Kevin N.
Published: June 2018

A pair of evolutionary biologists takes a closer look at nongenetic inheritance
The
135
Gene of Goatpox Virus Encodes an Inhibitor of NF-κB and Apoptosis and May Serve as an Improved Insertion Site To Generate Vectored Live Vaccine
Authors: Zhang Minmin , Sun Yirui , Chen Weiye , Bu Zhigao
Published: June 2018

Capripoxviruses are etiological agents of important diseases in sheep, goats, and cattle. There are rare reports about viral protein function related to capripoxviruses. In the present study, we found that the 135 protein of GTPV plays an important role in inhibition of innate immunity and apoptosis in host cells. Use of the
135
gene as the insertion site to generate a vectored vaccine resulted in stronger adaptive immune responses than those obtained using the
tk
locus as the insertion site. As capripoxviruses are promising virus-vectored vaccines against many important diseases in small ruminants and cattle, the
135
gene may serve as an improved insertion site to generate recombinant capripoxvirus-vectored live dual vaccines.
Rubella Viruses Shift Cellular Bioenergetics to a More Oxidative and Glycolytic Phenotype with a Strain-Specific Requirement for Glutamine
Authors: Bilz Nicole C. , Jahn Kristin , Lorenz Mechthild , Lüdtke Anja , Hübschen Judith M. , Geyer Henriette , Mankertz Annette , Hübner Denise , Liebert Uwe G. , Claus Claudia
Published: June 2018

RV pathologies, especially during embryonal development, could be connected with its impact on mitochondrial metabolism. With bioenergetic phenotyping we pursued a rather novel approach in virology. For the first time it was shown that a virus infection could shift the bioenergetics of its infected host cell to a higher energetic state. Notably, the capacity to induce such alterations varied among different RV isolates. Thus, our data add viral adaptation of cellular metabolic activity to its specific needs as a novel aspect to virus-host evolution. In addition, this study emphasizes the implementation of different viral strains in the study of virus-host interactions and the use of bioenergetic phenotyping of infected cells as a biomarker for virus-induced pathological alterations.
Epidemiology of infections and antimicrobial use in Greek Neonatal Units
Authors: Gkentzi Despoina , Kortsalioudaki Christina , Cailes Benjamin Campbell , Zaoutis Theoklis , Kopsidas John , Tsolia Maria , Spyridis Nikos , Siahanidou Soultana , Sarafidis Kosmas , Heath Paul T , Dimitriou Gabriel
Published: June 2018

Objective

To describe the epidemiology of neonatal infections and of antimicrobial use in Greek Neonatal Units (NNUs) in order to develop national, evidence-based guidelines on empiric antimicrobial use for neonatal sepsis in Greece.

Design

Retrospective analysis of prospectively collected infection surveillance data from 2012 to 2015, together with a Point Prevalence Survey (PPS) on antimicrobial use and the collection of data on local empiric antimicrobial policies.

Setting

16 NNUs in Greece participating in the neonIN infection surveillance network

Patients

Newborns in participating NNUs who had a positive blood, cerebrospinal fluid or urine culture and were treated with at least 5 days of antibiotics.

Results

459 episodes were recorded in 418 infants. The overall incidence of infection was 50/1000 NNU-admissions. The majority of episodes were late-onset sepsis (LOS) (413, 90%).Coagulase-negative Staphylococci(80%) were the most common Gram-positive organisms causing LOS andKlebsiellaspp (39%) the most common Gram-negative. Nearly half (45%) of theKlebsiellaspp were resistant to at least one aminoglycoside. The PPS revealed that 196 of 484 (40%) neonates were on antimicrobials. The survey revealed wide variation in empiric antimicrobial policies for LOS.

Conclusions

This is the largest collection of data on the epidemiology of neonatal infections in Greece and on neonatal antimicrobial use. It provides the background for the development of national evidence-based guidelines. Continuous surveillance, the introduction of antimicrobial stewardship interventions and evidence-based guidelines are urgently required.
Peak ACL force during jump landing in downhill skiing is less sensitive to landing height than landing position
Authors: Heinrich Dieter , van den Bogert Antonie J , Nachbauer Werner
Published: June 2018

Background

Competitive skiers face a high risk of sustaining an ACL injury during jump landing in downhill skiing. There is a lack of knowledge on how landing height affects this risk.

