bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterizing atomic magnetic gradiometers for fetal magnetocardiography
Authors: Sulai I. A. , DeLand Z. J. , Bulatowicz M. D. , Wahl C. P. , Wakai R. T. , Walker T. G.
Published: August 2019

Atomic magnetometers (AMs) offer many advantages over superconducting quantum interference devices due to, among other things, having comparable sensitivity while not requiring cryogenics. One of the major limitations of AMs is the challenge of configuring them as gradiometers. We report the development of a spin-exchange relaxation free vector atomic magnetic gradiometer with a sensitivity of 3 fT cm−1 Hz−1/2 and common mode rejection ratio >150 in the band from DC to 100 Hz. We introduce a background suppression figure of merit for characterizing the performance of gradiometers. It allows for optimally setting the measurement baseline and for quickly assessing the advantage, if any, of performing a measurement in a gradiometric mode. As an application, we consider the problem of fetal magnetocardiography (fMCG) detection in the presence of a large background maternal MCG signal.
Particles dispersion and deposition in inhomogeneous turbulent flows using continuous random walk models
Authors: Mofakham Amir A. , Ahmadi Goodarz
Published: August 2019

The suitability of the normalized Langevin stochastic equation with appropriate drift correction for simulation of instantaneous fluctuation velocities in inhomogeneous turbulent flows was studied. The Reynolds Stress Transport turbulence model of the ANSYS-Fluent code was used to evaluate the inhomogeneous turbulent flow properties in a two-dimensional duct flow. The simulation results were then used in an in-house Matlab particle tracking code and the trajectories of about 2 × 105 randomly distributed particles in the channel were evaluated by solving the particle equation of motion including the drag and Brownian forces under the one-way coupling assumption. The performance of the Continuous Random Walk (CRW) stochastic model using the conventional nonnormalized, as well as the normalized Langevin equations without and with the drift term for predicting a uniform distribution for the fluid-tracer particles in an inhomogeneous turbulent flow was examined. The accuracy of these models in predicting the deposition velocities and distribution of solid particles with diameters ranging from 10 nm to 30 μm was also carefully examined. In addition, the effects of including the finite-inertia coefficient in the drift term and using the corrected root mean square normal velocity in the near-wall region on the accuracy of the results were emphasized. By exploring the concentration profiles and deposition velocities of particles resulting from different CRW models, it was concluded that the Normalized-CRW model including the appropriate drift term leads to the most accurate results.
Tuning the shape of magneto-optical Kerr spectrum by changing the strip width in one-dimensional Ag-Co-Ag magnetoplasmonic nanogratings
Authors: Zhu Ruxian , Chen Leyi , Zong Zhenxing , Tang Zhixiong , Qian Jin , Tang Shaolong , Du Youwei
Published: August 2019

Magnetoplasmonic nanostructures have received significant attention as they have the ability to manipulate the magneto-optical response more precisely and efficiently. Here, we report a method to manipulate the shape of the longitudinal magneto-optical Kerr rotation spectrum in one-dimensional magnetoplasmonic nanogratings. It is found that changing the strip width of the nanograting can alter the sign of the maximal Kerr rotation of the two Kerr spectra. Experimentally, we obtained the maximal Kerr rotation angles of 0.30° and −0.18° at the wavelength of 530 nm for strip widths of 200 nm and 160 nm, respectively, in the Ag/Co/Ag grating sample. It has been revealed that the sign change of the two maximal Kerr angles is attributed to the relative contributions of the dipole-dipole interactions. These findings are of potential values for practical applications of magneto-optical devices.
Analytical solutions of incompressible laminar channel and pipe flows driven by in-plane wall oscillations
Authors: Józsa Tamás István
Published: August 2019

Emerging flow control strategies have been proposed to tackle long-lasting problems, for instance, precise mixing of chemicals and turbulent drag reduction. Employing actuators imposing in-plane wall oscillations are particularly popular. This paper investigates incompressible laminar rectangular channel and circular pipe flows driven by uniform and traveling wave in-plane wall oscillations. A comprehensive set of exact analytical solutions are presented describing parallel and concentric flows. Dimensionless groups are identified, and it is described how they characterize the one- and two-dimensional time-dependent velocity and pressure fields. The solutions enable to compute the oscillating boundary layer thickness. It is demonstrated that the dimensionless groups and the boundary layer thickness narrows the region of interest within the parameter space. In particular, the oscillating boundary layer thickness obtained from these laminar flows estimates a “radius of action” within which flow features can be altered to boost mixing or reduce turbulent friction drag. The results are suitable for software validation and verification, may open the way to promising complex wall oscillations, and ease the optimization task that delays the industrial application of flow controls.
Making inertial confinement fusion models more predictive
Authors: Gaffney Jim A. , Brandon Scott T. , Humbird Kelli D. , Kruse Michael K. G. , Nora Ryan C. , Peterson J. Luc , Spears Brian K.
Published: August 2019

