bluuebunny/crossref_metadata_2025 huggingface dataset:
Regional volumetric abnormalities in pediatric autism revealed by structural magnetic resonance imaging
Authors: Levman Jacob , Vasung Lana , MacDonald Patrick , Rowley Sean , Stewart Natalie , Lim Ashley , Ewenson Bryan , Galaburda Albert , Takahashi Emi
Published: August 2018

Autism is a group of complex neurodevelopmental disorders characterized by impaired social interaction, restricted and repetitive behavior. We performed a large‐scale retrospective analysis of 1,996 structural magnetic resonance imaging (MRI) examinations of the brain from 1,769 autistic and neurologically typically developing patients (aged 0–32 years), and extracted regional volumetric measurements distributed across 463 brain regions of each patient. The youngest autistic patients (<2.5 years) were diagnosed after imaging and identified retrospectively. Our study demonstrates corpus callosum volumetric abnormalities among autistic patients that are associated with brain overgrowth in early childhood (0–5 years old), followed by a shift towards known decreased volumes in later ages. Results confirm known increases in ventricular volumes among autistic populations and extends those findings to increased volumes of the choroid plexus. Our study also demonstrates distributed volumetric abnormalities among autistic patients that affect a variety of key regional white and grey matter areas of the brain potentially associated with known symptoms of autism.
Maternal dairy fat diet does not influence neurotrophin levels and cognitive performance in the rat offspring at adult age
Authors: Jawale Shruti , Joshi Sadhana , Kale Anvita
Published: August 2018

Cognitive development may be influenced by maternal nutrition especially fats. Indian population is vegetarian and main source of fat is dairy. This study investigates the effect of dairy fat consumption during pregnancy in an animal model on fatty acids, brain neurotrophins (brain derived neurotrophic factor: BDNF; and nerve growth factor: NGF) and cognitive performance in adult offspring. Pregnant Wistar rats were assigned to control (Control C) and four treatment groups: High fat diet (HFD); High fat diet supplemented with omega‐3 fatty acids (HFDO); High fat diet deficient in vitamin B12 (HFBD); High fat deficient in vitamin B12 supplemented with omega‐3 fatty acids (HFBDO). Half the dams were dissected on d20 of gestation, and the brains of their pups were collected. The remaining dams delivered on d22 of gestation and were assigned to a control diet. The cognitive performance of these adult offspring was assessed at 6 mo of age. Brain fatty acids were comparable to control in the pups at birth and offspring at 6 mo of age. The protein levels of BDNF in the pup brain at birth were lower in both the HFD (p < 0.01) and HFBD (p < 0.05) groups as compared to control. The mRNA levels of TrK B were lower (p < 0.05) in the pup brain at birth in the HFD as compared to control group. In the offspring at 6 mo of age the protein levels of BDNF and NGF in all the treatment groups were similar to that of control. However, the mRNA levels of only BDNF (p < 0.01 for both) were higher in the HFBD group as compared to both control and HFD groups. The cognitive performance of the adult offspring from various dietary groups was similar to control. In conclusion, consumption of a maternal high dairy fat diet although lowered the levels of brain BDNF in the pup at birth it does not affect the cognitive health of the adult offspring.
Explore Your Inner Child by Painting Science with Pixels
Authors: Cartier Kimberly
Published: August 2018

We always knew Microsoft Paint was useful for something.
A Statistical Study of Ionospheric Boundary Wave Formation at Venus
Authors: Chong Ghai Siung , Pope Simon A. , Walker Simon N. , Frahm Rudy A. , Zhang Tielong , Futaana Yoshifumi
Published: August 2018

Previous missions to Venus have revealed that encounters with plasma irregularities of atmospheric origin outside the atmosphere are not uncommon. A number of mechanisms have been proposed to discuss their origins as well as their roles in the atmospheric evolution of Venus. One such mechanism involves an ionopause with a wavelike appearance. By utilizing the magnetic field and plasma data from Venus Express, we present the first observational statistical analysis of the ionospheric boundary wave phenomena at Venus using data from 2006 to 2014. Results from the minimum variance analysis of all the photoelectron dropout events in the ionosphere reveal that the ionopause of Venus does not always appear to be smooth but often exhibits a wavelike appearance. In the northern polar region of Venus, the normal directions of the rippled ionospheric boundary crossings lie mainly in the terminator plane with the largest component predominantly along the dawn‐dusk (YVSO) direction. The average estimated wavelength of the boundary wave is 212 ± 12 km, and the average estimated velocity difference across the ionopause is 104 ± 6 km/s. The results suggest that the rippled boundary is a result of Kelvin‐Helmholtz instability. Analysis reveals a correlation between the normal directions and the locations of the boundary wave with respect to Venus. This indicates that the draping of magnetic field lines may play a role in enhancing the plasma flow along the dawn‐dusk direction, which could subsequently set up a velocity shear that favors the excitation of ionospheric boundary wave by the Kelvin‐Helmholtz instability along the dawn‐dusk direction.
The 6 September 2017 X9 Super Flare Observed From Submillimeter to Mid‐IR
Authors: Giménez de Castro C. G. , Raulin J.‐P. , Valle Silva J. F. , Simões P. J. A. , Kudaka A. S. , Valio A.
Published: August 2018

