bluuebunny/crossref_metadata_2025 huggingface dataset:
Ion heating and magnetic flux pile-up in a magnetic reconnection experiment with super-Alfvénic plasma inflows
Authors: Suttle L. G. , Hare J. D. , Lebedev S. V. , Ciardi A. , Loureiro N. F. , Burdiak G. C. , Chittenden J. P. , Clayson T. , Halliday J. W. D. , Niasse N. , Russell D. , Suzuki-Vidal F. , Tubman E. , Lane T. , Ma J. , Robinson T. , Smith R. A. , Stuart N.
Published: April 2018

This work presents a magnetic reconnection experiment in which the kinetic, magnetic, and thermal properties of the plasma each play an important role in the overall energy balance and structure of the generated reconnection layer. Magnetic reconnection occurs during the interaction of continuous and steady flows of super-Alfvénic, magnetized, aluminum plasma, which collide in a geometry with two-dimensional symmetry, producing a stable and long-lasting reconnection layer. Optical Thomson scattering measurements show that when the layer forms, ions inside the layer are more strongly heated than electrons, reaching temperatures of Ti∼Z¯Te≳300 eV—much greater than can be expected from strong shock and viscous heating alone. Later in time, as the plasma density in the layer increases, the electron and ion temperatures are found to equilibrate, and a constant plasma temperature is achieved through a balance of the heating mechanisms and radiative losses of the plasma. Measurements from Faraday rotation polarimetry also indicate the presence of significant magnetic field pile-up occurring at the boundary of the reconnection region, which is consistent with the super-Alfvénic velocity of the inflows.
Characterization of anisotropic thermal conductivity of suspended nm-thick black phosphorus with frequency-resolved Raman spectroscopy
Authors: Wang Tianyu , Han Meng , Wang Ridong , Yuan Pengyu , Xu Shen , Wang Xinwei
Published: April 2018

Frequency-resolved Raman spectroscopy (FR-Raman) is a new technique for nondestructive thermal characterization. Here, we apply this new technique to measure the anisotropic thermal conductivity of suspended nm-thick black phosphorus samples without the need of optical absorption and temperature coefficient. Four samples with thicknesses between 99.8 and 157.6 nm are studied. Based on steady state laser heating and Raman measurement of samples with a specifically designed thermal transport path, the thermal conductivity ratio (κZZ/κAC) is determined to be 1.86–3.06. Based on the FR-Raman measurements, the armchair thermal conductivity is measured as 14–22 W m−1 K−1, while the zigzag thermal conductivity is 40–63 W m−1 K−1. FR-Raman has great potential for studying the thermal properties of various nanomaterials. This study significantly advances our understanding of thermal transport in black phosphorus and facilitates the application of black phosphorus in novel devices.
Effects of rear cavities on the wake behind an accelerating D-shaped bluff body
Authors: Lorite-Díez M. , Jiménez-González J. I. , Gutiérrez-Montes C. , Martínez-Bazán C.
Published: April 2018

We investigate experimentally and numerically the transient development of the wake induced by a constant acceleration of a D-shaped bluff body, starting from rest and reaching a permanent regime of Reynolds number Re = 2000, under different values of acceleration and implementing three distinct rear geometrical configurations. Thus, alongside the classical blunt base, two control passive devices, namely, a straight cavity and an optimized, curved cavity, recently designed using adjoint optimization techniques, have also been used to assess their performance in transient flow conditions. Particle image velocimetry measurements were performed in a towing tank to characterize the near wake development in the early transient stages. It has been observed that the flow first develops symmetric shear layers with primary eddies attracted toward the base of the body due to the flow suction generated by the accelerated motion. Eventually, the interaction between the upper and lower shear layers provokes the destabilization of the flow and the symmetry breaking of the wake, finally giving rise to an alternate transitional vortex shedding regime. The transition between these phases is sped-up when the optimized cavity is used, reaching earlier the permanent flow conditions. In particular, the use of the optimized geometry has been shown to limit the growth of the primary eddies, decreasing both the recirculation and vortex formation length and providing with a more regularized, more organized vortex shedding. In addition, numerical simulations have been performed to evaluate the distribution of forces induced by the addition of rear cavities. In general, the aforementioned smoother and faster transition related to the use of optimized cavity translates into a lower averaged value of the drag coefficient, together with less energetic force fluctuations, regardless of the acceleration value.
A diffusion-limited reaction model for self-propagating Al/Pt multilayers with quench limits
Authors: Kittell D. E. , Yarrington C. D. , Hobbs M. L. , Abere M. J. , Adams D. P.
Published: April 2018

A diffusion-limited reaction model was calibrated for Al/Pt multilayers ignited on oxidized silicon, sapphire, and tungsten substrates, as well as for some Al/Pt multilayers ignited as free-standing foils. The model was implemented in a finite element analysis code and used to match experimental burn front velocity data collected from several years of testing at Sandia National Laboratories. Moreover, both the simulations and experiments reveal well-defined quench limits in the total Al + Pt layer (i.e., bilayer) thickness. At these limits, the heat generated from atomic diffusion is insufficient to support a self-propagating wave front on top of the substrates. Quench limits for reactive multilayers are seldom reported and are found to depend on the thermal properties of the individual layers. Here, the diffusion-limited reaction model is generalized to allow for temperature- and composition-dependent material properties, phase change, and anisotropic thermal conductivity. Utilizing this increase in model fidelity, excellent overall agreement is shown between the simulations and experimental results with a single calibrated parameter set. However, the burn front velocities of Al/Pt multilayers ignited on tungsten substrates are over-predicted. Possible sources of error are discussed and a higher activation energy (from 41.9 kJ/mol.at. to 47.5 kJ/mol.at.) is shown to bring the simulations into agreement with the velocity data observed on tungsten substrates. This higher activation energy suggests an inhibited diffusion mechanism present at lower heating rates.
Identifying influential nodes in complex networks: A node information dimension approach
Authors: Bian Tian , Deng Yong
Published: April 2018