Computer models of inertial confinement fusion (ICF) implosions play an essential role in experimental design and interpretation as well as our understanding of fundamental physics under the most extreme conditions that can be reached in the laboratory. Building truly predictive models is a significant challenge, with the potential to greatly accelerate progress to high yield and ignition. One path to more predictive models is to use experimental data to update the underlying physics in a way that can be extrapolated to new experiments and regimes. We describe a statistical framework for the calibration of ICF simulations using data collected at the National Ignition Facility (NIF). We perform Bayesian inferences for a series of laser shots using an approach that is designed to respect the physics simulation as much as possible and then build a second model that links the individual-shot inferences together. We show that this approach is able to match multiple X-ray and neutron diagnostics for a whole series of NIF “BigFoot” shots. Within the context of 2D radiation hydrodynamic simulations, our inference strongly favors a significant reduction in fuel compression over other known degradation mechanisms (namely, hohlraum issues and engineering perturbations). This analysis is expanded using a multifidelity technique to pick fuel-ablator mix from several candidate causes of the degraded fuel compression (including X-ray preheat and shock timing errors). Finally, we use our globally calibrated model to investigate the extra laser drive energy that would be required to overcome the inferred fuel compression issues in NIF BigFoot implosions.
Numerical simulations of a stick-slip spherical particle in Poiseuille flow
Authors: Trofa Marco , D’Avino Gaetano , Maffettone Pier Luca
Published: August 2019

The dynamics of a stick-slip “Janus” spherical particle suspended in a Newtonian fluid flowing in a cylindrical microchannel is studied by direct numerical simulations. Partial slip is imposed on half of the particle surface, whereas the no-slip boundary condition is present on the other half. The finite element method is used to solve the balance equations under creeping flow conditions. The translational and rotational velocities of the particle are evaluated at several orientations and distances from the tube centerline. The trajectories are then reconstructed by solving the kinematic equations where the velocities are taken by interpolating the simulation data. The particle dynamics is investigated by varying the initial position and orientation, the slip parameter, and the confinement ratio. The results, presented in terms of particle trajectories and phase portraits, highlight the existence of two relevant regimes: a periodic oscillation or a migration toward the tube axis for particle positions sufficiently far from or near the centerline, respectively. The basin of attraction of the tube axis grows with particle confinement and slip coefficient although the dynamics is qualitatively unaffected.
Monolayer metamaterial for full mode-converting transmission of elastic waves
Authors: Yang Xiongwei , Kweun Minwoo , Kim Yoon Young
Published: August 2019

For actual realization of full-power longitudinal-to-transverse (transverse-to-longitudinal) mode-converting transmission, we propose a single-phase “monolayer” anisotropic metamaterial that is easy to fabricate with a dimension of 4–5 times the target wavelength. Full-power mode conversion can be critically useful in ultrasonic applications, but this has not been experimentally validated because a metamaterial consisting of subwavelength unit cells is difficult to fabricate. Here, we achieve full-power mode-converting transmission with a monolayer, and its effective material properties should satisfy the required theoretical conditions. While an S-parameter based method can be employed to retrieve the effective material properties, an elaborate method should be developed to estimate its effective size because the monolayer metamaterial directly interfaces with the background medium. To this end, we propose a T-matrix based method to estimate its size. Finally, ultrasonic experiments performed with the designed monolayer confirmed the realization of nearly full-power mode conversion.
A numerical investigation of dynamics of bubbly flow in a ferrofluid by a self-correcting procedure-based lattice Boltzmann flux solver
Authors: Li You , Niu Xiao-Dong , Khan Adnan , Li De-Cai , Yamaguchi Hiroshi
Published: August 2019

In this work, the dynamics of bubbly flow in a dielectric ferrofluid under a uniform magnetic field has been numerically studied by a self-correcting procedure-based lattice Boltzmann flux solver. The investigation cases focus specifically on two bubbles merging and a single bubble rising in ferrofluid with a large density ratio under an applied uniform magnetic field. By accounting for the effects of the magnetic field intensity, susceptibility, Reynolds number, and Eotvos number, the mechanisms of bubble motion and deformation in the ferrofluid under the external magnetic field are analyzed.
Angle-resolved photoemission spectroscopy study of magnetic topological insulator candidates of Ce-doped Bi2–xCexSe3
Authors: Lee Eunsook , Seong Seungho , Yang Min Young , Kim Jinsu , Jung Myung-Hwa , Park Byeong-Gyu , Kim Younghak , Han Sang Wook , Kang J.-S.
Published: August 2019

The electronic structures of the magnetic topological insulator candidates of Ce-substituted Bi2–xCexSe3 (x ≤ 0.12) have been investigated through angle-resolved photoemission spectroscopy (ARPES), soft X-ray absorption spectroscopy (XAS), and soft X-ray magnetic circular dichroism (XMCD) measurements on high-quality single crystals. Ce 3d XAS and XMCD measurements provide evidence that the substituted Ce ions in Bi2–xCexSe3 are trivalent and magnetic, confirming the purely magnetic effect of the Ce-substitution. ARPES measurements reveal the formation of an energy gap (Δ) for x > 0, indicating that the finite Δ arises from the broken time-reversal symmetry due to the substituted magnetic Ce impurities.
Titanium dioxide investigated with time-differential perturbed angular correlation at CERN
Authors: Johnson-Groh Mara
Published: August 2019

