bluuebunny/crossref_metadata_2025 huggingface dataset:
A large-eddy simulation study of horizontal axis tidal turbine in different inflow conditions
Authors: Hu Qiuhao , Li Ye , Di Yujia , Chen Jianwei
Published: November 2017

In this paper, we present our recent work of numerical simulations of the horizontal axis tidal turbine, which combines the large eddy simulation with the actuator line method. The towing tank test is conducted to acquire the performance of an originally designed tidal turbine. We first validated our numerical model with the experimental data; in this case, a good agreement was obtained with the simple uniform flow. In addition, we used different inflow conditions in the simulations to investigate the impacts on the turbine wake. The results show that the structure and mixing rates of turbine wake were different for various inflow conditions. For turbulent inflow conditions, the turbine wake was asymmetric and mixes rapidly downstream of the turbine. The tip and root vortices can maintain stability for only a 1–2 blade radii distance. Furthermore, the preliminary results of the different turbulent intensities and the effect of the incident angle are presented.
Simulation results of influence of constricted arc column on anode deformation and melting pool swirl in vacuum arcs with AMF contacts
Authors: Wang Lijun , Zhang Xiao , Huang Xiaolong , Jia Shenli
Published: November 2017

In the process of vacuum arc breaking, the energy injected into the anode will cause anode melting, evaporation, and deformation, resulting in the formation of the anode melting pool. The anode activities have great influence on the arc behavior. When the arc current is large enough, even the influence of axial magnetic field is considered, the arc column still is in contraction state, which means the arc burns only on a part of the electrode. In this paper, the model of anode melting pool deformation and rotation is used, and the model includes anode melting and solidification module, magneto-hydro-dynamic module of the anode melting pool, the volume of fraction method, and the current continuity equation. In this paper, the diffuse arc area is selected as 100%, 75%, and 50%, respectively. The anode temperature and deformation, the anode melting layer thickness, and the rotational velocity of the anode melting pool are obtained. The results show that when the current is at 17.5 kA (rms) and the diffuse arc area is 100%, the anode's maximum temperature is 1477 K and the crater depth is 0.83 mm. But when the diffuse arc areas are 75% and 50%, the anode's maximum temperatures reach 1500 K and 1761 K, and the crater depths reach 1.2 mm and 3 mm, respectively. Arc contraction will lead to more serious anode deformation. A similar result is obtained when the simulation current is 12.5 kA. Under the similar situation, the simulation results in the crater depth, the residual melt layer thickness, the rotational speed of the melting pool, and the maximum temperature of the anode at current zero are in good agreement with the experimental results.
Wetlands classification and assessment of Ramsar sites in China based on time series Moderate Resolution Imaging Spectroradiometer (MODIS) imagery
Authors: Xing Liwei , Niu Zhenguo , Xu Panpan , Li Dachong
Published: November 2017

Globally, wetland loss and degradation have become serious environmental and ecological issues. Wetland monitoring of Ramsar sites in China is important for developing reasonable strategies to protect wetlands. Satellite image time series may be used for the long-term monitoring of wetland ecosystems. The present study used moderate-resolution imaging spectroradiometer (MODIS) time series data collected in 2001 and 2013 for 20 Ramsar sites in China and assessed the environmental status of these reserves using landscape metrics. The results showed that specific seasonal wetland classes, such as flooded mud, permanent water and seasonal marshes, can be identified using MODIS time series data with acceptable accuracy. In addition to wetland area, we suggest using other landscape metrics, including landscape integrity and landscape disturbance or degradation indices, to assess wetland environmental quality. The slight wetland loss (0.8%) noted in the 20 reserves evaluated herein could indicate the effectiveness of efforts of the Chinese government and local government agencies to protect Ramsar sites. The existing unfavourable environmental conditions, which were manifested by low landscape integrity and high landscape disturbance or degradation for some reserves, were caused primarily by increasing water requirements outside the reserves and by agricultural development within reserves. Therefore, determining how to balance relationships between economic development and ecological protection of the reserves will be important in the future.
SNARE priming is essential for maturation of autophagosomes but not for their formation
Authors: Abada Adi , Levin-Zaidman Smadar , Porat Ziv , Dadosh Tali , Elazar Zvulun
Published: November 2017

