bluuebunny/crossref_metadata_2025 huggingface dataset:
Nonlinear frequency conversion in one dimensional lithium niobate photonic crystal nanocavities
Authors: Jiang Haowei , Liang Hanxiao , Luo Rui , Chen Xianfeng , Chen Yuping , Lin Qiang
Published: July 2018

We demonstrate flexible nonlinear frequency up-conversion in high-Q lithium niobate photonic crystal nanobeam resonators. The high optical Q together with strong optical mode confinement allows us to observe clear second harmonic generation and sum frequency generation with an optical power around only tens of microWatts. These demonstrations show that high-Q lithium niobate photonic crystal nanoresonators are of great promise for nonlinear photonic applications.
Multiword units in machine translation and translation technology
Authors: Monti Johanna , Seretan Violeta , Corpas Pastor Gloria , Mitkov Ruslan
Published: July 2018

The correct interpretation of Multiword Units (MWUs) is crucial to many applications in Natural Language Processing but is a
challenging and complex task. In recent years, the computational treatment of MWUs has received considerable attention but we
believe that there is much more to be done before we can claim that NLP and Machine Translation (MT) systems process MWUs
successfully. In this chapter, we present a survey of the field with particular reference to Machine Translation and
Translation Technology.
A multilingual gold standard for translation spotting of German compounds and their corresponding multiword units
in English, French, Italian and Spanish
Authors: Clematide Simon , Lehner Stéphanie , Graën Johannes , Volk Martin
Published: July 2018

This article describes a new word alignment gold standard for German nominal compounds and their multiword translation
equivalents in English, French, Italian, and Spanish. The gold standard contains alignments for each of the ten
language pairs, resulting in a total of 8,229 bidirectional alignments. It covers 362 occurrences of 137 different
German compounds randomly selected from the corpus of European Parliament plenary sessions, sampled according to the
criteria of frequency and morphological complexity. The standard serves for the evaluation and optimisation of
automatic word alignments in the context of spotting translations of German compounds. The study also shows that in
this text genre, around 80% of German noun types are morphological compounds indicating potential multiword units in
their parallel equivalents.
Dutch compound splitting for bilingual terminology extraction
Authors: Macken Lieve , Tezcan Arda
Published: July 2018

As compounds pose a problem for applications that rely on precise word alignments, we developed a state-of-the-art
compound splitter for Dutch that makes use of corpus frequency information and linguistic knowledge. Domain-adaptation
techniques are used to combine large out-of-domain and dynamically compiled in-domain frequency lists.

As compounds are not always translated compositionally, we developed a novel methodology for word alignment. We train
the word alignment models twice: a first time on the original data set and a second time on the data set in which the
compounds are split into their component parts.

Experiments show that the compound splitter combined with the novel word alignment technique considerably improves
bilingual terminology extraction results.
A flexible framework for collocation retrieval and translation from parallel and comparable corpora
Authors: Mendoza Rivera Oscar , Mitkov Ruslan , Corpas Pastor Gloria
Published: July 2018

This paper outlines a methodology and a system for collocation retrieval and translation from parallel and comparable
corpora, developed with translators and language learners in mind. It is based on a phraseology framework, applies
statistical techniques, and employs source tools and online resources. The collocation retrieval and translation has
proved successful for English and Spanish and can be easily adapted to other languages. The evaluation results are
promising and future goals are proposed. Furthermore, conclusions are drawn on the nature of comparable corpora and
how they can be better exploited to suit particular needs of target users.
On identification of bilingual lexical bundles for translation purposes
Authors: Grabowski Łukasz
Published: July 2018

Grounded in phraseology and corpus linguistics, this paper aims to explore the use of bilingual lexical bundles to
improve the degree of naturalness and textual fit of translated texts. More specifically, this study attempts to
identify lexical bundles, that is, recurrent sequences of 3–7 words with similar discursive functions in a
purpose-designed comparable corpus of English and Polish patient information leaflets, with 100 text samples in each
language. Because of cross-linguistic differences, we additionally apply a number of formal criteria in order to
filter out the bundles in each subcorpus. The results show that bilingual lexical bundles with overlapping discourse
functions in texts and extracted from comparable corpora hold unexplored potential for machine translation,
computer-assisted translation and bilingual lexicography.
The quest for croatian idioms as multiword units
Authors: Kocijan Kristina , Librenjak Sara
Published: July 2018

Idiomatic expressions are types of MWUs in which the meaning of the unit does not equal the cummulative meaning of its
parts. They are culturally dependent, so the translation cannot be inferred from the expression itself. Croatian
language has a very rich idiomatic structure. A few such expressions can be understood in direct translation but most
are different from the literal translations. As the idioms are rooted in the tradition of the language and society
from which they hail, they need special treatment in computational linguistics. Using NooJ as an NLP tool, we describe
different types of Croatian idioms that will help us recognize them in texts. Idioms recognition should be given
special treatment, being the major task in translation.
Anaphora resolution, collocations and translation
Authors: Wehrli Eric , Nerima Luka
Published: July 2018