Using time-differential perturbed angular correlation, researchers investigate the hyperfine interactions of titanium dioxide using the ISOLDE facility at CERN.
Toxoplasma gondii seroprevalence in endangered bridled nailtail wallabies and co-occurring species
Authors: Ross Alexandra K. , Lowry Janelle , Elphinstone Andrew , Lawes Jasmin C.
Published: August 2019

The parasite Toxoplasma gondii can infect any warm-blooded species; however, seroprevalence in most species remains largely unknown. In this study we examined the presence of T. gondii antibodies in captured individuals in the two remaining wild populations and one captive population of endangered bridled nailtail wallabies (Onychogalea fraenata). Samples from cats (Felis catus), rabbits (Oryctolagus cuniculus) and dogs (Canis lupus) were also taken opportunistically during invasive species control at the two wild populations. Seventy-one wallabies, sixteen cats, four rabbits, and two dogs’ blood samples were tested for T. gondii using a modified agglutination test. Half of the tested feral cats (n = 8) were seropositive and all intermediate hosts were seronegative for T. gondii antibodies. This unexpected result suggests a loss of infected individuals before capture and testing, or parasite infectivity being suppressed by Queensland’s hot, dry climate.
Intensified texture of Zr702 sheet after slow cooling from near β-transus temperature
Authors: Zeng Lingguo , Zhu Yufan , Li Zhijun , Chai Linjiang , Chen Ke , Pan Hucheng , Yang Zhinan , Guo Ning , Yang Changlin
Published: August 2019

Microstructures and textures of a Zr702 sheet subjected to slow cooling (air cooling (AC) and furnace cooling (FC)) from a near β-transus temperature (980°C) were characterised by electron channelling contrast imaging and electron backscatter diffraction techniques. Results show that textural intensities of both the AC and the FC are markedly higher than that of the initial specimen and the FC specimen owns the strongest texture. After both the heat treatments, the initial bimodal basal textural features are retained with the recrystallisation textural component (0°, 30°, 30°) becoming dominant but the deformation textural component (0°, 30°, 0/60°) largely weakened. The textural intensification is attributed to strong variant selection during the β → α phase transformation and slow cooling-induced sufficient growth of residual prior α grains.
The Opioid and Related Drug Epidemics in Rural Appalachia: A Systematic Review of Populations Affected, Risk Factors, and Infectious Diseases
Authors: Schalkoff Christine A. , Lancaster Kathryn E. , Gaynes Bradley N. , Wang Vivian , Pence Brian W. , Miller William C. , Go Vivian F.
Published: August 2019

Background/aims

To examine trends in rural Appalachian opioid and related drug epidemics during the past 10 years, including at-risk populations, substance use shifts and correlates, and associated infections.

Methods

We conducted this review in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Seven databases were searched for quantitative studies, published between January 2006 and December 2017, of drug use, drug-related mortality, or associated infections in rural Appalachia.

Results

Drug-related deaths increased in study states, and a high incidence of polydrug toxicity was noted. Rural substance use was most common among young, white males, with low education levels. A history of depression/anxiety was common among study populations. Prescription opioids were most commonly used, often in conjunction with sedatives. Women emerged as a distinct user subpopulation, with different routes of drug use initiation and drug sources. Injection drug use was accompanied by risky injection behaviors and was associated with hepatitis C.

Conclusions

This review can help to inform substance use intervention development and implementation in rural Appalachian populations. Those at highest risk are young, white males who often engage in polysubstance use and have a history of mental health issues. Differences in risk factors among other groups and characteristics of drug use in rural Appalachian populations that are conducive to human immunodeficiency virus (HIV) spread also warrant consideration.
Provider–Patient Communication about Prescription Drug Abuse: A Qualitative Analysis of the Perspective of Prescribers
Authors: Mathis Stephanie M. , Hagaman Angela , Hagemeier Nicholas , Baker Katie , Pack Robert P.
Published: August 2019

Background

Provider–patient communication underpins many initiatives aimed at reducing the public health burden associated with prescription drug abuse in the United States. The purpose of this qualitative analysis was to examine the characteristics of provider–patient communication about prescription drug abuse from the perspective of prescribers.

Methods

From 2014 to 2015, 10 semi-structured interviews were conducted with a purposive sample of prescribers from multiple professions and medical fields in Central and South Central Appalachia. The interviews were conducted using a guide informed by Social Cognitive Theory and community theory research, audio-recorded, and transcribed verbatim. Thematic analysis, facilitated by NVivo 10 software, was used to generate themes.

Results

Prescribers described 3 primary communication patterns with patients related to prescription drug abuse—informative, counteractive, and supportive. Prescribers also reported multiple factors—personal (e.g., education, experiences, and feelings of tension) and environmental (e.g., relationship with a patient, clinical resources, and policies on controlled prescription drugs)—that affect provider–patient communication and, by association, delivery of patient care related to prescription drug abuse.

