bluuebunny/crossref_metadata_2025 huggingface dataset:
Cs diffusion in SiC high-energy grain boundaries
Authors: Ko Hyunseok , Szlufarska Izabela , Morgan Dane
Published: September 2017

Cesium (Cs) is a radioactive fission product whose release is of concern for Tristructural-Isotropic fuel particles. In this work, Cs diffusion through high energy grain boundaries (HEGBs) of cubic-SiC is studied using an ab-initio based kinetic Monte Carlo (kMC) model. The HEGB environment was modeled as an amorphous SiC, and Cs defect energies were calculated using the density functional theory (DFT). From defect energies, it was suggested that the fastest diffusion mechanism is the diffusion of Cs interstitial in an amorphous SiC. The diffusion of Cs interstitial was simulated using a kMC model, based on the site and transition state energies sampled from the DFT. The Cs HEGB diffusion exhibited an Arrhenius type diffusion in the range of 1200–1600 °C. The comparison between HEGB results and the other studies suggests not only that the GB diffusion dominates the bulk diffusion but also that the HEGB is one of the fastest grain boundary paths for the Cs diffusion. The diffusion coefficients in HEGB are clearly a few orders of magnitude lower than the reported diffusion coefficients from in- and out-of-pile samples, suggesting that other contributions are responsible, such as radiation enhanced diffusion.
Surfing liquid metal droplet on the same metal bath via electrolyte interface
Authors: Zhao Xi , Tang Jianbo , Liu Jing
Published: September 2017

We report a phenomenon that when exerting an electric field gradient across a liquid metal/electrolyte interface, a droplet of the same liquid metal can persistently surf on the interface without coalescence. A thin layer of the intermediate solution, which separates the droplet from direct metallic contacting and provides levitating force, is responsible for such surfing effect. The electric resistance of this solution film is measured, and the film thickness is further theoretically calculated. The fact that the levitating state can be switched on and off via a controlled manner paves the way for reliably manipulating liquid metal droplets or devices.
Traveling waves and conservation laws for highly nonlinear wave equations modeling Hertz chains
Authors: Przedborski Michelle , Anco Stephen C.
Published: September 2017

A highly nonlinear, fourth-order wave equation that models the continuum theory of long wavelength pulses in weakly compressed, homogeneous, discrete chains with a general power-law contact interaction is studied. For this wave equation, all solitary wave solutions and all nonlinear periodic wave solutions, along with all conservation laws, are derived. The solutions are explicitly parameterized in terms of the asymptotic value of the wave amplitude in the case of solitary waves and the peak of the wave amplitude in the case of nonlinear periodic waves. All cases in which the solution expressions can be stated in an explicit analytic form using elementary functions are worked out. In these cases, explicit expressions for the total energy and total momentum for all solutions are obtained as well. The derivation of the solutions uses the conservation laws combined with an energy analysis argument to reduce the wave equation directly to a separable first-order differential equation that determines the wave amplitude in terms of the traveling wave variable. This method can be applied more generally to other highly nonlinear wave equations.
AlGaN/GaN high electron mobility transistors with a low sub-threshold swing on free-standing GaN wafer
Authors: Liu Xinke , Gu Hong , Li Kuilong , Guo Lunchun , Zhu Deliang , Lu Youming , Wang Jianfeng , Kuo Hao-Chung , Liu Zhihong , Liu Wenjun , Chen Lin , Fang Jianping , Ang Kah-Wee , Xu Ke , Ao Jin-Ping
Published: September 2017

This paper reported AlGaN/GaN high electron mobility transistors (HEMTs) with low sub-threshold swing SS on free-standing GaN wafer. High quality AlGaN/GaN epi-layer has been grown by metal-organic chemical vapor deposition (MOCVD) on free-standing GaN, small full-width hall maximum (FWHM) of 42.9 arcsec for (0002) GaN XRD peaks and ultralow dislocation density (∼104-105 cm-2) were obtained. Due to these extremely high quality material properties, the fabricated AlGaN/GaN HEMTs achieve a low SS (∼60 mV/decade), low hysteresis of 54 mV, and high peak electron mobility μeff of ∼1456 cm2V-1s-1. Systematic study of materials properties and device characteristics exhibits that GaN-on-GaN AlGaN/GaN HEMTs are promising candidate for next generation high power device applications.
Singularity of connection Ricci flow for three-manifolds
Authors: Sheng Weimin , Yu Haobin
Published: September 2017

We study the long-time behavior of the solution to the connection Ricci flow on closed three-manifolds. The connection Ricci flow is a generalization of the Ricci flow to connection with torsion. We compare the evolving metrics under the connection Ricci flow and Ricci flow for some special cases. We obtain the blow-up rate of the Ricci tensor under the connection Ricci flow. Based on the result, we give the classification of the maximal solutions to the flow.
Massive parallel 3D PIC simulation of negative ion extraction
Authors: Revel Adrien , Mochalskyy Serhiy , Montellano Ivar Mauricio , Wünderlich Dirk , Fantz Ursel , Minea Tiberiu
Published: September 2017

