bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and manufacturing of a multi-zone phase-shifting coronagraph mask for extremely large telescopes
Authors: Martinez P. , Beaulieu M. , Barjot K. , Guyon O. , Gouvret C. , Marcotto A. , Belhadi M. , Caillat A. , Behaghel T. , Tisserand S. , Sauget V. , Gautier S. , Le Duigou J. M. , Knight J. M. , Dohlen K. , Vigan A. , Abe L. , Preis O. , Spang A. , Dejonghe J. , N’Diaye M.
Published: February 2020

Context. High-contrast imaging of exoplanets around nearby stars with future large-segmented apertures requires starlight suppression systems optimized for complex aperture geometries. Future extremely large telescopes (ELTs) equipped with high-contrast instruments operating as close as possible to the diffraction limit will open a bulk of targets in the habitable zone around M-stars. In this context, the phase-induced amplitude apodization complex mask coronagraph (PIAACMC) is a promising concept for high-efficiency coronagraphic imaging at small angular separations with segmented telescopes.

Aims. The complex focal plane mask of the PIAACMC is a multi-zone, phase-shifting mask comprised of tiled hexagons that vary in depth. The mask requires micro-fabrication techniques because it is generally made of hundreds micron-scale hexagonal zones with depths ranging over a few microns. We aim to demonstrate that the complex focal plane mask of a PIAACMC with a small inner working angle can be designed and manufactured for segmented apertures.

Methods. We report on the numerical design, specifications, manufacturing, and characterization of a PIAACMC complex focal plane mask for the segmented pupil experiment for exoplanet detection facility.

Results. Our PIAACMC design offers an inner working angle of 1.3 λ/D and is optimized for a 30% telescope-central-obscuration ratio including six secondary support structures (ESO/ELT design). The fabricated reflective focal plane mask is made of 499 hexagons, and the characteristic size of the mask features is 25 μm, with depths ranging over ±0.4 μm. The mask sag local deviation is measured to an average error of 3 nm and standard deviation of 6 nm rms. The metrological analysis of the mask using interferential microscopy gives access to an in-depth understanding of the component’s optical quality, including a complete mapping of the zone depth distribution zone-depth distribution. The amplitude of the errors in the fabricated mask are within the wavefront control dynamic range.

Conclusions. We demonstrate the feasibility of fabricating and characterizing high-quality PIAA complex focal plane masks.
Minimizing total completion time for flowshop scheduling problem with uncertain processing times
Authors: Allahverdi Muberra , Allahverdi Ali
Published: February 2020

The four-machine flowshop scheduling problem is investigated with the objective of minimizing total completion time. Job processing times are uncertain where only the lower and upper bounds are known. This problem is common in some manufacturing environments. Some mathematical (dominance) relations are established, and an algorithm (with ten scenarios) is proposed. The proposed algorithm converts the four-machine problem to a single machine problem for which an optimal solution is known for the deterministic problem. The difference among the scenarios is related to the weights assigned to the lower and upper bounds of processing times on the machines. The proposed algorithm is further improved by the established mathematical relations and are evaluated based on extensive computational experiments. The computational results indicate that three scenarios of the proposed algorithm perform much better than the others, and the errors of these three scenarios get better as the size of the problem increases. The results are statistically verified by constructing the confidence intervals.
Messungen zur Aushärtungstiefe von Bulk-Fill-Kompositen
Authors: Krause Inga , Althaus Annette , Köllner Christine , Kubusova Lubomira , Gente Michael
Published: February 2020

Die Aushärtungstiefe von Kompositen hängt von der applizierten Lichtdosis und den spezifischen Eigenschaften des verwendeten Materials ab. Während für herkömmliche Komposite eine maximale Schichtdicke von 2 mm zur vollständigen Aushärtung erlaubt ist, ermöglichen Bulk-Fill-Komposite sogar bei 4 mm dicken Schichten eine vollständige Lichtpolymerisation. In Anlehnung an das Messverfahren nach ISO 4049 wurden Proben der Bulk-Fill-Komposite Tetric EvoCeram Bulk Fill (Ivoclar Vivadent), x-tra fil (VOCO) und des Ormocers Admira Fusion x-tra (VOCO) getestet, um herauszufinden, ob die vom Hersteller angegebenen Belichtungszeiten tatsächlich die geforderte Aushärtungstiefe von 4 – 5 mm erreichen. Bei einer Lichtdosis von 10 J/cm2, die von der verwendeten Polymerisationslampe Celalux 2 innerhalb von ca. 14 Sekunden appliziert wurde, wurden Aushärtungstiefen von 4,6 sowie 6,3 und 4,6 mm gemessen. Eine Verdoppelung der Lichtdosis erhöhte bzw. eine Halbierung erniedrigte den jeweiligen Wert um 0,96 sowie 0,75 und 0,85 mm.
Veranstaltungsankündigung
Authors: Bundschu Marion
Published: February 2020

Der Schulungsort ist das Hotel Seligweiler (Seligweiler 1, 89081 Ulm-Seligweiler). Weitere Informationen zu den Veranstaltungen finden Sie unter www.wbs-ulm.de.
Defining Off-road Running: A Position Statement from the Ultra Sports
Science Foundation
Authors: Scheer Volker , Basset Patrick , Giovanelli Nicola , Vernillo Gianluca , Millet Gregoire P. , Costa Ricardo J. S.
Published: February 2020

