bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of the EndoMaster robot‐assisted surgical system in transoral robotic surgery: A cadaveric study
Authors: Tay Gerald , Tan Hiang‐Khoon , Nguyen Thien Khanh , Phee Soo Jay , Iyer N. Gopalakrishna
Published: June 2018

Background

The EndoMaster is a novel robot‐assisted surgical system originally designed for endoscopic resection of gastrointestinal polyps and tumours. It incorporates two robotic arms (a grasper and a probe for monopolar diathermy) into the end of a flexible endoscope, creating improved manoeuvrability, with two arms allowing for 9 degrees of movement and triangulation; this enables fine manipulation and dissection of tissues.

Methods

The EndoMaster was used in two human cadavers to perform 4 radical tonsillectomies to evaluate its performance in transoral robotic surgery (TORS).

Results

The EndoMaster allowed for good visualization of the surgical field and its compact form factor allowed for quick docking and avoided the problem of clashing of the working arms.

Conclusion

The EndoMaster system shows promising potential for use in TORS. Further refinements to movements of the effector arms are required.
Pregnancy outcomes of women who received conservative therapy for endometrial carcinoma or atypical endometrial hyperplasia
Authors: Matsuzaki Toshiya , Iwasa Takeshi , Kawakita Takako , Yamamoto Yuri , Abe Akiko , Hayashi Aki , Yano Kiyohito , Nishimura Masato , Kuwahara Akira , Irahara Minoru
Published: June 2018

Case

Approximately 3%‐25% of cases of endometrial carcinoma (EC) or atypical endometrial hyperplasia (AH) occur in women aged <40 years and conservative treatment with high‐dose medroxyprogesterone acetate (MPA) is administered to women who wish to preserve their fertility. Here is reported the pregnancy outcomes of patients with EC or AH who received MPA therapy at Tokushima University Hospital, Tokushima, Japan. The frequency of pregnancy and live births among the patients with EC or AH who received conservative treatment, followed by fertility treatment, were analyzed retrospectively.

Outcome

Twelve patients underwent fertility examinations and received fertility treatment immediately after the completion of conservative treatment for EC or AH. One patient had the complication of severe diabetes and total embryo cryopreservation was performed before her diabetes was treated. Among the other 11 patients, 8 (72.7%) became pregnant at least once and 6 (54.5%) experienced at least 1 live birth. Three patients (25.0%) suffered disease recurrence during or after the infertility treatment and all of the recurrences occurred in the EC cohort.

Conclusion

When patients with EC or AH wish to preserve their fertility, it is recommended that prompt and effective fertility treatment, including assisted reproductive technology, should be initiated just after conservative treatment because EC and AH exhibit relatively high recurrence rates among conservatively treated patients.
Product diversification strategy, business group affiliation, and IPO underpricing: A study of Chinese firms
Authors: Wang Xiaodan A. , Wan William P. , Yiu Daphne W.
Published: June 2018

Research Summary: Extant research has largely ignored if and how product diversification strategy influences IPO performance. We intend to fill this gap in the literature, especially in relation to transition economies where the role of diversification is institutionally bound. Specifically, drawing on the strategic actions and political connections arguments, we contend that the level of a firm's product diversification has a positive relationship with IPO underpricing. Given the prominent role of business groups in shaping firms’ diversification strategies in transition economy, we further examine whether business groups’ nonmarket capital—political, relational, and reputational capital—moderates the relationship between product diversification strategy and IPO underpricing.

Managerial Summary: Due to the lack of transparency, investors in transition economies face higher ex ante uncertainties and have to bear more investment risks. As such, IPO firms have to “leave more money on the table” to compensate investors. This study aims to answer the question of whether and how an IPO firm's corporate strategy and business group affiliation affect investors' perceived uncertainties and, thus, the need to leave a large amount of money on the table to compensate investors. Using a sample of IPO firms in China, this study finds that the nonmarket capital that stems from business group affiliation helps mitigate the uncertainties investors perceive with higher levels of diversification, thus reducing the need for IPO firms to discount their offerings too much so that they can retain more wealth for business development.
Standard errors and confidence intervals for variable importance in random forest regression, classification, and survival
Authors: Ishwaran Hemant , Lu Min
Published: June 2018

Random forests are a popular nonparametric tree ensemble procedure with broad applications to data analysis. While its widespread popularity stems from its prediction performance, an equally important feature is that it provides a fully nonparametric measure of variable importance (VIMP). A current limitation of VIMP, however, is that no systematic method exists for estimating its variance. As a solution, we propose a subsampling approach that can be used to estimate the variance of VIMP and for constructing confidence intervals. The method is general enough that it can be applied to many useful settings, including regression, classification, and survival problems. Using extensive simulations, we demonstrate the effectiveness of the subsampling estimator and in particular find that the delete‐d jackknife variance estimator, a close cousin, is especially effective under low subsampling rates due to its bias correction properties. These 2 estimators are highly competitive when compared with the .164 bootstrap estimator, a modified bootstrap procedure designed to deal with ties in out‐of‐sample data. Most importantly, subsampling is computationally fast, thus making it especially attractive for big data settings.
Photocontrollable Fluorogenic Probe for Visualizing Near‐Membrane Hypochlorite in Live Cells
Authors: Peng Pingping , Li Hao , Bai Lei , Wang Liulin , Chen Buxiang , Yu Changmin , Zhang Chengwu , Ge Jingyan , Li Lin , Huang Wei
Published: June 2018

