bluuebunny/crossref_metadata_2025 huggingface dataset:
Copper Oxide Nanoparticles as a Mild and Efficient Catalyst for N-Arylation of Imidazole and Aniline with Boronic Acids at Room Temperature
Authors: Thakur Ashim , Borah Raju , Raul Prasanta , Mahanta Abhijit , Shchukarev Andrey , Mikkola Jyri-Pekka
Published: March 2017

The present work describes the excellent catalytic activity of copper(II) oxide nanoparticles (NPs) towards N-arylation of aniline and imidazole at room temperature. The copper(II)oxide NPs were synthesized by a thermal refluxing technique and characterized by FT-IR spectroscopy; powder XRD, SEM, EDX, TEM, TGA, XPS, BET surface area analysis, and particle size analysis. The size of the NPs was found to be around 12 nm having a surface area of 164.180 m2 g–1.The catalytic system was also found to be recyclable and could be reused in subsequent catalytic runs without a significant loss of activity.
Remarkable Diagnostic Magnetic Resonance Imaging Findings in Sellar Xanthogranuloma: Report of Three First Cases in Latin America
Authors: Céspedes Mario , Vargas Jaime , Yañez Fernando , León Loreto , Arancibia Pablo , Putz Thomas
Published: March 2017

The sellar xanthogranuloma is a rare lesion of the sellar–parasellar region difficult to differentiate from other tumors such as craniopharyngiomas or Rathke's cleft cyst in the preoperative evaluation. As they are recently recognized as a separate entity and the few number of reports in the literature, its etiology is unknown and its impact remains uncertain. This article will describe the first three cases reported in Latin America, identified in one of them an imaging feature that may be helpful to elucidate an imaging growth pattern. Current evidence will be described regarding to the clinicopathological features, imaging diagnosis, and etiology origin theories.
Time dependent and temperature dependent properties of the forward voltage characteristic of InGaN high power LEDs
Authors: Fulmek P. L. , Haumer P. , Wenzl F. P. , Nemitz W. , Nicolics J.
Published: March 2017

Estimating the junction temperature and its dynamic behavior in dependence of various operating conditions is an important issue, since these properties influence the optical characteristics as well as the aging processes of a light-emitting diode (LED). Particularly for high-power LEDs and pulsed operation, the dynamic behavior and the resulting thermal cycles are of interest. The forward voltage method relies on the existence of a time-independent unique triple of forward-voltage, forward-current, and junction temperature. These three figures should as well uniquely define the optical output power and spectrum, as well as the loss power of the LED, which is responsible for an increase of the junction temperature. From transient FEM-simulations one may expect an increase of the temperature of the active semiconductor layer of some 1/10 K within the first 10 μs. Most of the well-established techniques for junction temperature measurement via forward voltage method evaluate the measurement data several dozens of microseconds after switching on or switching off and estimate the junction temperature by extrapolation towards the time of switching. In contrast, the authors developed a measurement procedure with the focus on the first microseconds after switching. Besides a fast data acquisition system, a precise control of the switching process is required, i.e. a precisely defined current pulse amplitude with fast rise-time and negligible transient by-effects. We start with a short description of the measurement setup and the newly developed control algorithm for the generation of short current pulses. The thermal characterization of the LED chip during the measurement procedures is accomplished by an IR thermography system and transient finite element simulations. The same experimental setup is used to investigate the optical properties of the LED in an Ulbricht-sphere. Our experiments are performed on InGaN LED chips mounted on an Al based insulated metal substrate (IMS), giving a comprehensive picture of the transient behavior of the forward voltage of this type of high power LED.
Coordinated multi-area energy and regulation joint dispatch under wind power uncertainty
Authors: Doostizadeh Meysam , Aminifar Farrokh , Lesani Hamid
Published: March 2017

Proliferated integration of variable renewable resources, especially wind power, in multi-area power systems brings about critical needs to coordinate balancing resources over the whole interconnected system. This paper proposes a coordination methodology in the real-time electricity market between regional interconnected power systems. The new method optimally dispatches generating units, determines interregional energy trading, and allocates regulation reserve throughout the entire system. The balancing resources in participating areas are shared and more effectively used to tackle the wind power uncertainty by means of a combined automatic generation control system. In order to comply with the existing operating philosophy of regional electricity markets, the augmented Lagrangian relaxation along with alternative direction method of multipliers are applied to provide a fully decentralized procedure with limited data interchanges between neighboring regions. Performance of the proposed method is examined on a two-area 6-bus and the modified three-area IEEE 118-bus test systems. The results confirm the applicability and effectiveness of the proposed model in providing flexible energy trading, regulation sharing, improved economic efficiency, and increased ability to integrate variable renewable energy into the power systems.
Micromagnetic simulation of electric-field-assisted magnetization switching in perpendicular magnetic tunnel junction
Authors: Yoshida Chikako , Noshiro Hideyuki , Yamazaki Yuichi , Sugii Toshihiro , Tanaka Tomohiro , Furuya Atsushi , Uehara Yuji
Published: March 2017