Collocation identification and anaphora resolution are widely recognised as major issues for natural language
processing, and particularly for machine translation. This paper focuses on their intersection domain, that is
verb-object collocations in which the object has been pronominalised. To handle such cases, an anaphora resolution
procedure must link the direct object pronoun to its antecedent. The identification of a collocation can then be made
on the basis of the verb and its object or its antecedent. Results obtained from the translation of a large corpus
will be discussed, as well as an evaluation of the precision of the anaphora resolution procedure for this specific
task.
When grammaticalization does not occur
Authors: Reinöhl Uta , Casaretto Antje
Published: July 2018

Recent decades have seen a surge of interest in grammaticalization. In this paper, however, we are not concerned with reaching a better understanding of the nature of grammaticalization phenomena or their triggering factors, but we ask under what circumstances grammaticalization does not take place, even if it would have seemed likely to – a topic that has scarcely been addressed in the literature. Based on a comparative investigation of the historical development of a class of Indo-European spatial adverbs, we argue that mismatches between layers of linguistic structure present one type of situation in which grammaticalization may be blocked. For grammaticalization to occur, the outer semantic-syntactic boundaries of the potentially grammaticalizing construction must be matched by prosodic boundaries. If prosodic chunking is shifted in relation to semantic-syntactic chunking, grammaticalization may be prevented.
Changing frequencies in a constructional landscape
Authors: Nieuwenhuijsen Dorien
Published: July 2018

Many studies on Spanish verbal periphrases either discuss the general features of the syntactic category or analyse the semantic and functional differences between specific members of that category. The present paper focusses on one particular periphrasis,parecer“to seem” + infinitive but, at the same time, takes into account a similar, impersonal construction withparecer. Adopting a constructionist, usage-based approach, data are drawn from a large diachronic corpus, which makes it possible to describe the interplay between the two competing constructions and identify different semantic and syntactic contexts that favoured the increase of the periphrasis in the 19th century at the cost of the impersonal construction. More generally, the paper addresses the relevance of studying individual constructions in the context of other semantically and/or formally related constructions, since a change in one particular area of the constructional landscape can have repercussions on other areas as well.
Languages as complete and distinct systems of reference
Authors: Langendoen D. Terence
Published: July 2018

Section 1 is an extended commentary on Edward Sapir’s formulation nearly a century ago of what he considered the two most fundamental properties of human language, first that each one is a formally complete system of reference to experience and second that each one is formally distinct from every other. Section 2 considers some aspects of the development of these formulations, noting that they have been considered separately and not integrated as fully fleshed out systems of reference, as Sapir envisioned. Section 3 examines more closely what such an integration looks like in a case involving simple arithmetic. Section 4 begins with a brief review of the accomplishments of Greco-Roman logic and more recent developments in the theory of logic, leading to a consideration of what may be needed to fulfill Sapir’s program. Section 5 summarizes some of my own recent research on extending first-order logic by replacing the unordered set of individuals with a specific ordering of a set of sets of individuals that is isomorphic to an ordering of sets of sets of numbers that contain no pairs of divisible numbers, which was investigated by Richard Dedekind shortly before the turn of the twentieth century.
Study of anti-corrosion and anti-wear properties on superhydrophobic aluminium alloy surfaces
Authors: Qiu Rongxian , Wu Zhilin , Xu Jinkai
Published: July 2018

To improve the wear and corrosion resistance of aluminium alloys in salt environments, we produced superhydrophobic surfaces via high-speed electrical discharge machining. The specimens were characterised using a scanning electron microscope and a laser scanning confocal microscope and through contact angle (CA) measurement, measurement of electrochemical corrosion at an electrochemical workstation and wear testing. Results showed that the superhydrophobic specimens had a water CA of 151.5°. The corrosion of the as-obtained superhydrophobic specimens was significantly reduced by more than 50%, indicating their excellent anti-corrosion properties. The wear of as-obtained superhydrophobic specimens were reduced by approximately 10–35% in dry conditions and by approximately 45–85% in 3.5% NaCl solution, revealing their excellent anti-wear properties in both dry and salt environments.
Effect of Er on properties of Zr-based bulk metallic glasses
Authors: Li Chun-Yan , Yin Jin-Feng , Ding Juan-Qiang , Zhu Fu-Ping , Zhao Yan-Chun , Kou Sheng-Zhong
Published: July 2018

(Zr0.6336Cu0.1452Ni0.1012Al0.12)100- xEr x( x = 0∼6) bulk metallic glasses were fabricated by copper mould suction casting method, and the effect of Er on properties was studied. The compressive plastic strain (εp) and compressive strength (σmax) at room temperature increases first and then decreases with the increase of Er content. The compressive plastic strain (εp) of the specimen is 35.1% when x = 2.6, which is about eight times than that of the specimen with x = 0. The compressive strength (σmax) is 2513 MPa, which is much higher than that of the specimen with x = 0. It indicates that Zr-based bulk metallic glasses could be strengthened and toughened by adding Er. The thermal stability decreases gradually and the glass-forming ability increases first and then decreases with the increase of Er content.
What Do Symmetries Tell Us about Structure?
Authors: Barrett Thomas William
Published: July 2018

