bluuebunny/crossref_metadata_2025 huggingface dataset:
Electronic spectra and excited-state dynamics of acridine and its hydrated clusters
Authors: Harthcock Colin , Zhang Jie , Kong Wei , Mitsui Masaaki , Ohshima Yasuhiro
Published: April 2017

We combine results from several different experiments to investigate the photophysics of acridine (Ac) and its hydrated clusters in the gas phase. Our findings are also compared with results from condensed phase studies. Similar to measurements of Ac dissolved in hydrocarbons, the lifetime of the first electronically excited state of isolated Ac in vacuum is too short for typical resonantly enhanced multiphoton ionization (REMPI) and laser induced fluorescence (LIF) experiments, hence no signal from REMPI and LIF can be attributed to monomeric Ac. Instead, sensitized phosphorescence emission spectroscopy is more successful in revealing the electronic states of Ac. Upon clustering with water, on the other hand, the lifetimes of the excited states are substantially increased to the nanosecond scale, and with two water molecules attached to Ac, the lifetime of the hydrated cluster is essentially the same as that of Ac in aqueous solutions. Detailed REMPI and ultraviolet–ultraviolet hole-burning experiments are then performed to reveal the structural information of the hydrated clusters. Although the formation of hydrogen bonds results in energy level reversal and energy separation between the first two excited states of Ac, its effect on the internal geometry of Ac is minimal, and all clusters with 1–3 water molecules demonstrate consistent intramolecular vibrational modes. Theoretical calculations reveal just one stable structure for each cluster under supersonic molecular beam conditions. Furthermore, different from mono- and di-water clusters, tri-water clusters consist of a linear chain of three water molecules attached to Ac. Consequently, the fragmentation pattern in the REMPI spectrum of tri-water clusters seems to be dominated by water trimer elimination, since the REMPI spectrum of Ac+·W3 is largely reproduced in the Ac+ mass channel, but not in the Ac+·W1 or Ac+·W2 channel.
A novel multi-jet burner for hot flue gases of wide range of temperatures and compositions for optical diagnostics of solid fuels gasification/combustion
Authors: Weng Wubin , Borggren Jesper , Li Bo , Aldén Marcus , Li Zhongshan
Published: April 2017

A novel multi-jet burner was built to provide one-dimensional laminar flat flames with a wide range of variable parameters for multipurpose quantitative optical measurements. The burner is characterized by two independent plenum chambers, one supporting a matrix of 181 laminar jet flames and the other supporting a co-flow from a perforated plate with small holes evenly distributed among the jets. A uniform rectangular burned gas region of 70 mm × 40 mm can be generated, with a wide range of temperatures and equivalence ratios by controlling independently the gas supplies to the two plenum chambers. The temperature of the hot gas can be adjusted from 1000 K to 2000 K with different flame conditions. The burner is designed to seed additives in gas or liquid phase to study homogeneous reactions. The large uniform region can be used to burn solid fuels and study heterogeneous reactions. The temperature was measured using two-line atomic fluorescence thermometry and the temperature profile at a given height above the burner was found to be flat. Different types of optical diagnostic techniques, such as line of sight absorption or laser-induced fluorescence, can be easily applied in the burner, and as examples, two typical measurements concerning biomass combustion are demonstrated.
Microfluidics: From crystallization to serial time-resolved crystallography
Authors: Sui Shuo , Perry Sarah L.
Published: April 2017

Capturing protein structural dynamics in real-time has tremendous potential in elucidating biological functions and providing information for structure-based drug design. While time-resolved structure determination has long been considered inaccessible for a vast majority of protein targets, serial methods for crystallography have remarkable potential in facilitating such analyses. Here, we review the impact of microfluidic technologies on protein crystal growth and X-ray diffraction analysis. In particular, we focus on applications of microfluidics for use in serial crystallography experiments for the time-resolved determination of protein structural dynamics.
Optimal control of complex networks: Balancing accuracy and energy of the control action
Authors: Shirin Afroza , Klickstein Isaac S. , Sorrentino Francesco
Published: April 2017

Recently, it has been shown that the control energy required to control a large dynamical complex network is prohibitively large when there are only a few control inputs. Most methods to reduce the control energy have focused on where, in the network, to place additional control inputs. We also have seen that by controlling the states of a subset of the nodes of a network, rather than the state of every node, the required energy to control a portion of the network can be reduced substantially. The energy requirements exponentially decay with the number of target nodes, suggesting that large networks can be controlled by a relatively small number of inputs as long as the target set is appropriately sized. Here, we see that the control energy can be reduced even more if the prescribed final states are not satisfied strictly. We introduce a new control strategy called balanced control for which we set our objective function as a convex combination of two competitive terms: (i) the distance between the output final states at a given final time and given prescribed states and (ii) the total control energy expenditure over the given time period. We also see that the required energy for the optimal balanced control problem approximates the required energy for the optimal target control problem when the coefficient of the second term is very small. We validate our conclusions in model and real networks regardless of system size, energy restrictions, state restrictions, input node choices, and target node choices.
Core-hole-induced dynamical effects in the x-ray emission spectrum of liquid methanol
Authors: Ljungberg M. P. , Zhovtobriukh I. , Takahashi O. , Pettersson L. G. M.
Published: April 2017