In the field of complex networks, how to identify influential nodes is a significant issue in analyzing the structure of a network. In the existing method proposed to identify influential nodes based on the local dimension, the global structure information in complex networks is not taken into consideration. In this paper, a node information dimension is proposed by synthesizing the local dimensions at different topological distance scales. A case study of the Netscience network is used to illustrate the efficiency and practicability of the proposed method.
Optimising methods for the recovery and quantification of di- and tripeptides in soil
Authors: Jämtgård Sandra , Robinson Nicole , Moritz Thomas , Colgrave Michelle L. , Schmidt Susanne
Published: April 2018

Di- and tripeptides are intermediaries in the nitrogen cycle and are likely to have roles in the soil–microbe–plant continuum, but they have hitherto been difficult to measure in soils. To lay the base for future studies of oligopeptides in soil, we added 10 known di- and tripeptides with diverse chemical properties to forest and agricultural soils and then recovered the peptides by means of induced diffusive fluxes using microdialysis, a minimally-intrusive soil sampling technique. The concentration of the peptides recovered with the probes was 25–39% (relative recovery) of the concentration in the external solution, and followed the same trend as previously observed for amino acids, with smaller peptides (e.g. Gly-Gly) recovered at a higher rate than larger ones (e.g. Tyr-Phe). After derivatisation with AccQ-Tag™, a standard method for amino acids, peptides were analysed by ultra-high-pressure liquid chromatography-triple quadrupole mass spectrometry. Multiple reaction monitoring mass spectrometry was used to quantify specific peptides with a short run time of 15 min and a detection limit of 0.01–0.02 pmol injected (0.005–0.01 pmol µL–1) for the different peptides. This methodology allowed successful analysis of all standard di- and tripeptides tested here. We conclude that microdialysis in combination with UHPLC-MS will allow measurement of plant-relevant fluxes of di- and tripeptides in undisturbed soil.
Transcriptome-wide discovery of coding and noncoding RNA-binding proteins
Authors: Huang Rongbing , Han Mengting , Meng Liying , Chen Xing
Published: April 2018

Significance

RNAs, both mRNAs and noncoding RNAs, usually exert their functions in the form of RNA–protein complexes. Although mRNA-binding proteins have been extensively studied, comprehensive identification of coding and noncoding RNA-binding proteins (RBPs) remains challenging. Herein, we developed a click chemistry-assisted RNA interactome capture (CARIC) strategy, which combines metabolic labeling of RNAs with an alkynyl uridine analog and in vivo RNA-protein photocross-linking, followed by click reaction with azide-biotin, affinity enrichment, and proteomic analysis. In HeLa cells, CARIC identified 597 RBPs, including 130 proteins not previously known as RBPs. Since CARIC captures RBPs bound to both mRNAs and noncoding RNAs, the obtained CARIC RBP list provides a valuable resource for studying the posttranscriptional gene regulation network.
Spider toxin inhibits gating pore currents underlying periodic paralysis
Authors: Männikkö Roope , Shenkarev Zakhar O. , Thor Michael G. , Berkut Antonina A. , Myshkin Mikhail Yu , Paramonov Alexander S. , Kulbatskii Dmitrii S. , Kuzmin Dmitry A. , Sampedro Castañeda Marisol , King Louise , Wilson Emma R. , Lyukmanova Ekaterina N. , Kirpichnikov Mikhail P. , Schorge Stephanie , Bosmans Frank , Hanna Michael G. , Kullmann Dimitri M. , Vassilevski Alexander A.
Published: April 2018

Significance

Voltage-gated ion channels contain domains that have discrete functionalities. The central pore domain allows current flow and provides ion selectivity, whereas peripherally located voltage-sensing domains (VSDs) are needed for voltage-dependent gating. Certain mutations trigger a leak current through VSDs, known as gating pore current. Hypokalemic periodic paralysis (HypoPP) type 2 is caused by mutations in the skeletal muscle voltage-gated sodium channel Na
V
1.4 that neutralize positive charges in S4 voltage-sensing segments of VSDs. We show that Hm-3 toxin from the crab spider
Heriaeus melloteei
inhibits gating pore currents through such mutant channels. We propose that Hm-3 and similar toxins may constitute useful hits in developing gating pore current inhibitors and HypoPP therapy.
Experimental demonstration of an isotope-sensitive warhead verification technique using nuclear resonance fluorescence
Authors: Vavrek Jayson R. , Henderson Brian S. , Danagoulian Areg
Published: April 2018

Significance

We present an experimental demonstration of an isotope-sensitive warhead verification protocol. The measurement is capable of detecting tampering with a warhead’s material or geometry with high statistical confidence in realistically attainable measurement times, while simultaneously protecting sensitive warhead design information. Such a protocol could enable the verifiable elimination of nuclear warheads under a future arms reduction treaty.
Cytotoxicity of CdSe-based quantum dots incorporated in glass nanoparticles evaluated using human keratinocyte HaCaT cells
Authors: Ando Masanori , Horie Masanori , Akazawa-Ogawa Yoko , Hagihara Yoshihisa , Murase Norio , Shigeri Yasushi
Published: April 2018