Mathematicians, physicists, and philosophers of physics often look to the symmetries of an object for insight into the structure and constitution of the object. My aim in this article is to explain why this practice is successful. In order to do so, I present a collection of results that are closely related to (and, in a sense, generalizations of) Beth’s and Svenonius’s theorems.
Energy Saving and Techno-economic Assessment of Self Aspirated Domestic LPG Stove with Porous Radiant Burner
Authors: Kaushik L K , Deb S , Muthukumar P
Published: July 2018

In this paper, a comparative study on energy and cost saving in a self-aspirated domestic LPG cook-stove with porous radiant burner (SAPRB) developed by Mishra et al. [1] with reference to a conventional LPG burner (CB) using Controlled Cooking Test (CCT) and Techno-economic Assessment (TEA) is presented. CCT estimates the total energy required for the preparation of typical food items, based on average daily food intake as reported in National Sample Survey [2]. In order to make a fair comparison between SAPRB and CB, the similar dishes were prepared in parallel in both the stoves. The fuel and time required for cooking of various dishes were recorded individually. Results indicated that the cook-stove with PRB is a better choice for the replacement of conventional LPG stove due to its economic and environmental superiority. On daily basis, SAPRB resulted in average saving of 50 min cooking time and 29.46% fuel consumption. SAPRB has been found to significantly reduce the emissions of CO by 84.4% and NOx by 91.3%. TEA showed annual saving of Rs. 2025/- and the cumulative present worth of annual savings over the life of the PRB cook-stove has been found as Rs. 16572/-, which are much higher than the capital cost of the PRB cook-stove (Rs. 990/-). The calculated Internal Rate of Return (IRR) has been found to be 209.3% which is much higher than rate of return (8%). Similarly, the payback period has been found less than 6 month, which is very small considering the life of the cook-stove (10 years).
Analysis of Transformer Conditions using Triangle Duval Method
Authors: Permana S , Sumarto S , Saputra W S
Published: July 2018

Electrical or thermal failure that occurred in the transformer oil can produce a dangerous gas called gas fault. By indicating the content of dissolved gases in the transformer oil, can be obtained information about what happened to the oil so it can be estimated indication of the type and cause of the failure in the transformer. The method used to identify and analyze the dissolved gases in oil is called Dissolved Gas Analysis (DGA). In this study conducted by the DGA Duval Triangle method for transformer oil used in geothermal power plant UPJP Kamojang PT. Indonesia Power. The results using Duval Triangle method produces thermal failure and partial discharge.
Control System Flatness Fabric on Double Folding Machine
Authors: Zahri Z M , Somantri Y
Published: July 2018

Increasing the production in the industry can bring the wrong fabric quality on the process of flat rolling cloth. Needs a simulation of prototype that is used as a simulation media that has the same shape and function as the tool or unit. Jointly to know how to work control on flatness of fabric in double folding machine, so as to give description and as media of simulation in industry. Multiply doubled, with this simulation is expected to be a reference and learning in the development of tools that can help the industry to be able to process cloth at the time of production. In application can improve the quality and quantity of production. The research method used in this research. As explained diagram block diagram used is a fabric sensor that is not right, whether the position of the fabric in a tilted / uneven then the electric photo sensor will give info to the arduino to force the servo motor and then the lever to fit the position of the fabric is tilted / uneven to flat back in position. At the conclusion for the future expected to be the tools that will be generated through research will show whether through this simulation can help and develop the process of fabric in the industry.
Smart Building Lighting System
Authors: Firdaus R , Mulyana E
Published: July 2018

In a building, lighting contributes 20-60% of the total consumption of electrical energy usage. To turn on and off the lamp with the switch manually sometimes people forget to turn it off when leaving the room. This resulted in the inefficiency of energy and cost, where the lamps work not based on need. To overcome this problem designed a lighting control system using internet of things concept so that the lights can be controlled and monitored remotely. This control system is designed using Arduino Mega 2560 as a microcontroller, relays as connectors and electric breakers voltage lamp and motion sensor as a switch that turns off the lights when there is no person in the room and indicator of the activity in the room. In addition, outdoor lights are lit in accordance with a predetermined schedule for more efficient power usage. With lighting control system is expected to reduce consumption of electrical energy usage so more efficient.
Reliability Evaluation of Power Distribution System with Reliability Index Assessment (RIA)
Authors: Sucita T , Mulyadi Y , Timotius C
Published: July 2018

Distribution network system reliability is a measure of the level of service of the system of electricity supply to consumers. This study aimed to get some reliability index value of the electricity distribution network system at PT PLN (Persero) APJ Bandung, namely the failure rate, the average output time, the average annual unavailability, SAIFI, SAIDI, CAIDI, ENS and then AENS. These results will be used as a reference for determining the level of reliability of the system. Search reliability index value itself is done by way of basic data recap interference on each unit in the network (UPJ) and then calculating the index of reliability by using formulas reliability index. The results of this study, the value of reliability indices SAIFI on the system 2.02 disorders / customer / year with a target of 1.27 disorders / customer / year, while the reliability index SAIDI on the system 0.28 hours / customer / year with a target of 0.21 hours / customer / year, with these results show electric power distribution network system of PT PLN (Persero) APJ Bandung could not reach the target reliability especially SAIFI and SAIDI. The results of this study are also expected to give an idea of the level of system reliability of electric power distribution network PT PLN (Persero) APJ Bandung.
Power Transformer Interruption Analysis Based on Dissolved Gas Analysis (DGA) using Artificial Neural Network
Authors: Muthi A , Sumarto S , Saputra W S
Published: July 2018