Conclusions

The findings suggest that provider–patient communication about prescription drug abuse is multidimensional and dynamic, characterized by multiple communication patterns and contributory factors. They have implications for (1) research aimed at advancing theoretical understanding of prescriber prescription drug abuse communication behaviors with patients and (2) interventions aimed at strengthening prescriber prescription drug abuse communication behaviors with patients.
Bayesian pharmacokinetic modeling of dynamic contrast-enhanced magnetic resonance imaging: validation and application
Authors: Mittermeier Andreas , Ertl-Wagner Birgit , Ricke Jens , Dietrich Olaf , Ingrisch Michael
Published: August 2019

Tracer-kinetic analysis of dynamic contrast-enhanced magnetic resonance imaging data is commonly performed with the well-known Tofts model and nonlinear least squares (NLLS) regression. This approach yields point estimates of model parameters, uncertainty of these estimates can be assessed e.g. by an additional bootstrapping analysis. Here, we present a Bayesian probabilistic modeling approach for tracer-kinetic analysis with a Tofts model, which yields posterior probability distributions of perfusion parameters and therefore promises a robust and information-enriched alternative based on a framework of probability distributions. In this manuscript, we use the quantitative imaging biomarkers alliance (QIBA) Tofts phantom to evaluate the Bayesian tofts model (BTM) against a bootstrapped NLLS approach. Furthermore, we demonstrate how Bayesian posterior probability distributions can be employed to assess treatment response in a breast cancer DCE-MRI dataset using Cohen’s d. Accuracy and precision of the BTM posterior distributions were validated and found to be in good agreement with the NLLS approaches, and assessment of therapy response with respect to uncertainty in parameter estimates was found to be excellent. In conclusion, the Bayesian modeling approach provides an elegant means to determine uncertainty via posterior distributions within a single step and provides honest information about changes in parameter estimates.
Estimation of Peatland Distribution Using Ratio Dual-pol from Sentinel-1A
Authors: Putiamini S , Marpaung F , Fernando D
Published: August 2019

In Indonesia, forests fires particularly in tropical peatland have are a major problem unresolved. These conditions need a strong peatland management to control and reduce forest fires. Monitoring peatland conditions are crucial for the actions. Additionally, Synthetic Aperture Radar (SAR) images have wide applications in remote sensing and mapping. It utilized area when meteorological conditions are not suitable for acquirement of optical data. In this research, we used a dual-pol (VV and VH) Sentinel-1A and estimated soil moisture of peat in Siak Regency, Riau Province, Indonesia using a modified Dubois Inversion. At the site, soil moisture at the four selected segments (namely, A1, A2, D1 and J1) are also measured in May 2017. Results show that the peatland areas have a ratio of polarimetric features (VH/VV) of 1.5 to 1.6.
Solution-based synthesis of kesterite thin film semiconductors
Authors: Todorov T , Hillhouse H W , Aazou S , Sekkat Z , Vigil-Galán O , Deshmukh S D , Agrawal R , Bourdais S , Valdés M , Arnou P , Mitzi D B , Dale P J
Published: August 2019

Large-scale deployment of photovoltaic modules is required to power our renewable energy future. Kesterite, Cu2ZnSn(S, Se)4, is a p-type semiconductor absorber layer with a tunable bandgap consisting of earth abundant elements, and is seen as a potential ‘drop-in’ replacement to Cu(In,Ga)Se2 in thin film solar cells. Currently, the record light-to-electrical power conversion efficiency (PCE) of kesterite-based devices is 12.6%, for which the absorber layer has been solution-processed. This efficiency must be increased if kesterite technology is to help power the future. Therefore two questions arise: what is the best way to synthesize the film? And how to improve the device efficiency? Here, we focus on the first question from a solution-based synthesis perspective. The main strategy is to mix all the elements together initially and coat them on a surface, followed by annealing in a reactive chalcogen atmosphere to react, grow grains and sinter the film. The main difference between the methods presented here is how easily the solvent, ligands, and anions are removed. Impurities impair the ability to achieve high performance (>∼10% PCE) in kesterite devices. Hydrazine routes offer the least impurities, but have environmental and safety concerns associated with hydrazine. Aprotic and protic based molecular inks are environmentally friendlier and less toxic, but they require the removal of organic and halogen species associated with the solvent and precursors, which is challenging but possible. Nanoparticle routes consisting of kesterite (or binary chalcogenides) particles require the removal of stabilizing ligands from their surfaces. Electrodeposited layers contain few impurities but are sometimes difficult to make compositionally uniform over large areas, and for metal deposited layers, they have to go through several solid-state reaction steps to form kesterite. Hence, each method has distinct advantages and disadvantages. We review the state-of-the art of each and provide perspective on the different strategies.
Successful ageing from old to very old: a longitudinal study of 12,432 women from Australia
Authors: Byles Julie E , Rahman Md Mijanur , Princehorn Emily M , Holliday Elizabeth G , Leigh Lucy , Loxton Deborah , Beard John , Kowal Paul , Jagger Carol
Published: August 2019

Objectives

We examined the development of disease and disability in a large cohort of older women, the extent to which these conditions exempt them from being classified as successful agers and different trajectories of disease, disability and longevity across women’s later life.

Methods

We used survey data from 12,432 participants of the 1921–26 birth cohort of the Australian Longitudinal Study of Women’s Health from 1996 (age 70–75) to 2016 (age 90–95). Repeated measures latent class analysis (RMLCA) identified trajectories of the development of disease with or without disability and according to longevity. Bivariate analyses and multivariable multinomial logistic regression models were used to examine the association between participants’ baseline characteristics and membership of the latent classes.