Objectives

To evaluate the effect of varied landing height on peak ACL force during jump landing and to compare the effect of the landing height with the effect of the landing position varied by the trunk lean of the skier.

Methods

A 25-degree-of-freedom sagittal plane musculoskeletal model of an alpine skier, accompanied by a dynamic optimisation framework, was used to simulate jump landing manoeuvres in downhill skiing. First, a reference simulation was computed tracking experimental data of competitive downhill skier performing a jump landing manoeuvre. Second, sensitivity studies were performed computing 441 landing manoeuvres with perturbed landing height and trunk lean of the skier, and the corresponding effects on peak ACL force were determined.

Results

The sensitivity studies revealed that peak ACL force increased with jump height and backward lean of the skier as expected. However, peak ACL was about eight times more sensitive to the trunk lean of the skier compared with landing height. The decreased sensitivity of the landing height was based on the lower effects on the knee muscle forces and the shear component of the knee joint reaction force.

Conclusion

Preventive measures are suggested to focus primarily on avoiding trunk backward lean of the skier, and consequently on proper jump preparation and technique, and secondarily on strategies to reduce landing height during jumps.
Factors associated with first-year discontinuation of Implanon in Upper Egypt: clients’ and providers’ perspectives
Authors: Aziz Mirette M , El-Gazzar Amira F , Elgibaly Omaima
Published: June 2018

Background

The etonogestrel implant Implanon is a favourable and cost-effective contraceptive method for women in developing countries, and expansion of its use represents a priority for the family planning (FP) programme in Egypt. We studied the factors affecting first-year Implanon discontinuation from clients' and providers' perspectives.

Methods

We used a mixed quantitative-qualitative methodology. We conducted a household survey of Implanon clients and three focus group discussions with FP physicians and directors.

Results

We found that 13.5% of Implanon users discontinued its use in the first year. Survival analysis found that clients who had previously used Implanon (HR 0.36, 95% CI 0.15 to 0.88) and whose husbands had secondary or a higher level of education (HR 0.36,95% CI 0.19 to 0.69) were less likely to discontinue Implanon use after the first year, while clients who experienced side effects of Implanon use were more likely to discontinue it (HR 3.6,95% CI 1.60 to 8.11). Other causes of discontinuation which emerged in the qualitative analysis were the unjustified advice for Implanon removal by non-gynaecologists, due to unrelated users' complaints, and deficient pre-insertion counselling.

Conclusions

Implanon has a low first-year discontinuation rate as compared with other contraceptive methods. FP clients should be given sufficient pre-insertion counselling about side effects of Implanon and duration of protection. Physicians should offer Implanon mainly to clients seeking long-term contraception in order to decrease its discontinuation rate and increase its cost effectiveness.
An unusual cause of intestinal failure
Authors: Stead Gavin Alistair , Warner Ben , Clough Jennifer , Lanaspre Effie , O’Donohue John
Published: June 2018

A 62-year-old man presented to the emergency department with 5 weeks of worsening lower abdominal pain associated with watery diarrhoea, vomiting and 10% loss of body weight. He had recently experienced night blindness.

There was no history of foreign travel. His past medical history included hypertension, sickle cell trait and type 2 diabetes well controlled on metformin. He had not been prescribed any recent steroids and denied significant alcohol intake.

On examination, he had a tachycardia at 110 bpm and was afebrile and normotensive. He was malnourished with pedal pitting oedema extending to both knees. His abdomen was soft but distended and diffusely tender.

Blood tests showed a serum albumin of 12 g/L. Stool samples were negative. HIV testing was negative, and immunoglobulin levels were normal.

CT of the abdomen showed thickened, hyperenhancing jejunal loops with diffuse mesenteric inflammatory fat stranding and enlarged mesenteric lymph nodes. Colonoscopy was unremarkable.

Enteroscopy showed granular oedematous mucosa and extensive, deep ulcerations. Jejunal biopsies were obtained. Microscopy samples were negative for tuberculosis (TB) culture.