The power transformer is an important component in the power system, as it is directly related to the reliability of the electric power system operation. Therefore, the diagnosis of disturbances in power transformers is important for device safety as well as electrical system stability. Dissolved Gas Analysis (DGA) is a disruptive diagnostic technique in power transformers that has been recognized effectively, because it provides knowledge of the state of the transformer based on the dissolved gas content in the transformer oil. The DGA test results can be represented by different methods such as Doernenburg ratio, Rogers ratio, IEC ratio, Duvals triangle, and key gases. The problem presented here is that two methods namely Doernenburg ratio and Rogers ratio, for the same data inputs give two different results from the error diagnosis to know the actual state of the transformer. In this paper, a combination method is proposed to solve the problem of conflict between Doernenburg ratio and Rogers ratio by utilizing multi-layer artificial neural network perceptron to localize and identify the error on the transformer and to select the most appropriate method.
Integrated Management Information System for Curriculum in University
Authors: Astutik I R I , Widiaty I
Published: July 2018

In university, a curriculum is one of the factors that play an important role in preparing graduated student that have High quality and qualified to compete in the era of globalization. The curriculum is also used as a reference in determining the learning achievement and also used as implementation guidelines in the faculty. Learning outcome in the curriculum Described in the courses that are used as material for study or teaching materials for lecturers. This study aims to create a management information system for curriculum that can assist the faculty, Academic Administration Bureau and Institute of Study and Development of education in Managing and evaluation a curriculum, especially when there is a new development in the curriculum. This research uses the Waterfall Software Development Life Cycle (SDLC) model for analyzing the flow of information system such as: (1) Requirement and Analysis, (2) System Design, (3) Implementation, (4) Integration and Testing, (5) Deployment of the system, (6) Maintenance. The system is also supported by twitter bootstrap framework technology that makes the system simple, easier and responsive.
Real Time Facial Recognition Using Principal Component Analysis (PCA) And EmguCV
Authors: Sultoni S , Abdullah A G
Published: July 2018

Facial recognition is a challenging research in the field of image processing and computer vision, especially for security systems, weight determiner, and emotional determination based on the face image recognition. Some of the methods that can be used in facial recognition are holistic, feature extraction, hybrids and intelligent systems. This paper used the method of characteristic extraction that used Principal Component Analysis (PCA) which was built using EmguCV application. The purpose of this research is to assess the accuracy of Principal Component Analysis (PCA) method when combined with Emgu CV in face recognition in real time. Based on the results of training and testing, it can be concluded that the PCA method combined with EmguCV has better accuracy, if the data used has the same characteristics, PCA and EmguCV can also be developed to make image processing application especially for security system, because it applies simple statistic method and easy- applied algorithm.
Phytophthora Species Detected in Two Ozark Forests with Unusual Patterns of White Oak Mortality
Authors: Reed Sharon E. , English James T. , Muzika Rose-Marie
Published: July 2018

Widespread decline and mortality of white oaks (Quercus alba) occurred in Missouri Ozark forests between 2011 and 2017. Symptoms included rapid crown death with bronzing of leaves, retention of dead leaves, crown dieback and thinning, and loss of large limbs within one year of death. Decline and mortality were associated with hillside drainages and fit descriptions of European oak forests predisposed to decline by pathogenic Phytophthora species. A survey was performed at two locations in 2014 and 2015 to assess the distribution of dead and declining white oaks, and the occurrence and distribution of Phytophthora species. Multiple Phytophthora species were detected, including P. cinnamomi, P. cactorum, P. europaea, and P. pini. P. cinnamomi was the most common and widely distributed species among plots at both locations. The detection of P. cinnamomi at the base of white oaks was not associated with poor crown vigor. However, more quantitative survey techniques are necessary to clearly evaluate this relationship. P. cinnamomi kills fine roots of white and red oaks in North America and has been associated with the decline of white oaks in the United States (Ohio) and other countries. Further studies are needed to determine the importance of P. cinnamomi in oak decline within the Ozark highlands.
Paecilomyces niveus: Pathogenicity in the Orchard and Sensitivity to Three Fungicides
Authors: Biango-Daniels Megan N. , Ayer Katrin M. , Cox Kerik D. , Hodge Kathie T.
Published: July 2018