Off-road running continues to grow in popularity, with differing event categories
existing, and terminologies are often used interchangeably and without
precision. Trail running, mountain running, skyrunning, fell running,
orienteering, obstacle course racing and cross-country running all take place
predominantly in off-road terrain. Ultramarathon running refers to any running
event over marathon distance conducted in any terrain and surface. Although some
overlap may exist between these running events, mainly through the common
denominator of off-road terrain, distinct features need to be recognised. As
scientific interest in these activities grows, it becomes important to clarify
these terms and develop a universal language for discussing these events.
Similarly, off-road running athletes are generally not properly defined within
the scientific literature, which makes intra- and inter-study comparisons
difficult. The current position statement of the Ultra Sports Science Foundation
highlights the different off-road running events and recommends clear reference
to distance, surface, elevation change and altitude, type of event (continuous
vs. staged), type of support, name and year of the event, governing body, and
guidance on terminology. We further recommend to describe off-road running
athletes by basic data, physiological determinants, training and competition
characteristics in the scientific literature in order to facilitate and guide
further research and practice.
Global solutions in a fully parabolic chemotaxis system with singular sensitivity and nonlinear signal production
Authors: Liu Dongmei
Published: February 2020

A fully parabolic chemotaxis system with singular sensitivity and nonlinear signal production is considered. Under suitable assumption on the sensitivity value and the signal production term, it is shown that this system admits a global classical solution. The proof is based on a series of a priori estimate techniques.
Covariant integral quantization of the unit disk
Authors: del Olmo M. A. , Gazeau J. P.
Published: February 2020

We implement a SU(1, 1) covariant integral quantization of functions on the unit disk. The latter can be viewed as the phase space for the motion of a “massive” test particle on (1+1)-anti-de Sitter space-time, and the relevant unitary irreducible representations of SU(1, 1) corresponding to the quantum version of such motions are found in the discrete series and its lower limit. Our quantization method depends on the choice of a weight function on the phase space in such a way that different weight functions yield different quantizations. For instance, the Perelomov coherent states quantization is derived from a particular choice. Semi-classical portraits or lower symbols of main physically relevant operators are determined, and the statistical meaning of the weight function is discussed.
Effect of variation in density on the stability of bilinear shear currents with a free surface
Authors: Barros Ricardo , Voloch José Felipe
Published: February 2020

We perform the stability analysis for a free surface fluid current modeled as two finite layers of constant vorticity, under the action of gravity and absence of surface tension. In the same spirit as Taylor [“Effect of variation in density on the stability of superposed streams of fluid,” Proc. R. Soc. London, Ser. A 132, 499 (1931)], a geometrical approach to the problem is proposed, which allows us to present simple analytical criteria under which the flow is stable. A strong destabilizing effect of stratification in density is perceived when the results are compared with those obtained for the physical setting where the vorticity interface is also a density interface separating two immiscible fluids with constant densities. In contrast with the homogeneous case, the stratified bilinear shear current is mostly unstable and can only be stabilized when the background current in the upper layer is constant.
Collinear interaction of vortex pairs with different strengths—Criteria for leapfrogging
Authors: Mavroyiakoumou Christiana , Berkshire Frank
Published: February 2020

We formulate a system of equations that describe the motion of four vortices made up of two interacting vortex pairs, where the absolute strengths of the pairs are different. Each vortex pair moves along the same axis in the same sense. In much of the literature, the vortex pairs have equal strength. The vortex pairs can either escape to infinite separation or undergo a periodic leapfrogging motion. We determine an explicit criterion in terms of the initial horizontal separation of the vortex pairs given as a function of the ratio of their strengths to describe a periodic leapfrogging motion when interacting along the line of symmetry. In the Appendix, we also contrast a special case of interaction of a vortex pair with a single vortex of the same strength in which a vortex exchange occurs.
Experimental characterization of ID-Hall, a double stage Hall thruster with an inductive ionization stage
Authors: Martín Ortega A. , Guglielmi A. , Gaboriau F. , Boniface C. , Boeuf J. P.
Published: February 2020

We present experimental results on the characterization of ID-Hall, a double stage Hall thruster with an inductively coupled magnetized ionization stage. This first experimental prototype of ID-Hall operates in a low power regime, typically below 400 W. The purpose of this work is not only to study the properties of ID-Hall and provide directions for optimization but also, and more generally, to study the relevance of the double stage concept with respect to important physical issues such as current oscillations and anomalous electron transport. We present experimental measurements of the current–voltage characteristics, extracted ion beam current (Faraday cup measurements), and ion energy and angular distribution functions (RPA measurements) in single and double stage regimes of operation, as a function of DC voltage and RF power. The results demonstrate that ions can be extracted from the inductive RF ionization stage even under conditions where the applied DC voltage is not sufficient to ionize the gas flow, i.e., ID-Hall can indeed operate in a double stage regime. At intermediate voltages, the overshoot observed in the current–voltage characteristics of single stage thrusters disappears in double stage operation, indicating a decrease in anomalous electron transport. Time-resolved and time-averaged ion energy distribution measurements show a coupling between ion energy, breathing mode oscillations, and the magnetic configuration of ID-Hall.
Numerical stability of time-dependent coupled-cluster methods for many-electron dynamics in intense laser pulses
Authors: Kristiansen Håkon Emil , Schøyen Øyvind Sigmundson , Kvaal Simen , Pedersen Thomas Bondo
Published: February 2020