Active Region 12673 is the most productive active region of solar cycle 24: in a few days of early September 2017, four X‐class and 27 M‐class flares occurred. SOL2017‐09‐06T12:00, an X9.3 flare also produced a two‐ribbon white light emission across the sunspot detected by Solar Dynamics Orbiter/Helioseismic and Magnetic Imager. The flare was observed at 212 and 405 GHz with the arcminute‐sized beams of the Solar Submillimeter Telescope focal array while making a solar map and at 10 μm, with a 17 arcsec diffraction‐limited infrared camera. Images at 10 μm revealed that the sunspot gradually increased in brightness while the event proceeded, reaching a temperature similar to quiet Sun values. From the images we derive a lower bound limit of 180‐K flare peak excess brightness temperature or 7,000 sfu if we consider a similar size as the white light source. The rising phase of mid‐IR and white light is similar, although the latter decays faster, and the maximum of the mid‐IR and white light emission is ∼200 s delayed from the 15.4‐GHz peak occurrence. The submillimeter spectrum has a different origin than that of microwaves from 1 to 15 GHz, although it is not possible to draw a definitive conclusion about its emitting mechanism.
Efficient and regioselective synthesis of γ-lactone glycosides through a novel debenzylative cyclization reaction
Authors: Delbrouck Julien A. , Tikad Abdellatif , Vincent Stéphane P.
Published: August 2018

An efficient and regioselective approach for the construction of synthetically important γ-lactone glycosides is reported from unprotected aldoses through a new debenzylative lactonization (DBL) reaction.
Freshwater clam extract reduces liver injury by lowering cholesterol accumulation, improving dysregulated cholesterol synthesis and alleviating inflammation in high-fat, high-cholesterol and cholic acid diet-induced steatohepatitis in mice
Authors: Yao Hsien-Tsung , Lee Pei-Feng , Lii Chong-Kuei , Liu Yun-Ta , Chen Szu-Han
Published: August 2018

Freshwater clam (Corbicula fluminea) is a traditional liver-protective food in Asia.
Ultrathin WS2 nanosheets vertically embedded in a hollow mesoporous carbon framework – a triple-shell structure with enhanced lithium storage and electrocatalytic properties
Authors: Zhang Xiue , Zhao Rongfang , Wu Qianhui , Li Wenlong , Shen Chao , Ni Lubin , Yan Hui , Diao Guowang , Chen Ming
Published: August 2018

HTSHNs WS2/C with ultrathin WS2 nanosheets vertically embedded in HMCSs provide abundant active sites, high conductivity and superior structural stability.
Rational design of Fe3O4@C nanoparticles for simultaneous bimodal imaging and chemo-photothermal therapy in vitro and in vivo
Authors: Han Qinghe , Wang Xiaodong , Sun Zhiqiang , Xu Xiaofei , Jin Longhai , Qiao Lixin , Yuan Qinghai
Published: August 2018

A simple and novel synthetic route was developed to fabricate multifunctional Fe3O4@C eccentric core–shell nanoparticles as synergetic pH/NIR-responsive drug delivery vehicles for simultaneous biomodal magnetic resonance/photoacoustic imaging and synergistic photothermal cancer therapy in vitro.
Highly efficient, all-solution-processed, flexible white quantum dot light-emitting diodes
Authors: Shen Piaoyang , Li Xiaomin , Cao Fan , Ding Xingwei , Yang Xuyong
Published: August 2018

Flexible information displays hold great promise for future optoelectronic applications. Herein, we report the fabrication of an efficient flexible white quantum dot (QD) light-emitting diode (QLED) with mixed red, green and blue QDs as emitters via an all-solution process. The resulting flexible QLED with a pure white emission shows high current efficiency of 10.5 cd A−1.
Semi-transparent polymer solar cells with optical adjusting layers
Authors: Shen Ping , Long Yongbing , Wang Guoxin , Wang Yufei , Guo Wenbin , Shen Liang
Published: August 2018

IPCE was broadened by adjusting the reflection phase shift, leading to an efficiency enhancement of 22.3% in semi-transparent polymer solar cells.
Biased contribution index: a new faster convergent index to maintain the fairness in peer‐to‐peer networks
Authors: Awasthi S.K. , Singh Y.N.
Published: August 2018

The free‐riding and large difference between upload and download amount of resources is a fundamental problem in a peer‐to‐peer network. An incentive mechanism, which can be implemented in a distributed fashion, can solve this problem. Global contribution (GC) approach is one such mechanism, but its speed of convergence is slow. This letter proposes a new index named biased contribution index (BCI). It is proved that BCI always converges at a certain value. Simulation results show that it converges faster than the GC.
Tracking, erosion and thermal distribution of micro‐AlN + nano‐SiO2 co‐filled silicone rubber for high‐voltage outdoor insulation
Authors: Nazir Muhammad Tariq , Phung Bao Toan , Yu Shihu , Zhang Yuanyuan , Li Shengtao
Published: August 2018