Significance

The contribution of SNARE-mediated membrane fusion to the different stages along the autophagic process is not well understood. In this work we demonstrate that inhibition of SNARE priming leads to impairment of the autophagic flux manifested by the accumulation of mature autophagosomes that do not fuse with the lysosomes. Our results suggest that SNARE priming is essential for the fusion of the autophagosome with the lysosome but not for autophagosome formation.
Correlating cell shape and cellular stress in motile confluent tissues
Authors: Yang Xingbo , Bi Dapeng , Czajkowski Michael , Merkel Matthias , Manning M. Lisa , Marchetti M. Cristina
Published: November 2017

Significance

Using a self-propelled Voronoi model of epithelia known to predict a liquid–solid transition, we examine the interplay between cell motility and cell shape, tuned by cortex contractility and cell–cell adhesion, in controlling the mechanical properties of tissue. Our work provides a unifying framework for existing, seemingly distinct notions of stress in tissues and relates stresses to material properties. In particular, we show that the temporal correlation function of shear stresses can be used to define an effective tissue viscosity that diverges at the liquid–solid transition. This finding suggests a unique way of analyzing traction force microscopy data that may provide information on tissue rheology.
In vivo bioluminescence imaging of labile iron accumulation in a murine model of
Acinetobacter baumannii
infection
Authors: Aron Allegra T. , Heffern Marie C. , Lonergan Zachery R. , Vander Wal Mark N. , Blank Brian R. , Spangler Benjamin , Zhang Yaofang , Park Hyo Min , Stahl Andreas , Renslo Adam R. , Skaar Eric P. , Chang Christopher J.
Published: November 2017

Significance

Iron is a required metal nutrient for life, and its altered homeostasis is associated with a number of diseases. We present a bioluminescent reporter for visualizing iron pools in living animals, where iron-dependent uncaging of
d
-aminoluciferin enables sensitive and selective imaging of ferrous over ferric forms of iron in luciferase-expressing cell and mouse models. Application of this technology to a model of systemic bacterial infection reveals elevation of iron in infected tissues that accompany markers for increased iron acquisition and retention. These data establish the ability to assess iron status in living animals and provide a unique platform for studying its contributions to stages of health, aging, and disease.
Imaging and quantifying ganglion cells and other transparent neurons in the living human retina
Authors: Liu Zhuolin , Kurokawa Kazuhiro , Zhang Furu , Lee John J. , Miller Donald T.
Published: November 2017

Significance

Ganglion cells are the primary building block of retinal neural circuitry, but have been elusive to observe and quantify in the living human eye. Here, we show a light microscopy modality that reveals not only the somas of these cells, but also their 3D packing geometry, primary subtypes, and spatial projection to other neurons. The method provides a glimpse of the rich tapestry of neurons, glia, and blood vessels that compose the retina, thus exposing the anatomical substrate for neural processing of visual information. Clinically, high-resolution images of retinal neurons in living eyes hold promise for improved diagnosis and assessing treatment of ganglion cell and other neuron loss in retinal disease.
T cell receptor sequencing of early-stage breast cancer tumors identifies altered clonal structure of the T cell repertoire
Authors: Beausang John F. , Wheeler Amanda J. , Chan Natalie H. , Hanft Violet R. , Dirbas Frederick M. , Jeffrey Stefanie S. , Quake Stephen R.
Published: November 2017