CdSe quantum dots (QDs) are potential fluorescent reagents, but leakage of Cd and Se often induces cytotoxicity. Here we prepared CdSe-based QDs with glass to reduce their leakage and examined their cytotoxicity using keratinocyte cells. The cytotoxicity of the QDs with glass was obviously lower than that of the commercial QDs with polymer, suggesting their safety for biological applications.
Natamycin, a New Biofungicide for Managing Crown Rot of Strawberry Caused by QoI-Resistant Colletotrichum acutatum
Authors: Haack Stacey E. , Ivors Kelly L. , Holmes Gerald J. , Förster Helga , Adaskaveg James E.
Published: April 2018

Anthracnose crown rot of strawberry, caused by Colletotrichum acutatum, is an important disease affecting California nursery and fruit production. Preplant dip treatments of transplants with fludioxonil-cyprodinil or azoxystrobin are industry standards for managing the disease and have been used extensively. Following reports of reduced efficacy of azoxystrobin in the field, high levels of quinone outside inhibitor (QoI) resistance were detected in California isolates of the pathogen. Resistance was associated with the G143A mutation in the cytochrome b gene, similar to a previous report from Florida, and there were no detected fitness penalties in pathogenicity or virulence. Therefore, several alternative fungicides were investigated in laboratory and field studies. Subsequently, the new biofungicide natamycin was identified. Baseline sensitivities of 74 isolates of C. acutatum to natamycin were determined to be unimodal, with a range from 0.526 to 1.996 μg/ml (mean 0.973 μg/ml). Although this toxicity was considerably lower than that of azoxystrobin (using sensitive isolates), fludioxonil, or cyprodinil, dip treatments of transplants with natamycin (at 500 or 1000 mg/liter) were highly effective. Disease severity and plant mortality in field studies with inoculated transplants were reduced to similarly low levels as treatments containing fludioxonil, whereas azoxystrobin failed in inoculations with QoI-resistant isolates of C. acutatum. Fruit yield was also significantly increased by natamycin as compared with the inoculated control. Differences in disease susceptibility were observed among cultivars evaluated, with Monterey and Portola more susceptible than Fronteras. Natamycin has a unique mode of action that is different from other fungicides registered on strawberry and, based on this research, was registered in the United States as a preplant, biofungicide dip treatment of strawberry transplants for management of anthracnose crown rot.
Comparison of Greenhouse-Based Inoculation Methods to Study Aggressiveness of Diaporthe helianthi Isolates Causing Phomopsis Stem Canker of Sunflower (Helianthus annuus)
Authors: Mathew Febina M. , Jordahl James G. , Gulya Thomas J. , Markell Samuel G.
Published: April 2018

Phomopsis stem canker is an economically important disease of sunflower (Helianthus annuus), and Diaporthe helianthi is one of the primary causal agents of the disease in the United States. The objective of this study was to evaluate inoculation methods of D. helianthi isolates on sunflower in the greenhouse. Four isolates of D. helianthi were selected to test the effectiveness of four inoculation methods using mycelial plugs as the inoculum, including stem wound, wound inoculation, petiole wound, and straw test. Infection was established by the D. helianthi isolates at 14 days after inoculation for all inoculation methods used. However, recovery of the pathogen from the inoculated plants differed significantly (P < 0.0001) among inoculation methods. Given higher mean recovery of D. helianthi isolates from the inoculated plants and the size of the lesions caused by the pathogen, the stem-wound inoculation method was found to be the most user friendly of the four inoculation methods.
Identification of Sunflower (Helianthus annuus) Accessions Resistant to Diaporthe helianthi and Diaporthe gulyae
Authors: Mathew Febina M. , Olson Taylor R. , Marek Laura F. , Gulya Thomas J. , Markell Samuel G.
Published: April 2018

Phomopsis stem canker is an important disease on sunflower (Helianthus annuus) in Minnesota, North Dakota, and South Dakota. To date, Diaporthe helianthi and D. gulyae have been reported as the common and primary causal agents in this region. The objectives of this study were to compare aggressiveness of the two species and evaluate the USDA cultivated sunflower germplasm collection for resistance to the two pathogens. Five D. helianthi isolates and five D. gulyae isolates were compared for their aggressiveness on the USDA susceptible confection inbred ‘HA 288’ using the stem-wound inoculation method. The results of this study demonstrated that D. helianthi and D. gulyae isolates did not vary significantly (P > 0.05) in their aggressiveness. Using a representative isolate of D. helianthi and D. gulyae, 49 accessions were screened for Phomopsis stem canker using the stem-wound method in the greenhouse. Among the 49 accessions, 13 and 4 accessions were less susceptible to D. helianthi and D. gulyae, respectively, compared with HA 288. Only one accession (PI 552939) was observed to be significantly less susceptible to both D. helianthi and D. gulyae when compared with HA 288.
The Effect of Under-Dosing Prophylactic Antibiotics in the Care of Open Tibial Fractures
Authors: Olinger Catherine R. , Carver David Christopher , Nolan Vikki G. , Weinlein John C.
Published: April 2018

Objectives:

To determine the frequency and effect of under-dosing prophylactic weight-based antibiotics in patients with open tibial fractures. We hypothesized that patients who did not receive appropriate weight-based dosing of prophylactic antibiotics would have higher rates of infection.

Design:

Retrospective cohort study.

Setting:

Level 1 Trauma Center.

Patients/Participants:

Patients 18 years of age or older with high-grade (Gustilo-Anderson type IIIA or IIIB) open extraarticular tibial fractures over a 5-year period.

Main Outcome:

The primary outcome was deep infection within one year of initial injury. Appropriate weight-based dosing of cefazolin was defined as: at least 1 g for patients <80 kg, 2 g for patients between 80 and 120 kg, and 3 g for patients >120 kg.