We investigate the numerical stability of time-dependent coupled-cluster theory for many-electron dynamics in intense laser pulses, comparing two coupled-cluster formulations with full configuration interaction theory. Our numerical experiments show that orbital-adaptive time-dependent coupled-cluster doubles (OATDCCD) theory offers significantly improved stability compared with the conventional Hartree-Fock-based time-dependent coupled-cluster singles-and-doubles (TDCCSD) formulation. The improved stability stems from greatly reduced oscillations in the doubles amplitudes, which, in turn, can be traced to the dynamic biorthonormal reference determinants of OATDCCD theory. As long as these are good approximations to the Brueckner determinant, OATDCCD theory is numerically stable. We propose the reference weight as a diagnostic quantity to identify situations where the TDCCSD and OATDCCD theories become unstable.
Relaxation and tilting of single and double layer structures of AlGaSb/GaSb-LPE studied by high resolution x-ray diffraction
Authors: Lopez-Salazar Primavera , Juarez-Diaz Gabriel , Martinez-Juarez Javier , Sosa-Rivadeneyra Martha Virginia , Contreras-Rascón Jorge I , Palomino-Jimenez Carlos , Luna-Lopez José Alberto
Published: February 2020

Epitaxial AlGaSb double-layer structures grown on GaSb (001) substrates by Liquid Phase Epitaxy (LPE) were analyzed by high-resolution x-ray diffraction (HRXRD). Four AlGaSb double-layer structures grown at 450 °C were analyzed varying the thickness of the first layer and maintaining the same thickness for a second layer growth. Symmetric reciprocal space mapping measurements around the (004) reflection and asymmetric rocking curves around the (115) reflections have revealed that a subsequent Al0.15Ga0.985Sb growth on an Al0.047Ga0.953Sb layer modifies the relaxation and lattice tilting of the first layer. This behavior is attributed to the formation of dislocations within the layers during the growth and transported between them. In this work, the study was realized ex situ and is in well agreement with in situ studies and theoretical predictions on the relaxation of epitaxial films in diverse materials. The structural analysis of lattice distortion in epitaxial layers is relevant since it could modify the electrical behavior of optoelectronic devices building with them.
Early spring egg hatching by the American lobster (Homarus americanus) linked to rising water temperature in autumn
Authors: Haarr Marthe Larsen , Comeau Michel , Chassé Jöel , Rochette Rémy
Published: February 2020

Increasing ocean temperatures may affect life cycles of organisms whose biological processes are temperature-dependent. Our objective was to determine whether hatching time of American lobster (Homarus americanus), which has a 2-year reproductive cycle, has advanced in the southern Gulf of St Lawrence, Canada, in response to rising temperature. We investigated temporal trends in hatching time 1989–2014 using fisheries monitoring data. We considered two metrics: the first week of the year when ovigerous females with prehatch or hatching clutches were observed [onset-of-hatching (OH)] and the rate of change in the ratio of females with prehatch/hatching vs. developing clutches each spring fishing season [rate of clutch development (RCD)]. OH advanced by 5 weeks and RCD increased by 40% on average. Comparisons of OH and RCD to cumulative degree-days going back 2 years prior to hatching suggested an effect of higher fall temperatures during early ovarian and embryonic development. The advancement of hatching time in response to environmental conditions 6–18 months before hatching occurs could lead to a mismatch with larval prey species with shorter life cycles. These findings highlight the importance of monitoring phenology of fished species and the need for further research into potential impacts of phenological changes.
Policy Dynamics in Federal Systems: A Framework for Analysis
Authors: Weaver R Kent
Published: February 2020

A central puzzle in federalism research is that federal arrangements have been associated with a variety of policy effects, ranging from emulation of policy innovations among sub-national units to policy variation based on preferences of state or provincial voters and elites to a competitive “race to the bottom.” This article outlines twelve federalism policy dynamics discussed in the literature and provides an analytical framework for understanding when specific policy dynamics are likely to emerge, in either a strong or muted form. Shifts in four sets of facilitating and limiting conditions shape specific federalism policy dynamics and their emergence, consolidation, or weakening over time.
Why Doesn't Science Matter Anymore?
Authors: Kennedy Maureen Shawn
Published: February 2020

Recent actions show lawmakers—and the public—are ignoring the evidence.
Commercial Interests in Continuing Medical Education: Where Do Electronic Health Record Vendors Fit?
Authors: Rubinstein Pesha F. , Middleton Blackford , Goodman Kenneth W. , Lehmann Christoph U.
Published: February 2020

The Accreditation Council for Continuing Medical Education (ACCME) will not accredit an organization that it defines as a commercial interest, that is an entity that produces, markets, resells, or distributes health care goods or services consumed by, or used on, patients. Thus, commercial interests are not eligible to be accredited organizations offering continuing medical education (CME) credit to physicians. This decision is based on the concern that commercial interests may use CME events to market their products or services to physicians, who then might inappropriately prescribe or administer those products or services to patients. Studies have shown that CME events supported by pharmaceutical companies, for example, have influenced physicians’ prescribing behaviors.

