bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantum dynamics of the intramolecular vibrational energy redistribution in OCS: From localization to quasi-thermalization
Authors: Pérez J. B. , Arce J. C.
Published: June 2018

We report a fully quantum-dynamical study of the intramolecular vibrational energy redistribution (IVR) in the electronic ground state of carbonyl sulfide, which is a prototype of an isolated many-body quantum system with strong internal couplings and non-Rice-Ramsperger-Kassel-Marcus (RRKM) behavior. We pay particular attention to the role of many-body localization and the approach to thermalization, which currently are topics of considerable interest, as they pertain to the very foundations of statistical mechanics and thermodynamics. We employ local-mode (valence) coordinates and consider initial excitations localized in one local mode, with energies ranging from low to near the dissociation threshold, where the classical dynamics have been shown to be chaotic. We propagate the nuclear wavepacket on the potential energy surface by means of the numerically exact multiconfiguration time-dependent Hartree method and employ mean local energies, time-dependent and time-averaged populations in quantum number space, energy distributions, entanglement entropies, local population distributions, microcanonical averages, and dissociation probabilities, as diagnostic tools. This allows us to identify a continuous localization → delocalization transition in the energy flow, associated with the onset of quantum chaos, as the excitation energy increases up to near the dissociation threshold. Moreover, we find that at this energy and ∼1 ps the molecule nearly thermalizes. Furthermore, we observe that IVR is so slow that the molecule begins to dissociate well before such quasi-thermalization is complete, in accordance with earlier classical-mechanical predictions of non-RRKM behavior.
The stability of the contact interface of cylindrical and spherical shock tubes
Authors: Crittenden Paul E. , Balachandar S.
Published: June 2018

The stability of the contact interface for radial shock tubes is investigated as a model for explosive dispersal. The advection upstream splitting method with velocity and pressure diffusion (AUSM+-up) is used to solve for the radial base flow. To investigate the stability of the resulting contact interface, perturbed governing equations are derived assuming harmonic modes in the transverse directions. The perturbed harmonic flow is solved by assuming an initial disturbance and using a perturbed version of AUSM+-up derived in this paper. The intensity of the perturbation near the contact interface is computed and compared to theoretical results obtained by others. Despite the simplifying assumptions of the theoretical analysis, very good agreement is observed. Not only can the magnitude of the instability be predicted during the initial expansion, but also remarkably the agreement between the numerical and theoretical results can be maintained through the collision between the secondary shock and the contact interface. Since the theoretical results only depend upon the time evolution of the base flow, the stability of various modes could be quickly investigated without explicitly solving a system of partial differential equations for the perturbed flow.
Spin-current coherence peak in superconductor/magnet junctions
Authors: Umeda Maki , Shiomi Yuki , Kikkawa Takashi , Niizeki Tomohiko , Lustikova Jana , Takahashi Saburo , Saitoh Eiji
Published: June 2018

Coherence peak effects in a superconductor induced by a thermal spin current are reported. We measured inverse spin Hall effects induced by spin injection from a ferrimagnetic insulator Y3Fe5O12 into a superconductor NbN using longitudinal spin Seebeck effects. In the vicinity of the superconducting transition temperature of the NbN, a large enhancement of the spin Seebeck voltage is observed, whose sign is opposite to that for the vortex Nernst effect, but is consistent with a calculation for a coherence peak effect in the superconductor NbN.
Mechanical properties of drug loaded diblock copolymer bilayers: A molecular dynamics study
Authors: Grillo Damián A. , Albano Juan M. R. , Mocskos Esteban E. , Facelli Julio C. , Pickholz Mónica , Ferraro Marta B.
Published: June 2018

In this work, we present results of coarse-grained simulations to study the encapsulation of prilocaine (PLC), both neutral and protonated, on copolymer bilayers through molecular dynamics simulations. Using a previously validated membrane model, we have simulated loaded bilayers at different drug concentrations and at low (protonated PLC) and high (neutral PLC) pH levels. We have characterized key structural parameters of the loaded bilayers in order to understand the effects of encapsulation of PLC on the bilayer structure and mechanical properties. Neutral PLC was encapsulated in the hydrophobic region leading to a thickness increase, while the protonated species partitioned between the water phase and the poly(ethylene oxide)-poly(butadiene) (PBD) interface, relaxing the PBD region and leading to a decrease in the thickness. The tangential pressures of the studied systems were calculated, and their components were decomposed in order to gain insights on their compensation. In all cases, it is observed that the loading of the membrane does not significantly decrease the stability of the bilayer, indicating that the system could be used for drug delivery.
Reference Correlation for the Viscosity of Ammonia from the Triple Point to 725 K and up to 50 MPa
Authors: Monogenidou S. A. , Assael M. J. , Huber M. L.
Published: June 2018

This paper presents a new wide-ranging correlation for the viscosity of ammonia based on critically evaluated experimental data. The correlation is designed to be used with a recently developed equation of state, and it is valid from the triple point to 725 K at pressures up to 50 MPa. The estimated uncertainty varies depending on the temperature and pressure, from 0.6% to 5%. The correlation behaves in a physically reasonable manner when extrapolated to 100 MPa; however, care should be taken when using the correlation outside of the validated range.
Omega-3 fatty acids and meloxicam supplementation and the incidence and histopathological changes associated with femoral head syndrome in broilers
Authors: Sooksong Suriya , Pirarat Nopadon , Angkanaporn Kris
Published: June 2018