Hypochlorous acid or hypochlorite (HClO/ClO−) near membrane is one of the most critical reactive oxygen species (ROS). Herein, a photocontrollable fluorogenic probe for directly detecting ClO− near membrane has been designed and synthesized. This probe HOCMem was constructed based on fluorescein by incorporation of a photolabile group (nitrobenzyl group), membrane‐anchoring unit (cholesterol) and ClO−‐sensitive moiety (benzoyl group). Upon the UV irradiation, the probe exhibited a significantly increased emission at 520 nm in the presence of ClO−. However, no fluorescence was observed with the treatment of only UV irradiation or ClO−. In addition, this new probe displayed a good linear relationship with the concentration of ClO− ranged from 1 to 50 μM with a detection limit of 260.77 nM, as well as excellent selectivity for ClO− over other analytes. Furthermore, cell‐based experiments showed the low cytotoxicity of this probe and its capacity for directly detecting near‐membrane ClO− with light switching on/off.
Fluorescent Polymer—Single‐Walled Carbon Nanotube Complexes with Charged and Noncharged Dendronized Perylene Bisimides for Bioimaging Studies
Authors: Huth Katharina , Glaeske Mareen , Achazi Katharina , Gordeev Georgy , Kumar Shiv , Arenal Raúl , Sharma Sunil K. , Adeli Mohsen , Setaro Antonio , Reich Stephanie , Haag Rainer
Published: June 2018

Fluorescent nanomaterials are expected to revolutionize medical diagnostic, imaging, and therapeutic tools due to their superior optical and structural properties. Their inefficient water solubility, cell permeability, biodistribution, and high toxicity, however, limit the full potential of their application. To overcome these obstacles, a water‐soluble, fluorescent, cytocompatible polymer—single‐walled carbon nanotube (SWNT) complex is introduced for bioimaging applications. The supramolecular complex consists of an alkylated polymer conjugated with neutral hydroxylated or charged sulfated dendronized perylene bisimides (PBIs) and SWNTs as a general immobilization platform. The polymer backbone solubilizes the SWNTs, decorates them with fluorescent PBIs, and strongly improves their cytocompatibility by wrapping around the SWNT scaffold. In photophysical measurements and biological in vitro studies, sulfated complexes exhibit superior optical properties, cellular uptake, and intracellular staining over their hydroxylated analogs. A toxicity assay confirms the highly improved cytocompatibility of the polymer‐wrapped SWNTs toward surfactant‐solubilized SWNTs. In microscopy studies the complexes allow for the direct imaging of the SWNTs' cellular uptake via the PBI and SWNT emission using the 1st and 2nd optical window for bioimaging. These findings render the polymer‐SWNT complexes with nanometer size, dual fluorescence, multiple charges, and high cytocompatibility as valuable systems for a broad range of fluorescence bioimaging studies.
Water infrastructure: A terrain for studying nonhuman agency, power relations, and socioeconomic change
Authors: Acevedo Guerrero Tatiana
Published: June 2018

In recent years attention has been paid to the matter of waters' infrastructure as part of a broader social science inquiry into infrastructure systems. From different approaches, works have documented how as infrastructure extracts, contains, channels, processes, leaks, or distributes waters it produces new kinds of spaces and reproduces inequalities or differences between them. Scholars studying water infrastructure have also participated in debates on nonhuman agency, materiality, and malfunction. This article provides a summarized account of the main strands of this literature with the purpose of providing an introductory overview of analyses on water infrastructure.

This article is categorized under:

Engineering Water > Sustainable Engineering of Water

Human Water > Water Governance
Ataxin‐2: A versatile posttranscriptional regulator and its implication in neural function
Authors: Lee Jongbo , Kim Minjong , Itoh Taichi Q. , Lim Chunghun
Published: June 2018

Ataxin‐2 (ATXN2) is a eukaryotic RNA‐binding protein that is conserved from yeast to human. Genetic expansion of a poly‐glutamine tract in human ATXN2 has been implicated in several neurodegenerative diseases, likely acting through gain‐of‐function effects. Emerging evidence, however, suggests that ATXN2 plays more direct roles in neural function via specific molecular and cellular pathways. ATXN2 and its associated protein complex control distinct steps in posttranscriptional gene expression, including poly‐A tailing, RNA stabilization, microRNA‐dependent gene silencing, and translational activation. Specific RNA substrates have been identified for the functions of ATXN2 in aspects of neural physiology, such as circadian rhythms and olfactory habituation. Genetic models of ATXN2 loss‐of‐function have further revealed its significance in stress‐induced cytoplasmic granules, mechanistic target of rapamycin signaling, and cellular metabolism, all of which are crucial for neural homeostasis. Accordingly, we propose that molecular evolution has been selecting the ATXN2 protein complex as an important trans‐acting module for the posttranscriptional control of diverse neural functions. This explains how ATXN2 intimately interacts with various neurodegenerative disease genes, and suggests that loss‐of‐function effects of ATXN2 could be therapeutic targets for ATXN2‐related neurological disorders.