Significance

The recent advances in cancer immunotherapy motivated us to investigate the clonal structure of the T cell receptor repertoire in breast tumors, normal breast, and blood in the same individuals. We found quantitatively distinct clonal structures in all three tissues, which enabled us to predict whether tissue is normal or tumor solely by comparing the repertoire of the tissue with blood. T cell receptor sequences shared between patients’ tumors are rare and, in general, do not appear to be specific to the cancer.
Characterisation of structural properties for AlSi10Mg alloys fabricated by selective laser melting
Authors: Wang Lianfeng , Jiang Xiaohui , Guo Miaoxian , Zhu Xiaogang , Yan Biao
Published: November 2017

Selective laser melting (SLM) is a form of additive manufacturing technology that makes it possible to create complex parts directly from metal powders. This technology offers a good balance between investment costs, range of materials and part quality. In the work, in order to investigate the structural properties of SLM AlSi10Mg alloys, the microstructure, structural performance and tensile fracture morphology of the alloys are analysed. The sample study results indicate good prospects, and the application of SLM in terms of aeronautics is studied to verify the structural properties. The ambient vibration test results show that SLM AlSi10Mg alloys could have a better performance in structural analysis and vibration test than the conventional manufacturing part and the reasons are analysed.

This paper is part of a thematic issue on Light Alloys.
Ragulator—a multifaceted regulator of lysosomal signaling and trafficking
Authors: Colaço Alexandria , Jäättelä Marja
Published: November 2017

The lysosomal Ragulator complex regulates cell metabolism and growth by coordinating the activities of metabolic signaling pathways with nutrient availability. In this issue, Filipek et al. (2017. J. Cell Biol. https://doi.org/10.1083/jcb.201703061) and Pu et al. (2017. J. Cell Biol. https://doi.org/10.1083/jcb.201703094) introduce a role for Ragulator in growth factor– and nutrient-regulated lysosomal trafficking.
Pulses and waves of contractility
Authors: Wu Min
Published: November 2017

The nature of signal transduction networks in the regulation of cell contractility is not entirely clear. In this study, Graessl et al. (2017. J. Cell Biol. https://doi.org/10.1083/jcb.201706052) visualized and characterized pulses and waves of Rho activation in adherent cells and proposed excitable Rho signaling networks underlying cell contractility.
USP1–UAF1 deubiquitinase complex stabilizes TBK1 and enhances antiviral responses
Authors: Yu Zhongxia , Song Hui , Jia Mutian , Zhang Jintao , Wang Wenwen , Li Qi , Zhang Lining , Zhao Wei
Published: November 2017

Optimal activation of TANK-binding kinase 1 (TBK1) is crucial for initiation of innate antiviral immunity and maintenance of immune homeostasis. Although several E3 ubiquitin ligases have been reported to regulate TBK1 activation by mediating its polyubiquitination, the functions of deubiquitinase on TBK1 activity remain largely unclear. Here, we identified a deubiquitinase complex, which is formed by ubiquitin specific peptidase 1 (USP1) and USP1-associated factor 1 (UAF1), as a viral infection–induced physiological enhancer of TBK1 expression. USP1–UAF1 complex enhanced TLR3/4 and RIG-I–induced IFN regulatory factor 3 (IRF3) activation and subsequent IFN-β secretion. Mechanistically, USP1 and UAF1 bound to TBK1, removed its K48-linked polyubiquitination, and then reversed the degradation process of TBK1. Furthermore, we found that ML323, a specific USP1–UAF1 inhibitor, attenuated IFN-β expression and enhanced viral replication both in vitro and in vivo. Therefore, our results outline a novel mechanism for the control of TBK1 activity and suggest USP1–UAF1 complex as a potential target for the prevention of viral diseases.
Final report of the supplementary comparison EURAMET.EM-S31 comparison of capacitance and capacitance ratio
Authors: Schurr J , Fletcher N , Gournay P , Thévenot O , Overney F , Johnson L , Xie R , Dierikx E
Published: November 2017