Paecilomyces rot of apples is a postharvest disease caused by the thermotolerant fungus Paecilomyces niveus (Byssochlamys nivea). The etiology of disease and the activity of fungicides against P. niveus are not yet well understood. This study evaluated the ability of P. niveus to infect ‘Gala’ apples growing in a conventionally managed orchard. In addition, the sensitivity of P. niveus isolates to postharvest fungicides difenoconazole, fludioxonil, and pyrimethanil was characterized for isolates from both agricultural and nonagricultural environments. Apples were wounded and mock-inoculated or inoculated with P. niveus in early July. At the time of harvest, 8 weeks after wounding, the inoculated apples had significantly larger lesions than mock-inoculated apples (P < 0.005). The average diameter of lesions on wound-inoculated apples was 11.17 mm ± 6.82 SD, while the average diameter of mock-inoculated lesions was 3.34 mm ± 1.85 SD. Disease symptoms in the orchard were similar to postharvest symptoms of Paecilomyces rot. Symptoms included a brown, flattened, circular lesion with faint concentric rings. The necrosis of mesocarp was firm and roughly U-shaped. Baseline isolates of P. niveus, from nonagricultural environments, were used to determine the effective fungicide dose at which growth was inhibited by 50% (EC50). Furthermore, fungicide sensitivity of P. niveus isolates was examined using relative growth assays at the mean baseline EC50 values to compare baseline isolates with isolates obtained from commercial apple orchards where they were likely exposed to fungicides. Among the exposed isolates, reduced sensitivity to all fungicides was observed, but significant differences between baseline and exposed isolates were only observed with fludioxonil (P < 0.0001). This is the first report demonstrating that P. niveus can infect apples that are wound-inoculated in the orchard and that isolates from agricultural environments are less sensitive to common fungicides, especially fludioxonil. This finding may have implications for the control of this postharvest diseases. Whether natural infections of apples by P. niveus is initiated in the orchard or during postharvest has yet to be determined.
Isocitrate dehydrogenase 1–mutated human gliomas depend on lactate and glutamate to alleviate metabolic stress
Authors: Lenting Krissie , Khurshed Mohammed , Peeters Tom H. , van den Heuvel Corina N. A. M. , van Lith Sanne A. M. , de Bitter Tessa , Hendriks Wiljan , Span Paul N. , Molenaar Remco J. , Botman Dennis , Verrijp Kiek , Heerschap Arend , ter Laan Mark , Kusters Benno , van Ewijk Anne , Huynen Martijn A. , van Noorden Cornelis J. F. , Leenders William P. J.
Published: July 2018

Diffuse gliomas often carry point mutations in isocitrate dehydrogenase (IDH1mut), resulting in metabolic stress. Although IDHmut gliomas are difficult to culture in vitro, they thrive in the brain via diffuse infiltration, suggesting brain‐specific tumor–stroma interactions that can compensate for IDH‐1 deficits. To elucidate the metabolic adjustments in clinical IDHmut gliomas that contribute to their malignancy, we applied a recently developed method of targeted quantitative RNA next‐generation sequencing to 66 clinical gliomas and relevant orthotopic glioma xenografts, with and without the endogenous IDH‐1R132H mutation. Datasets were analyzed in R using Manhattan plots to calculate distance between expression profiles, Ward's method to perform unsupervised agglomerative clustering, and the Mann Whitney U test and Fisher's exact tests for supervised group analyses. The significance of transcriptome data was investigated by protein analysis, in situ enzymatic activity mapping, and in vivo magnetic resonance spectroscopy of orthotopic IDH1mut‐ and IDHwt‐glioma xenografts. Gene set enrichment analyses of clinical IDH1mut gliomas strongly suggest a role for catabolism of lactate and the neurotransmitter glutamate, whereas, in IDHwt gliomas, processing of glucose and glutamine are the predominant metabolic pathways. Further evidence of the differential metabolic activity in these cancers comes from in situ enzymatic mapping studies and preclinical in vivo magnetic resonance spectroscopy imaging. Our data support an evolutionary model in which IDHmut glioma cells exist in symbiosis with supportive neuronal cells and astrocytes as suppliers of glutamate and lactate, possibly explaining the diffuse nature of these cancers. The dependency on glutamate and lactate opens the way for novel approaches in the treatment of IDHmut gliomas.—Lenting, K., Khurshed, M., Peeters, T. H., van den Heuvel, C. N. A. M., van Lith, S. A. M., de Bitter, T., Hendriks, W., Span, P. N., Molenaar, R. J., Botman, D., Verrijp, K., Heerschap, A., ter Laan, M., Kusters, B., van Ewijk, A., Huynen, M. A., van Noorden, C. J. F., Leenders, W. P. J. Isocitrate dehydrogenase 1–mutated human gliomas depend on lactate and glutamate to alleviate metabolic stress. FASEB J. 33, 557–571 (2019). www.fasebj.org
Enhancement of Photodynamic Therapy for Bowen's Disease Using Plum-Blossom Needling to Augment Drug Delivery
Authors: Wu Yun , Wang Peiru , Zhang Linglin , Wang Bo , Wang Xiuli
Published: July 2018

BACKGROUND

Bowen's disease (BD) is treated effectively with 5-aminolevulinic acid (ALA)-photodynamic therapy (ALA-PDT). Plum-blossom needling (PBN) may enhance topical drug delivery.

OBJECTIVE

To compare the effects of and adverse reactions to PBN and ALA-PDT of BD with those associated with ALA-PDT alone.

MATERIALS AND METHODS

Forty-three lesions from 24 patients were randomly assigned to 2 groups. The PBN-ALA-PDT group underwent vertical skin tapping with PBN before applying 10% ALA cream and narrow-band light-emitting diode irradiation (λ = 633 ± 10 nm; 100–200 J/cm2). The ALA-PDT group received ALA cream and irradiation only.