This article is categorized under:

RNA in Disease and Development > RNA in Disease

RNA Interactions with Proteins and Other Molecules > Protein–RNA Interactions: Functional Implications
Magnesium(II) Complexes with High Emission: The Distinct Charge‐Transfer Process from Transition Metal
Authors: Deng Wen‐Ting , Qu Hang , Huang Zhe‐Yu
Published: June 2018

Generally, the first‐row transition‐metal complexes are notorious in luminescence materials because of their metal‐ligand charge transfer in emission process. Herein, we rationally used magnesium instead the first‐row transition metal to coordinate with 2‐(anthracen‐9‐yl)‐1H‐imidazo[4,5‐f][1,10]phenanthroline (AIP) in the construction of luminescent complexes. Further investigation revealed AIP could work as detector for quantitative determination of Mg2+ cation. Comparing to other divalent cations, this fluorescence sensor exhibited high selectivity for the quantitative determination of Mg2+ with the low limit of detection (5 × 10–7 m). Through X‐ray single crystal diffraction, the crystal structures of [Mg(AIP2)(NO3)2·(H2O)4] (1), [Mn(AIP)(NO3)·EtOH] (2), and [Co2(AIP)2Cl4·(MeOH)2] (3) were observed in various arrangements. The theory calculations based on crystal structures indicated the MgII complex undergoes distinct charge‐transfer process from other transition‐metals based compounds, in which charge‐transfer excited‐state lifetimes were deactivated rapidly through metal‐to‐ligand charge‐transfer (MLCT) process. This study provided insight into construction of luminescence compounds by using d0 metals in main groups instead of transition metals.
In‐situ Complex and Sb–N Bond Formation in an Antimonato Polyoxovanadate Reaction System
Authors: Wendt Michael , Näther Christian , van Leusen Jan , Kögerler Paul , Bensch Wolfgang
Published: June 2018

The self‐assembly reaction towards the archetypal antimonato polyoxovanadate {V15Sb6} in the presence of two organic amines, 1‐(2‐aminoethyl)piperazine (aep) and diethylenetriamine (dien), and a simple NiII salt yields the compound {Ni(dien)2}2[(aepH)2V15Sb6O42(H2O)]·7.5H2O in which secondary [Ni(dien)2]2+ coordination complexes and covalent Sb–Naep bonds coexist. The latter augment the spherical [V15Sb6O42(H2O)]6– cluster core by two protonated aep groups that effectively reduce the polyanion's charge. The terminal NH3 groups of the two crystallographically independent aep units interlink two adjacent cluster anions through strong N–H···O interactions. In the solid state, this results in a tight 3D network of Sb–N and hydrogen bonds, which only starts to release its crystal water above 150 °C. As anticipated from its structure, the magnetic properties of the title compounds can be modeled using an additive approach.
N3LO corrections to jet production in deep inelastic scattering using the Projection-to-Born method
Authors: Currie J. , Gehrmann T. , Glover E. W. N. , Huss A. , Niehues J. , Vogt A.
Published: June 2018

Abstract

Computations of higher-order QCD corrections for processes with exclusive final states require a subtraction method for real-radiation contributions. We present the first-ever generalisation of a subtraction method for third-order (N3LO) QCD corrections. The Projection-to-Born method is used to combine inclusive N3LO coefficient functions with an exclusive second-order (NNLO) calculation for a final state with an extra jet. The input requirements, advantages, and potential applications of the method are discussed, and validations at lower orders are performed. As a test case, we compute the N3LO corrections to kinematical distributions and production rates for single-jet production in deep inelastic scattering in the laboratory frame, and compare them with data from the ZEUS experiment at HERA. The corrections are small in the central rapidity region, where they stabilize the predictions to sub per-cent level. The corrections increase substantially towards forward rapidity where large logarithmic effects are expected, thereby yielding an improved description of the data in this region.
Lepton flavour violation in the MSSM: exact diagonalization vs mass expansion
Authors: Crivellin Andreas , Fabisiewicz Zofia , Materkowska Weronika , Nierste Ulrich , Pokorski Stefan , Rosiek Janusz
Published: June 2018

Abstract

The forthcoming precision data on lepton flavour violating (LFV) decays require precise and efficient calculations in New Physics models. In this article lepton flavour violating processes within the Minimal Supersymmetric Standard Model (MSSM) are calculated using the method based on the Flavour Expansion Theorem, a recently developed technique performing a purely algebraic mass-insertion expansion of the amplitudes. The expansion in both flavour-violating and flavour-conserving off-diagonal terms of sfermion and supersymmetric fermion mass matrices is considered. In this way the relevant processes are expressed directly in terms of the parameters of the MSSM Lagrangian. We also study the decoupling properties of the amplitudes. The results are compared to the corresponding calculations in the mass eigenbasis (i.e. using the exact diagonalization of the mass matrices). Using these methods, we consider the following processes: ℓ → ℓ

′

γ, ℓ→3ℓ

′

, ℓ→2ℓ

′

ℓ

′′
, h→ℓℓ

′
as well as μ→e conversion in nuclei. In the numerical analysis we update the bounds on the flavour changing parameters of the MSSM and examine the sensitivity to the forthcoming experimental results. We find that flavour violating muon decays provide the most stringent bounds on supersymmetric effects and will continue to do so in the future. Radiative ℓ → ℓ