Currently, however, the ACCME does not recognize electronic health record (EHR) vendors, which are part of a multi-billion-dollar business, as commercial interests, and it accredits them to provide or directly influence CME events. Like pharmaceutical company-sponsored CME events, EHR vendor activities, which inherently only focus on use of the sponsoring vendor’s EHR system despite its potential intrinsic limitations, can lead to physician reciprocity. Such events also may inappropriately influence EHR system purchases, upgrades, and implementation decisions. These actions can negatively influence patient safety and care. Thus, the authors of this Perspective call on the ACCME to recognize EHR vendors as commercial interests and remove them from the list of accredited CME providers.
Building Patient–Physician Trust: A Medical Student Perspective
Authors: Gupta Nikita , Thiele Cameron M. , Daum Joshua I. , Egbert Lena K. , Chiang Jennifer S. , Kilgore Anthony E. , Johnson C.D.
Published: February 2020

Public trust in physicians has declined over the last 50 years. Future physicians will need to mend the patient–physician trust relationship. In conjunction with the American Medical Association’s Accelerating Change in Medical Education initiative, the Mayo Clinic Alix School of Medicine implemented the Science of Health Care Delivery (SHCD) curriculum—a 4-year curriculum that emphasizes interdisciplinary training across population-centered care; person-centered care; team-based care; high-value care; leadership; and health policy, economics, and technology—in 2015. In this medical student perspective, the authors highlight how the SHCD curriculum has the potential to address issues that have eroded patient–physician trust. The curriculum reaches this aim through didactic and/or experiential teachings in health equity, cultural humility and competence, shared decision making, patient advocacy, and safety and quality of care. It is the authors’ hope that novel medical education programs such as the SHCD curriculum will allow the nation’s future physicians to own their role in rebuilding and fostering public trust in physicians and the health care system.
Analysis of the Factors Affecting Lumbar Segmental Lordosis After Lateral Lumbar Interbody Fusion
Authors: Otsuki Bungo , Fujibayashi Shunsuke , Takemoto Mitsuru , Kimura Hiroaki , Shimizu Takayoshi , Murata Koichi , Matsuda Shuichi
Published: February 2020

Study Design.

Retrospective study.

Objective.

To elucidate factors that determine segmental lordosis after lateral retroperitoneal lumbar interbody fusion (LLIF) with percutaneous pedicle screw fixation.

Summary of Background Data.

LLIF has been widely used in degenerative lumbar spine surgery. However, the detailed mechanisms that determine segmental lordosis are still unknown.

Methods.

A total of 69 patients who underwent LLIF with posterior pedicle screw fixation without posterior osteotomy were analyzed. Computed tomography was performed before and within 2 weeks after surgery, and segmental lordotic angle (SLA) after surgery (Post-SLA) was predicted using multiple regression analysis. Explanatory factors considered in this study included SLA before surgery (Pre-SLA), disc height before surgery (DiscH), cage position (CageP; distance between the center of the cage and the center of the disc, where a positive value indicates an anterior cage position), cage angle (CageA), cage height (CageH), CageH–DiscH (amount of lift up), previous decompression surgery, and level fused.

Results.

A total of 102 levels were analyzed. Multiple regression analysis revealed that the Post-SLA can be predicted with three independent variables, CageP, Pre-SLA, and CageH–DiscH and the adjusted R2 was 0.70. In cases when the cage was located anteriorly (CageP > 3 mm), Post-SLA was greater with larger CageH, larger CageA, and larger Pre-SLA. When the cage was located in the middle (3 mm ≤CageP ≤–1 mm), Post-SLA was greater with larger CageP, larger Pre-SLA, and without previous decompression surgery. If the cage was located posteriorly (CageP < –1 mm), Post-SLA was greater with smaller CageH–DiscH and greater Pre-SLA.

Conclusion.

To gain maximum segmental lordosis in LLIF, the cage should be located anteriorly. Furthermore, if the cage can be located anteriorly, a thicker cage with proper angle cage will gain segmental lordosis. If the cage is located posteriorly, a thin cage should be selected.

Level of Evidence: 3
The Insertion Site Should Be Considered for the Empirical Therapy of Short-Term Central Venous and Arterial Catheter-Related Infections*
Authors: Buetti Niccolò , Ruckly Stéphane , Lucet Jean-Christophe , Perozziello Anne , Mimoz Olivier , Souweine Bertrand , Timsit Jean-François
Published: February 2020

Objectives:

Little is known on causative pathogens of intravascular catheters infection according to the catheter insertion site. The present study aimed to describe the epidemiology of causative microorganisms of catheter-related infection and colonization according to the insertion site.

Design:

Multicenter observational study using data from four large randomized controlled trials investigating different prevention strategies in which extensive prospective high-quality data collection at catheter insertion and catheter removal was performed.

Setting:

Twenty-five ICUs in France.

Patients:

Patients were recruited from 2006 to 2014 as soon as they required a catheterization with a short-term central venous catheter or peripheral arterial catheter with an expected duration of use of more than 48 hours. We described the distribution of microorganisms in central venous catheter and arterial catheter-related bloodstream infections and colonization according to the insertion type (femoral vs nonfemoral) included in the four studies.

Interventions:

None.