The feasibility of a voltage assisted unipolar switching in perpendicular magnetic tunnel junction (MTJ) has been studied using a micromagnetic simulation. Assuming a linear modulation of anisotropy field with voltage, both parallel (P) to anti-parallel (AP) and AP to P switchings were observed by application of unipolar voltage pulse without external magnetic field assistance. In latter case, the final P state can only be achieved with an ultrashort voltage pulse which vanishes before spin transfer torque (STT) becomes dominant to restore the initial AP state. In addition, it was found that the larger change in anisotropy field is required for the MTJ with smaller diameter.
PbSe/CdTe single quantum well infrared detectors
Authors: Chusnutdinow S. , Szot M. , Wojtowicz T. , Karczewski G.
Published: March 2017

We report on the fabrication and characterization of a new type of mid-infrared photodetector. The infrared sensitive element of the detector is a PbSe single quantum well (SQW) embedded in an intrinsic region of a CdTe p-i-n diode. Electron-beam-induced current (EBIC) measurements confirm the location of the PbSe SQW near the middle of the intrinsic CdTe layer. The measured diffusion length of minority carriers of about 0.5 μm allows effective collecting of the photoexcited carriers in the highly doped regions of the diodes. The PbSe/CdTe heterostructures exhibit a strong photosensitivity in the mid-infrared spectral region. Photo-response measurements show abnormal temperature dependence of the photosensitivity. The photo-response signal increases with decreasing temperature reaching a maximum at about 170 K and upon a further decrease in temperature the signal weakens and vanishes at about 100 K. Current-voltage measurements demonstrate very good junction characteristics with a rectifying ratio of 585 at ± 0.5 V and an ideality factor of 1.05 at room temperature. Possible mechanisms of carrier transport trough the junction are discussed.
Spin accumulation and transport signals in CoFe/MgO/Si devices with confined structure of n+-Si layer
Authors: Saito Y. , Inokuchi T. , Ishikawa M. , Ajay T. , Sugiyama H.
Published: March 2017

Observation of the spin signals in devices with low interface resistance of ferromagnetic/semiconductor junctions is one of the most important issues from the application view point. We demonstrate spin transport and accumulation signals in highly doped ∼1×1020 cm-3 n+-Si by using CoFe/MgO/n+-Si (10 nm, 20 nm)/n-Si devices. The highly doped n+-Si was confined within a thin n+-Si layer (10 nm and 20 nm in thickness). In this confined structure, we observed the spin accumulation signals for the devices with impurity concentration of ∼1×1020 cm-3 and the spin transport signals for the devices with ∼1 kΩμm2 interface resistance. This indicates that the n+ confined structure is important for observing and increasing spin signals in the low-interface-resistance region.
Rates of Water Exchange in 2,2′-Bipyridine and 1,10-Phenanthroline Complexes of CoII and MnII
Authors: Acharya Shravan S. , Winther-Jensen Bjorn , Spiccia Leone , Ohlin C. André
Published: March 2017

The rates and activation parameters of water exchange at pH 3.0 have been determined using variable temperature 17O NMR spectroscopy for four CoII complexes and one MnII complex: [Co(bpy)(H2O)4]2+, [Co(bpy)2 (H2O)2]2+, [Co(phen)-(H2O)4]2+, [Co(phen)2 (H2O)2]2+, and [Mn(bpy)(H2O)4]2+ (bpy = 2,2′-bipyridyl and phen = 1,10-phenanthroline). Substitution of aquo ligands with 1,10-phenanthroline or 2,2′-bipyridyl leads to an increase in the rate of exchange in the manganese complexes, from k298 (1.8 ± 0.1) × 107 s−1 for [Mn(H2O)6]2+ to (7.2 ± 0.3) × 107 s−1 for [Mn(phen)2 (H2O)2]2+, whereas the trends are more complex for the cobalt complexes. We have used the new data in conjunction with literature data for similar complexes to analyse the effect of M–OH2 distance and degree of substitution.
Preliminary evidence suggests freshwater turtles respond positively to an environmental water delivery during drought
Authors: Howard K. , Beesley L. , Ward K. , Stokeld D.
Published: March 2017

Environmental flows (e-flows) are a common management tool to improve the health of flow-regulated river systems and their biota. The effect of e-flows on fish, waterbirds and vegetation has been assessed in Australia, but their influence on turtles remains largely unstudied. We opportunistically examined the effect of e-flows on the eastern long-necked turtle (Chelodina longicollis), a species that occupies ephemeral aquatic habitats, by measuring an index of abundance (catch per unit effort) and body condition before and after an environmental watering event that replenished a severely contracted creek in the mid-Murray region. We found that average body condition increased after watering. Abundance decreased markedly after watering, but the change was not statistically significant. While the causal inference of our study was limited by the opportunistic nature of our before-after experimental design, this study provides preliminary evidence that environmental flows may improve the health of turtles occupying ephemeral floodplain habitats. We encourage further research into the effect of e-flows on turtles to confirm the hypothesis that the increase in average body condition recorded in the current study was a function of e-flows.
Memorializing the Wars of Religion in Early Seventeenth-Century French Picture Galleries: Protestants and Catholics Painting the Contested Past
Authors: van der Linden David
Published: March 2017

This article examines how Protestant and Catholic elites in early seventeenth-century France memorialized the Wars of Religion in purpose-built picture galleries. Postwar France remained a divided nation, and portrait galleries offered a sectarian memory of the conflict, glorifying party heroes. Historical picture galleries, on the other hand, promoted a shared memory of the wars, focusing on King Henry IV’s successful campaign against the Catholic League to unite the kingdom. This article argues that postwar elites made a sincere effort to manage religious tensions by allowing partisan memories to circulate in private while promoting a consensual memory in public.
Meta-analytic framework for liquid association
Authors: Wang Lin , Liu Silvia , Ding Ying , Yuan Shin-sheng , Ho Yen-Yi , Tseng George C
Published: March 2017

Motivation

Although coexpression analysis via pair-wise expression correlation is popularly used to elucidate gene-gene interactions at the whole-genome scale, many complicated multi-gene regulations require more advanced detection methods. Liquid association (LA) is a powerful tool to detect the dynamic correlation of two gene variables depending on the expression level of a third variable (LA scouting gene). LA detection from single transcriptomic study, however, is often unstable and not generalizable due to cohort bias, biological variation and limited sample size. With the rapid development of microarray and NGS technology, LA analysis combining multiple gene expression studies can provide more accurate and stable results.