Femoral head separation (FHS) is one of the problems commonly found in fast growing-type broilers that resulted in joint inflammation leading to lameness and poor animal welfare. This study aimed to examine the alimentary effects of omega-3 fatty acids (DHA) and meloxicam on the incidence of FHS in relation with changes in pathological features and serum concentrations of TNFα and IL1β in broilers. A total number of 1152 male day-old Cobb 500 broilers were divided into four groups. The chicks in T1 (Control) received the basal diet. Chicks in T2 to T4 were given burden of a modified speed bump, in which the chicks in T2 received the basal diet, and the chicks in T3 and T4 received 2% All-G-Rich (16% DHA) in the basal diet and meloxicam in drinking water (0.5 mg/kg BW) during Days 22–43 of age, respectively. It was demonstrated that the incidence of FHS in T4 was the smallest (P < 0.05) among groups although the incidence of FHS was not increased by modified speed bump itself. Although BW (and average daily gain) in T3 was the smallest, but the incidence of FHS was not decreased. An osteochondrosis cleft during histopathological examination could be detected even in the normal gross lesions. Serum concentrations in TNFα and IL1β were not different among groups. In conclusion, meloxicam as an anti-inflammatory drug was useful to alleviate the gross pathological changes of FHS whereas DHA was not effective at the used dosage. Studies on histopathological changes at the beginning of FHS lesion are necessary.
Meat and carcass quality of Dexter cattle compared with that of suckler, Charolais-cross calves: a preliminary study
Authors: Giller K. , Gangnat I. D. M. , Silacci P. , Messadene-Chelali J. , Kreuzer M. , Berard J.
Published: June 2018

Tenderness, flavour and colour are the most important quality traits of beef that are influenced by breed and age. Suckler calves (SC) produce very tender, high-quality meat. Extensively growing, small-framed breeds are known for high-quality beef, but information about the particularly small Dexter cattle (D) is yet unavailable. Eight D and seven Charolais-crossbreed SC were kept for 11 weeks on alpine pastures to be able to compare their meat quality. The SC were kept with their dams. The animals of the two breeds were slaughtered at different ages (D: 15 months and SC: 7 months) consistent with their respective production system conventions. Although this meant that age and breed effects were confounded, slaughter took place at the same carcass fatness score, thereby avoiding a confounding effect on meat quality. Quality of the carcass and of two muscles (M. biceps femoris, M. longissimus thoracis) was analysed. Despite being older, D had lower body and carcass weights, dressing percentage and bodyweight gains than SC. Dexter meat was darker than SC meat. Shear force did not differ between D and SC in the M. longissimus thoracis but was higher in the M. biceps femoris from D than from SC. Sensory analysis by a trained panel demonstrated an overall preference for D meat, associated with more favourable flavour and juiciness. Tenderness was not rated differently. Despite the unfavourable darker colour of D compared with SC meat, its characteristic flavour might attract consumers in a high-price niche market. For a more comprehensive characterisation, sensory evaluation of additional muscles is required. Additional measurements on a larger number of animals and muscles are required.
Genotype × management strategies to stabilise the flowering time of wheat in the south-eastern Australian wheatbelt
Authors: Flohr B. M. , Hunt J. R. , Kirkegaard J. A. , Evans J. R. , Lilley J. M.
Published: June 2018

Growers in the wheatbelt of south-eastern Australia need increases in water-limited potential yield (PYw) in order to remain competitive in a changing climate and with declining terms of trade. In drought-prone regions, flowering time is a critical determinant of yield for wheat (Triticum aestivum L.). Flowering time is a function of the interaction between management (M, establishment date), genotype (G, development rate) and prevailing seasonal conditions. Faced with increasing farm size and declining autumn rainfall, growers are now sowing current fast-developing spring wheat cultivars too early. In order to widen the sowing window and ensure optimum flowering dates for maximum yield, new G × M strategies need to be identified and implemented. This study examined the effect of manipulating genotype (winter vs spring wheat and long vs short coleoptile) and management (sowing date, fallow length and sowing depth) interventions on yield and flowering date in high-, medium- and low-rainfall zones in south-eastern Australia. Twelve strategies were simulated at nine sites over the period 1990–2016. At all sites, the highest yielding strategies involved winter wheats with long coleoptiles established on stored subsoil moisture from the previous rotation, and achieved a mean yield increase of 1200 kg/ha or 42% relative to the baseline strategy. The results show promise for winter wheats with long coleoptiles to widen the sowing window, remove the reliance on autumn rainfall for early establishment and thus stabilise flowering and maximise yield. This study predicts that G × M strategies that stabilise flowering may increase PYw.
Recovery from short-term complete submergence in temperate pasture grasses
Authors: Striker Gustavo G. , Ploschuk Rocío A.
Published: June 2018