We compute the x-ray emission spectrum of liquid methanol, with the dynamical effects that result from the creation of the core hole included in a semiclassical way. Our method closely reproduces a fully quantum mechanical description of the dynamical effects for relevant one-dimensional models of the hydrogen-bonded methanol molecules. For the liquid, we find excellent agreement with the experimental spectrum, including the large isotope effect in the first split peak. The dynamical effects depend sensitively on the initial structure in terms of the local hydrogen-bonding (H-bonding) character: non-donor molecules contribute mainly to the high-energy peak while molecules with a strong donating H-bond contribute to the peak at lower energy. The spectrum thus reflects the initial structure mediated by the dynamical effects that are, however, seen to be crucial in order to reproduce the intensity distribution of the recently measured spectrum.
A Gaussian theory for fluctuations in simple liquids
Authors: Krüger Matthias , Dean David S.
Published: April 2017

Assuming an effective quadratic Hamiltonian, we derive an approximate, linear stochastic equation of motion for the density-fluctuations in liquids, composed of overdamped Brownian particles. From this approach, time dependent two point correlation functions (such as the intermediate scattering function) are derived. We show that this correlation function is exact at short times, for any interaction and, in particular, for arbitrary external potentials so that it applies to confined systems. Furthermore, we discuss the relation of this approach to previous ones, such as dynamical density functional theory as well as the formally exact treatment. This approach, inspired by the well known Landau-Ginzburg Hamiltonians, and the corresponding “Model B” equation of motion, may be seen as its microscopic version, containing information about the details on the particle level.
Developments and difficulties in predicting the relative velocities of inertial particles at the small-scales of turbulence
Authors: Bragg Andrew D.
Published: April 2017

In this paper, we consider the development of theoretical models to predict the relative velocities of inertial particles in isotropic turbulence. In particular, we use our recently developed theory for the backward-in-time (BIT) relative dispersion of inertial particles in turbulence [Bragg et al., “Forward and backward in time dispersion of fluid and inertial particles in isotropic turbulence,” Phys. Fluids 28, 013305 (2016)] to develop the theoretical model by Pan and Padoan [“Relative velocity of inertial particles in turbulent flows,” J. Fluid Mech. 661, 73 (2010)]. We focus on the most difficult regime to model, the dissipation range, and find that the modified Pan and Padoan model (that uses the BIT dispersion theory) can lead to significantly improved predictions for the relative velocities, when compared with the Direct Numerical Simulation (DNS) data. However, when the particle separation distance, r, is less than the Kolmogorov lengthscale, η, the modified model overpredicts the DNS data. We explain how these overpredictions arise from two assumptions in the BIT dispersion theory that are in general not satisfied when the final separation of the BIT dispersing particles is <η. We then demonstrate the failure of both the original and modified versions of the Pan and Padoan model to predict the correct scale-invariant forms for the inertial particle relative velocity structure functions in the dissipation regime. It is shown how this failure, which is also present in other models, is associated with our current inability to correctly predict not only the quantitative but also the qualitative behavior of the radial distribution function in the dissipation range when St=O(1).
Flow reproducibility of whole blood and other bodily fluids in simplified no reaction lateral flow assay devices
Authors: Li H. , Han D. , Hegener M. A. , Pauletti G. M. , Steckl A. J.
Published: April 2017

The “no reaction” lateral flow assay (nrLFA) uses a simplified LFA structure with no conjugate pad and no stored reagents. In the nrLFA, the capillary-based transport time or distance is the key indicator, rather than the outcome of a biochemical reaction. Hence, the calibration and reproducibility of the nrLFA device are critical. The capillary flow properties of several membrane types (nitrocellulose, nylon, cellulose acetate, polyethersulfone, and polyvinylidene difluoride) are evaluated. Flow rate evaluations of MilliporeSigma Hi-Flow™ Plus (HF075, HF135 and HF180) nitrocellulose membranes on nrLFA are performed using bodily fluids (whole blood, blood plasma, and artificial sweat). The results demonstrate that fluids with lower viscosity travel faster, and membranes with slower flow rate exhibit higher capability to distinguish fluids with different viscosities. Reproducibility tests of nrLFA are performed on HF075, demonstrating excellent reproducibility. The coefficient of variation for blood coagulation tests performed with the nrLFA using induced coagulation was 5% for the plasma front and 2% for the RBC front. The effects of variation in blood hematocrit and sample volume are also reported. The overall results indicate that the nrLFA approach has a high potential to be commercially developed as a blood monitoring point-of-care device with simple calibration capability and excellent reproducibility.
Angle-resolved photoemission spectroscopy of liquid water at 29.5 eV
Authors: Nishitani Junichi , West Christopher W. , Suzuki Toshinori
Published: April 2017