The 3D PIC-MCC code ONIX is dedicated to modeling Negative hydrogen/deuterium Ion (NI) extraction and co-extraction of electrons from radio-frequency driven, low pressure plasma sources. It provides valuable insight on the complex phenomena involved in the extraction process. In previous calculations, a mesh size larger than the Debye length was used, implying numerical electron heating. Important steps have been achieved in terms of computation performance and parallelization efficiency allowing successful massive parallel calculations (4096 cores), imperative to resolve the Debye length. In addition, the numerical algorithms have been improved in terms of grid treatment, i.e., the electric field near the complex geometry boundaries (plasma grid) is calculated more accurately. The revised model preserves the full 3D treatment, but can take advantage of a highly refined mesh. ONIX was used to investigate the role of the mesh size, the re-injection scheme for lost particles (extracted or wall absorbed), and the electron thermalization process on the calculated extracted current and plasma characteristics. It is demonstrated that all numerical schemes give the same NI current distribution for extracted ions. Concerning the electrons, the pair-injection technique is found well-adapted to simulate the sheath in front of the plasma grid.
First-principles study of the structural and electronic properties of graphene/MoS2 interfaces
Authors: Hieu Nguyen Ngoc , Phuc Huynh Vinh , Ilyasov Victor V. , Chien Nguyen D. , Poklonski Nikolai A. , Van Hieu Nguyen , Nguyen Chuong V.
Published: September 2017

In this paper, we study the structural and electronic properties of graphene adsorbed on MoS2 monolayer (G/MoS2) with different stacking configurations using dispersion-corrected density functional theory. Our calculations show that the interaction between graphene and MoS2 monolayer is a weak van der Waals interaction in all four stacking configurations with the binding energy per carbon atom of −30 meV. In the presence of MoS2 monolayer, the linear bands on the Dirac cone of graphene at the interfaces are slightly split. A band gap about 3 meV opens in G/MoS2 interfaces due to the breaking of sublattice symmetry by the intrinsic interface dipole, and it could be effectively modulated by the stacking configurations. Furthermore, we found that an n-type Schottky contact is formed at the G/MoS2 interface in all four stacking configurations with a small Schottky barrier about 0.49 eV. The appearance of the non-zero band gap in graphene has opened up new possibilities for its application in electronic devices such as graphene field-effect transistors.
Observation of self-excited dust acoustic wave in dusty plasma with nanometer size dust grains
Authors: Deka Tonuj , Boruah A. , Sharma S. K. , Bailung H.
Published: September 2017

Dusty plasma with a nanometer size dust grain is produced by externally injecting carbon nanopowder into a radio frequency discharge argon plasma. A self-excited dust acoustic wave with a characteristic frequency of ∼100 Hz is observed in the dust cloud. The average dust charge is estimated from the Orbital Motion Limited theory using experimentally measured parameters. The measured wave parameters are used to determine dusty plasma parameters such as dust density and average inter particle distance. The screening parameter and the coupling strength of the dusty plasma indicate that the system is very close to the strongly coupled state.
The temporal evolution of the resistive pressure-gradient-driven turbulence and anomalous transport in shear flow across the magnetic field
Authors: Mikhailenko V. V. , Mikhailenko V. S. , Lee Hae June
Published: September 2017

The temporal evolution of the resistive pressure-gradient-driven mode in a sheared flow is investigated as a solution of the initial value problem by employing the sheared mode approach. It reveals the essential difference of the processes, which occur in the case of flows with velocity shear less than the growth rate of the instability in steady plasmas, with processes which occur in the flows with velocity shear larger than the growth rate. We found that the suppression of the turbulence by a sheared flow occurs only in the second case. In this case, the initial value scheme, which does not impose a priori any constraints on the form that solution may take, is necessary for the proper description of the temporal evolution and eventual suppression of the turbulence in a sheared flow.
Flexible graphene sound device based on laser reduced graphene
Authors: Tao Lu-Qi , Sun Hao , Liu Ying , Ju Zhen-Yi , Yang Yi , Ren Tian-Ling
Published: September 2017

Existing thermoacoustic devices are based on a complicated fabrication process, which extremely limits their practical applications. In this paper, we realize a flexible graphene sound device based on laser reduced graphene. The graphene oxide is converted into graphene by a 450 nm laser with a one-step process. The performance of the graphene sound device is affected by the laser power, the scanning speed, and the substrate thickness. The experimental results match well with the theoretical results. Besides, the sound device has the advantages of excellent flexibility, broad frequency spectrum (0–40 kHz), fast fabrication process, and low cost, which will become a promising alternative in the flexible electronic systems in the future.
Comparative leaf water relations and anatomical responses of three vetch species (Vicia narbonensis L., V. sativa L. and V. villosa Roth.) to cope with water stress
Authors: Haffani Sywar , Mezni Majid , Ben Nasri Mouhiba , Chaibi Wided
Published: September 2017