Measurements and Main Results:

A total of 7,235 patients and 15,259 catheters were included. Among central venous catheter, the distribution of microorganisms associated with catheter-related bloodstream infection and colonization was significantly different between femoral and nonfemoral sites. Among central venous catheter catheter-related bloodstream infection, nonfermenting Gram-negative bacilli were more frequently detected at the femoral site (31% vs 4% for nonfemoral site; p < 0.01). After adjustment for confounding factors, the femoral site was still associated with an increased risk for catheter-related bloodstream infection due to nonfermenting Gram-negative bacilli (odds ratio, 6.33; 95% CI, 1.59–25.28; p < 0.01). Among colonized arterial catheters, the distribution of microorganisms was significantly different between femoral and radial site (p < 0.01). Colonized arterial catheters due to nonfermenting Gram-negative bacilli were more frequently observed at the femoral site (20% vs nonfemoral site 12%; p = 0.01).

Conclusions:

The proportion of intravascular catheter infections due to nonfermenting Gram-negative bacilli was high for the femoral insertion site. Empirical antipseudomonal therapy should be considered if a femoral catheter-related bloodstream infection is suspected.
Challenges in ICU Care
Authors: Mucksavage Jeffrey , Kim Keri S.
Published: February 2020

Patients with Parkinson's disease (PD) face unique challenges when admitted to the hospital. The nature of the disease, complexity of the pharmacotherapeutic home regimens, and the medication-related policies of institutionalized care all contribute to the challenges patients and providers face. In addition, medication errors are common in this population. Incorrectly ordered or omitted home medications or delayed administration can have significant negative consequences including worsening of PD symptoms, dopamine agonist withdrawal syndrome, or malignant or hyperpyrexia syndrome. Also, this patient population may commonly encounter contraindicated medications ordered during their hospitalizations. These medication misadventures negatively affect patient care, which may lead to increased length of stay and significant adverse sequalae. Nurses, pharmacists, and other health care providers can help ease the anxiety of patients and their families by taking detailed medication histories, restarting home medication regimens, customizing medication administration to fit patients' needs, and screening patient profiles for drug-drug and drug-disease interactions. Education of hospital staff regarding the unique needs of this patient population and seeking the advice of specialists in PD can also promote improved patient care.
Modified-BEP Chemotherapy in Patients With Germ-Cell Tumors Treated at a Comprehensive Cancer Center
Authors: Aurilio Gaetano , Verri Elena , Frassoni Samuele , Bagnardi Vincenzo , Cossu Rocca Maria , Cullurà Daniela , Milani Martina , Mascia Roberta , Curigliano Giuseppe , Orsi Franco , Jereczek-Fossa Barbara A. , Musi Gennaro , Omodeo Salè Emanuela , De Cobelli Ottavio , Nolè Franco
Published: February 2020

Objectives:

Bleomycin, etoposide, and cisplatin (BEP) is the most common and successful chemotherapy regimen for germ-cell tumor (GCT) patients, accompanied by a bleomycin-induced dose-dependent lung toxicity in certain patients. In an attempt to reduce bleomycin-toxicity, we developed a modified-BEP (mBEP) regimen.

Materials and Methods:

Between August 2008 and February 2018, 182 unselected mainly testicular GCT patients (39 with adjuvant purpose and 143 with curative purpose) received a tri-weekly 5-day hospitalization schedule with bleomycin 15 U intravenous (IV) push on day 1 and 10 U IV continuous infusion over 12 hours on days 1 to 3, cisplatin 20 mg/m2 IV, and etoposide 100 mg/m2 IV on days 1 to 5. Pulmonary toxicity was assessed through chest computed tomography scan and clinical monitoring.

Results:

Median number of mBEP cycles was 3 (range: 1 to 4). In the curative setting, according to the International Germ Cell Cancer Collaborative Group (IGCCCG) prognostic system, 112, 21, and 9 patients had good-risk, intermediate-risk, and poor-risk class, respectively; 66 (46%) patients had complete response (CR), 67 (47%) had partial response (52 of whom became CR afterwards), 6 (4%) had stable disease (that in 3 became CR afterwards), 3 (2%) progressed, and 1 (1%) died of brain stroke. At a median follow-up of 2.67 years (interquartile range: 1.23-5.00 y), 1 and 5-year overall survival and progression-free survival were 99% and 95%, and 90% and 88%, respectively. In the entire patient population, there was grade 3/4 neutropenia in 92 patients (51%), febrile neutropenia in 11 patients (6%), grade 1/2 nausea in 74 patients (41%), and no death due to pulmonary toxicity.