′

γ decays and leptonic three-body decays ℓ → 3ℓ

′
show an interesting complementarity in eliminating “blind spots” in the parameter space. In our analysis we also include the effects of non-holomorphic A-terms which are important for the study of LFV Higgs decays.
Symmetry breaking patterns for inflation
Authors: Klein Remko , Roest Diederik , Stefanyszyn David
Published: June 2018

Abstract

We study inflationary models where the kinetic sector of the theory has a non-linearly realised symmetry which is broken by the inflationary potential. We distinguish between kinetic symmetries which non-linearly realise an internal or space-time group, and which yield a flat or curved scalar manifold. This classification leads to well-known inflationary models such as monomial inflation and α-attractors, as well as a new model based on fixed couplings between a dilaton and many axions which non-linearly realises higher-dimensional conformal symmetries. In this model, inflation can be realised along the dilatonic direction, leading to a tensor-to-scalar ratio r ∼ 0.01 and a spectral index n

s
∼ 0.975. We refer to the new model as ambient inflation since inflation proceeds along an isometry of an anti-de Sitter ambient space-time, which fully determines the kinetic sector.
A simple method to estimate the rate of the bamboo expansion based on one‐time measurement of spatial distribution of culms
Authors: Kobayashi Keito , Kitayama Kanehiro , Onoda Yusuke
Published: June 2018

Moso bamboo (Phyllostachys edulis) groves have been expanding in Japanese forests, thus an assessment of the rate of bamboo grove expansion is a critical issue. Previous studies used time‐series data which span typically more than a few years in order to determine the expansion of bamboo groves. This method cannot be used when time‐series data were not available. In this study, we developed and tested a simple indicator based on one‐time measurement of spatial distribution of culms to estimate the rate of bamboo grove expansion. Among 19 locations at four sites, the distribution patterns of culms from the pure bamboo stands to the expanding front were highly correlated with the actual edge expansion rate (E) based on the aerial photographs collected over ca. 15‐ and 30‐year periods. In contrast, the culm density in the original stand itself was not correlated with E. These results suggest that one‐time measurement of the distribution patterns of living culms (but not stand density) could be a useful indicator for estimating the expansion rates of bamboo groves.
A Subjective Personal Introspective Essay on the Evolution of Business Schools, the Fate of Marketing Education, and Aspirations toward a Great Society
Authors: Holbrook Morris B.
Published: June 2018

This essay pursues an approach that I call Subjective Personal Introspection (SPI) to comment on my own impressions concerning my experiences over the past fifty-plus years at one of our leading graduate schools of business. Herein, I trace my progress from MBA candidate to doctoral student to faculty member to retiree by suggesting ways in which – from my admittedly idiosyncratic perspective – business education has devolved toward a lower level of academic excellence, an abandonment of scholarly values, an unfortunate anti-intellectualism, a neglect of its commitment to the advancement of business- or marketing-related knowledge for its own sake, and a betrayal of its responsibility to work toward the protection of social welfare. Though the situation seems a bit hopeless, I offer a few modest suggestions for possible improvement.
Electromagnetohydrodynamic two-phase flow-induced vibrations in vertical heated upward flow
Authors: Abdollahzadeh Jamalabadi Mohammad Yaghoub
Published: June 2018

In this paper, a mathematical model is presented to determine the effect of electro-magneto-hydro-dynamic forces on steady-state fluid-induced vibrations of vapor and liquid water flow in a heated vertical channel. The two-phase flow model used in this study includes continuity, non-homogeneous Navier-Stokes, non-equilibrium temperature balance with an approximation of spherical harmonics method (P-1 model) for thermal radiation at low-pressure condition close to saturation (1–2 bars). Governing equations are solved by finite volume method. The result of the code is validated with the various experimental data's accessible in previous works. Then the code is used to estimate the effects of Lorentz forces on two-phase flow-induced vibrations. As shown, the fluid-induced vibrations increase with the increase of electro-magneto-hydrodynamic forces. As shown by the increase of Lorentz force, the fluid impact, cross-sectional, water-hammer forces, the frequency of two-phase fluctuations and peak velocities are controlled while the root-mean-square fluid force increased. Furthermore, the result has shown that the Lorentz force has not influenced the bubble departure frequency, surface tension force, and density of active nucleation site, bubble departure diameter, sound velocity, and the liquid superficial velocity.

Highlights EMHD effects on two phase flow induced vibrations in a vertical channel is performed. Lorentz force controls water-hammer impact and velocities but RMS force increases. Bubble departure, nucleation, and superficial velocity unaffected by Lorentz force.
An indoor thermal environment design system for renovation using augmented reality
Authors: Fukuda Tomohiro , Yokoi Kazuki , Yabuki Nobuyoshi , Motamedi Ali
Published: June 2018

The renovation projects of buildings and living spaces, which aim to improve the thermal environment, are gaining importance because of energy saving effects and occupants' health considerations. However, the indoor thermal design is not usually performed in a very efficient manner by stakeholders, due to the limitations of a sequential waterfall design process model, and due to the difficulty in comprehending the CFD simulation results for stakeholders. On the other hand, indoor greenery has been introduced to buildings as a method for adjusting the thermal condition. Creating a VR environment, which can realistically and intuitively visualize a thermal simulation model is very time consuming and the resulting VR environment created by 3D computer graphics objects is disconnected from the reality and does not allow design stakeholders to experience the feelings of the real world. Therefore, the objective of this research is to develop a new AR-based methodology for intuitively visualizing indoor thermal environment for building renovation projects. In our proposed system, easy-to-comprehend visualization of CFD results augment the real scenes to provide users with information about thermal effects of their renovation design alternatives interactively. Case studies to assess the effect of indoor greenery alternatives on the thermal environment are performed. In conclusion, integrating CFD and AR provides users with a more natural feeling of the future thermal environment. The proposed method was evaluated feasible and effective.