Histology revealed inflamed and ulcerated small bowel mucosa with plump endothelial cells with the appearance below. There were no granulomata (figures 1 and 2).Figure 1

Endoscopic examination of the jejunum.

Figure 2

Plump endothelial cells seen on microscopy.

Question

What is the differential diagnosis?
Reaching cardiovascular prevention guideline targets with a polypill-based approach: a meta-analysis of randomised clinical trials
Authors: Selak Vanessa , Webster Ruth , Stepien Sandrine , Bullen Chris , Patel Anushka , Thom Simon , Arroll Bruce , Bots Michiel L , Brown Alex , Crengle Sue , Dorairaj Prabhakaran , Elley C Raina , Grobbee Diederick E , Harwood Matire , Hillis Graham S , Laba Tracey-Lea , Neal Bruce , Peiris David , Rafter Natasha , Reid Christopher , Stanton Alice , Tonkin Andrew , Usherwood Tim , Wadham Angela , Rodgers Anthony
Published: June 2018

Objective

The aim of this study was to determine the effect of polypill-based care on the achievement of 2016 European Society of Cardiology (ESC) guideline targets for blood pressure (BP), low-density lipoprotein (LDL) cholesterol and antiplatelet therapy.

Methods

We conducted an individual participant data meta-analysis of three randomised clinical trials that compared a strategy using a polypill containing aspirin, statin and antihypertensive therapy with usual care in patients with a prior cardiovascular disease (CVD) event or who were at high risk of their first event. Overall, the trials included 3140 patients from Australia, England, India, Ireland, the Netherlands and New Zealand (75% male, mean age 62 years and 76% with a prior CVD event). The primary outcome for this study was the proportion of people achieving ESC guideline targets for BP, LDL and antiplatelet therapy.

Results

Those randomised to polypill-based care were more likely than those receiving usual care to achieve recommended targets for BP (62% vs 58%, risk ratio (RR) 1.08, 95% CI 1.02 to 1.15), LDL (39% vs 34%, RR 1.13, 95% CI 1.02 to 1.25) and all three targets for BP, LDL and adherence to antiplatelet therapy (the latter only applicable to those with a prior CVD event) simultaneously (24% vs 19%, RR 1.27, 95% CI 1.10 to 1.47) at 12 months. There was no difference between groups in antiplatelet adherence (96% vs 96%, RR 1.00, 95% CI 0.98 to 1.01). There was heterogeneity by baseline treatment intensity such that treatment effects increased with the fewer the number of treatments being taken at baseline: for patients taking 3, 2 and 0–1 treatment modalities the RRs for reaching all three guideline goals simultaneously were 1.10 (95% CI 0.94 to 1.30, 22% vs 20%), 1.62 (95% CI 1.09 to 2.42, 27% vs 17%) and 3.07 (95% CI 1.77 to 5.33, 35% vs 11%), respectively.

Conclusions

Polypill-based therapy significantly improved the achievement of all three ESC targets for BP, LDL and antiplatelet therapy compared with usual care, particularly among those undertreated at baseline.
Pacing: a new look. Don’t be deceived
Authors: Chow Chee Loong , Abu Baker Barveen , Mohamed Uwais
Published: June 2018

Clinical introduction

A 78-year-old man presents following a syncopal episode in the setting of intermittent sinus bradycardia and left bundle branch block (LBBB). With symptoms likely due to documented intermittent sinus node dysfunction, and finding of a diseased left bundle, a pacemaker was inserted (online supplementary figure 1 shows the electrode position in a PA fluroscopy view). His baseline ECG is shown in figure 1A, with a QRS width of 160 ms, and his echocardiogram revealed a left ventricular ejection fraction of 45%. His ECG day 1 postdevice insertion is shown in figure 1B. His device check confirmed excellent function. His QRS width on ECG postdevice insertion is now normalised to 80 ms.

Supplementary file 1

Question

What type of device therapy has this patient received?

Biventricular pacing.

Right ventricular outflow septal pacing.

His bundle pacing.

Right ventricular apical pacing.