Results

In this article, we proposed two meta-analytic approaches for LA analysis (MetaLA and MetaMLA) to combine multiple transcriptomic studies. To compensate demanding computing, we also proposed a two-step fast screening algorithm for more efficient genome-wide screening: bootstrap filtering and sign filtering. We applied the methods to five Saccharomyces cerevisiae datasets related to environmental changes. The fast screening algorithm reduced 98% of running time. When compared with single study analysis, MetaLA and MetaMLA provided stronger detection signal and more consistent and stable results. The top triplets are highly enriched in fundamental biological processes related to environmental changes. Our method can help biologists understand underlying regulatory mechanisms under different environmental exposure or disease states.

Availability and Implementation

A MetaLA R package, data and code for this article are available at http://tsenglab.biostat.pitt.edu/software.htm

Supplementary information

Supplementary data are available at Bioinformatics online.
In Pursuit of Progress Toward Effective Preterm Birth Reduction
Authors: Martin James N. , D'Alton Mary , Jacobsson Bo , Norman Jane E.
Published: March 2017

Recently the March of Dimes and the International Federation of Gynecology and Obstetrics Working Group on Preterm Birth released its findings from an extensive cross-country individual patient data analysis of 4.1 million singleton births in five high-income, very high human development index countries. The specific contributions of 21 risk factors for both spontaneous and health care provider-initiated preterm birth were assessed to better understand how these vary among the countries selected for intensive study. We also wished to evaluate whether currently used clinical interventions to prevent preterm birth are associated with lower rates of preterm delivery. Individual and population-attributable preterm birth risks were determined and an assessment made to identify any contribution to cross-country differences. With this massive data set it was possible to assess the ability to predict preterm birth given various sets of known risk factors. It was also possible to estimate the potential effects of successful interventions to reduce preterm birth in relation to advances in the research, health care policy, and clinical practice sectors. In this article we summarize the seven most important findings from these analyses. Clearly there is a paucity of explicit and currently identifiable factors that are amenable to intervention with current clinical practice or changes in public health policy. Thus, we see an urgent and critically important need for research efforts to elucidate the underlying biological causes of spontaneous preterm birth. The need for new innovative and effective interventions to successfully pursue progress toward effective preterm birth reduction has never been more apparent.
Association of Catastrophic Neonatal Outcomes With Increased Rate of Subsequent Cesarean Deliveries
Authors: Dan Ohad , Hochner-Celnikier Drorith , Solnica Amy , Loewenstein Yonatan
Published: March 2017

OBJECTIVE:

To evaluate whether full-term deliveries resulting in neonates diagnosed with hypoxic–ischemic encephalopathy are associated with a significant increase in the rate of subsequent unscheduled cesarean deliveries.

METHODS:

We conducted a retrospective chart review study and examined all deliveries in the Department of Obstetrics and Gynecology at Hadassah University Hospital, Mt. Scopus campus, Jerusalem, Israel, during 2009–2014. We reviewed all cases of hypoxic–ischemic encephalopathy in singleton, term, liveborn neonates and identified seven such cases, three of which were attributed to obstetric mismanagement and four that were not. We measured the rate of unscheduled cesarean deliveries before and after the events and their respective hazard ratio.

RESULTS:

Before a mismanaged delivery resulting in hypoxic–ischemic encephalopathy, the baseline rate of unscheduled cesarean deliveries was approximately 80 unscheduled cesarean deliveries for every 1,000 deliveries. In the first 4 weeks immediately after each of the three identified cases, there was a significant increase in the rate of unscheduled cesarean deliveries by an additional 48 unscheduled cesarean deliveries per 1,000 deliveries (95% confidence interval [CI] 27–70/1,000). This increase was transient and lasted approximately 4 weeks. We estimated that each case was associated with approximately 17 additional unscheduled cesarean deliveries (95% CI 8–27). There was no increase in the rate of unscheduled cesarean deliveries in cases of hypoxic–ischemic encephalopathy that were not associated with mismanagement.

CONCLUSION:

The increase in the rate of unscheduled cesarean deliveries after a catastrophic neonatal outcome may result in short-term changes in obstetricians' risk evaluation.
Predictors of Low Uptake of Prenatal Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Immunization in Privately Insured Women in the United States
Authors: Butler Anne M. , Layton J. Bradley , Li Dongmei , Hudgens Michael G. , Boggess Kim A. , McGrath Leah J. , Weber David J. , Becker-Dreps Sylvia
Published: March 2017

OBJECTIVE:

To examine the uptake of prenatal tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) immunization among pregnant women in the United States.