Angle-resolved photoemission spectroscopy of liquid water was performed using extreme ultraviolet radiation at 29.5 eV and a time-of-flight photoelectron spectrometer. SiC/Mg coated mirrors were employed to select the single-order 19th harmonic from laser high harmonics, which provided a constant photon flux for different laser polarizations. The instrument was tested by measuring photoemission anisotropy for rare gases and water molecules and applied to a microjet of an aqueous NaI solution. The solute concentration was adjusted to eliminate an electric field gradient around the microjet. The observed photoelectron spectra were analyzed considering contributions from liquid water, water vapor, and an isotropic background. The anisotropy parameters of the valence bands (1b1, 3a1, and 1b2) of liquid water are considerably smaller than those of gaseous water, which is primarily attributed to electron scattering in liquid water.
The effect of ions on the magnetic moment of vacancy for ion-implanted 4H-SiC
Authors: Peng B. , Zhang Y. M. , Dong L. P. , Wang Y. T. , Jia R. X.
Published: April 2017

The structural properties and the spin states of vacancies in ion implanted silicon carbide samples are analyzed by experimental measurements along with first-principles calculations. Different types and dosages of ions (N+, O+, and B+) were implanted in the 4H-silicon carbide single crystal. The Raman spectra, positron annihilation spectroscopy, and magnetization-magnetic field curves of the implanted samples were measured. The fitting results of magnetization-magnetic field curves reveal that samples implanted with 1 × 1016 cm−2 N+ and O+ ions generate paramagnetic centers with various spin states of J = 1 and J = 0.7, respectively. While for other implanted specimens, the spin states of the paramagnetic centers remain unchanged compared with the pristine sample. According to the positron annihilation spectroscopy and first-principles calculations, the change in spin states originates from the silicon vacancy carrying a magnetic moment of 3.0 μB in the high dosage N-implanted system and 2.0 μB in the O-doped system. In addition, the ratio of the concentration of implanted N ions and silicon vacancies will affect the magnetic moment of VSi. The formation of carbon vacancy which does not carry a local magnetic moment in B-implanted SiC can explain the invariability in the spin states of the paramagnetic centers. These results will help to understand the magnetic moments of vacancies in ion implanted 4H-SiC and provide a possible routine to induce vacancies with high spin states in SiC for the application in quantum technologies and spintronics.
Influence of surface anisotropy on magnetization distribution in thin magnetic films
Authors: Usov N. A. , Serebryakova O. N.
Published: April 2017

Three-dimensional numerical simulation of equilibrium micromagnetic configurations existing in thin ferromagnetic films with surface anisotropy is carried out taking into account the strong demagnetization field acting on the film magnetization and the true micromagnetic boundary condition on the film surface. The numerical results are obtained in the simplest Néel approximation for surface anisotropy energy, a surface anisotropy constant Ks being a single phenomenological parameter. It is found that the spin canted state has the lowest total energy as compared to various multi-domain configurations in the intermediate range of thickness, Lz,min < Lz < Lz,max, if the magnitude of surface anisotropy constant Ks is below a certain critical value. For small thickness, Lz < Lz,min, the film is perpendicular magnetized, whereas for a thicker film, Lz > Lz,max, nearly uniform in-plane magnetization, or the vortex has been obtained depending on the film in-plane aspect ratio. On the other hand, different labyrinth domain structures with large in-plane magnetization have been calculated in a thick enough film, Lz > Lz,max, with a sufficiently large surface anisotropy constant.
Contact-mechanical studies on adhesion of bio-inspired elastomeric nanofiber to stiff and soft materials
Authors: Lee Dong Yun , Lee Dae Ho
Published: April 2017

The adhesion behavior of elastomeric nanofibers was examined by a contact-mechanical approach using a Johnson–Kendall–Roberts (JKR) instrument. A nanofibrillar elastomer substrate was fabricated by replicating crosslinked polydimethylsiloxane (PDMS) from an anodic aluminum oxide (AAO) template. The adhesion behavior of a regular hexagonal array of PDMS nanofibers formed over a wide range was investigated using soft and stiff hemispherical probes, which were prepared using PDMS and polystyrene (PS), respectively. The intrinsic work of adhesion (W) of the elastomeric nanofibrillar substrate was observed to substantially decrease, which was more prominent for the less deformable PS probe, revealing a reduction in the real contact area. Meanwhile, the adhesion energy (G) in the dynamic state with increasing separation rate was greatly affected by the deformation of nanofibers. The energy-dissipation factor for the nanofibrillar surface was far larger than that for the flat surface, and this difference was more significant for the case of contact with the deformable PDMS probe. This resulted in a great increase in the adhesion energy, making it even larger than that of the flat surface, overcoming the reduction in the real contact area.
Modeling language family expansions
Authors: Wichmann Søren
Published: April 2017

This paper presents properties of a computer simulation of language migration. It takes as input a simulated phylogeny and a database of today’s populated places. At each time step, a language moves within a geographical quadrilateral defined by the minimal number, ch, of choices of populated places within the quadrilateral. The result is a constrained random walk defined by a combination of the ch parameter and the landscape, which comes into play via the restriction of the walk to populated places. The distribution of move distances is qualitatively similar across values of ch and resembles a Gamma distribution. Through comparisons with densities of real-world language families, the values of ch which yield the closest fits between real and simulated data are found.
Balancing content and language in CLIL
Authors: O Ceallaigh Tadhg , Ní Mhurchú Siobhán , Ní Chróinín Déirdre
Published: April 2017