The ability to recover from the impact of short-term submergence was assessed on four widely used grasses in pastures: Dactylis glomerata L., Bromus catharticus Vahl., Schedonorus arundinaceus Schreb. (syn. Festuca arundinacea) and Phalaris aquatica L. Six-week-old plants were subjected to a 5-day complete submergence in clear water, followed by a 15-day recovery period. Dry mass after submergence, shoot and root growth, number of tillers per plant, leaf stomatal conductance and leaf greenness during recovery were assessed. Dactylis glomerata and B. catharticus were sensitive to submergence, showing very low relative growth rate (RGR) of shoots and roots during recovery (37–67% lower than controls) along with early leaf senescence and persistent partial stomatal closure. Schedonorus arundinaceus exhibited an intermediate tolerance, sustaining high RGR of shoots (similar to controls) and fully adjusting its leaf functionality during recovery despite being affected during submergence (40% decrease in dry mass and 37% in tiller number). Phalaris aquatica performed outstandingly, with dry mass unaffected by submergence, and unaltered stomatal conductance, leaf greenness, tillering and shoot growth during recovery. Therefore, in areas where flooding can often cause plant submergence, P. aquatica is recommended whereas the other species are not, because they may be outcompeted by flood-tolerant species.
Ability of wild rabbit, Oryctolagus cuniculus, to lactate successfully in hot environments explains continued spread in Australia
Authors: Cooke B. D. , Brennan M. , Elsworth P.
Published: June 2018

Context European rabbits evolved in Spain and Portugal and are adapted to winter-rainfall Mediterranean habitats. On introduction into Australia in 1859, wild rabbits quickly colonised similar habitats across the southern two-thirds of the continent. However, over the past 40 years, they have spread further into monsoonal savanna habitats in northern Queensland. Aims To explain this, we considered adaptive responses of wild rabbits to hot conditions, particularly potential mechanisms for reducing the heat load of lactation, which has been identified as a likely limiting factor. Methods We analysed data from captive wild rabbits to identify mechanisms that could potentially reduce lactational heat load, and obtained data from shot samples of wild rabbits from northern Queensland to determine which of these might be most important in the field. Key results Rabbits spread food intake evenly across the 20-day lactation period and under hot conditions, captive wild individuals used body reserves to meet energy requirements for lactation, which is more energy efficient than converting digestible foods to milk. Conclusions This strategy reduces the heat load of lactation, enabling rabbits to suckle young successfully under hot conditions, but it comes at a cost. Rabbits need extra body reserves before breeding and need to regain those reserves between litters. Implications The slow spread of rabbits into Australia’s monsoonal savannas is likely to continue, given the rabbit’s reproductive flexibility and further natural selection for breeding in this environment.
A corpus-based study of the human impersonal pronoun ('n) mens in Afrikaans
Authors: Van Olmen Daniël , Breed Adri , Verhoeven Ben
Published: June 2018

This article compares the grammaticalizing human impersonal pronoun ('n) mens in Afrikaans to fully grammaticalized men and non-grammaticalized een mens in Dutch. It is shown that 'n mens and een mens can still be used lexically, unlike mens and men, and that ('n) mens and een mens are restricted to non-referential indefinite, universal-internal uses while men exhibits the whole range of (non-) referential indefinite ones. Despite the latter’s presence in the earliest Afrikaans data, it is argued not to have influenced the development of ('n) mens. This pronoun and Dutch een mens are also found to have syntactic functions other than subjecthood, unlike men. The contrast is attributed to their different degrees of grammaticalization. Lastly, the Afrikaans ‘man’-pronoun is shown to differ from its Dutch counterparts in relying on the second person singular for suppletion, though forms of ('n) mens are found to occasionally occur instead.
What kind of evaluative states are emotions? The attitudinal theory vs. the perceptual theory of emotions
Authors: Rossi Mauro , Tappolet Christine
Published: June 2018

This paper argues that Deonna and Teroni's attitudinal theory of emotions faces two serious problems. The first is that their master argument fails to establish the central tenet of the theory, namely, that the formal objects of emotions do not feature in the content of emotions. The second is that the attitudinal theory itself is vulnerable to a dilemma. By pointing out these problems, our paper provides indirect support to the main competitor of the attitudinal theory, namely, the perceptual theory of emotions.
Mindfulness mediates the relationship between mental toughness and pain catastrophizing in cyclists
Authors: Jones Martin I. , Parker John K.
Published: June 2018

The purpose of this study was to examine the direction and magnitude of the relationship between mental toughness and pain catastrophizing and to explore whether mindfulness mediated this relationship. The design of the study was cross‐sectional using self‐report data. We recruited 142 recreational cyclists (female = 32) via online cycling forums. We asked participants to complete measures of mental toughness, dispositional mindfulness, and pain catastrophizing. Following the initial screening of data and the identification of non‐normality and outliers, we calculated robust correlations and regressions to examine the size and direction of effects. Results revealed that mindfulness partially mediated a moderate negative relationship between mental toughness and pain catastrophizing. These results are consistent with prior theory regarding positive traits and their negative association with pain catastrophizing. Unique contributions included showing that mental toughness and mindfulness are positively associated and that mindfulness is negatively associated with pain catastrophizing in this sample of cyclists.
Creatine kinase, neuromuscular fatigue, and the contact codes of football: A systematic review and meta‐analysis of pre‐ and post‐match differences
Authors: Hagstrom Amanda D. , Shorter Kathleen A.
Published: June 2018