Results

Over one-third of women could be considered to be successful agers when in their early 70s, few women could still be classified in this category throughout their later life or by the end of the study when they were in their 90s (~1%). RMLCA identified six trajectory groups including managed agers long survivors (9.0%) with disease but little disability, usual agers long survivors (14.9%) with disease and disability, usual agers (26.6%) and early mortality (25.7%). A small group of women having no major disease or disability well into their 80s were identified as successful agers (5.5%). A final group, missing surveys (18.3%), had a high rate of non-death attrition. Groups were differentiated by a number of social and health factors including marital status, education, smoking, body mass index, exercise and social support.

Conclusions

The study shows different trajectories of disease and disability in a cohort of ageing women, over time and through to very old ages. While some women continue into very old age with no disease or disability, many more women live long with disease but little disability, remaining independent beyond their capacity to be classified as successful agers.
Climate change, individual emissions and agent-regret
Authors: Svoboda Toby
Published: August 2019

Some philosophers (e.g. Walter Sinnott-Armstrong) are skeptical that individuals are morally blameworthy for their own greenhouse gas emissions. Although an individual’s emissions may contribute to climate change that is on the whole very harmful, perhaps that contribution is too trivial to render it morally impermissible. Against this view, there have been attempts (e.g. by John Nolt) to show that an individual’s lifetime emissions cause non-trivial harm, but in this paper I will consider what follows if it is true that an individual is not blameworthy for her emissions. Specifically, I ask how a non-blameworthy emitter would best regard (in a moral sense) his or her own emissions. I will argue that the appropriate attitude to adopt here is one of agent-regret. This allows us to capture the moral disvalue of one’s emissions without entailing blame for them.
Machine learning empowers phosphoproteome prediction in cancers
Authors: Li Hongyang , Guan Yuanfang
Published: August 2019

Motivation

Reversible protein phosphorylation is an essential post-translational modification regulating protein functions and signaling pathways in many cellular processes. Aberrant activation of signaling pathways often contributes to cancer development and progression. The mass spectrometry-based phosphoproteomics technique is a powerful tool to investigate the site-level phosphorylation of the proteome in a global fashion, paving the way for understanding the regulatory mechanisms underlying cancers. However, this approach is time-consuming and requires expensive instruments, specialized expertise and a large amount of starting material. An alternative in silico approach is predicting the phosphoproteomic profiles of cancer patients from the available proteomic, transcriptomic and genomic data.

Results

Here, we present a winning algorithm in the 2017 NCI-CPTAC DREAM Proteogenomics Challenge for predicting phosphorylation levels of the proteome across cancer patients. We integrate four components into our algorithm, including (i) baseline correlations between protein and phosphoprotein abundances, (ii) universal protein–protein interactions, (iii) shareable regulatory information across cancer tissues and (iv) associations among multi-phosphorylation sites of the same protein. When tested on a large held-out testing dataset of 108 breast and 62 ovarian cancer samples, our method ranked first in both cancer tissues, demonstrating its robustness and generalization ability.

Availability and implementation

Our code and reproducible results are freely available on GitHub: https://github.com/GuanLab/phosphoproteome_prediction.

Supplementary information

Supplementary data are available at Bioinformatics online.
A Call to Action: The Role of Antiretroviral Stewardship in Inpatient Practice, a Joint Policy Paper of the Infectious Diseases Society of America, HIV Medicine Association, and American Academy of HIV Medicine
Authors: Koren David E , Scarsi Kimberly K , Farmer Eric K , Cha Agnes , Adams Jessica L , Pandit Neha Sheth , Chang Jennifer , Scott James , Hardy W David
Published: August 2019

Persons living with human immunodeficiency virus (HIV) and others receiving antiretrovirals are at risk for medication errors during hospitalization and at transitions of care. These errors may result in adverse effects or viral resistance, limiting future treatment options. A range of interventions is described in the literature to decrease the occurrence or duration of medication errors, including review of electronic health records, clinical checklists at care transitions, and daily review of medication lists. To reduce the risk of medication-related errors, antiretroviral stewardship programs (ARVSPs) are needed to enhance patient safety. This call to action, endorsed by the Infectious Diseases Society of America, the HIV Medicine Association, and the American Academy of HIV Medicine, is modeled upon the success of antimicrobial stewardship programs now mandated by the Joint Commission. Herein, we propose definitions of ARVSPs, suggest resources for ARVSP leadership, and provide a summary of published, successful strategies for ARVSP that healthcare facilities may use to develop locally appropriate programs.
Monitoring transcellular fluid shifts during episodes of intradialytic hypotension using bioimpedance spectroscopy
Authors: Ismail Abdul Hamid , Gross Theresa , Schlieper Georg , Walter Marian , Eitner Frank , Floege Jürgen , Leonhardt Steffen
Published: August 2019

Background

Transcellular fluid shifts during dialysis treatment could be related to the frequency and severity of intradialytic hypotension (IDH). We investigated that (i) in addition to ultrafiltration, extracellular fluid (ECF) is further depleted by transcellular fluid shifts and (ii) changes in intracellular fluid (ICF), which have been overlooked so far, or if they were considered, are not understood, might be due to these fluid shifts.