This research study examined the experiences of teachers and learners as they engaged with a CLIL programme, a physical education course being taught through the medium of the Irish language (L2) in English-medium primary schools in the Republic of Ireland. Five primary fourth grade teachers and the students (9–10 years old) in their classes from three primary schools in the Republic of Ireland participated in a unit of physical education (4–8 lessons) through the medium of the Irish language. Qualitative data collection and analysis included direct observation of lessons, an interview with each teacher, teachers’ written reflections and a focus group with 3–5 students from each class. Teachers reported that students became highly motivated as they were given the opportunities to use the Irish language in situations of personal choice. This new autonomy and motivation in turn fostered confidence and competence in language use. Several complex and persistent pedagogical challenges (e.g. balancing content and language in instruction) were uncovered in the analysis of data. This study increases our understanding of the complexity of the processes underlying and shaping a coherent CLIL pedagogy. Findings shed light on the yet-to-be-realised potential of CLIL as a lived embodied reality for all.
Utilizing electropalatography to train palatalized versus unpalatalized consonant productions by native speakers of American English learning Russian
Authors: Hacking Jane F. , Smith Bruce L. , Johnson Eric M.
Published: April 2017

Previous research has shown that English-speaking learners of Russian, even those with advanced proficiency, often have not acquired the contrast between palatalized and unpalatalized consonants, which is a central feature of the Russian consonant system. The present study examined whether training utilizing electropalatography (EPG) could help a group of Russian learners achieve more native-like productions of this contrast. Although not all subjects showed significant improvements, on average, the Russian learners showed an increase from pre- to post-training in the second formant frequency of vowels preceding palatalized consonants, thus enhancing their contrast between palatalized and unpalatalized consonants. To determine whether these acoustic differences were associated with increased identification accuracy, three native Russian speakers listened to all pre- and post-training productions. A modest increase in identification accuracy was observed. These results suggest that even short-term EPG training can be an effective intervention with adult L2 learners.
Functional load revisited
Authors: Sewell Andrew
Published: April 2017

The concept of functional load has been invoked for nearly a century in both research and pedagogy relating to pronunciation. However, it often suffers from a certain vagueness of definition. This article revisits the concept of functional load, outlining its origins and placing it within functionalist approaches to language and communication. The elaborated concept is then applied to the findings of lingua franca intelligibility studies, and it is argued that functional factors have explanatory potential. The application of functional load thus serves as a reinterpretation of the findings of lingua franca intelligibility studies by providing additional theoretical background. This reinterpretation suggests that although functional load is not a universal property of abstract language systems, certain features (such as consonants in general, and initial segments in particular) are widely relied upon in both lingua franca and non-lingua franca communication.
Distribution and duration of signs and parts of speech in Swedish Sign Language
Authors: Börstell Carl , Hörberg Thomas , Östling Robert
Published: April 2017

In this paper, we investigate frequency and duration of signs and parts of speech in Swedish Sign Language (SSL) using the SSL Corpus. The duration of signs is correlated with frequency, with high-frequency items having shorter duration than low-frequency items. Similarly, function words (e.g. pronouns) have shorter duration than content words (e.g. nouns). In compounds, forms annotated as reduced display shorter duration. Fingerspelling duration correlates with word length of corresponding Swedish words, and frequency and word length play a role in the lexicalization of fingerspellings. The sign distribution in the SSL Corpus shows a great deal of cross-linguistic similarity with other sign languages in terms of which signs appear as high-frequency items, and which categories of signs are distributed across text types (e.g. conversation vs. narrative). We find a correlation between an increase in age and longer mean sign duration, but see no significant difference in sign duration between genders.
Persia through the Lens: Poetics and Politics of Architectural Photographs in Pahlavi Iran
Authors: Kadoi Yuka
Published: April 2017

Having been introduced to the scholarly community and the general public through a variety of photographic presentations during the inter-war period, monuments in Iran, particularly those of pre-modern Islamic periods, became key buildings to be seized upon as the ultimate embodiment of Persian beauty. The lasting image of Persian Islamic architecture that was articulated through photographs continues not only to set an important benchmark for the understanding of the aesthetic and political matrix of the early twentieth century but also to provoke a methodological question as to the future of Persian architectural studies.
Patient and provider perspectives on the potential value and use of a bilingual online patient portal in a Spanish-speaking safety-net population
Authors: Ochoa Alejandro , Kitayama Ken , Uijtdehaage Sebastian , Vermillion Michelle , Eaton Michael , Carpio Felix , Serota Martin , Hochman Michael E
Published: April 2017

Objective

To assess patient and provider perspectives on the potential value and use of a bilingual patient portal in a large safety-net health system serving predominantly Spanish-speaking patients.

Materials and Methods

We captured patient and provider perspectives through the administration of surveys to assess Internet access, barriers, and facilitators to patient portal adoption, along with portal preferences. We report on these survey results using descriptive and comparative statistics.

Results

Four hundred patients (82% response rate) and 59 providers (80% response rate) participated in the study. Although 73% of providers believed that the patient portal would increase patient satisfaction, just 39% planned to recommend portal use to patients, citing concerns related to time and reimbursement. In contrast, 72% of patients believed the patient portal would strengthen the patient-provider relationship and 77% believed it would improve the quality of care. Latino patients in particular believed the patient portal would strengthen the patient-provider relationship. Seventy-five percent of patients reported interest in a mobile version of the portal.