Within the framework of the supplementary comparison EURAMET.EM-S31, 'Comparison of capacitance and capacitance ratio', five participants (the BIPM, METAS, LNE, PTB, and VSL) inter-compared their capacitance realisations traced to the quantum Hall resistance measured at either ac or dc. The measurands were the capacitance values of three 10 pF standards and one 100 pF standard, and optionally their voltage and frequency dependences. Because the results were not fully satisfying, the circulation was repeated, augmented by a link to the NMIA calculable capacitor. Also two ac-dc resistors were circulated and their frequency dependences were measured in terms of the ac-dc resistance standards involved in the particular capacitance realisations, to allow inter-comparison of these resistance standards. At the end and in any case, a good agreement is achieved within the expanded uncertainties at coverage factor k = 2. Furthermore, the comparison led to new insight regarding the stability and travelling behaviour of the capacitance standards and, by virtue of the link to the NMIA calculable capacitor, to a determination of the von Klitzing constant in agreement with the 2014 CODATA value.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Effects of word-of-mouth on the behavior of Austrian blood donors: a case study of the Red Cross Blood Donation Service
Authors: Martin Sebastian , Greiling Dorothea , Leibetseder Nina
Published: November 2017

The procurement of blood is an essential challenge of today’s health care. Current studies emphasize the influence of word-of-mouth (WOM) on health care behavior, including blood donation. Still, there exists no study which systematically investigates how WOM affects the behavior of blood donors. Therefore, this paper aims to contribute to this lack of research by focusing on Austrian blood donors as possible receivers and senders of WOM. A survey was distributed to 300 donors of the Austrian Red Cross with a return of 245 surveys. The results highlight the strong influence of WOM on the awareness of the blood service and the willingness to donate blood. Further, structured and organized procedures, friendly employees and respectful interaction were found to be important factors determining willingness to recommend blood donation. Family members as well as friends are the preferred WOM-receivers and the personal face-to-face contact is the favored channel of communication. The results also show that WOM-behavior is strongly influenced by factors such as age, gender and donation frequency. By helping blood bank managers to better understand how WOM affects donation intention and behavior, this study provides a new approach to attract blood donors.
Overview of antifungal dosing in invasive candidiasis
Authors: Pea Federico , Lewis Russell E
Published: November 2017

In the past, most antifungal therapy dosing recommendations for invasive candidiasis followed a ‘one-size fits all’ approach with recommendations for lowering maintenance dosages for some antifungals in the setting of renal or hepatic impairment. A growing body of pharmacokinetic/pharmacodynamic research, however now points to a widespread ‘silent epidemic’ of antifungal underdosing for invasive candidiasis, especially among critically ill patients or special populations who have altered volume of distribution, protein binding and drug clearance. In this review, we explore how current adult dosing recommendations for antifungal therapy in invasive candidiasis have evolved, and special populations where new approaches to dose optimization or therapeutic drug monitoring may be needed, especially in light of increasing antifungal resistance among Candida spp.
Transcriptome Profiling ofMelaleuca quinquenerviaChallenged by Myrtle Rust Reveals Differences in Defense Responses Among Resistant Individuals
Authors: Hsieh Ji-Fan , Chuah Aaron , Patel Hardip R. , Sandhu Karanjeet S. , Foley William J. , Külheim Carsten
Published: November 2017