Results:

Sixty-three patients met the inclusion criteria; 21 (33%) were under-dosed with cefazolin at the time of initial presentation. Among the 20 patients who subsequently developed deep infection, only 55% were appropriately dosed with cefazolin; of the patients who did not develop deep infection, 72% were appropriately dosed with cefazolin (P = 0.18). Univariate analysis revealed that hypertension was associated with infection (P = 0.049). Multivariable logistic regression analysis of infection due to all organisms did not reveal a statistically significant reduction in the odds of infection with appropriate weight-based dosing of cefazolin [Odds ratio = 0.42 (95% confidence interval, 0.12–1.48), P = 0.177]. Five of 7 (71%) of the gram positive, non-methicillin-resistant Staphylococcus aureus, infections occurred in patients who were under-dosed with cefazolin. Five (23.8%) of 21 patients who were under-dosed with cefazolin had gram-positive, non-methicillin-resistant S. aureus infections, compared to 2 (4.8%) of 42 patients who were appropriately dosed (P = 0.036).

Conclusions:

Under-dosing of weight-based antibiotics in the treatment of open fractures is common. Appropriate weight-based dosing of cefazolin for prophylaxis in high-grade open tibial fractures reduces the frequency of infection due to cefazolin-sensitive organisms. Interestingly, organisms not susceptible to cefazolin were responsible for the majority of infections. The effect of under-dosing of cefazolin and other weight-based antibiotics deserves further investigation in larger studies.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Sex-Mediated Response to the Beta-Blocker Landiolol in Sepsis: An Experimental, Randomized Study
Authors: Mathieu Calypso , Desrois Martine , Kober Frank , Lalevée Nathalie , Lan Carole , Fourny Natacha , Iché-Torres Magali , Tran Thi Thom , Lê Linh Thuy , Singer Mervyn , Mège Jean-Louis , Bernard Monique , Leone Marc
Published: April 2018

Objectives:

To investigate any gender effect of the beta-1 adrenergic blocker, landiolol, on cardiac performance and energy metabolism in septic rats, and to explore the expression of genes and proteins involved in this process.

Design:

Randomized animal study.

Setting:

University research laboratory.

Subjects:

Male and female Wistar rats.

Interventions:

One hour after cecal ligation and puncture, male and female rats were randomly allocated to the following groups: sham male, cecal ligation and puncture male, cecal ligation and puncture + landiolol male, sham female, cecal ligation and puncture female, and cecal ligation and puncture + landiolol female. Cardiac MRI was carried out 18 hours after cecal ligation and puncture to assess in vivo cardiac function. Ex vivo cardiac function measurement and 31P magnetic resonance spectroscopy were subsequently performed using an isovolumic isolated heart preparation. Finally, we assessed cardiac gene and protein expression.

Measurements and Main Results:

In males, landiolol increased indexed stroke volume by reversing the indexed end-diastolic volume reduction without affecting left ventricle ejection fraction. In females, landiolol did not increase indexed stroke volume and indexed end-diastolic volume but decreased left ventricle ejection fraction. Landiolol had no effect on ex vivo cardiac function and on high-energy phosphate compounds. The effect of landiolol on the gene expression of natriuretic peptide receptor 3 and on protein expression of phosphorylated-AKT:AKT ratio and endothelial nitric oxide synthase was different in males and females.

Conclusions:

Landiolol improved the in vivo cardiac performance of septic male rats while deleterious effects were reported in females. Expression of natriuretic peptide receptor 3, phosphorylated-AKT:AKT, and endothelial nitric oxide synthase are signaling pathways to investigate to better understand the sex differences in sepsis.
Comparison of In-Hospital and Long-term Outcomes of Sublobar Lung Cancer Surgery by VATS and Open Techniques
Authors: Tuminello Stephanie , Liu Bian , Wolf Andrea , Alpert Naomi , Taioli Emanuela , Flores Raja M.
Published: April 2018

Objective:

Sublobar resection is often used as an alternative surgical approach in lung cancer patients who are unlikely to tolerate a full lobe resection. This study aims to assess outcomes of video-assisted thoracoscopic surgeries (VATS) sublobar resection as a surgical technique.

Materials and Methods:

The SEER-Medicare database was queried to identify patients with primary lung cancer who had VATS or open sublobar resection. Baseline clinical differences between VATS and open patients were adjusted for in logistic regression and by propensity score matching to investigate surgical outcomes.

Results:

Patients undergoing VATS had a greater number of comorbidities (adjusted odds ratio [ORadj], 0.90; 95% confidence interval [CI], 0.85-0.96) and were less likely to have later stage cancer (ORadj, 0.80; 95% CI, 0.67-0.95), squamous compared with adenocarcinoma (ORadj, 0.82; 95% CI, 0.68-0.99), large (>30 mm) tumor size (ORadj, 0.56; 95% CI, 0.0.41-0.75). VATS patients were less likely to have nodes removed for examination during surgery (ORadj, 0.76; 95% CI, 0.64-0.90). After propensity matching (n=2148), patients who underwent VATS were less likely to experience in-hospital complications, blood transfusions, and a prolonged length of hospital stay than those who had open surgery. There was no statistically significant difference in in-hospital or long-term mortality between patients with VATS and open surgery.

Conclusion:

In the most compromised lung cancer patients, VATS sublobar resection might be the best option.
Mortality After Stereotactic Radiosurgery for Brain Metastases and Implications for Optimal Utilization
Authors: Rydzewski Nicholas R. , Khan Atif J. , Strauss Jonathan B. , Chmura Steven J.
Published: April 2018

Objectives:

Brain metastases are associated with cancer progression and poor outcomes. The use of stereotactic radiosurgery (SRS) to treat brain metastases has been increasing due to its potential to quickly treat metastatic disease while avoiding the morbidity associated with surgery or whole brain radiation therapy (WBRT). This study seeks to analyze practice patterns of the use of SRS for brain metastases, focusing on the endpoint of short-term mortality.