Figure 1

(A) Baseline ECG and (B) day 1 postpacemaker implantation.
Latent profile analysis approach to the relationship between patient and physician global assessments of rheumatoid arthritis activity
Authors: Karpouzas George A , Strand Vibeke , Ormseth Sarah R
Published: June 2018

Objective

Patients and physicians commonly differ in their assessments of rheumatoid arthritis (RA) activity. Clinically meaningful discordance thresholds or validation of their ability to predict functional outcomes are lacking. We explored whether an unbiased, person-centred latent profile analysis (LPA) approach could classify cases based on patient global assessment (PtGA) and physician global assessment (MDGA) assessments of RA activity. We further examined whether the LPA groups displayed greater differences in clinical outcomes compared with traditional threshold-based groups. Finally, we evaluated whether LPA yielded higher explanatory power for clinical outcomes.

Methods

LPA was performed in 618 patients with established RA from a single centre. A threshold-based discordance definition was used as a comparator, with patients classified into concordant (PtGA–MDGA within ± 3 cm), positively discordant (PtGA–MDGA ≥3 cm) and negatively discordant groups (PtGA–MDGA ≤−3 cm).

Results

LPA yielded five distinct groups: low PtGA/low MDGA (35.9%), moderate PtGA/moderate MDGA (18.6%), high PtGA/high MDGA (14.7%), high PtGA/low MDGA (23.3%) and low PtGA/high MDGA (7.4%). Groups differed across clinical, physical function, pain, fatigue, health-related quality of life, work productivity and activity impairment outcomes (p<0.001). Concordance groups, in particular, displayed marked heterogeneity in outcomes depending on the magnitude of disease activity reported, with the low/low group faring the best (p<0.001). The LPA solution demonstrated superior explanatory power for all outcomes (p<0.001).

Conclusions

We confirmed the validity and advantages of LPA in characterising the relationship between PtGA and MDGA over a conventional threshold-based definition. LPA yielded optimally distinct, clinically meaningful and cohesive groupings, demonstrating superior explanatory power for disease-related outcomes of interest.
Fluid, energy, and nutrient recovery via ad libitum intake of different commercial beverages and food in female athletes
Authors: McCartney Danielle , Irwin Christopher , Cox Gregory R. , Desbrow Ben
Published: June 2018

This study investigated the effect of consuming different commercial beverages with food ad libitum after exercise on fluid, energy, and nutrient recovery in trained females. On 4 separate occasions, 8 females (body mass (BM): 61.8 ± 10.7 kg; maximal oxygen uptake: 46.3 ± 7.5 mL·kg−1·min−1) lost 2.0% ± 0.3% BM cycling at ∼75% maximal oxygen uptake before completing a 4-h recovery period with ad libitum access to 1 of 4 beverages: Water, Powerade (Sports Drink), Up & Go Reduced Sugar (Lower Sugar (LS)-MILK) or Up & Go Energize (Higher Protein (HP)-MILK). Participants also had two 15-min opportunities to access food within the first 2 h of the recovery period. Beverage intake, total water/nutrient intake, and indicators of fluid recovery (BM, urine output, plasma osmolality), gastrointestinal tolerance and palatability were assessed periodically. While total water intake (from food and beverage) (Water: 1918 ± 580 g; Sports Drink: 1809 ± 338 g; LS-MILK: 1458 ± 431 g; HP-MILK: 1523 ± 472 g; p = 0.010) and total urine output (Water: 566 ± 314 g; Sports Drink: 459 ± 290 g; LS-MILK: 220 ± 53 g; HP-MILK: 230 ± 117 g; p = 0.009) differed significantly by beverage, the quantity of ingested water retained was similar across treatments (Water: 1352 ± 462 g; Sports Drink: 1349 ± 407 g; LS-MILK: 1238 ± 400 g; HP-MILK: 1293 ± 453 g; p = 0.691). Total energy intake (from food and beverage) increased in proportion to the energy density of the beverage (Water: 4129 ± 1080 kJ; Sports Drink: 5167 ± 643 kJ; LS-MILK: 6019 ± 1925 kJ; HP-MILK: 7096 ± 2058 kJ; p = 0.014). When consumed voluntarily and with food, different beverages promote similar levels of fluid recovery, but alter energy/nutrient intakes. Providing access to food and understanding the longer-term dietary goals of female athletes are important considerations when recommending a recovery beverage.
Characterization of Ge Quantum Dot Optical Waveguides for High Speed Optical Modulators
Authors: Khan Jan Amir , Heller Evan , Jain Faquir
Published: June 2018