METHODS:

Using MarketScan data, we conducted a historical cohort study among pregnant women with employer-based commercial insurance in the United States who delivered between January 1, 2010, and December 31, 2014. We examined temporal trends of uptake, predictors of uptake, and timing of Tdap immunization.

RESULTS:

Among 1,222,384 eligible pregnancies in 1,147,711 women, receipt of prenatal Tdap immunization increased from 0.0% of women who delivered in January 2010 to 9.8% who delivered in October 2012 (the date of the recommendation by the Advisory Committee on Immunization Practices for Tdap during every pregnancy) to 44.4% who delivered in December 2014. Among women who received Tdap during pregnancy, the majority were immunized between 27 weeks and 36 6/7 weeks of gestation per the Advisory Committee on Immunization Practices recommendation. In multivariable analyses among women who delivered between November 2012 and December 2014, rates of prenatal Tdap immunization were lower for women younger than 25 years of age (eg, 20–24 compared with 30–34 years rate ratio [RR] 0.83, 95% confidence interval [CI] 0.85–0.88), with other children (eg, three compared with zero children: RR 0.86, 95% CI 0.84–0.88), residing in the South compared with the Midwest (RR 0.81, 95% CI 0.80–0.82), or with emergency department visits in early pregnancy (RR 0.93, 95% CI 0.92–0.95). The proportion of pregnant women who received prenatal Tdap increased with increasing gestational age at birth.

CONCLUSION:

By the end of 2014, fewer than half of pregnant women in the United States were receiving prenatal Tdap immunization. Implementation and dissemination strategies are needed to increase Tdap coverage among pregnant women, especially those who are young, have other children, or reside in the South.
Missed Opportunities for Prevention of Mother-to-Child Transmission of Human Immunodeficiency Virus
Authors: Scott Gwendolyn B. , Brogly Susan B. , Muenz Daniel , Stek Alice M. , Read Jennifer S. ,   for the International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) P1025 Study Team
Published: March 2017

OBJECTIVE:

To identify missed opportunities for prevention of mother-to-child transmission of human immunodeficiency virus (HIV).

METHODS:

Data regarding HIV-infected children born between 2002 and 2009 to HIV-infected women enrolled in the U.S. International Maternal Pediatric Adolescent AIDS Clinical Trials prospective cohort study (protocol P1025) were reviewed. The characteristics of the HIV-infected infants and their mothers and the mothers' clinical management are described.

RESULTS:

Twelve cases of mother-to-child transmission of HIV occurred among 1,857 liveborn neonates, for a prevalence of 0.65 per 100 live births to HIV-infected women (95% confidence interval 0.33–1.13). Four transmissions occurred in utero, three were peripartum transmissions, and the timing of transmission for five neonates was unable to be determined. None were breastfed. Seven women had plasma viral loads greater than 400 copies/mL near delivery. Six women had less than 11 weeks of antiretroviral therapy during pregnancy; three of these women had premature deliveries. One woman received no antiretroviral therapy during pregnancy because she was diagnosed with HIV postpartum. Six had poor to moderate adherence to antiretroviral therapy. Four of the five mothers with viral loads greater than 1,000 copies/mL delivered preterm neonates. There were five women who delivered by cesarean; four were nonelective cesarean deliveries and only one was an elective cesarean delivery for HIV prevention.

CONCLUSION:

Despite access to high-level care and follow-up, a small proportion of HIV-infected women transmitted the virus to their neonates. This case series provides insight into factors contributing to HIV perinatal transmission and can inform the development of new strategies for prevention of mother-to-child transmission of HIV.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, https://clinicaltrials.gov, NCT00028145.
Intrauterine Hyperoxemia and Risk of Neonatal Morbidity
Authors: Raghuraman Nandini , Temming Lorene A. , Stout Molly J. , Macones George A. , Cahill Alison G. , Tuuli Methodius G.
Published: March 2017

OBJECTIVE:

To test the hypothesis that intrauterine hyperoxemia is associated with an increased risk of neonatal morbidity.

METHODS:

This was a secondary analysis of a prospective study of singleton, nonanomalous deliveries at or beyond 37 weeks of gestation at an institution with a universal umbilical cord gas policy from 2010 to 2014. The primary outcome was a composite of neonatal morbidity including neonatal death, meconium aspiration syndrome, intubation, mechanical ventilation, hypoxic–ischemic encephalopathy, and hypothermic therapy. Intrauterine hyperoxemia was defined as umbilical vein partial pressure of oxygen 90th percentile or greater of the cohort. Adjusted relative risks (RRs) were estimated for neonatal morbidity controlling for confounders. Analysis was performed for the entire cohort and stratified by the presence of acidemia defined as umbilical artery pH less than 7.1.

RESULTS:

Of 7,789 patients with validated paired cord gases, 106 (1.4%) had the composite neonatal morbidity. There was no difference in composite neonatal morbidity in patients with and without intrauterine hyperoxemia in the entire cohort (1.5% compared with 1.3%, adjusted RR 1.5, 95% confidence interval [CI] 0.9–2.7). The rate of acidemia was not significantly different in the two groups (1.9% compared with 1.8%, adjusted RR 1.5, 95% CI 0.9–2.5). In stratified analysis, there was evidence of effect modification (P for interaction <.001) with a significant association between intrauterine hyperoxemia and neonatal morbidity in the presence of acidemia (41.2% compared with 21.4%, adjusted RR 2.3, 95% CI 1.1–3.5), but not in its absence (0.8% compared with 1.0%, adjusted RR 1.0, 95% CI 0.5–2.2).