Plant growth and production are greatly affected by water deficit worldwide and particularly in Tunisia. In this context, a study was conducted to analyse the response of three vetch species (Vicia narbonensis, V. sativa and V. villosa) to four water treatments: 100% (Control), 80%, 60% and 40% of field capacity. Water stress led to important changes of both leaf physiology and anatomy. V. narbonensis kept cells turgor by adjusting the osmotic potential without changes in cell walls elasticity. V. sativa showed the most pronounced reductions of leaf water potential and the lowest osmotic adjustment under water stress although cell walls elasticity has not changed. However, V. villosa kept a higher fraction of apoplastic water over V. sativa that allowed it to maintain cells turgor despite the rigidity of its cell walls. Drought did not affect lamina thickness but increased the palisade parenchyma at the expense of spongy parenchyma. It was characterised by leaf lamina increase and constant thickness of the spongy parenchyma: a strategy to cope with drought. Moreover, stomata were reduced in size but were increased in number in order to avoid water loss.
Effects of ambient temperature and photoperiod on flowering time in faba bean (Vicia faba L.)
Authors: Catt Samuel C. , Paull Jeffrey G.
Published: September 2017

Flowering time is a vulnerable stage of plant development and is therefore a significant determinant of adaptation and grain yield in faba bean (Vicia faba L.). It is largely controlled by genotype, environmental factors of temperature and photoperiod, and genotype-by-environment interactions. The aim of this study was to evaluate variation in flowering time and the responses of flowering time to ambient temperature and photoperiod in Australian faba bean. Time of sowing experiments were carried out to assess variation among lines for flowering time (measured in days to flowering, thermal time to flowering and node of first flower) and to determine plant sensitivities to ambient temperature and photoperiod by regression analysis in the field, while four controlled environment experiments of differing temperature and photoperiod were undertaken to further analyse the variation in responses. Results showed significant variation in responses to both ambient temperature and photoperiod. Photoperiod was the main factor influencing variation in flowering time, with lines grouped as sensitive, intermediate or insensitive. The responses to ambient temperature were more complex. Most lines fit the traditional linear model, but with possible variation in optimal temperature and/or vernalisation response, while some lines showed temperature insensitivity.
Muscle and carapace tissue–diet isotope discrimination factors for the freshwater crayfish Cherax destructor
Authors: Mazumder Debashish , Johansen Mathew P. , Fry Brian , Davis Emma
Published: September 2017

This study examined a range of diets and two tissue types (muscle and carapace, representing protein and chitin biochemistry respectively) of Cherax destructor (Clark, 1936) to allow more accurate use of isotope data in trophic source estimates. The resulting Δ13Ctissue–diet and Δ15Ntissue–diet discrimination factors of muscle and carapace tissues showed significant differences among diets. For muscle, Δ13Ctissue–diet was higher (2.11–2.33‰) when C. destructor was fed with lamb, turkey and mixed animal and plant-based diets, 1.27–1.96‰ when C. destructor was fed with beef and kangaroo diets and negative (–1.36‰) when C. destructor was fed with an aquatic meat (tuna) diet. The Δ15Ntissue–diet discrimination factors were lower for muscle when C. destructor was fed aquatic meat (0.12‰) and mixed plant–animal diets (1.67‰), but higher for terrestrial meat diets (2.79–3.74‰). The Δ13Ctissue–diet for carapace followed similar patterns to that of muscle, but Δ15Ntissue–diet values were lower for carapace than muscle. Strong correlations were observed between muscle and carapace for δ13C (r=0.96, P<0.0001) and δ15N (r=0.82, P<0.0012) across the six diets evaluated, indicating that carapace can be used as a non-lethal alternative to muscle during field sampling.
Estimating Age at a Specified Length from the von Bertalanffy Growth Function
Authors: Ogle Derek H. , Isermann Daniel A.
Published: September 2017

Estimating the time required (i.e., age) for fish in a population to reach a specific length (e.g., legal harvest length) is useful for understanding population dynamics and simulating the potential effects of length-based harvest regulations. The age at which a population reaches a specific mean length is typically estimated by fitting a von Bertalanffy growth function to length-at-age data and then rearranging the best-fit equation to solve for age at the specified length. This process precludes the use of standard frequentist methods to compute confidence intervals and compare estimates of age at the specified length among populations. We provide a parameterization of the von Bertalanffy growth function that has age at a specified length as a parameter. With this parameterization, age at a specified length is directly estimated, and standard methods can be used to construct confidence intervals and make among-group comparisons for this parameter. We demonstrate use of the new parameterization with two data sets.

Received March 30, 2017; accepted June 9, 2017 Published online September 8, 2017
Oil and democratisation in Ghana
Authors: Odijie Ehis Michael
Published: September 2017

In this Debate, I argue that the 2007 discovery of oil in commercial quantities in Ghana is advancing rather than obstructing democratisation. Using the theory of political settlement and the institutional concept of feedback, I show that oil has led to democratic feedback.
‘We recommend compliance’: bargaining and leverage in Ethiopian–US intelligence cooperation
Authors: Odinga Sobukwe
Published: September 2017