Conclusion:

In GCT patients, our mBEP-schedule would suggest an effective treatment modality without suffering meaningful pulmonary toxicity.
Familial Cases of PENS: A Review of the Literature
Authors: Santos Silva Leandro F. , Miroux-Catarino Alexandre , Pimentel Bernardo V. , Amaro Cristina S. , Viana Isabel F.
Published: February 2020

Papular epidermal nevus with “skyline” basal cell layer (PENS) is a keratinocytic nevus that can occur sporadically or has a familial transmission. There are 5 families reported with PENS, in which there are 2 family members affected with each case. We present the sixth familial case, with the peculiarity of being the first time in which there are 3 family members with PENS, while reviewing the other cases described until now. In addition, we present a new histopathological finding, an inflammatory lichenoid infiltrate on the upper dermis in PENS lesions. This finding could be the result of trauma to the biopsied lesion, or it may represent a new inflammatory histological variant.
Evaluating Ten Top Tips (10TT)
Authors: Burr Kassidy , Roberson Kristina B. , Onsomu Elijah O. , Yancu Cecile N. , Pritchard Rachel
Published: February 2020

Adults living in rural areas are at greater risk of becoming overweight and obese due to health care disparities. A pre-/postmatched cohort design was used to evaluate a brief weight-loss counseling intervention, Ten Top Tips (10TT), in a rural primary care setting. The rank sum scores for total weight-loss behaviors and the subscales for dietary changes, self-monitoring, physical activity, and psychological coping taken before and 12 weeks after the intervention differed significantly (P = .0001). Ten Top Tips offers rural community clinics an effective weight-loss intervention.
Postmarket Modifications of High-risk Plastic Surgery Devices
Authors: Olaiya Oluwatobi R. , Oyesile Doyinsola , Stone Nicholas , Mbuagbaw Lawrence , McRae Mark H.
Published: February 2020

Background:

In the United States, high-risk medical devices must be cleared through the premarket approval (PMA) pathway, which requires clinical evidence ensuring safety and efficacy. Approved devices can be modified and reintroduced to market without additional study through the PMA supplemental review track. This study characterizes the changes of high-risk plastic surgery devices once they undergo initial clearance.

Methods:

A retrospective, cross-sectional analysis of the Food and Drug Administration (FDA) PMA database. The following data were extracted from the PMA database (January 1, 1980 to December 31, 2018): initial clearance date, device type, the number and type of supplement, supplement reason, and product withdrawal date. Data from the FDA medical device recall database were also extracted and reported. The median number of device modifications and median lifetime of device-years were calculated.

Results:

There have been 39 original plastic surgery devices approved by the FDA. There was no significant change with respect to initial clearance dates for original devices over time (r = 0.28; P = 0.084). PMA supplement usage has significantly increased with time (rs = 0.9174, P = 0.000). Overall, approved plastic surgery devices have undergone a median of 11 changes (IQR, 3–35). Breast implant devices collectively underwent the most modifications with a median of 28 modifications per device (IQR, 20.25–33.25).

Conclusions:

Over the past 2 decades, plastic surgery device manufacturers have significantly increased the use of supplement track review. High-risk plastic surgery devices may undergo frequent minor changes without clinical evidence to support the safety and efficacy of modified versions.
Structural Analysis of Glaucoma Brain and its Association With Ocular Parameters
Authors: Gracitelli Carolina P.B. , Duque-Chica Gloria L. , Sanches Liana G. , Moura Ana L. , Nagy Balazs V. , Teixeira Sergio H. , Amaro Edson , Ventura Dora F. , Paranhos Augusto
Published: February 2020

Precis:

Glaucoma patients presented a decreased occipital pole surface area in both hemispheres. Moreover, these parameters are independently correlated with functional and structural ocular parameters.

Purpose:

The purpose of this study was to evaluate structural brain abnormalities in glaucoma patients using 3-Tesla magnetic resonance imaging and assess their correlation with associated structural and functional ocular findings.

Patients and Methods:

This cross-sectional prospective study included 30 glaucoma patients and 18 healthy volunteers. All participants underwent standard automated perimetry, spectral-domain optical coherence tomography, and 3.0-Tesla magnetic resonance imaging.

Results:

There was a significant difference between the surface area of the occipital pole in the left hemisphere of glaucoma patients (mean: 1253.9±149.3 mm2) and that of control subjects (mean: 1341.9±129.8 mm2), P=0.043. There was also a significant difference between the surface area of the occipital pole in the right hemisphere of glaucoma patients (mean: 1910.5±309.4 mm2) and that of control subjects (mean: 2089.1±164.2 mm2), P=0.029. There was no significant difference between the lingual, calcarine, superior frontal, and inferior frontal gyri of glaucoma patients and those of the control subjects (P>0.05 for all comparisons). The surface area of the occipital pole in the left hemisphere was significantly correlated with perimetry mean deviation values, visual acuity, age, and retinal nerve fiber layer thickness (P=0.001, <0.001, 0.010, and 0.006, respectively). The surface area of the occipital pole in the right hemisphere was significantly correlated with perimetry mean deviation values, visual field indices, visual acuity, age, and retinal nerve fiber layer thickness (P<0.001, 0.007, <0.001, 0.046, and <0.001, respectively).

Conclusion:

Glaucoma patients presented a decreased occipital pole surface area in both hemispheres that independently correlated with functional and structural ocular parameters.
Hepatitis B Testing: Old Tricks for Newborn Players
Authors: Azhar Zainul , Purcell Rachael , Buttery Jim , Doherty Richard
Published: February 2020

We describe 2 preterm neonates with transient hepatitis B surface (HBs) antigenemia detected after Hepatitis B vaccination. Repeat serology in both cases tested negative for hepatitis B surface antigen, confirming transient HBs antigenemia. The duration of transient HBs antigenemia affirms current literature in the pediatric population.
CRISPR/Cas9-mediated mutation of asparagine-linked glycosylation 13 transcript variant 1 causes epilepsy in mice
Authors: Yu Baoli , Zhu Geng , Li Shangang , Chen Xuejin , Fang Qian , Zhang Yan , Liu Yixun , Li Shengtian , Wu Ji
Published: February 2020

Objective:

The asparagine-linked glycosylation 13 homolog (
Alg13
) has been identified as causative for congenital disorders of glycosylation type I with epilepsy. The aim of this study was to determine whether mice carrying a mutated version of
Alg13
could be used as a model for epileptic encephalopathies or congenital disorders of glycosylation type I.