Discussion

Patients from a safety-net health system, most of whom were Spanish-speaking, reported a high level of interest in the patient portal. Providers at the same health system expressed reluctance about the portal due to concerns related to time and reimbursement.

Conclusion

Bilingual patient portal implementation has considerable potential to promote health care engagement within Spanish-speaking safety-net populations; however, lack of provider engagement in the process could undermine the effort.
Formation of the young massive cluster R136 triggered by tidally-driven colliding H i flows
Authors: Fukui Yasuo , Tsuge Kisetsu , Sano Hidetoshi , Bekki Kenji , Yozin Cameron , Tachihara Kengo , Inoue Tsuyoshi
Published: April 2017

Understanding massive cluster formation is one of the important issues of astronomy. By analyzing the H i data, we have identified that the two H i velocity components (L- and D-components) are colliding toward the H i Ridge, in the southeastern end of the Large Magellanic Cloud (LMC), which hosts the young massive cluster R136 and ∼400 O/Wolf–Rayet stars (Doran et al. 2013, A&A, 558, A134) including the progenitor of SN 1987A. The collision is possibly evidenced by bridge features connecting the two H i components and by complementary distributions between them. We frame a hypothesis that the collision triggered the formation of R136 and the surrounding high-mass stars as well as the H i Ridge and the Molecular Ridge. Fujimoto and Noguchi (1990, PASJ, 42, 505) advocated that the last tidal interaction between the LMC and the Small Magellanic Cloud (SMC) induced collision of the L- and D-components about 0.2 Gyr ago. This model is consistent with numerical simulations (Bekki & Chiba 2007a, MNRAS, 381, L16). We suggest that a dense H i, cloud of 106 M⊙ partly including CO, a precursor of R136, was formed at the shock-compressed interface between the colliding L- and D-components. We suggest that part of the low-metallicity gas from the SMC was mixed in the tidal interaction based on the Planck/IRAS data of dust optical depth (Planck Collaboration 2014, A&A, 571, A11).
Complex Skill Training Transfers to Improved Performance and Control of Simpler Tasks After Stroke
Authors: Kantak Shailesh S. , Zahedi Nazaneen , McGrath Robert
Published: April 2017

Background. Given limited therapy time, it is important to practice tasks that optimize transfer to other tasks that cannot be practiced during therapy. However, little is known about how tasks can be selected for practice to optimize generalization.

Objective. One dimension of task selection is the complexity of the task. The purpose of the current study was to test if learning of a complex motor skill with the paretic arm would transfer to a simpler unpracticed goal-directed reaching task.

Design. This is an observational study, repeated measures design.

Methods. Fifteen participants with mild-to-moderate stroke practiced a complex motor skill using their paretic arm for 2 consecutive days. Complex skill learning was quantified using change in the speed-accuracy trade-off from baseline to 1 day and 1 month post-practice. Motor transfer was assessed as the change in goal-directed planar reaching performance and kinematics from 2 baselines to 1 day and 1 month post-practice. Nine additional participants with stroke were recruited as the test-alone group who only participated in the transfer tests to rule out the effects of repeated testing.

Results. Practice improved the speed-accuracy trade-off for the practiced complex skill that was retained over a period of 1 month. Importantly, complex skill practice, but not repeated testing alone, improved the long-term performance and kinematics of the unpracticed simpler goal-directed planar reaching task. Improvements in the unpracticed transfer task (reaching) strongly correlated with improvements in the practiced complex motor skill.

Limitations. We did not have a comparison stroke group that practiced task-specific reaching movements.

Conclusions. Given the limited number of tasks that can be practiced during therapy, training complex tasks may have an added advantage of transfer to improved simpler task performance.
Effect of Dexmedetomidine and Propofol on Basal Ganglia Activity in Parkinson Disease
Authors: Martinez-Simon Antonio , Alegre Manuel , Honorato-Cia Cristina , Nuñez-Cordoba Jorge M. , Cacho-Asenjo Elena , Trocóniz Iñaki F. , Carmona-Abellán Mar , Valencia Miguel , Guridi Jorge
Published: April 2017

Background

Deep brain stimulation electrodes can record oscillatory activity from deep brain structures, known as local field potentials. The authors’ objective was to evaluate and quantify the effects of dexmedetomidine (0.2 μg·kg-1·h-1) on local field potentials in patients with Parkinson disease undergoing deep brain stimulation surgery compared with control recording (primary outcome), as well as the effect of propofol at different estimated peak effect site concentrations (0.5, 1.0, 1.5, 2.0, and 2.5 μg/ml) from control recording.

Methods

A nonrandomized, nonblinded controlled clinical trial was carried out to assess the change in local field potentials activity over time in 10 patients with Parkinson disease who underwent deep brain stimulation placement surgery (18 subthalamic nuclei). The relationship was assessed between the activity in nuclei in the same patient at a given time and repeated measures from the same nucleus over time.