RESULTS

At 6 weeks, the PBN-ALA-PDT and ALA-PDT groups achieved complete response (CR) rates of 77.78% (14/18 lesions) and 40% (7/20 lesions), respectively, (p < .05), and 2/18 and 10/20 lesions, respectively, achieved CRs after further treatment; 2.9 ± 0.8 sessions and 3.4 ± 0.7 sessions, respectively, were required for the lesions to achieve CRs. The PBN-ALA-PDT group required fewer treatment sessions and had higher protoporphyrin IX fluorescence levels (p < .05).

CONCLUSION

Plum-blossom needling may improve the efficacy of ALA-PDT by enhancing ALA delivery for BD treatment.
Rhinovirus Species in Children With Severe Bronchiolitis
Authors: Hasegawa Kohei , Jartti Tuomas , Bochkov Yury A. , Gern James E. , Mansbach Jonathan M. , Piedra Pedro A. , Toivonen Laura , Camargo Carlos A.
Published: July 2018

In this analysis of 2 prospective multicenter, multi-year cohorts of children hospitalized for bronchiolitis in the United States and Finland, 306 rhinovirus infections were genotyped. Rhinovirus-A and -C species were predominant in the US study, while rhinovirus-C species was predominant in the Finland study. In both cohorts, there were no significant between-species differences in clinical characteristics, including acute severity measures.
Assessing Cochlear Implant Performance in Older Adults Using a Single, Universal Outcome Measure Created With Imputation in HERMES
Authors: Sharma Rahul K. , Chen Stephanie Y. , Grisel Jedidiah , Golub Justin S.
Published: July 2018

Objective:

In the era of big data, it is critical to aggregate results across different institutions. This is a major challenge for cochlear implant (CI) research given multiple, incompatible outcome measures. We use a large, national CI database to develop a formula to convert between the two most common measures: Consonant-Nucleus-Consonant word (CNCw) and Arizona Biomedical (AzBio). We then use this tool to analyze hearing outcomes in older adults with a single, universal outcome measure.

Study Design:

Analysis of a prospective, national cochlear implant database (HERMES).

Setting:

Multicentered, 32 US private practice and academic medical centers.

Patients:

CI subjects (n = 386, n = 430 ears; 10–102 years old; mean: 65).

Main Outcome Measure(s):

CNCw, AzBio.

Results:

Univariable linear regression equations were generated relating CNCw and AzBio scores at each time-point. Correlation (R2) was 0.71 (3 mo), 0.69 (6 mo), 0.63 (12 mo), and 0.56 (24 mo) (all p < 0.01). Using these equations, missing outcomes (CNCw, n = 83 or AZBio, n = 96) were imputed (calculated). The average absolute difference between observed and imputed CNCw (when both present) was 10.5% (95% CI = 9.8–11.3). On multivariable regression, age was not a significant predictor of CNCw (p = 0.38) after controlling for sex, hearing loss duration, use, and postoperative follow-up duration.

Conclusions:

We generated simple linear regression equations to calculate CNCw scores from AzBio, and vice versa, with good accuracy. This allowed one of the largest analyses of CI performance in older adults to date. We confirm that older age is not a significant predictor of performance when controlling for confounders.
The Microbiome and Pancreatic Cancer
Authors: Archibugi Livia , Signoretti Marianna , Capurso Gabriele
Published: July 2018

Many risk factors for pancreatic cancer are related with microbiome alteration. In the past few years, the human microbiome and its relation with the immune system have been linked with carcinogenesis of different organs distant from the gut, including the pancreas. Patterns of oral microbiome associated with periodontitis are associated with an increased risk of pancreatic cancer, possibly because of the increased systemic inflammatory response, or to the capacity of some specific bacteria to alter the host immune response, making it more favorable to cancer cells. Helicobacter pylori infection when affecting the gastric body mucosa with subsequent hypochlorhydria also seems associated with an increased risk of pancreatic cancer. The composition of the intestinal microbiome is different in animal models and in humans with pancreatic cancer who have a distinct microbiome population compared with controls. Some specific bacteria can migrate from the intestine to the pancreas, and their ablation restores the immune system activity through its reprogramming with a switch toward a Th1 response and displays a protective effect toward tumor growth. More research in this area might lead to progress in terms of pancreatic cancer prevention and treatment, possibly in association with immunotherapy.
Effect of Consent and Educational Adjuncts to Consent on Patient Perceptions About Colonoscopy
Authors: Fudman David I. , Papamichael Konstantinos , Roemi Lilach , Rao Varun , Falchuk Kenneth R. , Leffler Daniel A. , Feuerstein Joseph D.
Published: July 2018

Background and Aims:

Informed consent is a vital preprocedural step for endoscopy but there are substantial variations in its delivery. We therefore sought to assess a multifaceted intervention to improve the consent process.

Methods:

Gastroenterologists at a tertiary center were educated on the recommended components of informed consent. Following this, 3 cohorts of patients undergoing colonoscopy were surveyed before and after consent. In one cohort, the effect of optimized verbal consent alone was assessed. In the second and third groups, the effects of the addition of either a handout or a video describing colonoscopy and its risks were evaluated. The primary outcomes were the changes between preconsent and postconsent survey responses regarding confidence in understanding the procedure’s purpose, likelihood of adverse events, and levels of anxiety.