CONCLUSION:

Intrauterine hyperoxemia, compared with normoxemia, is associated with a small but significantly increased risk of neonatal morbidity in acidemic neonates.
Route of Delivery in Women With Stillbirth
Authors: Boyle Annelee , Preslar Jessica P. , Hogue Carol J. R. , Silver Robert M. , Reddy Uma M. , Goldenberg Robert L. , Stoll Barbara J. , Varner Michael W. , Conway Deborah L. , Saade George R. , Bukowski Radek , Dudley Donald J.
Published: March 2017

OBJECTIVE:

To describe delivery management of singleton stillbirths in a population-based, multicenter case series.

METHODS:

We conducted a retrospective chart review of 611 women with singleton stillbirths at 20 weeks of gestation or greater from March 2006 to September 2008. Medical and delivery information was abstracted from medical records. Both antepartum and intrapartum stillbirths were included; these were analyzed both together and separately. The primary outcome was mode of delivery. Secondary outcomes included induction of labor and indications for cesarean delivery. Indications for cesarean delivery were classified as obstetric (abnormal fetal heart tracing before intrapartum demise, abruption, coagulopathy, uterine rupture, placenta previa, or labor dystocia) or nonobstetric (patient request, repeat cesarean delivery, or not documented).

RESULTS:

Of the 611 total cases of stillbirth, 93 (15.2%) underwent cesarean delivery, including 43.0% (46/107) of women with prior cesarean delivery and 9.3% (47/504) of women without prior cesarean delivery. No documented obstetric indication was evident for 38.3% (18/47) of primary and 78.3% (36/46) of repeat cesarean deliveries. Labor induction resulted in vaginal delivery for 98.5% (321/326) of women without prior cesarean delivery and 91.1% (41/45) of women with a history of prior cesarean delivery, including two women who had uterine rupture. Among women with a history of prior cesarean delivery who had spontaneous labor, 74.1% (20/27) delivered vaginally, with no cases of uterine rupture.

CONCLUSION:

Women with stillbirth usually delivered vaginally regardless of whether labor was spontaneous or induced or whether they had a prior cesarean delivery. However, 15% underwent cesarean delivery, often without a documented obstetric indication.
What Is New in Labor Management?
Authors: Dunsmoor-Su Rebecca
Published: March 2017

This month, we focus on current research in labor management. Dr. Dunsmoor-Su discusses five recent publications, and each is concluded with a “bottom line” that is the take-home message. The complete reference for each can be found in Box 1 on this page, along with direct links to the abstracts.
Comparison of healing intra-articular fracture of distal femur using a Kirschner wire and autologous fibrin glue in an animal model
Authors: Azarpira Mohammad R. , Vazani Kasra , Ayatollahi Maryam , Azarpira Negar , Kaviani Maryam
Published: March 2017

Considering different surgical techniques for the fixation of osteochondral intra-articular fracture, the present study aimed to compare the efficacy of autologous fibrin glue and Kirschner wire (KW) on an osteochondral fracture in the left lateral condyle of Dutch rabbits with a control group. After 6 weeks, macroscopic and microscopic evaluation showed that autologous fibrin glue is easier and faster with a higher number of bone trabecula (P<0.05), whereas the healing rate and cellularity of the healing site were not different between the two groups (KW and glue). The use of autologous fibrin glue can be an alternative to KW fixation in the fixation of osteochondral fractures. Level of Evidence: Level II.
Use of analgesics in young adults as a predictor of health care utilization and pain prevalence: Israel defense forces experience
Authors: Dorfman Karina , Komargodski Olga , Magnezi Racheli , Lifshitz Stanislav , Tzur Dorit , Yavnai Nirit , Ifergane Gal
Published: March 2017

Pain evaluation in large community studies is difficult. Analgesics can be a useful tool in estimating pain-related conditions in which analgesic use is highly regulated. In this study, we evaluated analgesics consumption patterns of regular Israel Defense Force soldiers. We have performed a historical cohort study of 665,137 young adults during active duty in 2002 to 2012. Analgesics were prescribed to 518,242 (78%) soldiers, mostly for musculoskeletal pain (69.3%), abdominal pain (12.7%), and headache (12.1%). Acute (1-14 days), subacute (15-90), and chronic (>90 days) analgesic use episodes were experienced by 396,987 (59.7%), 74,591 (11.2%), and 46,664 (7%) of the population. In a multivariate model, predictors for chronic analgesics use were as follows: low intelligence, service in a combat supporting unit, previous pain diagnosis, male sex, Israeli nativity, low socioeconomic status, and high body mass index. Low intelligence had the highest odds ratio for chronic analgesic consumption (2.1) compared with other predictors. Chronic analgesic use was associated with a significant increase in health care utilization cost per year (911$ per soldier vs 199$ for nonusers), increased sick leave days per year (7.09 vs 0.67 for nonusers), and higher dropout rate from combat units (25% vs 9.2% for nonusers). Chronic use of analgesics is common among young adults, and it is an important predictor for unsuccessful military service and high health care utilization costs. Further studies in other setups are indicated.
Analgesic use in pregnancy and male reproductive development
Authors: Hurtado-Gonzalez Pablo , Mitchell Rod T.
Published: March 2017

Purpose of review

Male reproductive disorders are common and increasing in incidence in many countries. Environmental factors (including pharmaceuticals) have been implicated in the development of these disorders. This review aims to summarize the emerging epidemiological and experimental evidence for a potential role of in-utero exposure to analgesics in the development of male reproductive disorders.