Results

No significant difference was observed between the relative beta power of local field potentials in dexmedetomidine and control recordings (−7.7; 95% CI, −18.9 to 7.6). By contrast, there was a significant decline of 12.7% (95% CI, −21.3 to −4.7) in the relative beta power of the local field potentials for each increment in the estimated peak propofol concentrations at the effect site relative to the control recordings.

Conclusions

Dexmedetomidine (0.2 μg·kg-1·h-1) did not show effect on local field potentials compared with control recording. A significant deep brain activity decline from control recording was observed with incremental doses of propofol.
Human papilloma virus and lupus: the virus, the vaccine and the disease
Authors: Segal Yahel , Calabrò Michele , Kanduc Darja , Shoenfeld Yehuda
Published: April 2017

Purpose of review

Systemic lupus erythematosus (SLE) is a well known, widespread autoimmune disease, involving multiple organ systems, with a multifaceted, widely unmapped etiopathogenesis. Recently, a new aspect of morbidity has been described among SLE patients: infection with human papilloma virus (HPV). We set out to review data regarding the intricate relationship between the two and attempt to determine whether HPV may pose as a contributing factor to the development of SLE.

Recent findings

We relate to epidemiological, molecular and clinical data. We have found evidence in all these fields suggesting HPV to be involved in the pathogenesis of SLE: increased prevalence of HPV infection among SLE patients; vast molecular homology between viral peptides and human proteins associated with SLE; several reports of SLE development post-HPV vaccination. Our findings suggest a possible involvement of HPV infection in the induction of SLE, via a mechanism of immune cross-reaction due to molecular homology.

We review clinical, epidemiological and molecular data suggesting involvement of HPV infection in the pathogenesis of SLE. We suggest that these findings may justify the development of new HPV vaccines containing viral peptides that bear no homology to the human proteome, in order to avoid possible adverse immune cross-reactivity.
Body composition assessment in the prediction of osteoporotic fractures
Authors: Hars Mélany , Trombetti Andrea
Published: April 2017

Purpose of review

To give an overview of recent research findings and insights on the role of body composition assessment in fracture risk prediction.

Recent findings

While there is to date little doubt that bone mineral density (BMD) is a main pathogenic factor of osteoporotic fractures, recent studies have emphasized the independent contribution of body composition components, especially lean mass, to fracture risk. In this article, we address body composition changes with aging, before to focus on recent studies addressing the contribution of lean and fat mass to fracture risk, together with some hypothesized mechanisms and clinical implications.

Recent compelling evidence suggest that clinicians should recognize the potential role of muscle wasting in determining fracture risk among older adults and that measures of lean mass, especially appendicular lean mass – which can be assessed simultaneously with the BMD measurement – should be considered in fracture risk assessment beyond BMD and clinical risk factors. More evidence is needed to support certain fat-related indicators in fracture risk prediction, but regional adiposity measures appear promising. Further studies in the field should help to elucidate whether interventions effective at attenuate, prevent, or ultimately reverse skeletal lean mass loss or fat accumulation, may prevent fractures.
Neuron-Specific Enolase Predicts Poor Outcome After Cardiac Arrest and Targeted Temperature Management: A Multicenter Study on 1,053 Patients
Authors: Streitberger Kaspar Josche , Leithner Christoph , Wattenberg Michael , Tonner Peter. H. , Hasslacher Julia , Joannidis Michael , Pellis Tommaso , Di Luca Elena , Födisch Markus , Krannich Alexander , Ploner Christoph J. , Storm Christian
Published: April 2017

Objective:

Outcome prediction after cardiac arrest is important to decide on continuation or withdrawal of intensive care. Neuron-specific enolase is an easily available, observer-independent prognostic biomarker. Recent studies have yielded conflicting results on its prognostic value after targeted temperature management.

Design, Setting, and Patients:

We analyzed neuron-specific enolase serum concentrations 3 days after nontraumatic in-hospital cardiac arrest and out-of-hospital cardiac arrest and outcome of patients from five hospitals in Germany, Austria, and Italy. Patients were treated at 33°C for 24 hours. Cerebral Performance Category was evaluated upon ICU discharge. We performed case reviews of good outcome patients with neuron-specific enolase greater than 90 μg/L and poor outcome patients with neuron-specific enolase less than or equal to 17 μg/L (upper limit of normal).

Measurements and Main Results:

A neuron-specific enolase serum concentration greater than 90 μg/L predicted Cerebral Performance Category 4–5 with a positive predictive value of 99%, false positive rate of 0.5%, and a sensitivity of 48%. All three patients with neuron-specific enolase greater than 90 μg/L and Cerebral Performance Category 1–2 had confounders for neuron-specific enolase elevation. An neuron-specific enolase serum concentration less than or equal to 17 μg/L excluded Cerebral Performance Category 4–5 with a negative predictive value of 92%. The majority of 14 patients with neuron-specific enolase less than or equal to 17 μg/L who died had a cause of death other than hypoxic-ischemic encephalopathy. Specificity and sensitivity for prediction of poor outcome were independent of age, sex, and initial rhythm but higher for out-of-hospital cardiac arrest than for in-hospital cardiac arrest patients.