Disputes over the costs and benefits of intelligence liaisons between the US and its African allies are routine. The contentious and largely overlooked bargaining processes that stem from these disputes call into question prominent depictions of US–African security partnerships as rigidly hierarchical alliances. Through an assessment of compliance bargaining between Ethiopia and the US over the terms of their intelligence liaison, this article posits that, despite the vast power asymmetry between these allies, Ethiopia routinely dictated and policed the terms of this liaison, while consistently leveraging it as means to acquire political concessions from the US.
Improving patient safety and efficiency of medication reconciliation through the development and adoption of a computer-assisted tool with automated electronic integration of population-based community drug data: the RightRx project
Authors: Tamblyn Robyn , Winslade Nancy , Lee Todd C , Motulsky Aude , Meguerditchian Ari , Bustillo Melissa , Elsayed Sarah , Buckeridge David L , Couture Isabelle , Qian Christina J , Moraga Teresa , Huang Allen
Published: September 2017

Background and Objective

Many countries require hospitals to implement medication reconciliation for accreditation, but the process is resource-intensive, thus adherence is poor. We report on the impact of prepopulating and aligning community and hospital drug lists with data from population-based and hospital-based drug information systems to reduce workload and enhance adoption and use of an e-medication reconciliation application, RightRx.

Methods

The prototype e-medical reconciliation web-based software was developed for a cluster-randomized trial at the McGill University Health Centre. User-centered design and agile development processes were used to develop features intended to enhance adoption, safety, and efficiency. RightRx was implemented in medical and surgical wards, with support and training provided by unit champions and field staff. The time spent per professional using RightRx was measured, as well as the medication reconciliation completion rates in the intervention and control units during the first 20 months of the trial.

Results

Users identified required modifications to the application, including the need for dose-based prescribing, the role of the discharge physician in prescribing community-based medication, and access to the rationale for medication decisions made during hospitalization. In the intervention units, both physicians and pharmacists were involved in discharge reconciliation, for 96.1% and 71.9% of patients, respectively. Medication reconciliation was completed for 80.7% (surgery) to 96.0% (medicine) of patients in the intervention units, and 0.7% (surgery) to 82.7% of patients in the control units. The odds of completing medication reconciliation were 9 times greater in the intervention compared to control units (odds ratio: 9.0, 95% confidence interval, 7.4-10.9, P < .0001) after adjusting for differences in patient characteristics.

Conclusion

High rates of medication reconciliation completion were achieved with automated prepopulation and alignment of community and hospital medication lists.
Evaluation of Fracture and Osteotomy Union in the Setting of Osteogenesis Imperfecta: Reliability of the Modified Radiographic Union Score for Tibial Fractures (RUST)
Authors: Franzone Jeanne M. , Finkelstein Mark S. , Rogers Kenneth J. , Kruse Richard W.
Published: September 2017

Background:

Evaluation of the union of osteotomies and fractures in patients with osteogenesis imperfecta (OI) is a critical component of patient care. Studies of the OI patient population have so far used varied criteria to evaluate bony union. The radiographic union score for tibial fractures (RUST), which was subsequently revised to the modified RUST, is an objective standardized method of evaluating fracture healing. We sought to evaluate the reliability of the modified RUST in the setting of the tibias of patients with OI.

Methods:

Tibial radiographs of 30 patients with OI fractures, or osteotomies were scored by 3 observers on 2 separate occasions. Each of the 4 cortices was given a score (1=no callus, 2=callus present, 3=bridging callus, and 4=remodeled, fracture not visible) and the modified RUST is the sum of these scores (range, 4 to 16). The interobserver and intraobserver reliabilities were evaluated using intraclass coefficients (ICC) with 95% confidence intervals.

Results:

The ICC representing the interobserver reliability for the first iteration of scores was 0.926 (0.864 to 0.962) and for the second series was 0.915 (0.845 to 0.957). The ICCs representing the intraobserver reliability for each of the 3 reviewers for the measurements in series 1 and 2 were 0.860 (0.707 to 0.934), 0.994 (0.986 to 0.997), and 0.974 (0.946 to 0.988).

Conclusions:

The modified RUST has excellent interobserver and intraobserver reliability in the setting of OI despite challenges related to the poor quality of the bone and its dysplastic nature. The application and routine use of the modified RUST in the OI population will help standardize our evaluation of osteotomy and fracture healing.

Level of Evidence:

Level III—retrospective study of nonconsecutive patients.
Guided Growth of the Proximal Femur for the Management of Hip Dysplasia in Children With Cerebral Palsy
Authors: Portinaro Nicola , Turati Marco , Cometto Matteo , Bigoni Marco , Davids Jon R. , Panou Artemisia
Published: September 2017

Background:

Progressive hip displacement is one of the most common and debilitating deformities seen in children with cerebral palsy (CP). The aim of this study was to evaluate the results of temporary medial hemiepiphysiodesis of the proximal femur (TMH-PF) using a transphyseal screw to control hip migration during growth in children with CP.

Methods:

This was a retrospective study of children with CP and hip dysplasia, age 4 to 11 years and GMFCS levels III-V. There were 28 patients with 56 hips that underwent TMH-PF surgery between 2007 and 2010. Clinical and radiologic evaluation was performed preoperatively, at 6, 12, and 60 months following the index surgery. Acetabular index (AI), neck-shaft angle (NSA) and migration percentage (MP) were measured. All complications were recorded.