Materials and Methods:

This study used the National Cancer Database to observe cancer patients diagnosed with a non-Central Nervous System primary from 2010 to 2012 who presented at diagnosis with metastatic disease to the brain and received either WBRT or SRS. The primary endpoint was time to mortality determined by the Kaplan-Meier product-limit estimate of the failure function.

Results:

A total of 18,604 patients were included in the analysis from first day of treatment (16,219 patients received WBRT and 2385 received SRS). At 90 days, mortality was 39.3% for those who received WBRT and 20.0% for those who received SRS. For patients 70 and older who received SRS, mortality was 30.2% at 90 days.

Conclusions:

Analysis of short-term mortality after treatment for brain metastases by using the National Cancer Database provides a window into national treatment patterns and associated outcomes. Roughly 1 in 5 patients who receive SRS and roughly 1 in 3 patients 70 and older who receive SRS die within 90 days of treatment. These data suggest some degree of overutilization of SRS in some patient populations, most notably those patients over the age of 70.
Inhibiting the Inflammatory Injury After Myocardial Ischemia Reperfusion With Plasma-Derived Alpha-1 Antitrypsin: A Post Hoc Analysis of the VCU-α1RT Study
Authors: Abouzaki Nayef Antar , Christopher Sanah , Trankle Cory , Van Tassell Benjamin Wallace , Carbone Salvatore , Mauro Adolfo Gabriele , Buckley Leo , Toldo Stefano , Abbate Antonio
Published: April 2018

Background:

Despite the benefits of reperfusion in limiting myocardial injury, the infarct size continues to expand after reperfusion because of secondary inflammatory injury. Plasma-derived alpha-1 antitrypsin (AAT) inhibits the inflammatory injury in myocardial ischemia and reperfusion. To explore the effects of plasma-derived AAT on the inflammatory response to ischemia-reperfusion injury, we analyzed time-to-reperfusion and enzymatic infarct size estimates in a post hoc analysis of the VCU-α1RT clinical trial (clinicaltrials.gov NCT01936896).

Methods:

Ten patients with ST-segment elevation acute myocardial infarction (STEMI) were enrolled in an open-label, single-arm treatment study of Prolastin C, plasma-derived AAT, at 60 mg/kg infused intravenously within 12 hours of reperfusion. Biomarkers were measured serially over the first 72 hours, and patients were followed clinically for the occurrence of new-onset heart failure, recurrent MI, or death. Twenty patients with STEMI who had been enrolled in previous randomized trials with identical inclusion/exclusion criteria and had been assigned to placebo served as historical controls.

Results:

Time to percutaneous coronary intervention and time to drug did not significantly differ between groups. AAT-treated patients had a significantly shorter time-to-peak creatine kinase myocardial band (CK-MB) values (525 [480–735] vs. 789 [664–959] minute, P = 0.005) and CK-MB area under the curve (from 1204 [758–2728] vs. 2418 [1551–4289] U·day, P = 0.035), despite no differences in peak CK-MB (123 [30–196] vs. 123 [71–213] U/mL, P = 0.71).

Conclusions:

A single administration of Prolastin C given hours after reperfusion in patients with STEMI led to a significant shorter time to peak and area under the curve for CK-MB, despite similar peak CK-MB values. These preliminary data support the hypothesis that Prolastin C shortens the duration of the ischemia-reperfusion injury in patients with STEMI.
Vascular dysfunction across the stages of the menopausal transition is associated with menopausal symptoms and quality of life
Authors: Hildreth Kerry L. , Ozemek Cemal , Kohrt Wendy M. , Blatchford Patrick J. , Moreau Kerrie L.
Published: April 2018

Objective:

The menopausal transition is associated with somatic symptoms and increased rates of depression, which can impair quality of life (QOL) and increase cardiovascular disease (CVD) risk. This period is also associated with accelerated vascular aging (arterial stiffening and endothelial dysfunction), an antecedent to CVD. This secondary analysis sought to explore associations between depression, menopausal symptoms and QOL, and vascular aging across menopause stages.

Methods:

Arterial stiffness (carotid artery compliance), endothelial function (brachial artery flow-mediated dilation [FMD]), menopausal symptoms (Menopausal Symptom List [MSL]), depression (Center for Epidemiologic Studies Depression Scale [CES-D]), and QOL (Utian QOL Scale [UQOL]) were measured in 138 women (19-70 years) classified as premenopausal (n = 41, 34 ± 8 years; mean ± SD), early (n = 25, 49 ± 3 years), or late perimenopausal (n = 26, 50 ± 4 years), or early (n = 22, 55 ± 4 years) or late postmenopausal (n = 24, 61 ± 5 years). Differences across menopause stages were determined using one-way analysis of variance; associations between vascular measures and MSL, CES-D, and UQOL were tested using Pearson's correlation analyses.

Results:

Menopausal symptoms, depression, and QOL worsened across menopause stages, particularly in late perimenopausal women. Vasosomatic symptom frequency, and general somatic symptom frequency and severity were inversely correlated with carotid artery compliance and FMD (r = −0.27 to −0.18, all P < 0.05). Only correlations with general somatic symptoms were significant after adjusting for multiple comparisons. Total QOL was positively correlated with carotid artery compliance (r = 0.23, P = 0.01). CES-D scores were not correlated with carotid artery compliance or FMD (r = −0.08, −0.03, P = 0.35).