Conclusion:

High neuron-specific enolase serum concentrations reliably predicted poor outcome at ICU discharge. Prediction accuracy differed and was better for out-of-hospital cardiac arrest than for in-hospital cardiac arrest patients. Our “in-the-field” data indicate 90 μg/L as a threshold associated with almost no false positives at acceptable sensitivity. Confounders of neuron-specific enolase elevation should be actively considered: neuron-specific enolase–producing tumors, acute brain diseases, and hemolysis. We strongly recommend routine hemolysis quantification. Neuron-specific enolase serum concentrations less than or equal to 17 μg/L argue against hypoxic-ischemic encephalopathy incompatible with reawakening.
Physician Variation in Time to Antimicrobial Treatment for Septic Patients Presenting to the Emergency Department
Authors: Peltan Ithan D. , Mitchell Kristina H. , Rudd Kristina E. , Mann Blake A. , Carlbom David J. , Hough Catherine L. , Rea Thomas D. , Brown Samuel M.
Published: April 2017

Objectives:

Delayed initiation of appropriate antimicrobials is linked to higher sepsis mortality. We investigated interphysician variation in septic patients’ door-to-antimicrobial time.

Design:

Retrospective cohort study.

Setting:

Emergency department of an academic medical center.

Subjects:

Adult patients treated with antimicrobials in the emergency department between 2009 and 2015 for fluid-refractory severe sepsis or septic shock. Patients who were transferred, received antimicrobials prior to emergency department arrival, or were treated by an attending physician who cared for less than five study patients were excluded.

Interventions:

None.

Measurements and Main Results:

We employed multivariable linear regression to evaluate the association between treating attending physician and door-to-antimicrobial time after adjustment for illness severity (Acute Physiology and Chronic Health Evaluation II score), patient age, prehospital or arrival hypotension, admission from a long-term care facility, mode of arrival, weekend or nighttime admission, source of infection, and trainee involvement in care. Among 421 eligible patients, 74% received antimicrobials within 3 hours of emergency department arrival. After covariate adjustment, attending physicians’ (n = 40) median door-to-antimicrobial times varied significantly, ranging from 71 to 359 minutes (p = 0.002). The percentage of each physician’s patients whose antimicrobials began within 3 hours of emergency department arrival ranged from 0% to 100%. Overall, 12% of variability in antimicrobial timing was explained by the attending physician compared with 4% attributable to illness severity as measured by the Acute Physiology and Chronic Health Evaluation II score (p < 0.001). Some but not all physicians started antimicrobials later for patients who were normotensive on presentation (p = 0.017) or who had a source of infection other than pneumonia (p = 0.006). The adjusted odds of in-hospital mortality increased by 20% for each 1 hour increase in door-to-antimicrobial time (p = 0.046).

Conclusions:

Among patients with severe sepsis or septic shock receiving antimicrobials in the emergency department, door-to-antimicrobial times varied five-fold among treating physicians. Given the association between antimicrobial delay and mortality, interventions to reduce physician variation in antimicrobial initiation are likely indicated.
Primary Cutaneous Follicular Helper T-Cell Lymphoma: A Case Series and Review of the Literature
Authors: Wang James Y. , Nguyen Giang Huong , Ruan Jia , Magro Cynthia M.
Published: April 2017

Primary cutaneous follicular helper T-cell (Tfh) lymphoma is a recently described variant of peripheral T-cell lymphoma—not otherwise specified. This particular variant, usually presenting as a sudden onset of multiple plaques and nodules, is characterized by tumoral atypical T cells that express an array of Tfh markers, such as inducible T-cell costimulator, Bcl-6, CXCL13, PD-1, and CD10. The authors now present 3 patients whose known clinical skin findings are consistent with PTCL of Tfh origin (PTCL-Tfh). The typically protracted pattern of skin disease manifesting as scaly patches and plaques encountered in mycosis fungoides was not seen in our 3 cases, and there were distinguishing light microscopic and phenotypic features. These cases are similar to the few previous reported cases of PTCL-Tfh, although systemic involvement was not seen. The categorization of additional patients into this PTCL subtype in the medical literature would be needed to further characterize this new entity and may lead to better targeted treatments based on specific T-cell subtypes.
IncobotulinumtoxinA for Aesthetic Indications: A Systematic Review of Prospective Comparative Trials
Authors: Prager Welf , Nogueira Teixeira Diana , Leventhal Phillip S.
Published: April 2017

BACKGROUND

IncobotulinumtoxinA is a botulinum toxin type A (BoNTA) indicated for temporary improvement in the appearance of upper facial lines with well-established efficacy and safety profiles. Whether incobotulinumtoxinA and other BoNTAs are equipotent is subject of debate.

OBJECTIVE

To compare the efficacy of incobotulinumtoxinA and other BoNTAs for aesthetic applications.

MATERIALS AND METHODS

PubMed and Embase were systematically searched for prospective clinical trials comparing incobotulinumtoxinA with onabotulinumtoxinA, abobotulinumtoxinA, or placebo for aesthetic applications.