Highlights An indoor thermal environment design system for renovation projects is developed. Visualization of indoor CFD results in an AR environment is realized and tested. Users can study both architectural design and thermal environment simultaneously. Feasibility and practicality were validated through case studies of indoor greenery alternatives.
Surgical treatment of malignant colon polyps
Authors: Ramos Nuno Telo Preto , Gonçalves André , Silva Pedro Correia da , Barbosa José
Published: June 2018

Background In the therapeutic decision about the malignant colon polyp, several factors predicting residual disease after the endoscopic resection guide the decision of surveillance or surgical intervention. This is a challenging decision, because even in the presence of high-risk predictors currently used, only 15–30% of the patients will have residual disease in the surgical specimen.

Objective To evaluate patients with a diagnosis of malignant colon polyp at the Hospital Center of São João, who were indicated for surgical treatment, studying the predictors of residual disease in the surgical specimen.

Methods A retrospective study was carried out, based on the patients with malignant colon polyp diagnosed and treated at the Hospital Center of São João in the city of Porto, Portugal, between 2009 and 2016. The endoscopic, anatomopathological, surgical and follow-up data were reviewed.

Results Of the total number of patients in the study (n = 96), 59 (61.5%) were indicated for surgery after a multidisciplinary discussion. Of this group, 21 patients (35.6%) had residual disease in the surgical specimen, with presence of lymph node invasion in 8 patients (13.6%). The presence of malignancy in the surgical resection specimen was statistically significantly associated with: size of the resected polyp (p = 0.023); sessile polyp (p = 0.007); piecemeal resection (p = 0.002).

Conclusions The persistence of malignancy in the surgical specimen was associated with larger sessile polyps and piecemeal removal. A significant number of patients did not show malignancy in the surgical resection specimen, with more markers being required to better stratify patients.
Risk of Melanoma With Phosphodiesterase Type 5 Inhibitor Use Among Patients With Erectile Dysfunction, Pulmonary Hypertension, and Lower Urinary Tract Symptoms
Authors: Shkolyar Eugene , Li Shufeng , Tang Jean , Eisenberg Michael L.
Published: June 2018

Background

Phosphodiesterase type 5 inhibitors (PDE5is), a treatment for erectile dysfunction, pulmonary hypertension (pHTN), and lower urinary tract symptoms (LUTS), have been implicated in melanoma development.

Aim

We sought to determine the association between PDE5i use and melanoma development among patients with erectile dysfunction, pHTN, and LUTS.

Methods

This was a retrospective cohort study of subjects contained within the Truven Health MarketScan claims database, which provides information on insurance claims in the United States for privately insured individuals, from 2007–2015. Individuals taking PDE5i were identified through pharmacy claims. A comparison group of men diagnosed with conditions for which PDE5i are prescribed was assembled.

Outcomes

Cox proportional hazard models were used to estimate the hazard ratio (HR) (95% CI) of incident melanoma, basal cell carcinoma, and squamous cell carcinoma.

Results

Of 610,881 subjects prescribed PDE5i, 636 developed melanoma (0.10%). The control group had 8,711 diagnoses of melanoma. There was an association between increased PDE5i tablet use and melanoma (HR 1.05, 95% CI 1.05–1.09). This association was also present between PDE5i use and basal cell carcinoma (HR 1.04, 95% CI 1.02–1.07) and squamous cell carcinoma (HR 1.04, 95% CI 1.01–1.07). In patients with pHTN and LUTS prescribed PDE5is, there was no relationship between exposure and melanoma incidence (HR 0.74, 95% CI 0.48–1.13; and HR 1.03, 95% CI 0.97–1.10, respectively).

Clinical Implications

There is little evidence for a clinically relevant association between PDE5i use and melanoma incidence.

Strengths & Limitations

Our current work represents the largest study to date evaluating the relationship between PDE5i use and melanoma risk, and the first to examine all current indications of PDE5i use among men and women. Limitations include a patient population limited to commercially insured individuals, unknown patient medication compliance, and lack of information on patient skin type, lifestyle, and sun-exposure habits.

Conclusion

There is a slight association between higher-volume PDE5i use and development of melanoma, basal cell carcinoma, and squamous cell carcinoma. This association among all skin cancers implies that confounding may account for the observed association.
Injection medialization laryngoplasty improves dysphagia in patients with unilateral vocal fold immobility
Authors: Anis Mursalin M. , Memon Zainulabideen
Published: June 2018

Objective

To assess patient reported swallowing outcomes before and after injection medialization laryngoplasty in patients with unilateral vocal fold immobility (UVFI).