Thermal depolymerisation induced tracking and erosion of polymeric insulators is one of the key insulation failure modes and this process adversely affects the reliability of power delivery networks. This study reports the tracking, erosion and thermal distribution of micron‐AlN and micron‐AlN + nano‐SiO2 co‐filled silicone rubber composites. A tracking‐erosion model is presented to explain how the co‐filled set of particles directly affects such mechanisms. Aluminium nitride (AlN: 5–10 μm) and silica (SiO2: 20 nm) particles were procured for fabricating test samples. The inclined plane test according to IEC 60587 was carried out using tracking voltage method 2 with an initial applied voltage of 3 kV and a ramping rate of 0.25 kV/h over the duration of 240 min. Measurement results show co‐filled composites exhibit significantly lower physical tracking and erosion as compared to micron‐AlN filled composites. Thermal accumulation and average leakage current in co‐filled composites are found noticeably lower than micron‐filled counterparts. Moreover, the increased surface area of the combined co‐filled particles in the composites provides better scattering and reduce secondary electron collision. This may impede the release of high energy causing thermal degradation.
Comprehensive understanding of DC pole‐to‐pole fault and its protection for modular multilevel converters
Authors: Yang Xiaofeng , Xue Yao , Wen Piao , Li Zejie
Published: August 2018

A modular multilevel converter (MMC) is one of the promising voltage source converter topologies in the field of high‐voltage direct current (HVDC) transmission. MMCs are vulnerable to the direct current (DC) short‐circuit faults due to the high discharge current stress. This study first introduced the simplified equivalent circuits of MMCs under both normal and DC fault operation conditions. Then the MMC fault spread loops and fault energy distribution principles are presented. Moreover, a detailed comparative study of the existing DC fault handling schemes, which are classified as the rigid blocking and flexible blocking methods are carried out. It provides a technical reference for further study on the MMC DC fault protection schemes for the HVDC transmission system.
Restoration algorithm for noisy complex illumination
Authors: Liu Zhanwen , Gao Tao , Kong Fanjie , Jiao Ziheng , Yang Aodong , Li Shuying , Liu Bo
Published: August 2018

Although promising results have been achieved in the restoration of complex illumination images with the Retinex algorithm, there are still some drawbacks in the processing of Retinex. Considering the noise characteristics of complex illumination images, in this study, we propose a novel restoration algorithm for noisy complex illumination, which combines guided adaptive multi‐scale Retinex (GAMSR) and improvement BayesShrink threshold filtering (IBTF) based on double‐density dual‐tree complex wavelet transform (DDDTCWT) domain. Extensive restoration experiments are conducted on three typical types images and the same image with different noises. On the basis of a series of evaluation indexes, we compare our method to those of state‐of‐the‐art algorithms. The results show that (i) SSIM of the proposed IBTF is superior to traditional Bayes threshold method by 15% as the standard variance is 100. (ii) PSNR of the proposed GAMSR enhances 15% to traditional MSR. (iii) The clarity of final results for restoration speeds up three times than that of original images, and the information entropy is improved slightly too. Therefore, the proposed method can effectively enhance the details, edges and textures of the image under complex illumination and noises.
All‐stop, skip‐stop, or transfer service: an empirical study on preferences of bus passengers
Authors: Fan Aihua , Chen Xumei , Wang Youan , Kou Weibin
Published: August 2018

This study analyses the effects of individual and trip characteristics on passenger travel choice behaviours when presented with all‐stop, skip‐stop, and transfer services. Bus stops are classified into two types: an ‘AB Station’ provides both all‐stop and skip‐stop services and an ‘A Station’ provides only all‐stop service. Passenger travel choice behaviours ‘from AB to AB’ and ‘from AB to A’ are studied based on travel choice probabilities. A stated preference survey was conducted in Beijing to collect individual and trip characteristics for various travel circumstances and used to develop passenger choice probability models based on logit model. The results show that the probability of choosing skip‐stop service increases with the increase in travel distance and the decrease in in‐vehicle time; transfer service is not popular, even for a long trips; skip‐stop and transfer services are more attractive to passengers taking a mandatory trip; there are differences in choice behaviours between male and female passengers; compared to high‐income passengers, low‐to‐middle income passengers exhibit a lower probability of choosing transfer service because of the additional travel cost. This study contributes to predicting future demands for different bus services, the implementation and optimisation of skip‐stop strategies, and bus schedule improvement.
Efficient bias reduction approach of time‐of‐flight‐based wireless localisation networks in NLOS states
Authors: Xiong Hailiang , Peng Meixuan , Zhu Kongfan , Yang Yang , Du Zhengfeng , Xu Hongji , Gong Shu
Published: August 2018

An efficient bias mitigation algorithm based on time of flight is proposed for positioning the target location and reducing the non‐line‐of‐sight (NLOS) error and clock jitter error in three‐dimensional wireless cooperative localisation networks. Through linearising the range‐based expressions and utilising novel three‐step weighted linear least squares algorithm, an algebraic solution of target can be derived, in which the clock jitter error and NLOS error can be alleviated effectively. Meanwhile, the Cramer–Rao lower bound (CRLB) is derived for the standard of performance evaluation. The location accuracy of the proposed algorithm is analysed and compared with the conventional methods through simulation experiment. The simulation results indicate that the precision of the proposed algorithm can approach the CRLB, what is more, the proposed algorithm can provide obvious improvements in positioning accuracy compared to the state‐of‐the‐art approaches.
Facile synthesis of Ag3PO4 microcrystals and its enhanced photocatalytic disinfection
Authors: Tseng Chi‐Shun , Wu Tsunghsueh , Lin Yang‐Wei
Published: August 2018