RESULTS

Fifteen articles met the selection criteria. Two studies found that incobotulinumtoxinA was noninferior or equivalent to onabotulinumtoxinA for the treatment of glabellar frown lines (GFLs). Eight studies found no difference in efficacy between incobotulinumtoxinA and other BoNTAs. One study suggested differences in response rates at certain time points between incobotulinumtoxinA and onabotulinumtoxinA for GFLs, and one suggested differences for dynamic horizontal forehead lines but not for GFLs or lateral periorbital lines, but both had study design issues limiting the ability to draw conclusions. Finally, 3 placebo-controlled studies demonstrated the efficacy of incobotulinumtoxinA for treating GFLs and upper facial lines.

CONCLUSION

The weight of the evidence from comparative clinical trials indicates that incobotulinumtoxinA, onabotulinumtoxinA, and abobotulinumtoxinA have similar efficacy for aesthetic applications.
Safety of Cochlear Implants in Electrosurgery: A Systematic Review of the Literature
Authors: Behan James , Higgins Shauna , Wysong Ashley
Published: April 2017

BACKGROUND

The implications of electrosurgical instrument use in patients with cochlear implants (CIs) are becoming increasingly relevant for dermatologic surgeons as the number of implanted CI devices continues to grow. The literature, however, fails to provide clear recommendations for appropriate treatment of these patients.

OBJECTIVE

To systematically consolidate and critique the current literature regarding electrosurgical instrument use in patients with CI, to determine implications of various electrosurgical devices and settings on CI function and health of cochlear tissues, and to devise recommendations for appropriate use.

MATERIALS AND METHODS

The manuscript was created based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. A broad search of PubMed, Access Medicine, Clinical Key, Ovid, Scopus, the Cochrane Library, and Web of Science was performed using key words such as CI, electrosurgery, and/or electrosurgical device. Criteria for inclusion included being written in English language and institutional access to manuscript. All years were included. Additional references were obtained from personal communication with CI manufacturers. Study biases were assessed through evaluation of funding and/or sponsoring agencies for included studies.

RESULTS

The authors' search yielded a total of 8 studies, 5 of which were a level of evidence 5, 2 of which were level of evidence 4, and 1 of which was a level of evidence 3. The remaining study was relegated only to device testing. These studies were complicated by inaccurate terminology and inconsistent recommendations.

CONCLUSION

The body of evidence evaluating electrosurgical instrument use in patients with CI is severely limited in number and quality. Thus, vague and inconsistent recommendations have emerged that place patients at risk of serious and costly adverse effects. In light of this, the authors suggest use of the most conservative recommendations available for electrosurgical instrument use in patients with CI.
Advancing Keloid Treatment: A Novel Multimodal Approach to Ear Keloids
Authors: Jones Michael E. , McLane Jennifer , Adenegan Rachael , Lee JoAnne , Ganzer Christine A.
Published: April 2017

BACKGROUND/OBJECTIVE

Management of keloids of the pinna, in particular, those located in the helix and antihelix and lobule that occur as complications of ear piercing.

MATERIALS AND METHODS

Retrospective analysis of 49 patients treated with extralesional surgical excision of keloids localized to the ear followed by the application of autologous platelet-rich plasma (PRP) to wound site and postoperative in-office superficial radiation therapy (SRT). Radiation protocol consisted of 1 to 3 fractions, with cumulative dosage ranging from 1,300 to 1,800 cGy. Average follow-up was 24 months to assess for evidence of recurrence and adverse side effects.

RESULTS

Fifty ear keloids were treated with this method, age from 15 to 66 (mean = 32, SD = 16) of which 14 were male and 35 female. Almost 30% (n = 14) of patients acknowledged the source of injury that led to the development of the keloid was ear piercing. Treatment protocol achieved a 94% success rate with 3 patients who reported recurrence.

CONCLUSION

Surgical excision combined with intraoperative PRP, adjuvant postoperative in-office SRT achieved a 94% nonrecurrence rate on follow-up over a 2-year period. Outcomes provide preliminary, albeit, strong evidence to support this multimodal method as a viable alternative in the management of keloids localized to the ear.
Elongated Dorsal Nasal Flap to Reconstruct Large Defects of the Nose
Authors: Redondo Pedro , Bernad Isabel , Moreno Ester , Ivars Marta
Published: April 2017

BACKGROUND

The typical reconstructive option for closing large-sized defects of the distal half of the nose is the paramedian forehead flap. Other alternatives are a melolabial interpolation flap and bilobed or trilobed flaps. The dorsal nasal (Rieger) flap is suitable for closing small-sized defects at this location, especially when they are medially located.

OBJECTIVE

The authors describe a modified dorsal nasal flap reconstruction for large nasal defects. The novelty of this study lies in lengthening the leading edge of flap rotation, which may provide tissue either from the adjacent nasal skin, the nasofacial groove, or the cheek.

MATERIALS AND METHODS

The authors performed a retrospective chart review of all patients with large defects (>20 mm) of the nose who underwent modified dorsal nasal flap repair between January 2004 and March 2015 at a single academic center.

RESULTS

Twenty-seven patients (16 male, 11 female; ages 44–88, mean age 62 years) had defects (the smallest 15 × 21 mm, and the largest 32 × 37 mm) on the lower portion of the nasal pyramid. Follow-up ranged from 12 months to 11 years with good or excellent results in all cases.

CONCLUSION

Elongated dorsal nasal flap is a reproducible one-stage flap for large defects of the nose, with minimal risk of aesthetic or functional complications.