Methods

Thirty-six patients were categorized as haemodynamically stable, asymptomatic IDH or unstable (symptomatic IDH) according to their changes in systolic blood pressure and associated clinical symptoms. Their intradialytic changes in body fluids were studied using bioimpedance spectroscopy measurements and compared among groups.

Results

For IDH-prone patients, data showed a rapid drop in ECF that was more than expected from the ultrafiltration rate (UFR) profile and was associated with a significant increase in ICF (P = 0.001). Study of accumulative loss profiles of ECF revealed a loss in ECF up to 300 ml, more than that predicted from UFR for unstable patients.

Conclusions

The considerable discrepancy between the expected and measured loss in ECF might provide evidence of transcellular fluid shifts possibly induced by changes in plasma osmolarity due to haemodialysis. Moreover, the results suggest a pattern of fluid removal in IDH-prone patients that significantly differs from that in haemodynamically stable patients.
Effects of body weight variation in obese kidney recipients: a retrospective cohort study
Authors: Montero Nuria , Quero Maria , Arcos Emma , Comas Jordi , Rama Inés , Lloberas Núria , Coloma Ana , Meneghini Maria , Manonelles Anna , Melilli Edoardo , Bestard Oriol , Tort Jaume , Cruzado Josep M
Published: August 2019

Background

Obese kidney allograft recipients have worse results in kidney transplantation (KT). However, there is lack of information regarding the effect of body mass index (BMI) variation after KT. The objective of the study was to evaluate the effects of body weight changes in obese kidney transplant recipients.

Methods

In this study we used data from the Catalan Renal Registry that included KT recipients from 1990 to 2011 (n = 5607). The annual change in post-transplantation BMI was calculated. The main outcome variables were delayed graft function (DGF), estimated glomerular filtration rate (eGFR) and patient and graft survival.

Results

Obesity was observed in 609 patients (10.9%) at the time of transplantation. The incidence of DGF was significantly higher in obese patients (40.4% versus 28.3%; P < 0.001). Baseline obesity was significantly associated with worse short- and long-term graft survival (P < 0.05) and worse graft function during the follow-up (P < 0.005). BMI variations in obese patients did not improve eGFR or graft or patient survival.

Conclusions

Our conclusion is that in obese patients, decreasing body weight after KT does not improve either short-term graft outcomes or long-term renal function.
Complications While Waiting for IBD Surgery—Short Report
Authors: Wasmann Karin A ,   IBD study group Amsterdam UMC, location AMC, Buskens Christianne J , Bemelman Willem A , Hompes Roel , Tanis Pieter J , D’Haens Geert R A M , Dolmaci Onur B , Groen Jip , van der Bilt Jarmila , Ponsioen Cyriel I J , Duijvestein Marjolijn , Lowenberg Mark , Wildenberg Manon E , Gecse Krisztina B
Published: August 2019

Background and Aims

While striving to meet the quality standards for oncological care, hospitals frequently prioritize oncological procedures, resulting in longer waiting times to surgery for benign diseases like inflammatory bowel disease [IBD]. The aim of this Short Report is to highlight the potential consequences of a longer interval to surgery for IBD patients.

Methods

The mean waiting times to elective surgery for IBD patients with active and inactive disease [e.g. pouch surgery after subtotal colectomy] at the Amsterdam UMC, location AMC, between 2013 and 2015 were compared with those for colorectal cancer surgery. Correlations between IBD waiting times and disease complications [e.g. >5% weight loss, abscess formation] and additional health-care consumption [e.g. telephone/outpatient clinic appointment, hospital admission] during these waiting times were assessed.

Results

The mean waiting was 10 weeks [SD 8] for patients with active disease [n = 173] and 15 weeks [SD 16] for those with inactive disease [n = 97], remarkably higher than that for colorectal cancer patients [5 weeks]. While awaiting surgery, 1 out of 8 patients had to undergo surgery in an acute or semi-acute setting. Additionally, 19% of patients with active disease had disease complications, and 44% needed additional health care. The rates were comparable for patients with inactive disease.

Conclusions

The current waiting time to surgery is not medically justified and creates a burden for health-care resources. This issue should be brought to the attention of policy makers, as it requires a structural solution. It is time to also set a maximally acceptable waiting time to surgery for IBD patients.
Mental health system costs, resources and constraints in South Africa: a national survey
Authors: Docrat Sumaiyah , Besada Donela , Cleary Susan , Daviaud Emmanuelle , Lund Crick
Published: August 2019