Facile synthesis of silver phosphate (Ag3PO4) microcrystals was developed for the novel application in the disinfection of pathogens with visible light. Ag3PO4 microcrystals from different synthesis routes were produced and characterised by scanning electron microscopy and UV–visible diffuse reflectance spectroscopy. The antibacterial activity of the Ag3PO4 microcrystals was also evaluated for its effectiveness in eradicating pathogens (Escherichia coli and Staphylococcus aureus) under white‐light light‐emitting‐diode irradiation. The prepared Ag3PO4 microcrystals displayed higher and more stable photocatalytic antibacterial activity (>99% eradication rate within 10 min) comparing to Ag+ ions used only. This can be attributed to the oxidation of the photogenerated hole and the adsorption of Ag+ ions. This study demonstrated the strong photocatalytic activity of the as‐prepared Ag3PO4 microcrystals, promising for industrial applications related to the eradication of pathogens from wastewater.
Solar cycle 24: An unusual polar field reversal
Authors: Janardhan P. , Fujiki K. , Ingale M. , Bisoi S. K. , Rout D.
Published: August 2018

Context. It is well known that the polarity of the Sun’s magnetic field reverses or flips around the maximum of each 11 year solar cycle. This is commonly known as polar field reversal and plays a key role in deciding the polar field strength at the end of a cycle, which is crucial for the prediction of the upcoming cycle.

Aims. We aim to investigate solar polar fields during cycle 24, using measurements of solar magnetic fields in the latitude range 55°–90° and 78°–90°, to report a prolonged and unusual hemispheric asymmetry in the polar field reversal pattern in solar cycle 24.

Methods. This study was carried out using medium resolution line-of-sight synoptic magnetograms from the magnetic database of the National Solar Observatory at Kitt Peak (NSO/KP), USA for the period between February 1975 and October 2017, covering solar cycles 21–24 and high-resolution line-of-sight synoptic magnetograms from the Michaelson Doppler Imager instrument onboard the Solar Heliospheric Observatory. Synoptic magnetograms using radial measurements from the Heliospheric Magnetic Imager instrument onboard the Solar Dynamics Observatory, covering solar cycle 23 and 24, were also used.

Results. We show that the southern solar hemisphere unambiguously reversed polarity in mid-2013 while the reversal in the field in the northern solar hemisphere started as early as June 2012, was followed by a sustained period of near-zero field strength lasting until the end of 2014, after which the field began to show a clear rise from its near-zero value. While this study compliments a similar study carried out using microwave brightness measurements which claimed that the field reversal process in cycle 24 was completed by the end of 2015, our results show that the field reversal in cycle 24 was completed earlier that is, in late 2014. Signatures of this unusual field reversal pattern were also clearly identifiable in the solar wind, using our observations of interplanetary scintillation at 327 MHz which supported our magnetic field observations and confirmed that the field reversal process was completed at the end of 2014.
Volume Change of Pedicled Latissimus Dorsi Muscle Flap after Partial Breast Reconstruction
Authors: Kang Chang Min , Shim Jeong Su
Published: August 2018

Introduction Despite successful breast reconstruction with oversized latissimus dorsi muscle flap after breast-conserving surgery for breast cancer, esthetic problems continue to exist due to flap shrinkage. The purpose of this study was to evaluate the objective volume change of pedicled latissimus dorsi muscle flap when it is used in breast reconstruction.

Methods Patients who were diagnosed with breast cancer and underwent a breast-conserving surgery with immediate breast reconstruction with pedicled latissimus dorsi myocutaneous flap between October 2009 and November 2015 were studied. Eleven patients who were followed up for more than 1 year after operation were included in the study. We evaluated the volume of muscle portion of the latissimus dorsi myocutaneous flap with computed tomography (CT) scan. We analyzed the rate of volume change of the latissimus dorsi muscle every year until 5 years after the operation.

Result The latissimus dorsi muscle flaps of all 11 patients showed a volume decrease over time. The rate of volume change of the latissimus dorsi muscle flaps decreased 8.04% in the first year, 6.36% in the second year, 5.05% in the third year, 2.88% in the fourth year, and 2.56% in the fifth year after operation in average.

Conclusion This research shows the possibility of objectively evaluating the volume change of pedicled latissimus dorsi muscle flaps after breast reconstruction. The findings will be helpful in designing the size of the flaps to use on defects after breast-conserving surgery.
A Hyperbaric Warm Perfusion System Preserves Tissue Composites Ex vivo and Delays the Onset of Acute Rejection
Authors: Villamaria Carole , Spencer Jerry , Lawson Shari , Wang Lin , Raj Thomas , Wolf E. , Parida Bijaya , Gorantla Vijay , Rickard Rory , Davis Michael , Fries Charles
Published: August 2018

Background Ischemia–reperfusion injury (IRI) precipitates acute rejection of vascularized composite allografts (VCA). Hyperbaric preservation of tissues ex vivo, between harvest and revascularization, may reduce IRI and mitigate acute rejection of VCA.

Methods A porcine heterotopic musculocutaneous gracilis flap model was used. In phase 1, control autografts (n = 5) were infused with University of Wisconsin Solution (UWS) and stored at 4°C for 3 hours. Intervention autografts (n = 5) were placed in a hyperbaric oxygen organ preservation system for 5 hours and infused with hyperoxygenated UWS at 20°C and 3 atm. Grafts were replanted into the animals' necks. In phase 2, similarly treated control (n = 8) and intervention grafts (n = 8) were allotransplanted into the necks of animals separated by a typed and standardized genetic mismatch. No systemic immunosuppression was given. Systemic markers of IRI, and clinical and histopathological assessments of necrosis and rejection were performed.