Quantum Dot (QD) Optical Modulators can provide high speed modulation in low cost indirect bandgap materials. Si based optical modulators can be realized with the inclusion of self-assembled Ge QDs to provide low cost, high speed CMOS compatible optical devices. In this paper, we present the optical characterization of a novel Ge-QD Si-SiO2 based waveguide for use in as an optical modulator. Optical performance figures of merit are investigated including insertion loss (IL) measurements, and Wavelength dependent loss (WDL). We present a multimode waveguide fabricated with conventional CMOS processing. The waveguide provides 4.43dB/cm loss and individual discrete absorption regimes corresponding to the unique minibands produced by superlattice properties of the self-assembled Ge QDs in the IR regime. Absorption properties of the Ge QDs are demonstrated and verified against the QD superlattice bandgap model. Analysis and simulation is presented to qualitatively compare the QD bandgap energies with the reported optical properties. The QD functionalized structure demonstrates the fundamental optical principles of a QD waveguide, setting the foundation for a active modulation testing of this QD based optical modulator.
Circuits and Simulation of Quaternary SRAM Using Quantum Dot Channel Field Effect Transistors (QDC-FETs)
Authors: Saman Bander , Kondo Jun , Chandy J. , Jain F. C.
Published: June 2018

This paper presents the design and simulation of static random access memory (SRAM) using Quantum Dot Channel Field-Effect Transistors (QDC-FETs). A QDC-FET consist of two quantum dots (3 nm to 4 nm) forming n-channel between the source and drain Quantum Dot Channel (QDC) on a p-Si substrate regions. The quantum dot channel enables higher-mobility transport on very low-mobility substrates. The structure of a quantum dot channel QDC-FET that has shown four-state characteristics of charge carriers from one channel to other channel of the device. It shows that four states can be obtained in an inverter made of four-state QDC-FETs. The four stats QDC-FETs is suitable for quaternary logic application with less complex and more area efficient than existing quaternary logic circuits. The device with four-state has been modeled using Berkeley Short-channel IGFET Model (BSIM) and Analog Behavioral Model (ABM), the model is suitable for transient analysis at circuit level. This model is optimized for a quaternary inverter logic and used to replace a conventional CMOS SRAM.
Chirped Superlattices as Adjustable Strain Platforms for Metamorphic Semiconductor Devices
Authors: Islam Md Tanvirul , Chen Xinkang , Kujofsa Tedi , Ayers John E.
Published: June 2018

Chirped superlattices are of interest as buffer layers in metamorphic semiconductor device structures, because they can combine the mismatch accommodating properties of compositionally-graded layers with the dislocation filtering properties of superlattices. Important practical aspects of the chirped superlattice as a buffer layer are the surface strain and surface in-plane lattice constant. In this work two basic types of InGaAs/GaAs chirped superlattice buffers have been studied. In design I (composition modulated), the average composition is varied by modulating the composition of one of the two layers in the superlattice period, but the individual layer thicknesses were fixed. In design II (thickness modulated), the individual layer thicknesses were modulated, but the compositions were fixed. In this paper the surface strain and surface in-plane lattice constant for these chirped superlattices are presented as functions of the top composition and period for each of these basic designs.
Dynamical X-Ray Diffraction Analysis of a GaAs/In0.3Ga0.7As Single Quantum Well Grown on a GaAs (001) Substrate
Authors: Althowibi F. A. , Ayers J. E.
Published: June 2018

We applied the mosaic crystal model to calculate the dynamical x-ray rocking curves for a coherently-strained GaAs/In0.3Ga0.7As/GaAs single quantum well grown epitaxially on a GaAs (001) substrate for a number of reflection profiles, including 004, 113, 224, 044 and 444 reflections. We show that it is possible to estimate the threading dislocation density in the quantum well, and therefore detect the pseudomorphic-metamorphic transition, using the widths or normalized intensities of the primary quantum well Bragg peak, or using the widths of the Pendellösung fringes associated with the quantum well structure.
The Measurement of Microwave Absorption Characteristics of Nanocomposites Using a Coaxial Line Technique
Authors: Teber Ahmet , Bansal Rajeev , Unver Ibrahim S. , Mehmedi Zilhicce
Published: June 2018