Methods

Case series with chart review of patients with UVFI who underwent injection medialization laryngoplasty at a community laryngology practice by a single clinician between October 2015 and December 2017. Patient‐reported validated surveys of swallowing impairment, Eating Assessment Tool (EAT‐10), demographics, etiology and duration of symptoms were recorded before and after injection. A paired t test was done on EAT‐10 surveys before and after IML to assess for statistical significance.

Results

Twenty‐one patients with UVFI and glottic insufficiency underwent IML between October 2015 and December 2017. Nineteen of 21 patients (90%) presented with dysphagia (EAT‐10 ≥ 3). 76% of patients with dysphagia reported improvement in swallowing function after IML. The EAT‐10 scores of UVFI patients with dysphagia before and after IML were 17.0 ± 14.0 and 4.2 ± 9.6, respectively (p = 0.004).

Conclusions

Nearly all patients with UVFI and glottic insufficiency report associated dysphagia. Three fourths of these patients perceive improvement in their swallowing function after injection medialization laryngoplasty. Patients with idiopathic UVFI may have a more sustained improvement and those with severe preop dysphagia may not benefit. Further research is necessary to refine patient selection and to assess duration of improved swallowing function.
Age-adjusted D-dimer thresholds in the investigation of suspected pulmonary embolism: A retrospective evaluation in patients ages 50 and older using administrative data
Authors: Senior Kevin , Burles Kristin , Wang Dongmei , Grigat Daniel , Innes Grant D. , Andruchow James E. , Lang Eddy S. , McRae Andrew D.
Published: June 2018

Objectives

D-dimer testing is an important component of the workup for pulmonary embolism (PE). However, age-related increases in D-dimer concentrations result in false positives in older adults, leading to potentially unnecessary imaging utilization. The objective of this study was to quantify the test characteristics of an age-adjusted D-dimer cut-off for ruling out PE in older patients investigated in actual clinical practice.

Methods

This observational study used administrative data from four emergency departments from July 2013 to January 2015. Eligible patients were ages 50 and older with symptoms of PE who underwent D-dimer testing. The primary outcome was 30-day diagnosis of PE, confirmed by imaging reports. Test characteristics of the D-dimer assay were calculated using the standard reference value (500 ng/ml), the local reference value (470 ng/ml), and an age-adjusted threshold (10 ng/ml × patient’s age).

Results

This cohort includes 6,655 patients ages 50 and older undergoing D-dimer testing for a possible PE. Of these, 246 (3.7%) were diagnosed with PE. Age-adjusted D-dimer cut-offs were more specific than standard cut-offs (75.4% v. 63.8%) but less sensitive (90.3% v. 97.2%). The false-negative risk in this population was 0.49% using age-adjusted D-dimer cut-offs compared with 0.15% with traditional cut-offs.

Conclusion

Age-adjusted D-dimer cut-offs are substantially more specific than traditional cut-offs and may reduce CT utilization among older patients with suspected PE. We observed a loss of sensitivity, with an increased risk of false-negatives, using age-adjusted cut-offs. We encourage further evaluation of the safety and accuracy of age-adjusted D-dimer cut-offs in actual clinical practice.
Body mass index and wealth index: positively correlated indicators of health and wealth inequalities in Nairobi slums
Authors: Haregu T. N. , Mohamed S. F. , Muthuri S. , Khayeka-Wandabwa C. , Kyobutungi C.
Published: June 2018

Introduction

Wealth index is a known predictor of body mass index (BMI). Many studies have reported a positive association between BMI and socioeconomic status (SES). However, an in-depth investigation of the relationship between BMI and wealth index is lacking for urban slum settings.

Objective

To examine the association between BMI and wealth index in an urban slum setting in Nairobi, Kenya.

Methods

A total of 2003 adults between 40 and 60 years of age were included. BMI was derived from direct weight and height measurements. Wealth Index was computed using the standard principal component analysis of household amenities ownership. The relationship between BMI and wealth index was assessed using both linear and logistic regression models.

Results

We found that BMI linearly increased across the five quintiles of wealth index in both men and women, after adjusting for potential confounding factors. The prevalence of obesity increased from 10% in the first wealth quintile to 26.2% in the fifth wealth quintile. The average BMI for women entered the overweight category at the second quintile wealth status, or the third quintile for the total population.

Conclusion

There exists a strong positive relationship between BMI and wealth index in slum settings. Health promotion interventions aimed at reducing obesity may consider using wealth index in priority setting.
On universal features of the turbulent cascade in terms of non-equilibrium thermodynamics
Authors: Reinke Nico , Fuchs André , Nickelsen Daniel , Peinke Joachim
Published: June 2018