Results Autotransplanted tissue composites preserved in the hyperbaric chamber showed histopathological evidence of less muscle necrosis at 3 hours (p = 0.05). Despite a longer period of ischemia, no evidence was found of a difference in systemic markers of IRI following revascularization in these groups. Allotransplanted tissues supported ex vivo within the hyperbaric perfusion device experienced acute rejection significantly later than corresponding controls.

Conclusion Hyperbaric warm perfusion preserves musculocutaneous tissue composites ex vivo for longer than standard cold preservation in this model. This translates into a delay in acute rejection of allotransplanted tissue composites.
Limb Salvage and Functional Outcomes following Free Tissue Transfer for the Treatment of Recalcitrant Diabetic Foot Ulcers
Authors: Lu Jocelyn , DeFazio Michael , Lakhiani Chrisovalantis , Abboud Michel , Penzler Morgan , Elmarsafi Tammer , Kim Paul , Attinger Christopher , Evans Karen
Published: August 2018

Background Recent evidence documenting high success rates following microvascular diabetic foot reconstruction has led to a paradigm shift in favor of more aggressive limb preservation. The primary aim of this study was to examine reconstructive and functional outcomes in patients who underwent free tissue transfer (FTT) for recalcitrant diabetic foot ulcers (DFUs) at our tertiary referral center for advanced limb salvage.

Methods Between June 2013 and June 2016, 29 patients underwent lower extremity FTT for diabetic foot reconstruction by the senior author (K.K.E.). In all cases, microsurgical reconstruction was offered as an alternative to major amputation for the management of recalcitrant DFUs. Overall rates of flap survival, limb salvage, and postoperative ambulation were evaluated. The lower extremity functional scale (LEFS) score was used to assess functional outcomes after surgery.

Results Overall rates of flap success and lower limb salvage were 93 and 79%, respectively. Flap failure occurred in two patients with delayed microvascular compromise. Seven patients in this series ultimately required below-knee amputation secondary to recalcitrant infection (n = 5), intractable pain (n = 1), and limb ischemia (n = 1). The average interval between FTT and major amputation was 8 months (r, 0.2–15 months). Postoperative ambulation was confirmed in 25 patients (86%) after a mean final follow-up of 25 months (r, 10–48 months). The average LEFS score for all patients was 46 out of 80 points (r, 12–80 points), indicating the ability to ambulate in the community with some limitations.

Conclusion FTT for the management of recalcitrant DFUs is associated with high rates of reconstructive success and postoperative ambulation. However, several patients will eventually require major amputation for reasons unrelated to ultimate flap survival. These data should be used to counsel patients regarding the risks, functional implications, and prognosis of microvascular diabetic foot reconstruction.
Effect of Segment Length and Number of Osteotomy Sites on Cancellous Bone Perfusion in Free Fibula Flaps
Authors: Ritschl Lucas , Georg Rali , Kolk Andreas , Kesting Marco , Wolff Klaus-Dietrich , Mücke Thomas , Fichter Andreas
Published: August 2018

Background Indocyanine green (ICG) videoangiography is routinely used to evaluate skin and organ perfusion and to assess patency rates of microvascular anastomoses. This study uses ICG angiography as a novel approach to qualitatively and quantitatively evaluate bone perfusion of microvascular fibula grafts intraoperatively and to assess the effect of fibula segment length and number of osteotomies on bone perfusion.

Methods All patients planned for mandible reconstruction using a microvascular fibula graft between January 2013 and May 2017 were considered for this study. ICG videoangiography of cancellous bone perfusion was performed using a handheld ICG camera. Videos were analyzed, and a perfusion curve was generated. Peak enhancement, time to peak, slope, and wash-in area under the curve were extracted; rise time, wash-in rate (WiR), and wash-in perfusion index were calculated. Results were statistically analyzed with regard to distal fibula segment length and number of osteotomy sites.

Results Thirty-nine patients (age 59 ± 8 years) were included in the study. Mandible reconstruction was achieved with 1 (n = 15), 2 (n = 13), or 3 (n = 11) fibula segments. The WiR was 6.4 ± 2.3 and 4.4 ± 0.2 before and after proximal osteotomy, respectively. The wash-in perfusion index was 114.2 ± 48.4 before and 84.4 ± 20.0 after proximal osteotomy. Bone perfusion was significantly reduced after additional proximal osteotomies. Both the segment length and number of proximal osteotomies correlated with bone perfusion, with longer segments and fewer osteotomies showing higher perfusion.

Conclusion This study demonstrates the feasibility of cancellous bone perfusion analysis using ICG and can serve as a basis for future bone perfusion studies. Additional osteotomies and short segment length negatively affects cancellous bone perfusion of the distal fibula segment in free fibula flaps. The extent to which the observed decrease in arterial inflow to the distal fibula segment affects the further course of healing needs to be addressed in future studies.
Impact of Contralateral Symmetry Procedures on Long-Term Patient-Reported Outcomes following Unilateral Prosthetic Breast Reconstruction
Authors: Razdan Shantanu , Panchal Hina , Albornoz Claudia , Pusic Andrea , McCarthy Colleen , Cordeiro Peter , Disa Joseph , Mehrara Babak , Matros Evan
Published: August 2018

Background One aim of unilateral postmastectomy breast reconstruction (BR) is to restore symmetry with the contralateral breast. As such, unilateral prosthetic reconstruction often requires a contralateral symmetry procedure (CSP). There is sparse literature on the impact of CSPs on long-term patient-reported outcomes (PROs) such as satisfaction and health-related quality of life (HRQoL). This study aims to describe PROs following CSPs, using a validated PRO tool, BREAST-Q. The hypothesis is that CSPs are associated with greater patient-reported satisfaction and HRQoL.