Physiological or performance tests are routinely utilised to assess athletes’ recovery. At present, the ideal tool to assess recovery remains unknown. Therefore, the aim of this systematic review was to examine the change in creatine kinase (CK) and neuromuscular function as measured via a countermovement jump (CMJ) following a match in the contact codes of football. A comprehensive search of databases was undertaken with RevMan (V 5.3) used for statistical analysis. Our results demonstrated that CK pre‐ versus post‐match (standardised mean difference (SMD) = 0.90, 95% CI = 0.50 to 1.31, p < .0001), CK pre‐ versus 24 h post‐match (SMD = 1.50, 95% CI = 1.12 to 1.88, p < .00001), and CK pre‐ versus 48 h post‐match all increased significantly (SMD = 0.90, 95% CI = 0.50 to 1.31, p < .0001), while CMJ peak power (PP) pre‐ versus post‐match (SMD = −0.59, 95% CI = −1.12 to −0.06, p = .03), and pre‐ versus 24 h post‐match (SMD = −0.80, 95% CI = −1.31 to −0.28, p = .002) decreased significantly. There was a significant relationship between the change in CK and the change in CMJ PP from immediately pre to immediately post (r = −0.924, p = .025), and between CMJ immediately following a match and 24 h CK change (r = −0.983, p = .017). In conclusion, CK levels increase and performance in the CMJ decreases following a match of a contact code of football. The identification of this relationship may allow coaching staff to implement a standalone measure of recovery.
The social policy agendas of populist radical right parties in comparative perspective
Authors: Fenger Menno
Published: June 2018

In many European countries and in the US, populist right-wing parties are gaining ground. The political agenda of these parties is dominated by their reluctant or even out-right hostile position against migration and foreigners and a strong emphasis on nationalist values in combination with an anti-globalisation economic agenda. In most cases, the social agenda of the radical right parties and politicians are more ambiguous and less clearly explicated. These parties rely on working class ‘insiders’ and therefore may be expected to oppose austerity measures, but at that same time have firm opinions about deservingness and conditionality that may sometimes harm the interests of their voters. This article sets out to explore the social policy agenda of radical right parties in six different countries: the US, Sweden, the Netherlands, Belgium, Germany and France. The article uses content analysis of speeches and party manifestos as its main method of data analysis.
Performance of Surveillance Case Definitions in Detecting Respiratory Syncytial Virus Infection Among Young Children Hospitalized With Severe Respiratory Illness—South Africa, 2009–2014
Authors: Rha Brian , Dahl Rebecca M , Moyes Jocelyn , Binder Alison M , Tempia Stefano , Walaza Sibongile , Bi Daoling , Groome Michelle J , Variava Ebrahim , Naby Fathima , Kahn Kathleen , Treurnicht Florette , Cohen Adam L , Gerber Susan I , Madhi Shabir A , Cohen Cheryl
Published: June 2018

Analyses of hospital-based sentinel surveillance for acute lower respiratory infection in children aged <5 years in South Africa revealed that a fever-based case definition for severe acute respiratory infection had low sensitivity for identifying RSV-positive cases, particularly in young infants.
Two planetary systems with transiting Earth-sized and super-Earth planets orbiting late-type dwarf stars
Authors: Díez Alonso E , González Hernández J I , Suárez Gómez S L , Aguado D S , González Gutiérrez C , Suárez Mascareño A , Cabrera-Lavers A , González-Nuevo J , Toledo–Padrón B , Gracia J , de Cos Juez F J , Rebolo R
Published: June 2018

We present two new planetary systems found around cool dwarf stars with data from the K2 mission. The first system was found in K2-239 (EPIC 248545986), characterized in this work as M3.0V and observed in the 14th campaign of K2. It consists of three Earth-sized transiting planets with radii of 1.1, 1.0, and 1.1 R⊕, showing a compact configuration with orbital periods of 5.24, 7.78, and 10.1 d, close to 2:3:4 resonances. The second was found in K2-240 (EPIC 249801827), characterized in this work as M0.5V and observed in the 15th campaign. It consists of two transiting super-Earths with radii 2.0 and 1.8 R⊕ and orbital periods of 6.03 and 20.5 d. The equilibrium temperatures of the atmospheres of these planets are estimated to be in the range of 380–600 K and the amplitudes of signals in transmission spectroscopy are estimated at ∼10 ppm.
Independent Associations With 30- and 90-Day Unplanned Readmissions After Elective Lumbar Spine Surgery: A National Trend Analysis of 144 123 Patients
Authors: Elsamadicy Aladine A , Ren Xinru , Kemeny Hanna , Charalambous Lefko , Sergesketter Amanda R , Rahimpour Shervin , Williamson Theresa , Goodwin C Rory , Abd-El-Barr Muhammad M , Gottfried Oren N , Xie Jichun , Lad Shivanand P
Published: June 2018

BACKGROUND

Unplanned hospital readmissions contribute significantly to soaring national healthcare expenditures. To alleviate this burden, Centers for Medicare and Medicaid Services implemented initiatives to penalize hospitals for unplanned 30-d hospital readmissions. There is a paucity of data identifying patient risk factors independently associated with 30- and 90-d readmissions.

OBJECTIVE

To investigate similarities in patient risk factors associated with 30- and 90-d unplanned readmissions following elective lumbar spine surgery.