The inclusion of mental health in the Sustainable Development Goals represents a global commitment to include mental health among the highest health and development priorities for investment. Low- and middle-income countries (LMICs), such as South Africa, contemplating mental health system scale-up embedded into wider universal health coverage-related health system transformations, require detailed and locally derived estimates on existing mental health system resources and constraints. The absence of these data has limited scale-up efforts to address the burden of mental disorders in most LMICs. We conducted a national survey to quantify public expenditure on mental health and evaluate the constraints of the South African mental health system. The study found that South Africa’s public mental health expenditure in the 2016/17 financial year was USD615.3 million, representing 5.0% of the total public health budget (provincial range: 2.1–7.7% of provincial health budgets) and USD13.3 per capita uninsured. Inpatient care represented 86% of mental healthcare expenditure, with nearly half of total mental health spending occurring at the psychiatric hospital-level. Almost one-quarter of mental health inpatients are readmitted to hospital within 3 months of a previous discharge, costing the public health system an estimated USD112 million. Crude estimates indicate that only 0.89% and 7.35% of the uninsured population requiring care received some form of public inpatient and outpatient mental healthcare, during the study period. Further, mental health human resource availability, infrastructure and medication supply are significant constraints to the realization of the country’s progressive mental health legislation. For the first time, this study offers a nationally representative reflection of the state of mental health spending and elucidates inefficiencies and constraints emanating from existing mental health investments in South Africa. With this information at hand, the government now has a baseline for which a rational process to planning for system reforms can be initiated.
Inclusion of jellyfish in 30+ years of Ecopath with Ecosim models
Authors: Lamb Philip D , Hunter Ewan , Pinnegar John K , Doyle Thomas K , Creer Simon , Taylor Martin I
Published: August 2019

A review of the functional role of jellyfish in Ecopath with Ecosim (EwE) models by Pauly et al. [Pauly, D., Graham, W., Libralato, S., Morissette, L., and Deng Palomares, M. L. 2009. Jellyfish in ecosystems, online databases, and ecosystem models. Hydrobiologia, 616: 67–85.] a decade ago concluded that recreation of jellyfish population dynamics in models required additional ecological research and the careful consideration of their unique biology during model construction. Here, amidst calls for ecosystem-based management and the growing recognition of jellyfishes' role in foodwebs, we investigate how jellyfish are implemented in EwE models and identify areas requiring improvement. Over time, an increasing percentage of models have included jellyfish. Jellyfish were often linked to the wider ecosystem, with many predators and prey included in models. However, ecotrophic efficiency, a measure of the extent to which they are used by higher trophic levels, was frequently set at low values, suggesting that jellyfish are still perceived as under-utilized components of the ecosystem. Moving forward, greater care should be taken to differentiate the functional roles played by ctenophores, cnidarians, and pelagic tunicates. Additionally, when feasible, early life stages should be incorporated as multi-stanza groups to more accurately depict jellyfishes' complex life cycle.
Late surgical conversions after abdominal endovascular aortic repair: underlying mechanisms, clinical results and strategies for prevention
Authors: Juraszek Andrzej , Rylski Bartosz , Kondov Stoyan , Scheumann Johannes , Kreibich Maximilian , Morlock Julia , Schröfel Holger , Berger Tim , Kari Fabian , Siepe Matthias , Beyersdorf Friedhelm , Czerny Martin
Published: August 2019

OBJECTIVES

Our goal was to report our results of late surgical conversion after endovascular aneurysm repair (EVAR).

METHODS

Variables analysed included baseline data, preinterventional anatomy, type of endovascular intervention, indications for conversion, operative technique, postoperative complications and follow-up survival rate.

RESULTS

Between April 2011 and May 2018, 16 patients with late complications after EVAR underwent open surgical conversion at our institution. The mean age was 73.6 [standard deviation (SD) 8.9] years. There were 3 (18.8%) female patients. In 15 patients, the indication for primary EVAR was abdominal aortic aneurysm, and in 1 patient, chronic abdominal aortic dissection. Five patients underwent secondary EVAR service interventions for endoleak treatment between the index EVAR and the final secondary surgical conversion. Thirteen patients underwent surgery in an elective setting and 3 patients underwent emergency surgery. The mean time from EVAR to open surgical conversion was 6.31 (SD 4.0) years (range 1.2–16.0 years). The most common indication for conversion was endoleak formation (n = 12, 75%), followed by 3 cases of aortic rupture (1 patient with primary type 1 endoleak) and 2 cases of stent graft infection—1 with and 1 without an aortoduodenal fistula. One patient died during emergency open surgery of cardiopulmonary instability. Three patients developed postoperative renal dysfunction with recovery of their renal function before discharge. The in-hospital mortality rate was 12.5%. The median follow-up was 16.5 months (interquartile range 21 months). Freedom from death and aortic reintervention was 100%, respectively. After careful review of the index computed tomography scans for EVAR, the majority of failures could have been anticipated due to trade-offs with regard to length, diameter, morphology, shape and angulation of the proximal and/or distal landing zone.