Results:

All radiographic measurements were significantly improved at the final follow-up. Positive correlations were found between NSA, MP, and AI. Multiple regression analysis revealed that MP, time from surgery, and age were influenced by the decrease of the NSA. The femoral physis grew off the screw in 9 hips within 36 months. The screw head broke during attempted screw exchange in 1 hip. The remain cases (4 hips) were treated by placing a second screw parallel to the existing one. Finally, progressive subluxation occurred in 3 hips when the physis grew off the screw and were treated by skeletal reconstruction.

Conclusions:

TMH-PF was effective in controlling progressive subluxation of the hip in the majority of cases, obviating the need for major reconstructive surgery in these children with CP.

Level of Evidence:

Level IV.
Intervention Mapping Approach in the Design of an Interactive Mobile Health Application to Improve Self-care in Heart Failure
Authors: Athilingam Ponrathi , Clochesy John M. , Labrador Miguel A.
Published: September 2017

Heart failure is a complex syndrome among older adults who may experience and interpret symptoms differently. These differences in symptom interpretation may influence decision-making in symptom management. A well-informed and motivated person may develop the knowledge and skills needed to successfully manage symptoms. Therefore, the patient-centered mobile health application HeartMapp was designed to engage patients with heart failure in self-care management by offering tailored alerts and feedback using mobile phones. The main objective of this article is to describe the six-step intervention mapping approach including (1) the initial needs assessment, (2) proximal program objective, (3) selection of theory-based methods, (4) the translation of objectives into an actual program plan for mobile health intervention, (5) adaptation and implementation plan, and (6) evaluation plan that assisted the team in the development of a conceptual framework and intervention program matrix during the development of HeartMapp. The HeartMapp intervention takes the information, motivation, and behavioral skills model as the theoretical underpinning, with “patient engagement” as the key mediator in achieving targeted and persistent self-care behavioral changes in patients with heart failure. The HeartMapp intervention is proposed to improve self-care management and long-term outcomes.
Hypertension in the Faith Community
Authors: Bangurah Saphie S. , Vardaman Shellye A. , Cleveland Kelli K.
Published: September 2017

Inadequate blood pressure (BP) control in hypertension carries a major financial and public health burden. This study examined the efficacy of behavioral and lifestyle changes on BP control among African American adults, aged 55 years and older in a faith-based setting. The study was supported by clergy who helped to engage participants in interventions. Nurse-led diet and exercise teaching with BP monitoring led to lower BP readings over a 4-week intervention.
Patient Satisfaction With Propofol for Outpatient Colonoscopy: A Prospective, Randomized, Double-Blind Study
Authors: Padmanabhan Anantha , Frangopoulos Christoforos , Shaffer Lynn E.T.
Published: September 2017

BACKGROUND:

Previous literature has shown that propofol has ideal anesthetic properties for patients undergoing colonoscopy, a common procedure at outpatient surgery centers. However, there is a paucity of information regarding patient satisfaction with propofol.

OBJECTIVE:

The aim of this study was to evaluate patient satisfaction with propofol compared with nonpropofol (fentanyl/midazolam) anesthesia for outpatient colonoscopies. Safety and complications were secondary end points.

DESIGN:

This study was a double-blind, randomized, parallel-group controlled clinical trial (NCT 02937506).

SETTING:

This study was conducted at a single ambulatory surgery center at an urban teaching community health system.

PATIENTS:

Patients were scheduled for outpatient colonoscopy. Those with high-risk cardiac or pulmonary disease were excluded.

INTERVENTIONS:

Anesthesia personnel administered either fentanyl/midazolam (n = 300) or propofol (n = 300) for sedation during outpatient colonoscopy. A single, highly experienced endoscopist performed all colonoscopies.

MAIN OUTCOME MEASURES:

The primary outcomes measured were patient satisfaction (5-point Likert scale) and procedure complications. Data were collected on the day of endoscopy by the nursing staff of the postanesthesia care unit. A subinvestigator blinded to the randomization called patients 24 to 72 hours after discharge to obtain data on postprocedure problems and status of resumption of normal activities. Analysis was intention-to-treat.

RESULTS:

Fewer patients who received propofol remembered being awake during the procedure (2% vs 17% for fentanyl, p < 0.0001) and were more likely to rate the amount of anesthesia received as being “just right” (98.7% vs 91.3% for fentanyl, p = 0.0002) and state that they were “very satisfied” with their anesthesia (86.3% vs 74% for fentanyl, p = 0.0005). Twenty-six percent of fentanyl procedures were rated “difficult” compared with 4.3% for propofol (p < 0.0001), and complications were fewer in the propofol group (2.7% vs 11.7%, p < 0.0001).

LIMITATIONS:

The endoscopist could not be completely blinded to the anesthetic administered.

CONCLUSIONS:

Patients prefer propofol over a combination of fentanyl/midazolam as their anesthetic for outpatient colonoscopies. From a patient and provider perspective, propofol appears to be superior to fentanyl/midazolam for outpatient colonoscopy. See Video Abstract at http://links.lww.com/DCR/A445.
Chemical Peels: Indications and Special Considerations for the Male Patient
Authors: Reserva Jeave , Champlain Amanda , Soon Seaver L. , Tung Rebecca
Published: September 2017

BACKGROUND

Chemical peels are a mainstay of aesthetic medicine and an increasingly popular cosmetic procedure performed in men.