Results:

In total, 240 patients were included with 79 to 81 patients per group. There were no significant differences among the groups’ survey responses. Compared with patients receiving verbal consent alone, fewer patients in the handout and video groups increased their perceived risk of adverse events following consent, but this difference did not reach significance (P=0.08). Examining all groups together, anxiety levels changed significantly after consent (P=0.003), with 31% of patients reducing their anxiety level, 8% increasing it, and 62% having no change.

Conclusions:

The consent process appears to decrease patient anxiety about colonoscopy. When used in conjunction with a high-quality verbal consent, written or video educational adjuncts provided on the day of colonoscopy likely have no effect on patient perceptions.
A New Data Resource to Examine Meals on Wheels Clients’ Health Care Utilization and Costs
Authors: Shan Mingyang , Gutman Roee , Dosa David , Gozalo Pedro L. , Ogarek Jessica A. , Kler Sarah , Thomas Kali S.
Published: July 2018

Background:

Access to social services (eg, nutrition) can impact older adults’ health care utilization and health outcomes. However, data documenting the relationship between receiving services and objective measures of health care utilization remain limited.

Objectives:

To link Meals on Wheels (MOW) program data to Medicare claims to enable examination of clients’ health and health care utilization and to highlight the utility of this linked dataset.

Research Design:

Using probabilistic linking techniques, we matched MOW client data to Medicare enrollment and claims data. Descriptive information is presented on clients’ health and health care utilization before and after receiving services from MOW.

Subjects:

In total, 29,501 clients were from 13 MOW programs.

Measures:

Clients’ demographics, chronic conditions, and hospitalization, emergency department (ED), and nursing home (NH) utilization rates.

Results:

We obtained a one-to-one link for 25,279 clients. Among these, 14,019 were Medicare fee-for-service (FFS) beneficiaries and met inclusion criteria for additional analyses. MOW clients had high rates of chronic conditions (eg, almost 90% of FFS clients were diagnosed with hypertension, compared with 63% of FFS beneficiaries in their communities). In the 6 months before receiving MOW services, 31.6% of clients were hospitalized, 24.9% were admitted to the ED and 13% received care in a NH. In the 6 months after receiving meals, 24.2% were hospitalized, 19.3% were admitted to the ED, and 9.5% received care in a NH.

Conclusions:

Linking MOW data to Medicare claims has the potential to shed additional light on the relationships among social services, health status, health care use, and benefits to clients’ well-being.
Uterine PEComas
Authors: Bennett Jennifer A. , Braga Ana C. , Pinto Andre , Van de Vijver Koen , Cornejo Kristine , Pesci Anna , Zhang Lei , Morales-Oyarvide Vicente , Kiyokawa Takako , Franco Zannoni Gian , Carlson Joseph , Slavik Tomas , Tornos Carmen , Antonescu Cristina R. , Oliva Esther
Published: July 2018

Uterine perivascular epithelioid cell tumors (PEComas) are rare neoplasms that may show overlapping morphology and immunohistochemistry with uterine smooth muscle tumors. In this study, we evaluated the morphologic, immunohistochemical, and molecular features of 32 PEComas, including 11 with aggressive behavior. Two distinct morphologies were observed: classic (n=30) and those with a lymphangioleiomyomatosis appearance (n=2). In the former, patients ranged from 32 to 77 (mean: 51) years and 13% had tuberous sclerosis. Tumors ranged from 0.2 to 17 (mean: 5.5) cm with 77% arising in the corpus. Epithelioid cells were present in 100% and a spindled component was seen in 37%. Nuclear atypia was low (53%), intermediate (17%), or high (30%). Mitoses ranged from 0 to 36 (mean: 6) and 0 to 133 (mean: 19) per 10 and 50 high-power fields, with atypical mitoses present in 30%. Thin and delicate vessels were noted in 100%, clear/eosinophilic and granular cytoplasm in 93%, stromal hyalinization in 73%, necrosis in 30%, and lymphovascular invasion in 10%. All tumors were positive for HMB-45, cathepsin K, and at least one muscle marker, with most expressing melan-A (77%) and/or MiTF (79%). A PSF-TFE3 fusion was identified in one while another showed a RAD51B-OPHN1 fusion. Follow-up ranged from 2 to 175 (mean: 41) months, with 63% of patients alive and well, 20% dead of disease, 13% alive with disease, and 3% dead from other causes. In the latter group (n=2), patients were 39 and 49 years old, one had tuberous sclerosis, while the other had pulmonary lymphangioleiomyomatosis. Both tumors expressed HMB-45, cathepsin K, and muscle markers, but lacked TFE3 and RAD51B rearrangements. The 2 patients are currently alive and well. Application of gynecologic-specific criteria (≥4 features required for malignancy: size ≥5 cm, high-grade atypia, mitoses >1/50 high-power fields, necrosis, and lymphovascular invasion) for predicting outcome misclassified 36% (4/11) of aggressive tumors; thus, a modified algorithm with a threshold of 3 of these features is recommended to classify a PEComa as malignant.
Consistent Amplification of FRS2 and MDM2 in Low-grade Osteosarcoma
Authors: He Xin , Pang Zongguo , Zhang Xianliang , Lan Ting , Chen Huijiao , Chen Min , Yang Hong , Huang Juan , Chen Yihua , Zhang Zhang , Jing Wenyi , Peng Ran , Zhang Hongying
Published: July 2018