CONCLUSIONS

Despite being a challenging operation, late surgical conversion after EVAR yields excellent results with regard to outcome and freedom from the need for further aortic interventions. An anticipative strategy adhering to current recommendations for using or refraining from using EVAR in patients with anatomical challenges will help reduce the need for secondary surgical conversions and keep them to minimum.
Energy conservation analysis of regenerative radiator for low-temperature heating
Authors: Li Cuimin , Li Chunying , Wang Lei
Published: August 2019

In this paper, the phase change plate is made of the organic phase change material (PCM) with the phase change temperature of about 30°C. The PCM is installed in the capillary natural convection radiator with the water supply temperature of 30–60°C. A low-temperature natural convection radiator with heat storage function is formed. The mathematic model is established by enthalpy method and solved by line-by-line iteration method. The applicability and economy of the equipment in Shanghai area are calculated. Taking the time ratio and average temperature of the target domain as the limiting parameters, the operation schemes suitable for three representative days are determined, and the optimum thickness of the phase change plate is 0.05 m for use in Shanghai. The regenerative low-temperature heating radiator provides a new idea for the application of PCMs in the field of low-temperature heating. The conclusions obtained provide a basis for further research and application of the equipment.
General Court clarifies for the first time the scope of protection of plant variety denominations under Article 7(1)(m) of the European Trade Mark Regulation
Authors: Martin Stefan
Published: August 2019

Case T-569/18, Kordes' Rose Monique, General Court of the European Union, decision of 18 June 2019, EU:T:2019:421
Cerebrospinal Fluid Shunting Improves Long-Term Quality of Life in Idiopathic Normal Pressure Hydrocephalus
Authors: Israelsson Hanna , Eklund Anders , Malm Jan
Published: August 2019

BACKGROUND

The short- and long-term impact of cerebrospinal fluid shunting on quality of life (QoL) in idiopathic normal pressure hydrocephalus (INPH) is poorly understood.

OBJECTIVE

To investigate QoL in shunted INPH patients compared to the population and to investigate which factors influence QoL in INPH.

METHODS

INPH patients consecutively shunted in Sweden during 2008-2010 were scrutinized. Population-based controls were age- and sex-matched to the patients. Included participants were the following: 176 INPH patients and 368 controls. QoL was assessed using the EuroQol 5-dimension 5-level (EQ5D5L) instrument, which measures overall QoL and health status in 5 dimensions. Independency (accommodation and/or need for in-home care) and comorbidities were assessed. Patients were followed up 6-45 mo after surgery (mean follow-up time: 21 mo).

RESULTS

Shunting improved QoL (P < .001) and health status in all dimensions (P < .005). Shunted INPH patients had lower QoL than controls (P < .001). The patients’ health status in mobility, self-care, daily activities, and anxiety/depression was worse than the controls both before and after surgery (P < .001). The main predictors of low QoL in INPH were symptoms of depression (P < .001) and severity of gait disturbance (P = .001). Fewer INPH patients than controls lived independently (45% vs 85%, P < .001). Time after shunting had no influence on QoL.

CONCLUSION

QoL remains improved in shunted INPH patients at a mean follow-up time of 21 mo, but the patients do not reach the same QoL as the population. Symptoms of depression and severity of gait disturbance are the strongest predictors of low QoL in INPH.
BSCI-02. tGLI1 IS A NOVEL, ACTIONABLE TARGET FOR THE TREATMENT OF BREAST CANCER BRAIN METASTASES
Authors: Doheny Daniel , Sirkisoon Sherona , Rimkus Tadas , Zhu Dongqin , Aguayo Noah , Harrison Alexandria , Anguelov Marlyn , Xing Fei , Metheny-Barlow Linda , Watabe Kounosuke , Thomas Alexandra , Masters Adrianna Henson , Strowd Roy , Lo Hui-Wen
Published: August 2019

Despite improvements in early detection and intervention, breast cancer remains the second leading cause of cancer-related death in women and the second most common cancer to metastasize to the brain. Current standard of care options for breast cancer brain metastases (BCBM) include stereotactic radiosurgery, whole-brain radiotherapy, and surgical resection. Local and distant recurrences are common leading to significant morbidity; effective FDA-approved drugs for these patients remain a significant unmet need. Our laboratory discovered an alternative splice variant of glioma-associated oncogene homolog 1 (GLI1), termed truncated GLI1 (tGLI1) that is a tumor-specific gain-of-function transcription factor preferentially expressed in most BCBM samples and recurrent gliomas. Recent results established that tGLI1 promotes breast cancer stem cells (BrCSCs) and is associated with preferential metastasis to the brain and radioresistance, justifying tGLI1 as an ideal therapeutic target for BCBM patients. To identify tGLI1-targeting agents, we screened 1,520 compounds across three commercial drug libraries and found ketoconazole, an FDA-approved azole antifungal and component of previously studied anti-neoplastic regimens, selectively killed tGLI1-expressing breast cancer cells with heightened efficacy against the CSC subpopulation in vitro. tGLI1 knockdown abolished the ability of ketoconazole to target BrCSCs, indicating that ketoconazole effect is dependent on tGLI1. Intracardiac mouse studies showed ketoconazole selectively inhibited circulating tGLI1-positive breast cancer cells from developing into brain metastases and suppressed the progression of existing brain metastases. Mass spectrometry demonstrated ketoconazole effectively penetrated the blood-brain barrier (BBB) and blood-tumor barrier (BTB). Mechanistic studies suggest that ketoconazole-dependent cell kill is, in part, mediated through disruption of the tGLI1-STAT3 interaction. Collectively, our preclinical results demonstrate that ketoconazole is an effective inhibitor of BrCSCs and brain metastasis of tGLI1-positive breast cancer. Based on these promising preclinical data, we opened a window-of-opportunity study in patients with BCBM and recurrent gliomas to determine if ketoconazole treatment alters tGLI1 signaling in humans (NCT03796273).