OBJECTIVE

To review the indications for chemical peels with an emphasis on performing this procedure in male patients.

MATERIALS AND METHODS

Review of the English PubMed/MEDLINE literature and specialty texts in cosmetic dermatology, oculoplastic, and facial aesthetic surgery regarding sex-specific use of chemical peels in men.

RESULTS

Conditions treated successfully with chemical peels in men include acne vulgaris, acne scarring, rosacea, keratosis pilaris, melasma, actinic keratosis, photodamage, resurfacing of surgical reconstruction scars, and periorbital rejuvenation. Chemical peels are commonly combined with other nonsurgical cosmetic procedures to optimize results. Male patients may require a greater number of treatments or higher concentration of peeling agent due to increased sebaceous quality of skin and hair follicle density.

CONCLUSION

Chemical peels are a cost-effective and reliable treatment for a variety of aesthetic and medical skin conditions. Given the increasing demand for noninvasive cosmetic procedures among men, dermatologists should have an understanding of chemical peel applications and techniques to address the concerns of male patients.
Raman Microscopy: A Noninvasive Method to Visualize the Localizations of Biomolecules in the Cornea
Authors: Kaji Yuichi , Akiyama Toshihiro , Segawa Hiroki , Oshika Tetsuro , Kano Hideaki
Published: September 2017

Purpose:

In vivo and in situ visualization of biomolecules without pretreatment will be important for diagnosis and treatment of ocular disorders in the future. Recently, multiphoton microscopy, based on the nonlinear interactions between molecules and photons, has been applied to reveal the localizations of various molecules in tissues. We aimed to use multimodal multiphoton microscopy to visualize the localizations of specific biomolecules in rat corneas.

Methods:

Multiphoton images of the corneas were obtained from nonlinear signals of coherent anti-Stokes Raman scattering, third-order sum frequency generation, and second-harmonic generation.

Results:

The localizations of the adhesion complex-containing basement membrane and Bowman layer were clearly visible in the third-order sum frequency generation images. The fine structure of type I collagen was observed in the corneal stroma in the second-harmonic generation images. The localizations of lipids, proteins, and nucleic acids (DNA/RNA) was obtained in the coherent anti-Stokes Raman scattering images.

Conclusions:

Imaging technologies have progressed significantly and been applied in medical fields. Optical coherence tomography and confocal microscopy are widely used but do not provide information on the molecular structure of the cornea. By contrast, multiphoton microscopy provides information on the molecular structure of living tissues. Using this technique, we successfully visualized the localizations of various biomolecules including lipids, proteins, and nucleic acids in the cornea. We speculate that multiphoton microscopy will provide essential information on the physiological and pathological conditions of the cornea, as well as molecular localizations in tissues without pretreatment.
Antiretroviral Therapy in HIV-Infected Children With Tuberculosis
Authors: Sulis Giorgia , Amadasi Silvia , Odone Anna , Penazzato Martina , Matteelli Alberto
Published: September 2017

Background:

Tuberculosis (TB) is the major cause of mortality in HIV-infected children globally. Current guidelines about the management of antiretroviral therapy in children with TB are based on a limited number of nonrandomized studies involving small numbers of participants. The aim of the study was to systematically retrieve and critically appraise available evidence on the efficacy and safety of different antiretroviral regimens in children with HIV infection who are receiving treatment for active TB.

Methods:

We conducted a systematic review of the literature according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Records were retrieved through March 2016 from Medline, Embase and manual screening of key conference proceedings. Four specific research questions assessing available treatment options were defined.

Results:

Although 4 independent searches were conducted (1 for each Population, Intervention, Comparator, Outcomes question), results were elaborated and interpreted together because of significant overlap among the retrieved records. Six observational studies were selected for qualitative synthesis while meta-analysis could not be performed.

Conclusion:

Evidence for optimal treatment options for HIV/TB coinfected children is limited. As the global community strives to reach the fast-track HIV treatment targets and eliminate childhood TB deaths, it must ensure that coinfected children are included in key treatment studies and expand this neglected but crucial area of research.
Mycobacterium tuberculosis Diversity by Exact Tandem Repeats-Variable Number Tandem Repeat Method in Azerbaijan, Iran
Authors: Danandeh Mostafa , Moadab Seyed Reza , Asgharzadeh Mohammad , Alizadeh Naser , Ghotaslou Reza
Published: September 2017

Background

Tuberculosis (TB) is the leading cause of adult deaths among infectious agents. One of the genetic fingerprinting techniques to study the epidemiology of TB is variable number tandem repeat (VNTR). The purpose of this study was to determine the diversity of Mycobacterium tuberculosis isolated from patients in Azerbaijan, Iran by exact tandem repeats (ETR)-VNTR method.