Conclusions:

Vascular dysfunction across the stages of menopause was associated with greater frequency and severity of menopausal symptoms, and lower QOL, but not depression. Mechanisms underlying these associations (eg, inflammation, oxidative stress) should be explored.
Double-Bubble Technique in Descemet Membrane Endothelial Keratoplasty for Vitrectomized Eyes: A Case Series
Authors: Hayashi Takahiko , Kobayashi Akira
Published: April 2018

Purpose:

To describe a modified technique for Descemet membrane endothelial keratoplasty (DMEK) in vitrectomized eyes that had undergone transscleral-sutured intraocular lens (IOL) implantation (IOL-suture) and pars plana vitrectomy.

Methods:

This was a prospective interventional case series. Patients exhibiting endothelial dysfunction with aphakia, or dislocated IOLs, who underwent IOL-suture and pars plana vitrectomy, were enrolled. Patients underwent DMEK using the “double-bubble technique,” which is characterized by the placement of 2 bubbles, 1 above and 1 beneath the graft. One small air bubble is placed over the graft for the purpose of unfolding the graft; the other large bubble is injected under the graft to enable fixation of the graft. Best spectacle-corrected visual acuity, central corneal thickness, endothelial cell density, the time of graft unfolding (using a surgical video), and the incidence of intraoperative/postoperative complications were analyzed.

Results:

This study included 6 eyes of 6 patients (3 men and 3 women; mean age 78.0 ± 2.5 years). Although the unfolding time was relatively long (10.1 ± 4.5 minutes), all surgeries were uneventful. Rebubbling was required in 1 eye (16.6%). Best spectacle-corrected visual acuity improved significantly in all eyes. There was no primary graft failure.

Conclusions:

This technique (double bubble technique) enables safe and easy DMEK surgery, even in eyes that have been previously vitrectomized and IOL-sutured. Further clinical studies with a large number of patients exhibiting complex eyes are required to definitively establish the clinical value of this technique.
Perinatal Yellow Fever: A Case Report
Authors: Diniz Lilian Martins Oliveira , Romanelli Roberta Maia Castro , de Carvalho Andréa Lucchesi , Teixeira Daniela Caldas , de Carvalho Luis Fernando Andrade , Ferreira Cury Verônica , Filho Marcelo Pereira Lima , Perígolo Graciele , Heringer Tiago Pires
Published: April 2018

An outbreak of yellow fever in Brazil made it possible to assess different presentations of disease such as perinatal transmission. A pregnant woman was admitted to hospital with yellow fever symptoms. She was submitted to cesarean section and died due to fulminant hepatitis. On the sixth day, the newborn developed liver failure and died 13 days later. Yellow fever polymerase chain reaction was positive for both.
Distribution of Adrenergic Receptor Subtypes and Responses to Topical 0.5% Apraclonidine in Patients With Blepharoptosis
Authors: Park Seong Jun , Jang Sun Young , Baek Ji Sun , Chin Susie , Jang Jae Woo
Published: April 2018

Purpose:

To determine the relationship between the distribution of adrenergic receptors in the human eyelid and the eyelid elevation after topically instilling 0.5% apraclonidine in blepharoptosis patients.

Methods:

A total of 26 blepharoptotic patients (30 eyelids) were included in the experimental study. Marginal reflex distance 1 was measured before and after topical instillation of 0.5% apraclonidine. Eyelids were divided into 2 groups according to the responses to topical 0.5% apraclonidine. Patients who positively responded to apraclonidine were classified as group A and those that negatively responded to it were classified as group B. Müller’s muscle was obtained during the blepharoptotic surgery, followed by immunohistochemical staining and scoring. This study was approved by the Institutional Review Board of Kim’s Eye Hospital and the study protocol adhered to the tenets of the Declaration of Helsinki.

Results:

α-1D staining intensity was significantly higher in group A than in B (p < 0.001) and α-2C and β-1 staining intensities were significantly higher in group B than in A (p < 0.001 and p < 0.05, respectively). The difference in β-2 staining intensity between groups A and B was not statistically significant.

Conclusions:

α-1D adrenoceptor was predominant in patients showing a positive response to topical 0.5% apraclonidine. Because apraclonidine has an α-1 agonistic effect, α-1D adrenoceptor may contribute to apraclonidine’s elevating effect in patients with blepharoptosis.
Eye-Preserving Surgery Followed by Adjuvant Radiotherapy for Lacrimal Gland Carcinoma: Outcomes in 37 Patients
Authors: Woo Kyung In , Sagiv Oded , Han Jisang , Frank Steven J. , Kim Yoon-Duck , Esmaeli Bita
Published: April 2018

Purpose:

To describe the clinical outcomes of eye-preserving surgery followed by adjuvant radiotherapy in patients with lacrimal gland carcinoma.

Methods:

Thirty-seven patients with lacrimal gland carcinoma who underwent eye-preserving surgery were studied.

Results:

At last follow up, 32 patients were alive without disease, 3 patients were alive with disease with distant metastasis, 1 patient had died of disease, and 1 patient had died of other cause. The 5-year recurrence-free survival rate was worse in patients without than in patients with adjuvant radiotherapy (p = 0.001) and worse in patients with T3-T4 tumors than in patients with T1-T2 tumors (p = 0.027). At last follow up, 25 patients (68%) had visual acuity of 20/40 or better.