Microwave absorption properties (MAP) of manganese soft spinel ferrite (MnFe2O4) nanoparticles (MSF NPs) mixed with multi-walled carbon nanotubes (MWCNTs) and molded as toroid-shaped pellets were experimentally studied using a coaxial line technique in the frequency range of 2-18 GHz. We used the coaxial line technique because of the smaller sample size, a wider frequency range, and a uniform cross section. The MAP were derived from the measured constitutive parameters, according to the transmission line theory. The results indicate that MWCNTs blended with ferrite nanoparticles represent a promising choice for broadband microwave absorbing materials.
Exact solution of degenerate and nondegenerate optical parametric oscillator coupled with a squeezed thermal bath
Authors: Villegas-Martínez B. M. , Moya-Cessa H. M. , Soto-Eguibar F.
Published: June 2018

We solve exactly the master equation of the degenerate and nondegenerate parametric oscillator in the presence of a squeezed reservoir. We show that the formal solutions of both systems can be obtained in terms of the density operator by applying squeeze transformations and using the superoperators formalism.
Weak vs. 𝒟-solutions to linear hyperbolic first-order systems with constant coefficients
Authors: Katzourakis Nikos
Published: June 2018

We establish a consistency result by comparing two independent notions of generalized solutions to a large class of linear hyperbolic first-order PDE systems with constant coefficients, showing that they eventually coincide. The first is the usual notion of weak solutions defined via duality. The second is the new notion of [Formula: see text]-solutions which we recently introduced and arose in connection to the vectorial calculus of variations in [Formula: see text] and fully nonlinear elliptic systems. This new approach is a duality-free alternative to distributions and is based on the probabilistic representation of limits of difference quotients.
Demand-Driven Single- and Multitarget Mixture Preparation Using Digital Microfluidic Biochips
Authors: Shalu  , Kumar Srijan , Singla Ananya , Roy Sudip , Chakrabarty Krishnendu , Chakrabarti Partha P. , Bhattacharya Bhargab B.
Published: June 2018

Recent studies in algorithmic microfluidics have led to the development of several techniques for automated solution preparation using droplet-based digital microfluidic (DMF) biochips. A major challenge in this direction is to produce a mixture of several reactants with a desired ratio while optimizing reactant cost and preparation time. The sequence of mix-split operations that are to be performed on the droplets is usually represented as a mixing tree (or graph). In this article, we present an efficient mixing algorithm, namely, Mixing Tree with Common Subtrees (
MTCS
), for preparing single-target mixtures.
MTCS
attempts to best utilize intermediate droplets, which were otherwise wasted, and uses morphing based on permutation of leaf nodes to further reduce the graph size. The technique can be generalized to produce multitarget ratios, and we present another algorithm, namely, Multiple Target Ratios (
MTR
). Additionally, in order to enhance the output load, we also propose an algorithm for droplet streaming called Multitarget Multidemand (
MTMD
). Simulation results on a large set of target ratios show that
MTCS
can reduce the mean values of the total number of mix-split steps (
T

ms

) and waste droplets (
W
) by 16% and 29% over
Min-Mix
(Thies et al. 2008) and by 22% and 34% over
RMA
(Roy et al. 2015), respectively. Experimental results also suggest that
MTR
can reduce the average values of
T

ms

and
W
by 23% and 44% over the repeated version of
Min-Mix
, by 30% and 49% over the repeated version of
RMA
, and by 9% and 22% over the repeated-version of
MTCS
, respectively. It is observed that
MTMD
can reduce the mean values of
T

ms

and
W
by 64% and 85%, respectively, over
MTR
. Thus, the proposed multitarget techniques
MTR
and
MTMD
provide efficient solutions to multidemand, multitarget mixture preparationon a DMF platform.
Designing with the sensorial
Authors: Fox Tyler
Published: June 2018

This forum highlights conversations at the intersection of design methods and social studies of technology. By highlighting a diversity of perspectives on design interventions and programs, we aim to forge new connections between HCI design and communication, science and technology studies, and media studies scholarship. ---
Daniela Rosner, Editor