Methods This study is a single institutional analysis of prospectively collected BREAST-Q scores of patients who underwent unilateral prosthetic BR during 2011 to 2015. Women 18 years and older with BREAST-Q scores measured ≥ 9months after BR with or without CSP(s) at the time of expander replacement were included. Patients were classified into four subcohorts: augmentation, mastopexy, reduction, and no symmetry procedure (controls). Sociodemographic, clinical characteristics, and BREAST-Q scores were analyzed. Multivariable linear regression was performed.

Results Of 553 patients, 67 (12%) underwent contralateral augmentation, 68 (12%) mastopexy, 93(17%) reduction, and 325 (59%) were controls. Mean follow-up time was 52 months. Satisfaction with breast and outcomes were higher in the augmentation compared with the control groups (p = 0.01). On multivariable analysis, augmentation remained an independent predictor of satisfaction with breast (p = 0.04). Physical well-being scores were lower for contralateral mastopexy and reduction compared with the controls with a trend toward statistical significance on multivariable models. Psychological and sexual well-being was similar across groups.

Conclusion Prosthetic reconstruction with contralateral breast augmentation was associated with greater satisfaction with breast and reconstructive outcome. In contrast, breast reduction and mastopexy procedures demonstrated equivalent satisfaction with breasts compared with controls but may be associated with lower physical well-being. Such information can be used to improve the shared decision-making process for women who choose unilateral prosthetic BR.
Practice Patterns after the Therapeutic Hypothermia After Pediatric Cardiac Arrest Out-of-Hospital Trial: A Survey of Pediatric Critical Care Physicians
Authors: Gildea Marianne , Moler Frank , Page Kent , Pemberton Victoria , Holubkov Richard , Nadkarni Vinay , Dean J. , Olson Lenora
Published: August 2018

The Therapeutic Hypothermia After Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) Trial showed therapeutic hypothermia, versus normothermia, did not significantly improve 1-year survival with good neurobehavioral outcome. Our survey of pediatric critical care physicians, designed to assess the use of targeted temperature management (TTM) after publication of the main THAPCA-OH Trial results, found most respondents were aware of trial results, and over 90% agreed THAPCA-OH was well-designed with important clinical outcomes. While most respondents reported TTM usage consistent with THAPCA-OH results in different patient scenarios, 15% did not select TTM for fever management. Since trials prior to THAPCA-OH established that fever is harmful following brain injury, the continued incomplete adoption of TTM warrants further research on challenges and facilitators to the adoption of clinical trial findings.
Functional Dissociation between Cognitive Estimation and Object Naming in Focal Temporal and Frontal Lobe Epilepsies
Authors: Braun Isabella , Schwarz Michael , Walther Katrin , Stemmler Mark , Kasper Burkhard , Hamer Hajo
Published: August 2018

Purpose This study addresses specific impairments of cognitive estimation and object naming in patients with focal temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE). It was investigated whether selective impairments can be explained by differences in lesion localization and functional hemispheric specialization.

Materials and Methods Seventy-eight patients (39 females, 39 males) with FLE and TLE were investigated using the German “Test zum Kognitiven Schätzen” and the “Boston Naming Test” to assess cognitive estimation abilities and visual object naming.

Questions According to theoretical models that support a distinct hemispheric dominance for estimation and naming, it was expected that epilepsy localization in the right hemisphere would result in impairments of cognitive estimation, whereas patients with left epileptogenic foci would show deficits in object naming.

Results In comparison to a healthy control group, a significant impairment in estimation performance was present in patients with right temporal mesial and right frontal epilepsy. A significant impairment of naming performance was found in patients with left temporal mesial, right temporal mesial, left temporal neocortical, and left frontal epilepsy. Overall, localization-dependent deficits were detected in patients with hippocampal sclerosis (cognitive estimation and object naming), right frontal epilepsy (cognitive estimation), and left temporal neocortical/left frontal epilepsy (object naming). In patients with right temporal neocortical epilepsy, no functional deficits were found.

Conclusion It is hypothesized that there is a functional dissociation between cognitive estimation processes and object naming due to different functional specialization of the left and right hemispheres, respectively.
Hand Perfusion in Patients with Physiological or Pathological Allen's Tests
Authors: Flick Nina , Kamal Mohammad , Steegmann Julius , Kloss-Brandstätter Anita , Teichmann Jan , Hölzle Frank , Lethaus Bernd , Bartella Alexander
Published: August 2018

Background The Allen test (AT) is a widely used clinical tool for the preoperative assessment of sufficient dual vessel hand perfusion although the impact of a pathological AT on tissue perfusion of the hand is not entirely clear. This study reveals perfusion changes of the hand in patients with pathological and physiological AT after terminating the dual blood supply.

Methods Patients were distributed into 2 groups (physiological and pathological AT) that each contained 25 members. Perfusion of the thumb, middle, and small fingers was measured with a laser Doppler based (“oxygen-to-see” [O2C]) device. A steady state was measured and also values at 1, 3, 5, and 10 minutes after radial occlusion were measured.