Methods:

A model of epileptic encephalopathy was established in C57BL/6 mice by introducing mutations in
Alg13
via the clustered regularly interspaced palindromic repeats (CRISPR)/CRISPR-associated protein 9 (CRISPR/Cas9) system. All surgical procedures were approved by the Institutional Animal Care and Use Committee of Shanghai Jiao Tong University (A2016084) on October 8, 2016.

Results:

Mice with 3 different mutations,

Alg13
-54nt

,

Alg13
-5nt

and

Alg13
-4nt

, all of which are located in
Alg13
transcript variant 1, were created. The

Alg13
-5nt

mice exhibited spontaneous seizures similar to patients with
Alg13
mutations, suggesting that they could be used as a model for epilepsy. Western blot analysis demonstrated that

Alg13
-5nt

mice had lower levels of Alg13 expression than wild-type mice. Video observations showed that two of the 17

Alg13
-5nt

mice had stage 5 seizures involving jumping and falling, while 12 had stage 3 seizures with head nodding.

Conclusion:

The
Alg13
mouse model provides an outstanding tool for studying epileptic encephalopathies and investigating different aspects of defects in glycosylation or other post-translational modification that cannot be assessed in patients or cell culture systems.
Translation, Reliability, and Validity of the French Version of the Amputee Mobility Predictor
Authors: Côté-Martin Marie-Élène , Tremblay Andrée , Couture Mélanie , Roy Jean-Sébastien
Published: February 2020

Introduction

The Amputee Mobility Predictor (AMP) is an instrument designed to evaluate ambulatory capacity with and without a prosthesis in persons with lower-limb amputation. The purpose of the study is to cross-culturally adapt and translate the AMP into French (AMP-F), and to determine the reliability and construct validity of AMP-F.

Materials and Methods

The AMP was translated and cross-culturally adapted to French following standardized procedures. Thereafter, the AMP-F was subjected to psychometric evaluation with 30 participants with lower-limb amputation. Each participant completed the AMP-F three times: once with each of the two raters on the day of the first evaluation (interrater reliability) and a third time at the second evaluation by one of the two raters, held within 9 days of the first (intrarater reliability). Other tests completed at the second evaluation include the Locomotor Capabilities Index questionnaire and the 6-minute walk test, administered to measure construct validity.

Results

The AMP-F was developed as a result of the translation process. It showed excellent intrarater (intraclass correlation coefficient [ICC] = 0.97; MDC90, 7.0) and interrater (ICC = 0.95; MDC90, 6.3) reliability. Correlations were high between the AMP-F and the 6-minute walk test (r = 0.71) as well as the Locomotor Capabilities Index in persons with amputation (r = 0.88).

Conclusions

The AMP-F is a reliable and valid instrument for the evaluation of ambulatory capacity in individuals with lower-limb amputation. The AMP-F will allow clinicians residing in a francophone country to have access to a valid and reliable instrument for the evaluation of ambulatory capacity with and without prosthesis in individuals with lower-limb amputation.
Computer-aided diagnosis of isocitrate dehydrogenase genotypes in glioblastomas from radiomic patterns
Authors: Lo Chung-Ming , Weng Rui-Cian , Cheng Sho-Jen , Wang Hung-Jung , Hsieh Kevin Li-Chun
Published: February 2020

World Health Organization tumor classifications of the central nervous system differentiate glioblastoma multiforme (GBM) into wild-type (WT) and mutant isocitrate dehydrogenase (IDH) genotypes. This study proposes a noninvasive computer-aided diagnosis to interpret the status of IDH in glioblastomas from transformed magnetic resonance imaging patterns. The collected image database was composed of 32 WT and 7 mutant IDH cases. For each image, a ranklet transformation which changed the original pixel values into relative coefficients was 1st applied to reduce the effects of different scanning parameters and machines on the underlying patterns. Extracting various textural features from the transformed ranklet images and combining them in a logistic regression classifier allowed an IDH prediction. We achieved an accuracy of 90%, a sensitivity of 57%, and a specificity of 97%. Four of the selected textural features in the classifier (homogeneity, difference entropy, information measure of correlation, and inverse difference normalized) were significant (P < .05), and the other 2 were close to being significant (P = .06). The proposed computer-aided diagnosis system based on radiomic textural features from ranklet-transformed images using relative rankings of pixel values as intensity-invariant coefficients is a promising noninvasive solution to provide recommendations about the IDH status in GBM across different healthcare institutions.
A systematic review and meta-analysis of rituximab combined with methotrexate versus methotrexate alone in the treatment of rheumatoid arthritis
Authors: Wang Zhao , Bao Hong-wei , Ji Yong
Published: February 2020

Background:

This meta-analysis aimed to explore the efficacy and safety of rituximab combined with methotrexate (MTX) versus MTX alone in the treatment of rheumatoid arthritis (RA).