METHODS

The National Readmission Database (NRD) was queried to identify patients undergoing elective lumbar spine surgery between 2013 and 2014. Patients were grouped by no readmission (Non-R), unplanned readmission within 30 days (30-R), and unplanned readmission within 31 to 90 days (90-R). Multivariate analysis determined factors associated with 30- and 90-d readmissions.

RESULTS

We identified 144 123 patients with 10 592 (7.3%) patients experiencing an unplanned readmission (30-R: n = 7228 [5.0%]; 90-R: n = 3364 [2.3%]; Non-R: n = 133 531). The most common inpatient complication observed in those patients readmitted was dural tear (30-R: 7.7%, 90-R: 4.6%, Non-R: 4.3%). The most prevalent 30- and 90-d complication seen among the readmitted cohort was infection (30-R: 18.5%, 90-R: 7.4%). In multivariate regression analysis, age, insurance status, chronic obstructive pulmonary disorder (COPD), depression, hypertension, diabetes, deficiency anemia, and obesity were independently associated with 30-d readmission; however, age and obesity were not independently associated with 90-d readmission.

CONCLUSION

Our study demonstrated national unplanned readmission rates after elective spinal surgery to be 7.3%. With age, insurance status, COPD, depression, hypertension, diabetes, deficiency anemia, obesity, and depression all independently associated with unplanned hospital readmission. Future solutions that focus on reducing preventable readmissions may improve patient outcomes and reduce healthcare costs.
Brain Tectal Tumors: A Flexible Approach
Authors: Perin Alessandro , Galbiati Tommaso Francesco , Casali Cecilia , Legnani Federico Giuseppe , Mattei Luca , Prada Francesco Ugo , Saini Marco , Saladino Andrea , Riker Nicole , DiMeco Francesco
Published: June 2018

BACKGROUND AND IMPORTANCE

Mesencephalic tectal gliomas represent a subset of midbrain tumors, which are more frequent in children than in adults. They usually become symptomatic when causing hydrocephalus by occluding the aqueduct. Because of their slow progression, due to their benign histology, they are characterized by a relatively good prognosis, although hydrocephalus might jeopardize patients’ prognosis. Treatment is usually represented by cerebrospinal fluid diversion associated or not with biopsy.

CLINICAL PRESENTATION

We report 2 illustrative cases of tectal gliomas in adults where endoscopic third ventriculostomy (ETV) and simultaneous endoscopic biopsy were obtained during the same operation by means of a single burr hole with a flexible endoscope.

CONCLUSION

We recommend using this overlooked neurosurgical tool for such cases, since it allows the surgeon to safely perform an ETV, then judge whether biopsy can be done or not, without harming the patient, and possibly achieving an important piece of information (histopathological diagnosis) to manage this subset of oncological patients.
Development and Implementation of an Inexpensive, Easily Producible, Time Efficient External Ventricular Drain Simulator Using 3-Dimensional Printing and Image Registration
Authors: Bow Hansen , He Le , Raees Muhammad Aanish , Pruthi Sumit , Chitale Rohan
Published: June 2018

BACKGROUND

External ventricular drain (EVD) placement is one of the most commonly performed procedures in neurosurgery, frequently by the junior neurosurgery resident. Simulators for EVD placement are often costly, time-intensive to create, and complicated to set up.

OBJECTIVE

To describe creation of a simulator that is inexpensive, time-efficient, and simple to set up.

METHODS

This simulator involves printing a hollow head using a desktop 3-dimensional (3D) printer. This head is registered to a commercially available image-guidance system. A total of 11 participants volunteered for this simulation module. EVD placement was assessed at baseline, after verbal teaching, and after live 3D view instruction.

RESULTS

Accurate placement of an EVD on the right side at the foramen of Monro or the frontal horn of the lateral ventricle increased from 44% to 98% with training. Similarly, accurate placement on the left increased from 42% to 85% with training.

CONCLUSION

During participation in the simulation, accurate placement of EVDs increased significantly. All participants believed that they had a better understanding of ventricular anatomy and that this module would be useful as a teaching tool for neurosurgery interns.
Resection of 2 Intradural Extramedullary Cervical Spine Tumors in a Patient With Neurofibromatosis Type 2: 3-Dimensional Operative Video
Authors: Dekker Simone E , Glenn Chad A , Ostergard Thomas A , Wu Osmond C , Alonso Fernando , Pace Jonathan A , Rothstein Brian D , Ray Abhishek , Bambakidis Nicholas C
Published: June 2018

This 3-dimensional operative video illustrates resection of 2 cervical spine schwannomas in a 19-yr-old female with neurofibromatosis type 2. The patient presented with lower extremity hyperreflexity and hypertonicity. Magnetic resonance imaging (MRI) demonstrated 2 contrast-enhancing intradural extramedullary cervical spine lesions causing spinal cord compression at C4 and C5. The patient underwent a posterior cervical laminoplasty with a midline dural opening for tumor resection. Curvilinear spine cord compression is demonstrated in the operative video. After meticulous dissection, the tumors were resected without complication. The dural closure was performed in watertight fashion followed by laminoplasty using osteoplastic titanium miniplates and screws. Postoperative MRI demonstrated gross total resection with excellent decompression of the spinal cord. The postoperative course was uneventful. The natural history of this disease, treatment options, and potential complications are discussed.
Characterization of Balance Control After Moderate to Severe Traumatic Brain Injury: A Longitudinal Recovery Study
Authors: Perez Olinda Habib , Green Robin E , Mochizuki George
Published: June 2018

Background

Balance impairments after traumatic brain injury (TBI) are common and persist after injury. Postural asymmetries in balance have been reported, but not quantified, across recovery.