Conclusions:

In patients with lacrimal gland carcinoma, eye-preserving surgery and adjuvant radiotherapy is associated with reasonable local control rates and visual and ocular function. Postoperative adjuvant radiotherapy seems to enhance local control rates.
Oral Care Clinical Trial to Reduce Non–Intensive Care Unit, Hospital-Acquired Pneumonia: Lessons for Future Research
Authors: McNally Edel , Krisciunas Gintas P. , Langmore Susan E. , Crimlisk Janet T. , Pisegna Jessica M. , Massaro Joseph
Published: April 2018

Hospital-acquired pneumonia (HAP) contributes greatly to patient mortality and healthcare costs. Studies have shown that aggressive oral care in intensive care units (ICUs) can significantly reduce pneumonia rates, and hospitals have implemented stringent protocols in this setting. However, little is known about the effectiveness of aggressive oral care in reducing HAP in non–intensive care wards, prompting us to conduct a nonrandomized controlled clinical trial. A structured toothbrushing program was provided to an experimental cohort of patients. A control group received usual care. Patient demographics, toothbrushing frequency, and pneumonia diagnosis were recorded over a 3.5-month period. Difference in pneumonia rates was computed using unadjusted and multivariate logistic regression analyses. No significant difference in pneumonia rates between control and experimental groups was found (1.7% versus 1.8%). Toothbrushing rates increased significantly in the experimental group (p = .002) but fell short of protocol frequency. It became apparent that aggressive toothbrushing program implementation requires nursing-led interdisciplinary involvement, more intensive training, a streamlined documentation system, and efficient compliance tracking. Lessons from this study should be used for future large-scale research. A secondary analysis of these data did, however, suggests that increasing toothbrushing rates may have the potential to reduce pneumonia in the non-ICU acute care setting.
Evaluation of postprandial hypoglycemia in patients with nonalcoholic fatty liver disease by oral glucose tolerance testing and continuous glucose monitoring
Authors: Oki Yusuke , Ono Masafumi , Hyogo Hideyuki , Ochi Tsunehiro , Munekage Kensuke , Nozaki Yasuko , Hirose Akira , Masuda Kosei , Mizuta Hiroshi , Okamoto Nobuto , Saibara Toshiji
Published: April 2018

Objective

Nonalcoholic fatty liver disease (NAFLD) is often associated with insulin resistance and glucose intolerance. Postprandial hypoglycemia frequently occurs in NAFLD patients; however, the details remain unclear.

Patients and methods

The 75-g oral glucose tolerance test (75gOGTT) in 502 patients with biopsy-proven NAFLD and continuous glucose monitoring (CGM) in 20 patients were performed, and the characteristics and causes of postprandial hypoglycemia were investigated.

Results

The proportion of patients in the Hypo subgroup [plasma glucose (PG) at 180 min<fasting-PG (FPG)] among patients with normal glucose tolerance was significantly higher than that with diabetes mellitus and impaired glucose tolerance or impaired fasting glucose. FPG and hemoglobin A1c (HbA1c) were lower, and area under the curve of total insulin secretion within 120 min (<120 min) was higher in Hypo than Hyper in overall patients. Although FPG and PG at 30 min were higher in Hypo than Hyper, HOMA-IR and the insulinogenic index were not different in normal glucose tolerance and impaired glucose tolerance or impaired fasting glucose. In multivariate logistic regression analysis, low HbA1c, low fasting immunoreactive insulin, and high area under the curve of total insulin secretion (<120 min) were found to be independent factors associated with hypoglycemia. CGM showed postprandial hypoglycemia until lunch in 70% of NAFLD patients. However, no remarkable relationship in terms of hypoglycemia was identified between the 75gOGTT and CGM.

Conclusion

Postprandial hypoglycemia was identified in many NAFLD patients detected by 75gOGTT and CGM. It was clarified that important causes of postprandial hypoglycemia were related to low HbA1c, an early elevation of PG, low fasting and relatively low early insulin secretion, and delayed hyperinsulinemia.
Concurrent extrahepatic autoimmune disorders: unexplored dimension of autoimmune liver disease in children
Authors: Jain Vikas , Yachha Surender K. , Bhatia Eesh , Sarma Moinak S. , Srivastava Anshu
Published: April 2018

Background and aim

No comprehensive and prospective data are available for concurrent extrahepatic autoimmune disorders (CEAIDs) in children with autoimmune liver disease (AILD). The aim of this study was to evaluate CEAIDs in AILD and their effect on AILD outcome.

Patients and methods

Enrolled AILD and CEAIDs children were diagnosed on the basis of simplified and standard diagnostic criteria, respectively. The clinicopathological profile, treatment response, and outcome were compared between AILD with CEAIDs (group A) and AILD without CEAIDs (group B).

Results

In 62 AILD children, CEAIDs were found in 42% (n=26) [vitiligo (42%), celiac disease (CD) (15%), potential CD (15%), autoimmune hemolytic anemia (AIHA) (15%)]. CEAIDs were asymptomatic in 75%. Single CEAID was found in 81% (21/26) and multiple CEAID was found in 19% (5/26). Significantly less biochemical remission (46.1 vs. 74.2%, P=0.03), more treatment failure (23 vs. 3.2%, P=0.04), and higher mortality (15.3 vs. 3.2%, P=0.04) were encountered in group A compared with group B. On multivariate analysis (n=57), less biochemical remission in vitiligo (P=0.04); more treatment failure in AIHA (P=0.004) and vitiligo (P=0.04); and high mortality in AIHA (P=0.02) subgroups were reported. CD treatment has good impact on AILD outcome. All cases of diabetes mellitus in AILD were steroid-induced rather than because of autoimmunity (absence of antibody against tyrosine phosphatase and glutamic acid decarboxylase and elevated C-peptide).