Low-grade osteosarcoma (LGOS) encompasses low-grade central osteosarcoma (LGCOS) and parosteal osteosarcoma (POS). LGOSs are characterized by a supernumerary ring and giant rod chromosomes containing the 12q13-15 amplicon. The fibroblast growth factor receptor substrate 2 (FRS2) gene is located close toMDM2andCDK4. Recent studies identified consistent amplification ofFRS2gene in atypical lipomatous tumor/well-differentiated liposarcoma and dedifferentiated liposarcoma. The aim of this study was to evaluate the frequency ofFRS2amplification and its relationship with the clinicopathologic features of LGOSs. The amplification ofFRS2andMDM2genes were analyzed by fluorescence in situ hybridization using 22 LGOSs (3 LGCOSs, 14 classic POSs, and 5 dedifferentiated POSs) and 85 control samples of bone and soft tissue. The clinicopathologic features of the 22 LGOSs were described. Amplification ofFRS2was detected in 21/22 (95%) of the LGOSs, including 3 (100%) LGCOSs and 18 (95%) POSs. All 22 LGOSs showedMDM2amplification (100%). The onlyMDM2+/FRS2−LGOS was dedifferentiated POS (the dedifferentiated component was conventional osteosarcoma). In the control group, all of the atypical lipomatous tumor/well-differentiated liposarcoma/dedifferentiated liposarcomas (DDLs) (10/10, 100%) wereFRS2-amplified, whereas the remaining 75 control cases wereFRS2-nonamplified. These findings indicate that theFRS2gene is consistently amplified in classic and dedifferentiated LGOSs but not in their histologic mimics. These results offer another avenue for investigating the biology of LGOSs. WhetherFRS2-nonamplified tumors exhibit unusual clinicopathologic features needs further investigation. Some so-called “high-grade osteosarcomas harboring 12q13-15 amplification” may be unrecognized dedifferentiated LGOSs.
Treatment of Apert Hand Syndrome: Strategies for Achieving a Five-Digit Hand
Authors: Raposo-Amaral Cassio Eduardo , Denadai Rafael , Furlan Pedro , Raposo-Amaral Cesar Augusto
Published: July 2018

Background:

Apert hand reconstruction requires complex surgical planning. The purpose of this study was to describe the authors’ 8-year surgical experience with Apert syndrome hand reconstruction, and provide specific surgical strategies for achieving a five-digit hand in Upton type I and II hands.

Methods:

A retrospective analysis of consecutive Apert syndrome patients who underwent web-space releases between 2007 and 2015 was performed. Demographic, surgical, and outcome data were verified through medical records, clinical photographs, radiographic images, and patient interviews.

Results:

A total of 41 Apert syndrome patients [23 boys (56.1 percent) and 18 girls (43.9 percent)] have been treated at our hospital since 2007. A five-digit hand was achieved in all patients (100 percent) with Upton type I and II hands, and in eight patients (72.7 percent) with Upton type III hands. A four-digit hand was obtained in three of 11 patients (27.3 percent) with Upton type III hands. Four of 20 patients (25 percent) with Upton type I hands, three of 10 patients (30 percent) with Upton type II hands, and six of 11 patients (54.5 percent) with Upton type III hands required subsequent revision for aesthetic reasons.

Conclusions:

Upton type III hands have demonstrated higher revision rates than type I and II hands, regardless of whether a four- or five-digit hand is obtained. Treatment strategies for Apert syndrome hands based on hand type are offered to guide four–web-space release in all patients with Upton type I and II hands.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
How to Identify Organizational High-Alert Medications
Authors: Schepel Lotta , Lehtonen Lasse , Airaksinen Marja , Lapatto-Reiniluoto Outi
Published: July 2018

Objectives

High-alert medications may cause significant patient harm when used in error. Hospital-specific safety data should be used to customize high-alert medication lists to fit the local context. The aim of this study was to identify organizational high-alert medications by evaluating university hospital’s data on adverse drug reaction (ADR) and medication error (ME).

Methods

The Anatomical Therapeutic Chemical (ATC) codes and top active substances in ADR (n = 401) and ME (n = 11,668) reports of Helsinki University Hospital from 2015–2016 were analyzed and compared with hospitals’ drug consumption and the Institute for Safe Medication Practices’ (ISMP) list of high-alert medications.

Results

The top ATC groups and active substances in ADR and ME reports were not similar. The most numerous ATC groups were L, antineoplastic and immunomodulating agents (30%) in ADRs and N, nervous system (26%) in MEs. According to ADR and ME reports, several high-alert medications from Institute for Safe Medication Practices’ lists, such as antineoplastic agents, antithrombotics, opioids, and insulins, should be considered high-alert medications also in Helsinki University Hospital. Although no ADR reports of amphotericin B existed, it had the highest number of MEs causing severe/moderate harm or unexpected reactions relative to its consumption.

Conclusions

To identify organizational high-alert medications, both drug safety information and medication safety information should be used. Adverse drug reaction and ME data are needed to recognize high-alert medications, but these should also be combined with a literature search and local expert opinions.