Features of the turbulent cascade are investigated for various datasets from three different turbulent flows, namely free jets as well as wake flows of a regular grid and a cylinder. The analysis is focused on the question as to whether fully developed turbulent flows show universal small-scale features. Two approaches are used to answer this question. First, two-point statistics, namely structure functions of longitudinal velocity increments, and, second, joint multiscale statistics of these velocity increments are analysed. The joint multiscale characterisation encompasses the whole cascade in one joint probability density function. On the basis of the datasets, evidence of the Markov property for the turbulent cascade is shown, which corresponds to a three-point closure that reduces the joint multiscale statistics to simple conditional probability density functions (cPDFs). The cPDFs are described by the Fokker–Planck equation in scale and its Kramers–Moyal coefficients (KMCs). The KMCs are obtained by a self-consistent optimisation procedure from the measured data and result in a Fokker–Planck equation for each dataset. Knowledge of these stochastic cascade equations enables one to make use of the concepts of non-equilibrium thermodynamics and thus to determine the entropy production along individual cascade trajectories. In addition to this new concept, it is shown that the local entropy production is nearly perfectly balanced for all datasets by the integral fluctuation theorem (IFT). Thus, the validity of the IFT can be taken as a new law of the turbulent cascade and at the same time independently confirms that the physics of the turbulent cascade is a memoryless Markov process in scale. The IFT is taken as a new tool to prove the optimal functional form of the Fokker–Planck equations and subsequently to investigate the question of universality of small-scale turbulence in the datasets. The results of our analysis show that the turbulent cascade contains universal and non-universal features. We identify small-scale intermittency as a universality breaking feature. We conclude that specific turbulent flows have their own particular multiscale cascades, in other words, their own stochastic fingerprints.
Buoyancy-driven flow in a confined aquifer with a vertical gradient of permeability
Authors: Hinton Edward M. , Woods Andrew W.
Published: June 2018

We examine the injection of fluid of one viscosity and density into a horizontal permeable aquifer initially saturated with a second fluid of different viscosity and density. The novel feature of the analysis is that we allow the permeability to vary vertically across the aquifer. This leads to recognition that the interface may evolve as either a rarefaction wave that spreads at a rate proportional to$t$, a shock-like front of fixed length or a mixture of shock-like regions and rarefaction-wave-type regions. The classical solutions in which there is no viscosity ratio between the fluids and in which the formation has constant permeability lead to an interface that spreads laterally at a rate proportional to$t^{1/2}$. However, these solutions are unstable to cross-layer variations in the permeability owing to the vertical shear which develops in the flow, causing the structure of the interface to evolve to the rarefaction wave or shock-like structure. In the case that the viscosities of the two fluids are different, it is possible that the solution involves a mixture of shock-like and rarefaction-type structures as a function of the distance above the lower boundary. Using the theory of characteristics, we develop a regime diagram to delineate the different situations. We consider the implications of such heterogeneity for the prediction of front locations during$\text{CO}_{2}$sequestration. If we neglect the permeability fluctuations, the model always predicts rarefaction-type solutions, while even modest changes in the permeability across a layer can introduce shocks. This difference may be very significant since it leads to the$\text{CO}_{2}$plume occupying a greater fraction of the pore space between the injector and the leading edge of the$\text{CO}_{2}$front in a layer of the same mean permeability. This has important implications for estimates of the fraction of the pore space that the$\text{CO}_{2}$may access.
The Silchester ‘Nymphaeum’
Authors: Fulford Michael
Published: June 2018

A carved coping stone found on the site of a spring near the amphitheatre, Silchester, and first reported in 1873, was rediscovered in 2014. It does not compare in its carved detail with coping stones from the amphitheatres at Chester and London, nor with that recovered from the West Gate, Silchester, in 1890; nor does its basal width correspond with that of the arena wall of the Silchester amphitheatre. It is likely to have formed part of a monumental basin, similar to that found at Coventina's Well, Northumberland, and to have commemorated the location of a spring and its associated (unknown) deity. Similarity with the type and decoration of architectural stone used in the construction of the forum-basilica suggests a Hadrianic–Antonine date.
Indistinguishable Sceneries on the Boolean Hypercube
Authors: GROSS RENAN , GRUPEL URI
Published: June 2018

We show that the scenery reconstruction problem on the Boolean hypercube is in general impossible. This is done by using locally biased functions, in which every vertex has a constant fraction of neighbours coloured by 1, and locally stable functions, in which every vertex has a constant fraction of neighbours coloured by its own colour. Our methods are constructive, and also give super-polynomial lower bounds on the number of locally biased and locally stable functions. We further show similar results for ℤn and other graphs, and offer several follow-up questions.
From Barriers to Assets: Rethinking factors impacting advance care planning for African Americans
Authors: Sanders Justin J. , Johnson Kimberly S. , Cannady Kimberly , Paladino Joanna , Ford Dee W. , Block Susan D. , Sterba Katherine R.
Published: June 2018

Objective

We aimed to explore multiple perspectives regarding barriers to and facilitators of advance care planning (ACP) among African Americans to identify similarities or differences that might have clinical implications.

Method

Qualitative study with health disparities experts (n = 5), community members (n = 9), and seriously ill African American patients and caregivers (n = 11). Using template analysis, interviews were coded to identify intrapersonal, interpersonal, and systems-level themes in accordance with a social ecological framework.

Result

Participants identified seven primary factors that influence ACP for African Americans: religion and spirituality; trust and mistrust; family relationships and experiences; patient-clinician relationships; prognostic communication, care preferences, and preparation and control. These influences echo those described in the existing literature; however, our data highlight consistent differences by group in the degree to which these factors positively or negatively affect ACP. Expert participants reinforced common themes from the literature, for example, that African Americans were not interested in prognostic information because of mistrust and religion. Seriously ill patients were more likely to express trust in their clinicians and to desire prognostic communication; they and community members expressed a desire to prepare for and control the end of life. Religious belief did not appear to negate these desires.