Conclusion

All AILD children should be screened for CEAIDs as the majority are asymptomatic. The AILD outcome was favorable in CD, but poor in vitiligo and AIHA. We suggest the incorporation of CEAIDs in a pediatric AILD scoring system.
A novel scoring model for predicting mortality risk in patients with cirrhosis and hepatorenal syndrome
Authors: Zhang Shuan , He Ling-Ling , Wang Xin-Hui , Dang Zhi-Bo , Liu Xiao-Li , Li Meng-Ge , Wang Xian-Bo , Yang Zhi-Yun
Published: April 2018

Background and aims

This study aimed to create a risk scoring model for death from cirrhosis and hepatorenal syndrome, improve the detection rate of high-risk groups, and provide clinical evidence for early intervention treatment.

Patients and methods

We retrospectively recruited 196 patients with cirrhosis and hepatorenal syndrome between 1 January 2013 and 31 July 2014 at Beijing Ditan Hospital, Capital Medical University, China. The clinical information, biochemical values, age, and sex of the patients were included in the multivariate logistic regression model for screening independent risk factors. The model was validated in 56 patients with cirrhosis and hepatorenal syndrome between 1 August 2014 and 31 December 2014 at Beijing Ditan Hospital, Capital Medical University, China.

Results

The death risk prediction scoring model included the following four independent risk factors: liver cancer, neutrophil above 70%, alanine aminotransferase higher than 40 U/l, and creatinine higher than 127 mmol/l. The sum death risk score ranged from 0 to 5: 0–2 identified patients with a lower risk of death (mortality rates: 12–41.4%), whereas 3–5 identified patients with a higher risk of death (mortality rates: 48.8–80%). Receiver-operating characteristic curves were constructed for the scoring model and the areas under the curves (AUC) were compared using the z-test. The AUC of the scoring model was 0.843. In addition, the AUC of validated model in 56 patients was 0.742.

Conclusion

The scoring model can accurately predict mortality risk in patients with hepatorenal syndrome.
Postmortem Vitreous Sodium and Chloride Elevate After 1 Hour and Magnesium After 2 Hours in Bovine Eyeballs Immersed in Salt Water
Authors: Tse Rexson , Kuo Ta-chen , Garland Jack , Lam Leo , Sunderland Michael , Kesha Kilak , Elstub Hannah , Cala Allan , Stables Simon
Published: April 2018

Background

Postmortem vitreous sodium (Na) and chloride (Cl) are good ancillary tests in diagnosing salt-water drowning. Vitreous Na and Cl appear to elevate from salt-water drowning and immersion, whereas vitreous magnesium (Mg) appears to be unaffected by drowning, but elevates from immersion. The relative changes of these electrolytes during salt-water immersion are unknown, particularly with shorter immersion times. Understanding the relative changes may aid in the interpretation of vitreous electrolytes in bodies recovered from salt water.

Aim

The aim of this study was to compare the changes of vitreous Na, Cl, and Mg when immersed in salt water.

Methods

Bovine eyeballs were randomized into 2 groups (submerged in salt water and control). The vitreous Na, Cl, and Mg from 6 eyeballs were measured from each group (without replacement) at 1, 2, 4, and 6 hours.

Results

There were no statistically significant elevations in bovine vitreous Na and Cl for up to 1 hour and vitreous Mg for up to 2 hours.

Conclusions

Bovine vitreous Na and Cl elevate earlier than Mg when immersed in salt water. Assuming similar physical properties, an elevation in vitreous Mg in bodies immersed in salt water indicates the immersion effects of causing raised vitreous Na and Cl have started.
A Risk Scoring System for the Prediction of Functional Deterioration, Institutionalization, and Mortality Among Medicare Beneficiaries
Authors: McClintock Heather F. , Kurichi Jibby E. , Kwong Pui L. , Xie Dawei , Stineman Margaret G. , Bogner Hillary R.
Published: April 2018

Objective

We sought to develop a risk scoring system for predicting functional deterioration, institutionalization, and mortality. Identifying predictors of poor health outcomes informs clinical decision-making, service provision, and policy development to address the needs of persons at greatest risk for poor health outcomes.

Design

This is a cohort study with 21,257 community-dwelling Medicare beneficiaries 65 yrs and older who participated in the 2001–2008 Medicare Current Beneficiary Survey.

 Derivation of the model was conducted in 60% of the sample and validated in the remaining 40%. Multinomial logistic regression model generated β coefficients, which were used to create a risk scoring system. Our outcome was instrumental activity of daily living stage transitions (stable/improved function and functional deterioration), institutionalization, or mortality for 2 yrs of follow-up.

Results

A total of 18 factors were identified for functional deterioration (P < 0.05). In the derivation cohort, the likelihood of functional deterioration ranged from 6.27% to 33.51%, risk of institutionalization from 0.07% to 12.13%, and risk of mortality from 2.13% to 31.83%, in comparison with stable/improved function.

Conclusions

A risk scoring system predicting Medicare beneficiaries' risk of functional deterioration, institutionalization, and mortality based on demographic and clinical indicators may feasibly be developed with implications for healthcare delivery.
Ultrasound Imaging for Muscle Variations
Authors: Ata Ayşe Merve , Kara Murat , Aydin Gülümser , Kaymak Bayram , Gürçay Eda , Özçakar Levent
Published: April 2018

Anatomical variations of the muscles are seen with different frequencies. Although most of them are asymptomatic; in certain cases, their existence requires attention with regard to entrapment syndromes, mass lesions, botulinum toxin injections, and tendon transfers. Herein, as ultrasound imaging is a convenient method for muscle imaging, it can easily be used in daily practice for prompt understanding of such muscular variations. In this report, we demonstrated and discussed a similar scenario in an asymptomatic individual (and his close family members) using ultrasound imaging for scanning the digastric flexor carpi ulnaris, gastrocnemius tertius, and supernumerary fibularis longus muscles.