Results In patients with a physiological AT, only 1 out of 18 values differed significantly from the steady state measurements after 10 minutes, whereas patients with a pathological AT showed significant alterations in 8 out of 18 values. Oxygen saturation of the superficial and deep tissues appeared to be significantly worse in patients with a pathological AT.

Conclusion Patients with a pathological AT suffered significantly more from the loss of dual hand perfusion than patients with a physiological AT. Patients with a pathological AT need more time to compensate for the altered perfusion pattern.
The Pseudoproline Approach to Peptide Cyclization
Authors: Jolliffe Katrina A.
Published: August 2018

The development of efficient methods for the synthesis of cyclic peptides is of interest because of the many potential applications of this class of molecule. Pseudoprolines are derived from serine, threonine, and cysteine and can be used as traceless turn-inducers to facilitate the cyclization of a wide range of linear peptide precursors. The incorporation of a pseudoproline into the peptide to be cyclized generally results in a cyclization reaction that proceeds more quickly and with higher yield than that of an analogous sequence without the pseudoproline. Installation of a pseudoproline at the C-terminal position of a linear peptide sequence has also been shown to eliminate any epimerization of this residue during the reaction. Following pseudoproline-mediated cyclization, these turn-inducers can be removed on treatment with acid in a similar manner to other protecting groups to provide the native peptide sequence, and in the case of cysteine-derived pseudoprolines, the resulting cysteine can be readily converted into alanine through desulfurization. These traceless turn-inducers have been successfully used in the synthesis of cyclic peptides containing either serine, threonine, cysteine or alanine residues.
Use and Opinions of Prescription Opioids Among Older American Adults: Sociodemographic Predictors
Authors: Grol-Prokopczyk Hanna
Published: August 2018

Objectives

This study identifies sociodemographic predictors of prescription opioid use among older adults (age 65+) during the peak decade of U.S. opioid prescription, and tests whether pain level and Medicaid coverage mediate the association between low wealth and opioid use. Predictors of prescription nonsteroidal anti-inflammatory drug (NSAID) use, and of opinions of both drug classes, are also examined.

Method

Regressions of opioid and NSAID use on sociodemographic characteristics, pain level, and insurance type were conducted using Health and Retirement Study 2004 core and 2005 Prescription Drug Study data (n = 3,721). Mediation analyses were conducted, and user opinions of drug importance, quality, and side effects were assessed.

Results

Low wealth was a strong, consistent predictor of opioid use. Both pain level and Medicaid coverage significantly, but only partially, mediated this association. Net of wealth, there were no significant associations between education and use of, or opinions of, either class of drugs.

Discussion

Among older American adults, the poorest are disproportionately likely to have been exposed to prescription opioid analgesics. Wealth, rather than education, drove social class differences in mid-2000s opioid use. Opioid-related policies should take into account socioeconomic contributors to opioid use, and the needs and treatment histories of chronic pain patients.
Implementation trial of school staff health promotion: Polish experiences
Authors: Woynarowska-Sołdan Magdalena
Published: August 2018

The paper presents the results of the trial implementation of staff health promotion in the Health Promoting Schools (HPS) programme in Poland. The design and key results of the summative evaluation of the 3-year project and activities of schools after completion of the project are described. Over 900 teachers and non-teaching employees from 21 schools participated in the project. Its purpose was to verify the schools’ ability to take action related to the promotion of staff health in the HPSs in Poland. The results of the summative evaluation of the project were considered positive and promising. The percentage of persons who declared that they take greater care of their health, and teachers who described their health as very good, increased. Most employees introduced beneficial changes in their health behaviours. In all schools, changes in working conditions and personnel relations were introduced. Eighty-two per cent of teachers and seventy-five per cent of other employees had a positive attitude to the project and ninety per cent declared that the activities ought to be continued. Nearly all the schools’ project leaders considered it a valuable initiative, had personal benefits and satisfaction from its implementation. After completing the project, 16/20 schools continued activities promoting the health of employees. Since the trial implementation of health promotion among school staff was considered a success, in 2016 some indicators relating to school staff health were included in the self-evaluation of HPS, and work began to prepare coordinators of regional and district HPS networks to work with the schools.
Stressful conditions affect reproducing cuttlefish (Sepia officinalis), reducing egg output and quality
Authors: O’Brien Caitlin E , Bellanger Cécile , Jozet-Alves Christelle , Mezrai Nawel , Darmaillacq Anne-Sophie , Dickel Ludovic
Published: August 2018

Stress has profound effects on animals, particularly if it occurs during reproduction or embryonic development. The cuttlefish Sepia officinalis is an economically and scientifically important species that is often cultured in captivity. The effects of stressors applied to reproducing females and developing embryos were investigated and compared by measuring the number and quality of eggs produced by females in a typical captive setting with females subjected to stress during egg-laying (confined space and repeated removal from the water) as well as comparing the hatching size and success of embryos subjected to naturally occurring (predator cues) and artificial (random bouts of bright LED light) stressors. Stressed females produced significantly fewer eggs and fewer of those eggs hatched. In addition, nearly a quarter of stressed mothers laid mostly white eggs lacking the dark pigment typical of this species. In contrast to maternal stress, stressors applied directly to embryos had no effect on hatching rate and neither maternal nor embryonic stress was associated with differences in hatching size. Our results suggest that reducing stress during egg-laying can increase aquacultural egg yields in S. officinalis and that the presence of pigment-less (white) eggs is a sign of maternal stress during egg-laying.
Robust H∞ control of neutral system for sampled-data dynamic positioning ships
Authors: Zheng Minjie , Zhou Yujie , Yang Shenhua , Li Lina
Published: August 2018