Objective

The objective of this study was to characterize balance recovery after moderate to severe TBI, with a focus on postural asymmetry.

Design

A secondary analysis of prospectively collected data was used in this study.

Methods

Data were from 45 participants with moderate to severe TBI. Participants’ balance in 2 bipedal stances and 2 unipedal stances was assessed with force plates at approximately 2, 5, and 12 months after injury. Single-visit data from participants who were matched for age and served as healthy controls were collected for visual comparison using 95% confidence intervals. Spatial and temporal center-of-pressure (COP) measures were calculated from force plates in the anteroposterior (AP) and mediolateral (ML) directions.

Results

Despite improvements in net ML COP postural sway from 2 to 5 months after injury, there were no changes in AP postural sway across recovery. Postural sway in individuals with TBI was higher than normative values at all time points in both directions. Interlimb synchrony did not change across recovery in either direction. TBI weight-bearing asymmetry was lower than normative values at all time points and did not change across recovery. The characteristics of unipedal stance differed between limbs.

Limitations

Sample size was reduced as a result of the inclusion and exclusion criteria; future studies will benefit from a larger sample size.

Conclusions

The absence of recovery in ML COP postural sway, interlimb synchrony, and weight-bearing symmetry indicated that reduced ML control may contribute to balance impairments after TBI. These impairments may extend to dynamic balance tasks and may also place individuals with TBI at a higher risk for falls.
Chitosan Oligosaccharide Induces Resistance toPseudomonas syringaepv.tomatoDC3000 inArabidopsis thalianaby Activating Both Salicylic Acid– and Jasmonic Acid–Mediated Pathways
Authors: Jia Xiaochen , Zeng Haihong , Wang Wenxia , Zhang Fuyun , Yin Heng
Published: June 2018

Chitosan oligosaccharide (COS) is an effective plant immunity elicitor; however, its induction mechanism in plants is complex and needs further investigation. In this study, the Arabidopsis–Pseudomonas syringae pv. tomato DC3000 (hereafter called DC3000) interaction was used to investigate the induction effect and the underlying mechanisms of COS. COS is effective in inducing resistance to DC3000 in Arabidopsis, and our results demonstrate that treatment with COS 3 days before DC3000 inoculation provided the most effective resistance. Disease severity in jar1 (jasmonic acid [JA]-deficient mutant), NahG, and sid2 (salicylic acid [SA]-deficient mutants) suggest both the SA and JA pathways are required for the Arabidopsis response to DC3000. COS pretreatment induced resistance in wild type (WT), jar1, and also, although to a lesser degree, in NahG and sid2 plants, implying that the SA and JA pathways play redundant roles in COS-induced resistance to DC3000. In COS-pretreated plants, expression of genes related to the SA pathway (PR1, PR2, and PR5) and SA content increased in both WT and jar1. Moreover, expression of genes related to the JA pathway (PDF1.2 and VSP2) and JA content both increased in WT and NahG. In conclusion, COS induces resistance to DC3000 in Arabidopsis by activating both SA- and JA-mediated pathways, although SA and JA pathways play redundant roles in this COS-induced resistance.
How Does Botrytis cinerea Infect Red Raspberry?
Authors: Kozhar O. , Peever T. L.
Published: June 2018

Botrytis cinerea, causal agent of gray mold, is one of the most important pathogens affecting raspberry in the U.S. Pacific Northwest and worldwide. Fungicides are currently applied to control the disease starting from 5 to 10% bloom and continuing on a calendar basis throughout the season rather than according to inoculum level or infection risk primarily because the disease cycle on red raspberry is poorly understood. Botrytis cinerea was isolated from raspberry flowers and fruit sampled at seven developmental stages during each of 2015 and 2016 in a northwestern Washington raspberry field untreated with fungicides. Incidence of colonization of flowers was low (15% of total sampled flowers), but increased as fruit developed, and peaked in mature fruit (67% of total sampled fruit). In the early stages of flower development, B. cinerea recovery was greatest from the carpel (80% of carpels colonized) compared with other floral organs. As fruit matured, additional floral parts were colonized by B. cinerea, possibly facilitating secondary internal or external infections of mature fruit. Average weekly minimum air temperature, average weekly night air temperature, cumulative rain, average weekly leaf wetness percentage, and duration of leaf wetness >90% were significantly positively correlated with B. cinerea colonization of raspberry in NW Washington during two seasons of this study. Our data does not support the hypothesis that the bloom period is the critical window for B. cinerea colonization of red raspberry and suggest that later colonization of developing fruit may be more important for gray mold development on raspberry. The outcomes of this research provide useful information for improvement of gray mold disease management strategies for red raspberry in NW Washington and elsewhere.
Does evidence support the use of cat allergen immunotherapy?
Authors: Dhami Sangeeta , Agarwal Arnav
Published: June 2018

Purpose of review

Cat allergy can manifest as allergic rhinitis, conjunctivitis and/or asthma. With widespread cat ownership and exposure, cat allergy has emerged as a major cause of morbidity. Cat allergen immunotherapy is a potential disease modifying treatment for patients with cat allergy. We examine evidence on the effectiveness, cost-effectiveness and safety of cat allergen immunotherapy and consider the clinical contexts in which it should be prescribed.