Recent findings

A number of epidemiological studies have demonstrated an association between in utero exposure to analgesics and the development of cryptorchidism, although these findings are not consistent across all studies. Where present, these associations primarily relate to exposure during the second trimester of pregnancy. In vivo and in vitro experimental studies have demonstrated variable effects of exposure to analgesics on Leydig cell function in the fetal testis of rodents, particularly in terms of testosterone production. These effects frequently involve exposures that are in excess of those to which humans are exposed. Investigation of the effects of analgesics on human fetal testis have also demonstrated effects on Leydig cell function. Variation in species, model system, dosage and timing of exposure is likely to contribute to differences in the findings between studies.

There is increasing evidence for analgesic effects on the developing testis that have the potential to impair male reproductive function. However, the importance of these findings in relation to human-relevant exposures and the risk of male reproductive disorders remain unclear.
The Use of a Triage-Based Protocol for Oral Rehydration in a Pediatric Emergency Department
Authors: Hendrickson Marissa A. , Zaremba Jennifer , Wey Andrew R. , Gaillard Philippe R. , Kharbanda Anupam B.
Published: March 2017

Background

Guidelines recommend oral rehydration therapy (ORT) and avoidance of laboratory tests and intravenous fluids for mild to moderate dehydration in children with gastroenteritis; oral ondansetron has been shown to be an effective adjunct.

Objectives

The aim of this study was to determine if a triage-based, nurse-initiated protocol for early provision of ondansetron and ORT could safely improve the care of pediatric emergency department (ED) patients with symptoms of gastroenteritis.

Methods

This study evaluated a protocol prompting triage nurses to assess dehydration in gastroenteritis patients and initiate ondansetron and ORT if indicated. Otherwise well patients aged 6 months to 5 years with symptoms of gastroenteritis were eligible. Prospective postintervention data were compared with retrospective, preintervention control subjects.

Results

One hundred twenty-eight (81 postintervention and 47 preintervention) patients were analyzed; average age was 2.1 years. Ondansetron use increased from 36% to 75% (P< 0.001). Time to ondansetron decreased from 60 minutes to 30 minutes (P= 0.004). Documented ORT increased from 51% to 100% (P< 0.001). Blood testing decreased from 37% to 21% (P= 0.007); intravenous fluid decreased from 23% to 9% (P= 0.03). Fifty-two percent of postintervention patients were discharged with prescriptions for ondansetron. There were no significant changes in ED length of stay, admissions, or unscheduled return to care.

Conclusions

A triage nurse–initiated protocol for early use of oral ondansetron and ORT in children with evidence of gastroenteritis is associated with increased and earlier use of ondansetron and ORT and decreased use of IV fluids and blood testing without lengthening ED stays or increasing rates of admission or unscheduled return to care.
Statin-Associated Autoimmune Myopathy
Authors: Nazir Salik , Lohani Saroj , Tachamo Niranjan , Poudel Dilliram , Donato Anthony
Published: March 2017

Background

Statins are a group of drugs that reduce the levels of triglycerides and cholesterol in blood by inhibiting HMG-CoA reductase, an enzyme involved in rate limiting step in cholesterol synthesis. About 2–20% patients on statins develop toxic myopathies, which usually resolve on discontinuation of statin. More recently, an immune-mediated necrotizing myopathy has been found to be associated with statin use which in most cases requires treatment with immunosuppressants.

Objective

To perform a systematic review on published case reports and case series of statin-associated autoimmune myopathy.

Methods

A comprehensive search of PUBMED, EMBASE, Cochrane library and ClinicalTrials.gov databases was performed for relevant articles from inception until March 19, 2016 to identify cases of statin-associated necrotizing myopathy and characterize their symptoms, evaluation and response to treatment.

Results

A total of 16 articles describing 100 patients with statin-associated autoimmune myopathy were identified. The mean age of presentation was 64.72 years, and 54.44% were males. The main presenting clinical feature was proximal muscle weakness, which was symmetric in 83.33% of patients. The mean creatine kinase (CK) was 6853 IU/l. Anti-HMG-CoA reductase antibody was positive in all cases tested (n = 57/57, 100%). In patients with no anti-HMG-CoA antibody results, diagnosis was established by findings of necrotizing myopathy on biopsy. Among the 83 cases where muscle biopsy information was available, 81.48% had necrosis, while 18.51% had combination of necrosis and inflammation. Most (83.82%) patients received two or more immunosuppressants to induce remission. Ninety-one percent had resolution of symptoms after treatment.

Conclusion

Statin-associated necrotizing myopathy is a symmetric proximal muscle weakness associated with extreme elevations of CK. It is common in males and can occur after months of statin use. It is associated with necrosis on muscle biopsy and the presence of anti-HMG-CoA reductase antibodies. It usually requires discontinuation and immune suppression for resolution. Rechallenge with statin is unsuccessful in most cases.
Use of Hydroxychloroquine Is Associated With Improved Lipid Profile in Rheumatoid Arthritis Patients
Authors: Restrepo Jose Felix , del Rincon Inmaculada , Molina Emily , Battafarano Daniel F. , Escalante Agustin
Published: March 2017

Background/Purpose

We examined the association between hydroxychloroquine (HCQ) and plasma lipid and glucose levels in rheumatoid arthritis (RA) cohort.