Significance of results

The literature on ACP in African Americans may not accurately reflect the experience of seriously ill African Americans. What are commonly understood as barriers to ACP may in fact not be. We propose reframing stereotypical barriers to ACP, such as religion and spirituality, or family, as cultural assets that should be engaged to enhance ACP. Although further research can inform best practices for engaging African American patients in ACP, findings suggest that respectful, rapport-building communication may facilitate ACP. Clinicians are encouraged to engage in early ACP using respectful and rapport building communication practices, including open-ended questions.
Raising a Tantrum About Climate Change
Authors: Showstack Randy
Published: June 2018

One year ago today, President Trump vowed to exit the United States from the Paris climate pact. Eos discusses this with climatologist Michael Mann, author of the new book The Tantrum that Saved the World.
A Biogeochemical Compromise: The High Methane Cost of Sequestering Carbon in Restored Wetlands
Authors: Hemes Kyle S. , Chamberlain Samuel D. , Eichelmann Elke , Knox Sara H. , Baldocchi Dennis D.
Published: June 2018

Peatland drainage is an important driver of global soil carbon loss and carbon dioxide (CO2) emissions. Restoration of peatlands by reflooding reverses CO2 losses at the cost of increased methane (CH4) emissions, presenting a biogeochemical compromise. While restoring peatlands is a potentially effective method for sequestering carbon, the terms of this compromise are not well constrained. Here we present 14 site years of continuous CH4 and CO2 ecosystem‐scale gas exchange over a network of restored freshwater wetlands in California, where long growing seasons, warm weather, and managed water tables result in some of the largest wetland ecosystem CH4 emissions recorded. These large CH4 emissions cause the wetlands to be strong greenhouse gas sources while sequestering carbon and building peat soil. The terms of this biogeochemical compromise, dictated by the ratio between carbon sequestration and CH4 emission, vary considerably across small spatial scales, despite nearly identical wetland climate, hydrology, and plant community compositions.
Jupiter's Influence on the Building Blocks of Mars and Earth
Authors: Brasser R. , Dauphas N. , Mojzsis S. J.
Published: June 2018

Radiometric dating indicates that Mars accreted in the first ~4 Myr of the solar system, coinciding with the formation and possible migration of Jupiter. While nebular gas from the protoplanetary disk was still present, Jupiter may have migrated inward and tacked at 1.5 AU in a 3:2 resonance with Saturn. This migration excited planetary building blocks in the inner solar system, resulting in extensive mixing and planetesimal removal. Here we evaluate the plausible nature of Mars's building blocks, focusing in particular on how its growth was influenced by Jupiter. We use dynamical simulations and an isotopic mixing model that traces the accretion. Dynamical simulations show that Jupiter's migration causes the late stages of Earth's and Mars's accretion to be dominated by EC (enstatite chondrite)‐type material due to the loss of ordinary chondrite planetesimals. Our analysis of available isotopic data for Mars shows that it consists of approximately
ordinary chondrite by mass (2σ). The large uncertainties indicate that isotopic analyses of Martian samples are generally too imprecise to definitely test model predictions; in particular, it remains uncertain whether or not Mars accreted predominantly EC material in the latter stages of its formation history. Dynamical simulations also provide no definitive constraint on Mars's accretion history due to the great variety of dynamical pathways that the Martian embryo exhibits. The present work calls for new measurements of isotopic anomalies in Martian meteorites targeting siderophile elements (most notably Ni, Mo, and Ru) to constrain Mars's accretion history and its formation location.
Surface Slip From the 2014 South Napa Earthquake Measured With Structure From Motion and 3‐D Virtual Reality
Authors: Trexler Charles C. , Morelan Alexander E. , Oskin Michael E. , Kreylos Oliver
Published: June 2018

The detailed features of an earthquake surface rupture may decay quickly in the landscape due to erosion or repair, such that primary displacements are seldom available for repeated study within the weeks following an earthquake. Here we describe a rapidly deployable field workflow using structure‐from‐motion (SfM) photogrammetry to produce three‐dimensional models of offset features and apply the technique to the 24 August 2014 Mw 6.0 South Napa earthquake surface rupture. We use repeated analyses of SfM point clouds using 3‐D interactive virtual reality tools to derive precise and reproducible fault‐slip measurements along the surface rupture and document the temporal evolution of afterslip at two sites along its trace. The SfM technique, combined with 3‐D virtual reality, enables archiving of primary field relationships and assessment of uncertainty in those data to a degree that was previously inaccessible.
Generation of Infrasound Waves at Sites of Underground Mine Collapses
Authors: Che Il‐Young , Kim Geunyoung , Kim Youngchai , Kim Kwangsu
Published: June 2018

In 2015 and 2016, collapse‐induced earthquakes, accompanied by surface subsidence, occurred at two underground mines in South Korea and were followed by impulsive infrasound signals that were detectable at distances greater than 200 km. To explain the infrasound generation caused by the collapses, we hypothesize that excess pressure was released by the rapid outflow of an underground air mass into the atmosphere caused by the sudden implosion of earth into the underground space. We tested this idea with a physical model that assumes a displaced air volume as a monopole source with reduced pressure. The estimated volumes of the two collapses were ~1.7 × 105 and ~7.3 × 105 m3, respectively, which agrees with the collapse volumes inferred from surface subsidence data. The infrasound generation model we used is applicable to the monitoring of other catastrophic failures within manmade or natural subsurface cavities.