Plants have developed complex defense mechanisms to protect themselves against pathogens. A wide-host-range fungus, Austropuccinia psidii, which has caused severe damage to ecosystems and plantations worldwide, is a major threat to Australian ecosystems dominated by members of the family Myrtaceae. In particular, the east coast wetland foundation tree species Melaleuca quinquenervia, appears to be variably susceptible to this pathogen. Understanding the molecular basis of host resistance would enable better management of this rust disease. We identified resistant and susceptible individuals of M. quinquenervia and explored their differential gene expression in order to discover the molecular basis of resistance against A. psidii. Rust screening of germplasm showed a varying degree of response, with fully resistant to highly susceptible individuals. We used transcriptome profiling in samples collected before and at 5 days postinoculation (dpi). Differential gene expression analysis showed that numerous defense-related genes were induced in susceptible plants at 5 dpi. Mapping reads against the A. psidii genome showed that only susceptible plants contained fungal-derived transcripts. Resistant plants exhibited an overexpression of candidate A. psidii resistance-related genes such as receptor-like kinases, nucleotide-binding site leucine-rich repeat proteins, glutathione S-transferases, WRKY transcriptional regulators, and pathogenesis-related proteins. We identified large differences in the expression of defense-related genes among resistant individuals.
Stage IIB Flatfoot Reconstruction Using Literature-based Equations for Heel Slide and Lateral Column Lengthening
Authors: Conti Matthew S. , Deland Jonathan T. , Ellis Scott J.
Published: November 2017

Adult acquired flatfoot deformity (AAFD) is a disease characterized by insufficiency of the medial longitudinal arch of the foot. Stage IIB AAFD occurs when there is a passively correctible collapse of the arch, increased abduction at the talonavicular joint, and hindfoot valgus. In the mid-1990s, a flatfoot reconstruction was proposed that combined the use of a medializing calcaneal osteotomy (MCO), a lateral column lengthening (LCL), and soft-tissue procedures for the treatment of stage IIB AAFD. More recent literature has suggested guidelines for the amount of correction necessary for each of these procedures based on individual deformity. In this paper, we describe our technique for flatfoot reconstruction for stage IIB AAFD, which includes a MCO, LCL, and flexor digitorum longus (FDL) transfer. Importantly, we discuss our preferred method of preoperatively planning the amount of medial translation for the MCO as well as the maximum amount of LCL to prevent overcorrection of the abduction deformity. This allows us to tailor the reconstruction and optimize our results. Studies looking at outcomes following flatfoot reconstructions for stage IIB AAFD demonstrate excellent short-term and long-term results. We conclude by discussing complications of the operation, postoperative management, and the future of the technique.

Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.
In vitro and in vivo antimelanoma effect of ethyl ester cyclohexyl analog of ethylenediamine dipropanoic acid
Authors: Isakovic Andjelka M. , Petricevic Sasa M. , Ristic Slavica M. , Popadic Dusan M. , Kravic-Stevovic Tamara K. , Zogovic Nevena S. , Poljarevic Jelena M. , Zivanovic Radnic Tatjana V. , Sabo Tibor J. , Isakovic Aleksandra J. , Markovic Ivanka D. , Trajkovic Vladimir S. , Misirlic-Dencic Sonja T.
Published: November 2017

Melanoma, an aggressive skin tumor with high metastatic potential, is associated with high mortality and increasing morbidity. Multiple available chemotherapeutic and immunotherapeutic modalities failed to improve survival in advanced disease, and the search for new agents is ongoing. The aim of this study was to investigate antimelanoma effects of O,O-diethyl-(S,S)-ethylenediamine-N,N′di-2-(3-cyclohexyl) propanoate dihydrochloride (EE), a previously synthesized and characterized organic compound. Mouse melanoma B16 cell viability was assessed using acid phosphatase, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, sulforhodamine B, and lactate dehydrogenase assays. Apoptosis and autophagy were investigated using flow cytometry, fluorescence and electron microscopy, and western blotting. In vivo antitumor potential was assessed in subcutaneous mouse melanoma model after 14 days of treatment with EE. Tumor mass and volume were measured, and RT-PCR was used for investigating the expression of autophagy-related, proapoptotic, and antiapoptotic molecules in tumor tissue. Investigated organic compound exerts significant cytotoxic effect against B16 cells. EE induced apoptosis, as confirmed by phosphatidyl serine externalisation, caspase activation, and ultrastructural features typical for apoptosis seen on fluorescence and electron microscopes. The apoptotic mechanism included prompt disruption of mitochondrial membrane potential and oxidative stress. No autophagy was observed. Antimelanoma action and apoptosis induction were confirmed in vivo, as EE decreased mass and volume of tumors, and increased expression of several proapoptotic genes. EE possesses significant antimelanoma action and causes caspase-dependent apoptosis mediated by mitochondrial damage and reactive oxygen species production. Decrease in tumor growth and increase in expression of proapoptotic genes in tumor tissue suggest that EE warrants further investigation as a candidate agent in treating melanoma.
Immune checkpoint inhibitor therapy in a liver transplant recipient with a rare subtype of melanoma: a case report and literature review
Authors: Kuo James C. , Lilly Leslie B. , Hogg David
Published: November 2017