Methods

This is a retrospective cohort analysis of 1261 RA patients comparing fasting lipid profiles and plasma glucose between patients who were and were not taking HCQ. We divided patients into 3 groups based on HCQ exposure during follow-up: those who had never taken HCQ, those who took it intermittently, and those who took it continuously. We used multivariable models and propensity scoring to compensate for the effect of nonrandom treatment assignment.

Results

We followed 1261 RA patients for a total of 4605 observations between 1996 and 2014. After adjusting for age, sex, ethnicity, other disease-modifying antirheumatic drugs (DMARDs), lipid-lowering medications, body mass index (BMI), and smoking, patients taking HCQ at baseline had significantly lower total cholesterol (TC) (P≤ 0.001), low-density lipoprotein (LDL) (P≤ 0.001), triglycerides (P= 0.013), and lipid profile ratios TC/high-density lipoprotein (HDL) (P≤ 0.001) and LDL/HDL (P≤ 0.001), as well as higher HDL (P≤ 0.001).

In longitudinal analyses, after adjusting for confounders, patients who continuously took HCQ showed significantly lower TC, LDL, TC/HDL, and LDL/HDL and higher HDL (P≤ 0.01). Fasting plasma glucose levels were not significantly associated with HCQ exposure.

Conclusions

Hydroxychloroquine use was associated with lower lipid levels but not with the plasma glucose in this RA cohort. These findings support the need for a randomized trial to establish the role of HCQ in cardiovascular disease prevention in RA patients.
Role of Laparoscopy in Patients With Abdominal Trauma at Level-I Trauma Center
Authors: Parajuli Purushottam , Kumar Subodh , Gupta Amit , Bansal Virinder Kumar , Sagar Sushma , Mishra Biplab , Singhal Maneesh , Kumar Atin , Gamangatti Shivanand , Gupta Babita , Sawhney Chhavi , Misra Mahesh C.
Published: March 2017

Introduction:

Abdominal trauma is one of the preventable causes of death in polytrauma patients. Decision and timing of laparotomy is a major challenge. Rate of nontherapeutic laparotomy is still high. Laparoscopy can avoid nontherapeutic laparotomy and also provide a reliable and accurate diagnosis of injury.

Materials and Methods:

This ambispective observational study was conducted in the division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, All India Institute Medical Sciences, New Delhi. Retrospective analysis of prospectively maintained data of cases from January 1, 2008 through April 30, 2013 and prospective analysis of cases from May 1, 2013 through March 31, 2015 was done using appropriate measures. Hemodynamically stable or responders fulfilling inclusion criteria were included. Selected patients underwent the laparoscopic procedure and if required converted to laparotomy.

Results:

Of the 3610 patients of abdominal trauma, laparotomy was done in 1666 (46.14%) patients and laparoscopy was done in 119 (3.29%) patients. Rate of reduction of nontherapeutic laparotomy in patients with abdominal trauma using diagnostic laparoscopy was 55.4%. However laparotomy could be avoided in 59.7%. Laparoscopy was 100% accurate in identifying injuries in our study. No injuries were missed in these patients. Fever and wound infection were significantly higher in laparotomy group. Chest infection and sepsis were also higher in laparotomy group but the difference was not statistically significant. Median length of hospital stay in laparoscopy group was 4 days (range: 1 to 28 d) and in laparotomy group was 9.5 days (range: 2 to 55 d) with P-value of 0.001.

Conclusions:

Laparoscopy has a role in management of hemodynamically stable patients with suspected abdominal injury to prevent nontherapeutic laparotomies, and thereby decreasing postoperative complications.
Validation of a Laparoscopic Ferromagnetic Technology-based Vessel Sealing Device and Comparative Study to Ultrasonic and Bipolar Laparoscopic Devices
Authors: Chen Jennwood , Jensen Curtis R. , Manwaring Preston K. , Glasgow Robert E.
Published: March 2017

Introduction:

Ferromagnetic heating is a new electrosurgery energy modality that has proven effective in hemostatic tissue dissection as well as sealing and dividing blood vessels and vascularized tissue. The purpose of this study was to evaluate a ferromagnetic-based laparoscopic vessel sealing device with respect to sealing and dividing vessels and vascularized tissue and to compare performance against current vessel sealing technologies.

Materials and Methods:

A laparoscopic vessel sealing device, Laparoscopic FMsealer (LFM), was studied for efficacy in sealing and dividing blood vessels and comparative studies against predicate ultrasonic, Harmonic Ace+(US), and/or bipolar, LigaSure 5 mm Blunt Tip and/or Maryland (BP), devices in vivo using a swine model and in vitro for comparison of seal burst pressure and reliability. Mann-Whitney and Student t test were used for statistical comparisons.