Methods

We used the ETR-VNTR method to analyze the genotypes of M. tuberculosis isolates. Forty-seven isolates were collected from pulmonary and extra pulmonary Tuberculosis patients associated with epidemiological data such as human immunodeficiency virus, anti-TB drugs use, cigarette smoking, diabetes mellitus, lung cancer, contact with TB patients, Bacillus Calmette–Guérin vaccine use, cough, housekeeping, fever, and other risk factors from April 2013 to February 2015 in Tabriz Research Center of Tuberculosis and Lung Disease. Three loci ETR-A, ETR-B, and ETR-C of VNTR patterns were studied. The patients' data were checked to determine the relationships between the epidemiological data and M. tuberculosis diversities.

Results

Among the 47 isolates, 45 separate ETR-VNTR patterns consist of 9 clusters, 24 nonclusters (unique patterns) were found. No locus was observed in 2 samples. Diabetes and close household contacts were identified as important risk factors for TB in our subjects with unique patterns.

Conclusions

Thirty-three distinct patterns were distinguished. In the case of respiratory symptoms in patients with diabetes and close household contact patients, TB can be considered as the important differential diagnosis with unique patterns.
Mycobacterium Avium Complex Immune Reconstitution Inflammatory Syndrome Associated With Infliximab Use
Authors: Siegel Marc O.
Published: September 2017

Tumor necrosis factor-α inhibitors are a mainstay therapy for patients with moderate to severe Crohn disease. Use of these agents is widely recognized to be associated with an increased risk for tuberculosis as well as fungal and intracellular bacterial infections. However, nontuberculous mycobacterial infections are less well recognized complications of tumor necrosis factor-α inhibitor therapy and can be fatal if undiagnosed. More recently, immune reconstitution inflammatory syndrome has been associated with discontinuation of tumor necrosis factor-α inhibitor therapy. We describe a patient with severe Crohn disease treated with high-dose infliximab therapy who developed disseminated Mycobacterium avium complex and who, after initial improvement with antimycobacterial therapy, subsequently developed an immune reconstitution inflammatory syndrome 13 weeks after her infliximab was discontinued.
Examining Factors, Strategies, and Processes to Decrease Physical Therapy Turnover Rates in Acute Care Hospitals: A Review of the Literature
Authors: Vatwani Archana , Hill Cheryl J.
Published: September 2017

A review of the literature was performed to understand trends, patterns, and strategies to improve retention of physical therapists in acute care hospitals. The purpose of this article is to discuss contributing factors and explore 2 specific groups of strategies—human factors and quality management/quality control—to reduce attrition and increase retention of acute care hospital physical therapists. This article also discusses processes such as changing organizational variables, continuously assessing the workforce, establishing an internal leadership bank, and employee/management surveys as strategies to enhance retention of acute care physical therapists.

A variety of collective actions by both managers and employees can be implemented to reduce the challenges of acute care physical therapy turnover. No one action is more important than the others. Recommendations for future research include a qualitative study of employees who have worked in and subsequently left acute care hospitals to understand their lived experiences. Furthermore, a retrospective review of organizations' human resource files on employees who have left might uncover additional factors specific to the organization that are related to turnover. In addition, further studies addressing acute care physical therapists employed longer than 5 years might reveal more about their motivations for staying in such a challenging work environment.
Performance of a quick pregnancy test on whole blood in early pregnancy units: a prospective cohort study
Authors: Legoupil Caroline , Enderle Isabelle , Le Baccon Flore-Anne , Bendavid Claude , Peltier Lucas , Bauville Estelle , Leveque Jean , Lavoue Vincent , Le Lous Maela
Published: September 2017

Objective

To assess the diagnostic performance of the NG-Test human chorionic gonadotropin (hCG) WB, which is a new point-of-care (POC) hCG whole-blood test.

Materials and methods

This prospective study included women consulted in early pregnancy units for vaginal bleeding and/or pelvic pain with unknown pregnancy status after medical consultation including a pelvic ultrasound scan. A new POC test (the NG-Test hCG WB) and the usual laboratory serum test (considered the gold standard) were performed in patients. The results were interpreted in a blinded manner. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the NG-Test hCG WB.

Results

During the study period, 200 patients were included. The pregnancy rate was 17%. For the laboratory test, with a 5 UI/l hCG positivity threshold, the sensitivity, specificity, PPV, NPV, and Youden index of the NG-Test hCG WB were 89.7, 100, 100, 97.9, and 0.90%, respectively. Considering a 10 UI/l hCG positivity threshold, test sensitivity, specificity, PPV, NPV, and Youden index were 96.3, 100, 100, 99.3, and 0.96%, respectively. False-negative cases were either extremely brief pregnancies or residual hCG after miscarriage. The result was obtained within 5 min with the NG-Test hCG WB versus 90±31 min with the laboratory test. It was easy to use.

Conclusion

The NG-Test hCG WB showed a high sensitivity, specificity, PPV, and NPV. Its use as triage in the case of a negative pelvic ultrasound exam is a potential strategy to improve patient flow, with an average time saving of 85 min.
Postoperative Changes After Closed Reduction of Nasal Fracture
Authors: Lim Hyoseob , Kang Kwang Rae , Koh Sung Hoon , Jung Sung Won , Jung Soyeon
Published: September 2017

Nasal bone fracture is the most common facial fracture; however, surgery does not guarantee reduction and complications, such as undercorrection, overcorrection, and deviation, may occur. By analyzing findings of computed tomography (CT) immediately and at 3 months postoperatively, we evaluated the accuracy of reduction and long-term changes to the nasal bone.