Methods:

We performed an electronic search of PubMed (1950–January 2018), EMBASE (1974–January 2018), the Cochrane Library (January 2018 Issue 3), the Google database (1950–January 2018), and the Chinese Wanfang database (1950–January 2018). Only randomized controlled trials (RCTs) were included. The American College of Rheumatology 20% improvement criteria (ACR20), ACR50, ACR70, total complication rate, and infection rate were the outcomes. A fixed/random effects model was used according to the heterogeneity assessed by the I
2 statistic. Data analysis was performed using Stata 12.0 software.

Results:

A total of five RCTs with 3299 patients (rituximab combined with MTX group = 1787, MTX only group = 1512) were included in the meta-analysis. The pooled risk ratio showed that the administration of rituximab combined with MTX was associated with more ACR20, ACR50, and ACR70 than the administration of MTX only (P < .05). There were no significant differences between the two groups in terms of the total complication rate and the infection rate (P > .05).

Conclusion:

The administration of rituximab combined with MTX was effective and safe for RA patients. Additional high-quality RCTs with long-term follow-ups should be conducted in the future to identify the potential complications in the long term.
Surgical treatment of intra-articular distal radius fractures with the assistance of three-dimensional printing technique
Authors: Kong Lingde , Yang Gang , Yu Jian , Zhou Yanqing , Li Sujuan , Zheng Quanhui , Zhang Bing
Published: February 2020

Background:

The aim of this study was to evaluate the effectiveness and safety of surgical treatment of intra-articular distal radius fractures (DRFs) with the assistance of three-dimensional (3D) printing technique.

Methods:

Patients with intra-articular DRFs in our hospital from February 2017 to November 2018 were enrolled in this study, and were randomly assigned to 2 parallel groups to receive surgical treatment with the assistance of 3D printing technique or not. For patients in the 3D printing group, the surgical procedure was simulated with 3D physical model before surgery. Volar plate and K-wire fixation were performed in all patients. Patients in the 2 groups were compared in terms of intraoperative indexes and postoperative function.

Results:

A total of 32 patients were included in our study. During surgery, mean operation time in the 3D model group was significantly lower than that in the routine group (P < .001). Besides, significantly less blood was lost in the 3D model group than that in the routine group (P < .001). Furthermore, the 3D model group had a significantly less times of intraoperative fluoroscopy than that in the routine group (P = .002). However, the 3D model group showed no significant difference in visual analog scale (VAS) score, the disabilities of the arm, shoulder, and hand (DASH) score, or active wrist range of motion (ROM) in comparison with the routine group (P > .05).

Conclusion:

With the assistance of 3D printing technique, the operation time, amount of intraoperative bleeding, and times of intraoperative fluoroscopy can be reduced during the surgical treatment of intra-articular DRFs with volar plating and K-wire fixation. This technique is safe and effective, and is worth spreading in other orthopedic surgeries.
Trends in late and advanced HIV diagnoses among migrants in Australia; implications for progress on Fast-Track targets
Authors: Marukutira Tafireyi , Gunaratnam Praveena , Douglass Caitlin , Jamil Muhammad S. , McGregor Skye , Guy Rebecca , Gray Richard Thomas , Spelman Tim , Horyniak Danielle , Higgins Nasra , Giele Carolien , Crowe Suzanne Mary , Stoove Mark , Hellard Margaret
Published: February 2020

Achieving the Joint United Nations Program on human immunodeficiency virus (HIV)/AIDS Fast-Track targets requires additional strategies for mobile populations. We examined trends and socio-demographics of migrants (overseas-born) and Australian-born individuals presenting with late and advanced HIV diagnoses between 2008 and 2017 to help inform public health approaches for HIV testing coverage and linkage to care and treatment.

We conducted a retrospective population-level observational study of individuals diagnosed with HIV in Australia and reported to the National HIV Registry. Annual proportional trends in late (CD4+ T-cell count <350 cells/μL) and advanced (CD4+ T-cell count <200 cells/μL). HIV diagnoses were determined using Poisson regression.

Of 9926 new HIV diagnoses from 2008 to 2017, 84% (n = 8340) were included in analysis. Overall, 39% (n = 3267) of diagnoses were classified as late; 52% (n = 1688) of late diagnoses were advanced. Of 3317 diagnoses among migrants, 47% were late, versus 34% of Australian-born diagnoses (P < .001).

The annual proportions of late (incidence rate ratio [IRR] 1.00; 95% confidence interval [CI] 0.99–1.01) and advanced HIV diagnoses (IRR 1.01; 95% CI 0.99–1.02) remained constant. Among migrants with late HIV diagnosis, the proportion reporting male-to-male sex exposure (IRR 1.05; 95% CI 1.03–1.08), non-English speaking (IRR 1.03; 95% CI 1.01–1.05), and individuals born in countries in low HIV-prevalence (IRR 1.02; 95% CI 1.00–1.04) increased. However, declines were noted among some migrants’ categories such as females, heterosexual exposure, English speaking, and those born in high HIV-prevalence countries.

Late HIV diagnosis remains a significant public health concern in Australia. Small declines in late diagnosis among some migrant categories are offset by increases among male-to-male exposures. Reaching the Fast-Track targets in Australia will require targeted testing and linkage to care strategies for all migrant populations, especially men who have sex with men.