This study focuses on the robust ${H}_{\infty }$ sampled-data control problem of neutral system for dynamic positioning (DP) ships. Using the input delay approach and a state-derivative control law, the ship DP system is turned into a neutral system with time-varying delays. By incorporating the delay-decomposition technique, Wirtinger-based integral inequality and an augmented Lyapunov–Krasovskii functional, less conservative result is derived for the resulting system. Sufficient conditions are established to determine the system’s asymptotical stability and achieve ${H}_{\infty }$ performance using Lyapunov stability theorems. Then the ${H}_{\infty }$ sampled-data controller is obtained by analyzing the stabilization conditions. Finally, simulation result is shown that the proposed method is effective.
The Korean Triage and Acuity Scale: associations with admission, disposition, mortality and length of stay in the emergency department
Authors: Kwon Hyuksool , Kim Yu Jin , Jo You Hwan , Lee Jae Hyuk , Lee Jin Hee , Kim Joonghee , Hwang Ji Eun , Jeong Joo , Choi Yoo Jin
Published: August 2018

Objective

The Korean Triage and Acuity Scale (KTAS) was implemented in our emergency department (ED) in May 2016 and is fully integrated into the electronic medical record (EMR) system. Our objective was to determine whether the KTAS is associated with changes in admissions to the hospital, admission disposition, inpatient mortality and length of stay (LOS).

Design

Quasi-experimental, uncontrolled before-and-after study.

Setting

The urban tertiary teaching hospital with 1100 beds and receives approximately annual 90 000 ED visits.

Participants

122 370 patients who visited the ED during the before-and-the after period.

Interventions

ED staff were educated on the KTAS for 1 month, after which the KTAS evaluation period began. Admission, disposition, mortality and LOS were compared between the ‘before’ period (1 June 2015 to 30 April 2016) and the ‘after’ period (1 June 2016 to 30 April 2017).

Main outcome measures

Admissions to the hospital, admission disposition, inpatient mortality and LOS.

Results

A total of 59 220 and 63 150 patients were included in the before-and-after periods of KTAS implementation, respectively. The pattern of admission and disposition changed significantly after implementation of the KTAS. The mean LOS was 343 min (standard deviation [SD] = 432 min) during the before period, which significantly decreased to 289 min (SD = 333 min) after implementation (P < 0.001). The total mortality rate was significantly reduced after implementation of the KTAS (213 (0.36%) vs. 179 (0.28%), P = 0.020).

Conclusion

Implementation of the KTAS changed admission and disposition patterns and reduced the LOS and mortality in the ED.
Heterogeneous network embedding for identifying symptom candidate genes
Authors: Yang Kuo , Wang Ning , Liu Guangming , Wang Ruyu , Yu Jian , Zhang Runshun , Chen Jianxin , Zhou Xuezhong
Published: August 2018

Objective

Investigating the molecular mechanisms of symptoms is a vital task in precision medicine to refine disease taxonomy and improve the personalized management of chronic diseases. Although there are abundant experimental studies and computational efforts to obtain the candidate genes of diseases, the identification of symptom genes is rarely addressed. We curated a high-quality benchmark dataset of symptom-gene associations and proposed a heterogeneous network embedding for identifying symptom genes.

Methods

We proposed a heterogeneous network embedding representation algorithm, which constructed a heterogeneous symptom-related network that integrated symptom-related associations and applied an embedding representation algorithm to obtain the low-dimensional vector representation of nodes. By measuring the relevance between symptoms and genes via calculating the similarities of their vectors, the candidate genes of given symptoms can be obtained.

Results

A benchmark dataset of 18 270 symptom-gene associations between 505 symptoms and 4549 genes was curated. We compared our method to baseline algorithms (FSGER and PRINCE). The experimental results indicated our algorithm achieved a significant improvement over the state-of-the-art method, with precision and recall improved by 66.80% (0.844 vs 0.506) and 53.96% (0.311 vs 0.202), respectively, for TOP@3 and association precision improved by 37.71% (0.723 vs 0.525) over the PRINCE.

Conclusions

The experimental validation of the algorithms and the literature validation of typical symptoms indicated our method achieved excellent performance. Hence, we curated a prediction dataset of 17 479 symptom-candidate genes. The benchmark and prediction datasets have the potential to promote investigations of the molecular mechanisms of symptoms and provide candidate genes for validation in experimental settings.
A Coskewness Shrinkage Approach for Estimating the Skewness of Linear Combinations of Random Variables*
Authors: Boudt Kris , Cornilly Dries , Verdonck Tim
Published: August 2018

Decision-making in finance often requires an accurate estimate of the coskewness matrix to optimize the allocation to random variables with asymmetric distributions. The classical sample estimator of the coskewness matrix performs poorly for small sample sizes. A solution is to use shrinkage estimators, defined as the convex combination between the sample coskewness matrix and a target matrix. We propose unbiased consistent estimators for the MSE loss function and include the possibility of having multiple target matrices. In a portfolio application, we find that the proposed shrinkage coskewness estimators are useful in mean–variance–skewness efficient portfolio allocation of funds of hedge funds.