Patients with pure nasal bone fracture were evaluated from January 1, 2010 to December 31, 2011. First, we categorized fracture types according to the Stranc-Robertson classification system, using preoperative CT findings (ie, F1, F2, L1, and L2). We categorized each result of reduction by immediate postoperative CT scan findings as “Excellent,” “Good,” “Fair,” and “Poor,” with “Excellent” and “Good” ratings being considered a “Success.” We evaluated changes to the nasal bone at 3 months after reduction, using the same grade.

A total of 128 patients were analyzed. The results of patients in the F1 group were better than those of other patients immediately postoperatively, whereas those of the L2 group were worse. The overall success rate was 49.2% (58/118). At 3 months postoperatively, 33 cases exhibited an improvement to a higher grade, whereas 25 cases improved from an unacceptable outcome to a successful outcome, with the overall success rate being 70.3% (83/118).

Immediately postoperative CT scans can be helpful for surgeons in determining whether a secondary adjustment is necessary. Incompletely reduced nasal bone showed spontaneous improvement in bony arrangement according to our study, so simple observation could be a choice.
Examination of Nasolacrimal Duct Morphometry Using Cone Beam Computed Tomography in Patients With Unilateral Cleft Lip/Palate
Authors: Altun Oğuzhan , Dedeoğlu Numan , Avci Mehmet
Published: September 2017

Objective:

The cleft lip/palate (CLP) deformity negatively affects the anatomy of the nasal cavity and maxilla. The effects of this deformity on the lacrimal system have been unidentified yet. This study aimed to evaluate the morphometric changes in the nasolacrimal duct using cone-beam computed tomography (CBCT) in patients with unilateral CLP.

Materials and Methods:

Retrospective bilateral measurements of the narrowest transversal diameters and the lengths of the nasolacrimal ducts were made for the affected and unaffected sides of 28 patients with CLP and 28 control patients, using the CBCT images. The measurements were statistically compared.

Results:

The mean narrowest transversal diameter of the nasolacrimal duct for the affected side of the patients with unilateral CLP was statistically significantly narrower than the unaffected side (P = 0.01). There were no statistically significant differences between the control group and the affected and unaffected sides of patient group with unilateral CLP regarding the nasolacrimal duct diameter. The differences were not statistically significant among all groups regarding the mean nasolacrimal duct length.

Conclusion:

The diameter of the nasolacrimal duct at the affected side of unilateral CLP was narrower than the unaffected side. According to this result, the CLP deformity can have an effect on the nasolacrimal duct diameter. However, CLP might not affect the nasolacrimal duct length.
Large-Scale Study of Long-Term Anteroposterior Stability in a Surgery-First Orthognathic Approach Without Presurgical Orthodontic Treatment
Authors: Jeong Woo Shik , Lee Jang Yeol , Choi Jong Woo
Published: September 2017

Presurgical orthodontic treatment has long been known as a prerequisite in the traditional orthognathic approach. However, achieving ideal decompensation is very difficult even in the presurgical orthodontic period. For minimization of this problem, the surgery-first orthognathic concept has been introduced. The authors hypothesized that this treatment modality will be feasible for skeletal class III dentofacial deformity patients. In this study, the authors tried to compare the traditional and surgery-first approaches regarding long-term outcomes in terms of stability, based on large-scale data. The patients included in this study had skeletal class III dentofacial deformities, and all underwent, and completed, orthognathic surgery between December 2007 and December 2015. The inclusion criteria were based on presurgical simulation on the dental model, and the authors predicted the potential of the surgery-first approach by this preoperative simulation model. Patients with cleft-related syndromes, those who underwent orthognathic surgeries due to facial asymmetry or class II deformity were excluded from the study. In total, 104 class III patients were enrolled in the surgery-first group and 51 class III patients in the traditional orthodontic-first group. Satisfactory results were achieved in all 155 patients with dentofacial deformity in this study. Overall, the analysis revealed that anteroposterior skeletal long-term stability in the surgery-first approach was not different, statistically or otherwise, from that in the orthodontic-first approach. Anteroposterior skeletal stability was maintained well in the surgery-first approach. In conclusion, surgery-first approach without presurgical orthodontic treatment can achieve similar results of long-term anteroposterior stability in correcting dentofacial deformities as the orthodontic treatment-first approach.
Simultaneous Reconstruction of Both Facial Paralysis and Temporomandibular Joint Ankylosis With a Composite Flap From Dorsum of Foot
Authors: Akdag Osman , Evin Seyda Guray , Karamese Mehtap , Tosun Zekeriya
Published: September 2017

Free extensor digitorum brevis muscle flap in facial paralysis, and the second metatarsophalangeal joint flap is used at the temporomandibular joint reconstruction for a long time. Anatomically, these flaps can be harvested through even the same pedicle flap even on the same regions. Literature is available of their usage along with the use of hand and upper extremity reconstruction. Unlike this example, the authors have used these flaps in maxillofacial region where facial paralysis and temporomandibular joint reconstruction will be performed together. In this study, clinical report and surgical details of this flap have been shared.