Recent findings

The European Association of Allergy and Clinical Immunology systematic reviews on allergic rhinitis and asthma along with the accompanying guidelines on allergic rhinitis were used as primary sources of evidence. Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are most common routes of administration for allergen immunotherapy (AIT). A limited number of high-quality studies related to cat dander have shown mixed results in improvements in ocular and nasal symptoms, asthma symptoms, peak expiratory flow rate and medication use scores with subcutaneous immunotherapy. Two studies examining cat dander and cat-related allergy response with sublingual immunotherapy have shown mixed results in terms of symptomatic response. One randomized trial examining intralymphatic immunotherapy has shown a positive symptom response and a favourable safety profile. Although studies have reported mixed results regarding safety of SCIT, adverse events have been reported more commonly with SCIT than SLIT.

There is a limited body of high-quality evidence on the effectiveness and safety of cat AIT and no high-quality data on its cost-effectiveness. The available evidence on effectiveness is mixed based on studying a limited array of immunological, physiological and patient-reported outcome measures. Based on this evidence and extrapolating on the wider evidence base in AIT, it is likely that some patients may benefit from this modality of treatment, particularly those with moderate-to-severe disease who are inadequately controlled on allergen avoidance measures and pharmacotherapy and those who are monosensitized to Felix Domesticus 1. Further evidence is, however, required from larger trials before more definitive advice can be offered.
The Matrix: Moving From Principles to Pragmatics in Medical School Curriculum Renewal
Authors: Jarvis-Selinger Sandra , Hubinette Maria
Published: June 2018

Many medical programs embarking on curriculum renewal begin with overarching goals and principles, but struggle with how to translate these into an implementable curriculum and assessment practices. This article describes the Matrix, a tool developed as a means of transforming high-level pedagogic principles into a concrete curriculum while addressing the complexities of curriculum content, context, people, and places. Using a known framework as an analytic lens, the authors explore the Matrix’s intended and unintended impacts on the University of British Columbia Medical Doctor Undergraduate Program (MDUP).

The Matrix is a graphical representation of the 130 weeks of the renewed MDUP curriculum. Its focus is on week-level objectives, which are mapped to year-level milestones and deconstructed into individual session objectives via virtual course books.

The Matrix had several predictable outcomes. It served as a tool for translating principles into a pragmatic curriculum. It created a curriculum map that reflected the original vision for renewal, enabled curriculum drift monitoring, and provided a high-level yet detailed visual representation. However, this innovation had unexpected system impacts with respect to multiple levels of governance, and it enabled realignment of the MDUP’s governance structure with the functionality required to administer the renewed curriculum.

The Matrix created a foundation for curriculum mapping at the MDUP. It has transitioned from the curriculum development and renewal phase into a useful implementation framework. The authors propose that it could be adapted by others for local use.
Spanish Language Concordance in U.S. Medical Care: A Multifaceted Challenge and Call to Action
Authors: Ortega Pilar
Published: June 2018

Patient–physician language discordance within the growing Spanish-speaking patient population in the United States presents a significant challenge for health systems. The Civil Rights Act, an Executive Order, and federal standards establish legal requirements regarding patients’ legal right to access medical care in their language of origin and to culturally and linguistically appropriate services, and national competency standards for undergraduate and graduate medical education and licensing examinations support the importance of patient–physician communication. However, no requirements or guidelines currently exist for medical Spanish educational resources, and there is no standardized process to assess the competency of medical students and physicians who use Spanish in patient care. Relatedly, existing data regarding current medical Spanish educational resources are limited, and Spanish proficiency evaluations are often based on self-assessments. Future efforts should use a multifaceted approach to address this complex challenge. A standardized process for Spanish-language-concordant medical care education and quality assurance should incorporate the validation of medical Spanish educational resources, competency requirements for medical usage of Spanish, an incentivized certification process for physicians who achieve medical Spanish competency, and health system updates that include routine collection of language concordance data and designation of Hispanic-serving health centers.
The ALiEM Faculty Incubator: A Novel Online Approach to Faculty Development in Education Scholarship
Authors: Chan Teresa M. , Gottlieb Michael , Sherbino Jonathan , Cooney Robert , Boysen-Osborn Megan , Swaminathan Anand , Ankel Felix , Yarris Lalena M.
Published: June 2018

Problem

Early- and midcareer clinician educators often lack a local discipline-specific community of practice (CoP) that encourages scholarly activity. As a result, these faculty members may feel disconnected from other scholars.

Approach

Academic Life in Emergency Medicine (ALiEM) piloted the Faculty Incubator. This longitudinal, asynchronous, online curriculum focused on developing a virtual CoP among 30 early- to midcareer medical educators (the “incubatees”), 8 core faculty mentors, and 10 guest mentors. The yearlong curriculum included 12 monthly modules focusing on core concepts in medical education scholarship. The initiative connected the incubatees with a virtual community of peers and mentors, with whom they completed multiple scholarly projects, sought mentorship, and engaged professionally. The authors used an online, closed, social media platform (Slack) to facilitate the exchange of ideas.