Results:

In division of 10 cm swine small bowel mesentery in vivo, the laparoscopic FMsealer [12.4±1.8 sec (mean±SD)], was faster compared with US (26.8±2.5 s) and BP (30.0±2.7 s), P<0.05 LFM versus US and BP. Blinded histologic evaluation of 5 mm vessel seals in vivo showed seal lateral thermal spread to be superior in LFM (1678±433 μm) and BP (1796±337 μm) versus US (2032±387 μm), P<0.001. In vitro, seal burst strength and success of sealing 2 to 4 mm arteries were as follows (mean±SD mm Hg, % success burst strength >240 mm Hg): LFM (1079±494 mm Hg, 98.1% success) versus BP (1012±463, 99.0%), P=NS. For 5 to 7 mm arteries: LFM (1098±502 mm Hg, 95.3% success) versus BP (715±440, 91.8%), P<0.001 in burst strength and P=NS in % success. Five 60 kg female swine underwent 21-day survival studies following ligation of vessels ranging from 1 to 7 mm in diameter (n=186 total vessels). Primary seal was successful in 97%, 99% including salvage seals. There was no evidence of postoperative bleeding at sealed vessels at 21-day necropsy.

Conclusion:

The Laparoscopic FMsealer is an effective tool for sealing and dividing blood vessels and vascularized tissue and compares favorably to current technologies in clinically relevant end points.
Twenty-Four–Hour Voiding Diaries Versus 3-Day Voiding Diaries: A Clinical Comparison
Authors: Elmer Caroline , Murphy Amber , Elliott John O. , Book Nicole M.
Published: March 2017

Objective

This study aimed to determine if 24-hour versus 3-day voiding diary affects medical decision making for women with urinary incontinence.

Methods

A retrospective chart review was conducted of patients presenting to the OhioHealth Urogynecology Physician group for urinary incontinence from 2009 to 2011. Practice protocol includes patient completion of a 3-day voiding diary before their appointment. Diagnostic and treatment plans were extracted based on the initial patient encounter and 3-day voiding diary. A chart review was then completed with the first 24 hours of the same diaries, principal history, and physical examination data compiled into a separate chart. These charts were then reevaluated by the same physician who initially provided care to the patient but were blinded to their previous orders, impressions, and plans. New plans were then created based on the 24-hour diaries and compared with the original plans.

Results

One hundred eighty-six charts were reviewed. There was good agreement between 24-hour and 3-day diaries in recommendations for first-line behavioral modifications (Κ > 0.6) and moderate agreement between diaries in initiation of medical therapy or trial of incontinence pessary (Κ > 0.4). However, 24-hour diaries resulted in a statistically significant increase in invasive diagnostic tests (P < 0.019) and other treatment recommendations when compared with 3-day diaries.

Conclusions

Use of 24-hour diaries may result in increased testing when compared with 3-day diaries. It may be prudent to postpone invasive testing in those patients who initially are noncompliant with a longer diary until a more complete history can be obtained.
No general relationship between mass and temperature in endothermic species
Authors: Riemer Kristina , Guralnick Robert P , White Ethan
Published: March 2017

Bergmann’s rule is a widely-accepted biogeographic rule stating that individuals within a species are smaller in warmer environments. While there are many single-species studies and integrative reviews documenting this pattern, a data-intensive approach has not been used yet to determine the generality of this pattern. We assessed the strength and direction of the intraspecific relationship between temperature and individual mass for 952 bird and mammal species. For eighty-seven percent of species, temperature explained less than 10% of variation in mass, and for 79% of species the correlation was not statistically significant. These results suggest that Bergmann’s rule is not general and temperature is not a dominant driver of biogeographic variation in mass. Further understanding of size variation will require integrating multiple processes that influence size. The lack of dominant temperature forcing weakens the justification for the hypothesis that global warming could result in widespread decreases in body size.
Intraocular injection of ES cell-derived neural progenitors improve visual function in retinal ganglion cell-depleted mouse models
Authors: Divya Mundackal Sivaraman , Rasheed Vazhanthodi Abdul , Schmidt Tiffany , Lalitha Soundararajan , Hattar Samer , James Jackson
Published: March 2017

Retinal ganglion cells (RGC) transplantation is a promising strategy to restore visual function resulting from irreversible RGC degeneration occurring in glaucoma or inherited optic neuropathies. We previously demonstrated FGF2 induced differentiation of mouse embryonic stem cells (ESC) to RGC lineage, capable of retinal Ganglion Cell Layer (GCL) integration upon transplantation in mice. Here, we evaluated possible improvement of visual function by transplantation of ES cell derived neural progenitors in RGC depleted glaucoma mice models. ESC derived neural progenitors (ES-NP) were transplanted into NMDA (N-Methyl-D-Aspartate) injected, RGC-ablated mouse models and a pre-clinical glaucoma mouse model (DBA/2J) having sustained higher intra ocular pressure (IOP). Visual acuity and functional integration was evaluated by behavioural experiments and immunohistochemistry, respectively. GFP-expressing ES-NPs transplanted in NMDA-injected RGC-depleted mice differentiated into RGC lineage and possibly integrating into GCL. An improvement in visual acuity was observed after two months of transplantation, when compared to the pre-transplantation values. Expression of c-Fos in the transplanted cells, upon light induction, further suggests functional integration into the host retinal circuitry. However, the transplanted cells did not send axonal projections into optic nerve. Transplantation experiments in DBA/2J mouse showed no significant improvement in visual functions, possibly due to both host and transplanted retinal cell death which could be due to an inherent high IOP. We showed that, transplantation of ES-NPs into the retina of RGC-ablated mouse models could survive, differentiate to RGC lineage, and possibly integrate into GCL to improve visual function. However, for the survival of transplanted cells in glaucoma, strategies to control the IOP are warranted.