Outcomes

In the inaugural year (March 2016–February 2017), the mentorship team facilitated exceptional levels of online engagement among incubatees. All participants (incubatees, core mentors, and guest mentors) shared 1,081 files and exchanged a total of 22,665 messages (approximately 62 per day). Of these, 3,036 (13.4%) were via open channels, 5,483 (24.2%) via small groups, and 14,146 (62.4%) via direct messages.

Next Steps

The ALiEM Faculty Incubator represents a proof of concept, and initial outcomes show that it is possible to engage an international group of early- to midcareer medical educators to create a vibrant online CoP. The Faculty Incubator leaders plan to determine whether this engaged group of health professions educators will increase their scholarly output as a result of this initiative.
Glucocorticoids and antimalarials in systemic lupus erythematosus: an update and future directions
Authors: Ugarte Amaia , Danza Alvaro , Ruiz-Irastorza Guillermo
Published: June 2018

Purpose of review

The purpose of this review is highlighting the most recent evidence on the clinical efficacy and toxicity of glucocorticoids and antimalarials in systemic lupus erythematosus (SLE) and provide recommendations on their current use.

Recent findings

Glucocorticoid toxicity is well known. Recent data confirm the increased risk of infection and damage accrual. An observational study form Hong Kong has seen increased mortality among users of high-dose prednisone regimes. Several studies support the efficacy of medium-low doses and methyl-prednisolone pulses in lupus patients, both with and without nephritis.

New data confirm the effects of antimalarials in preventing SLE activity, damage and infections, and in decreasing mortality. New screening recommendations for hydroxychloroquine maculopathy have been recently published. Combining mepacrine and hydroxychloroquine in patients with refractory cutaneous and/or articular lupus activity has proved highly effective.

Universal therapy with hydroxychloroquine should be aimed to patients with SLE without contraindications. Doses greater than 4 mg/kg/day should be avoided and regular eye screening warranted to minimize the risk of macular toxicity. Every effort should be made to reduce the dose of oral glucocorticoids. In moderate-severe flares, pulse methyl-prednisolone are more effective and much less toxic than increasing the oral doses of prednisone.
Early-onset Scoliosis: Contemporary Decision-making and Treatment Options
Authors: Hasler Carol C.
Published: June 2018

Early-onset scoliosis (EOS) describes a wide array of diagnoses and deformities exposed to growth. This potentially life-threatening condition is still 1 of the biggest challenges in pediatric orthopaedics. The enlightenment of Bob Campbell’s thoracic insufficiency syndrome concept and the negative impact of the earlier short and straight spine fusion approach on respiratory function and survival have fueled the evolution of EOS care. Despite all the progress made, growth-friendly spine surgery remains to be a burden to patients and caregivers. Even down-sized implants and remote-controlled noninvasive rod expansions do not omit unexpected returns to the operating room: failures of foundations, rod breakage, difficulties to keep the sagittal balance, progressive transverse plane deformities, stiffening, and the need for final instrumented fusion are still common. However, past experience and the current multitude of surgical strategies and implants have sharpened the decision-making process, patients with thoracic insufficiency syndrome require earliest possible vertical expandable prosthetic titanium ribs application. Flexible deformities below 60 degrees, with normal spinal anatomy and without thoracic involvement, benefit from serial Mehta casting which revived as a long available but not-used strategy. In case of progression, standard double growing rods or—if available, affordable, and applicable—magnetically controlled motorized rods provide deformity control and growth promotion. Shilla growth-guiding technique is a less costly alternative. Its lack of stiff lengthening boxes or actuators may be beneficial in difficult deformities. Anterior convex flexible tethering promises benefits of sparing the trunk muscles and keeping mobility. However, this step towards a true nonfusion concept has yet to stand the test of broad clinical application.
Obesity in Kidney Transplantation
Authors: Glicklich Daniel , Mustafa M. Raza
Published: June 2018

Obesity is now common among children and adults who are kidney transplant candidates and recipients. It is associated with an increased risk of cardiovascular disease and kidney failure. This also pertains to potential living kidney donors with obesity. Obese patients with end-stage renal disease benefit from transplantation as do nonobese patients, but obesity is also associated with more risk. A complicating factor is that obesity is also associated with increased survival on maintenance dialysis in adults, but not in children. The assessment of obesity and body habitus should be individualized. Body mass index is a common but imperfect indicator of obesity. The medical management of obesity in renal failure patients is often unsuccessful. Bariatric surgery, specifically laparoscopic sleeve gastrectomy, can result in significant weight loss with reduced morbidity, but many patients do not agree to undergo this treatment. The best approach to manage obese transplant candidates and recipients is yet unresolved.
Vulvar Tuberculosis Cutis Orificialis Concomitant to Pulmonary Tuberculosis: A Case Report
Authors: Oliveira Mayara , Vita-Campos Clarissa , Jeunon Thiago
Published: June 2018

Tuberculosis (TB) is a common condition with increasing incidence worldwide. Cutaneous TB represents a small portion of extrapulmonary TB. Health care professionals must be aware of cutaneous forms of TB to avoid delay in diagnosis and treatment. We present a case of a 59-year-old woman with vulvar TB cutis orificialis in association with pulmonary TB without any other involvement of genitourinary system. We discuss epidemiological aspects, classification, treatment, range of histopathological patterns, and use of ancillary techniques for diagnosis.