Immunotherapy with immune checkpoint inhibitors (ICIs) may be considered as a treatment option for various types of tumors, but the transplant recipient population as well as patients requiring long-term systemic immunosuppression for other reasons have been systematically excluded from clinical trials involving ICIs. We report a case of successful treatment with ICI in a liver transplant recipient diagnosed with a rare subtype of melanoma. This patient had not required any modification to her antirejection immunosuppression before or during immunotherapy, had not experienced any serious immune-related adverse event, and had a durable objective response for nearly 1.5 year now. A summary of a literature review on other case reports is included to show that ICIs can be safe and provide clinically meaningful benefit in transplant patients, although acute rejection and graft loss remain a significant risk. Given the serious complication of graft failure, a detailed discussion of risks and benefits with immunotherapy needs to be made for an informed consent. Nevertheless, transplant recipients with cancer should not be deprived of this potentially life-saving or life-prolonging treatment, and inclusion of this population in future clinical trials should be considered.
Cytokeratin Profile of Basal Cell Carcinomas According to the Degree of Sun Exposure and to the Anatomical Localization
Authors: García-de-la-Fuente Mª Reyes , Santacana Maria , Valls Joan , Vilardell Felip , Fernández Armenteros José Manuel , Pujol Ramon , Gari Eloi , Casanova Josep Manel
Published: November 2017

Basal cell carcinoma (BCC) seems to originate from ultraviolet light-induced mutations involving the bulge or the outer sheath of the hair follicle cells. However, the etiopathogenic mechanisms involved in the development of these tumors in nonphotoexposed and in hairless areas remain unclear. The cytokeratin (CK) profile (including CK5/6, CK7, CK14, CK15, CK17, and CK19) from a series of different BCC subtypes developing in sun-exposed and non–sun-exposed areas, including hairless regions, was evaluated. The authors have observed that CK7 expression in BCC is associated with the anatomical localization of the tumor and its sun-exposition, but not with other factors such as histological subtype. The expression of this CK is higher in BCCs located in non–sun-exposed and nonhairy areas, such as the vulvar semimucosa and the nipple. Because CK7 is a marker of simple glandular epithelia, the authors suggest a glandular origin for BCCs located in hairless and nonphotoexposed areas.
Practice Patterns and Job Satisfaction of Mohs Surgeons
Authors: Kohli Nita , Golda Nicholas
Published: November 2017

BACKGROUND

There is a paucity of data on Mohs surgery workforce patterns.

OBJECTIVE

To identify if gender differences exist in practice patterns of Mohs surgeons, factors that influence these differences, and factors influencing job satisfaction among Mohs surgeons.

MATERIALS AND METHODS

An electronic survey was distributed to dermatology organizations targeting members of the American College of Mohs Surgery (ACMS), from October 2015 to April 2016.

RESULTS

Two hundred twenty-seven ACMS members responded; 37% were women. Twenty-five percent of women and 19% of men work part time. Thirty-seven percent of women practice in academia versus 22% of men. Forty-three percent of women and 23% of men identified children as a factor affecting their ability to work full time. Gender comparisons for current job satisfaction show 57% of women and 35% of women being very satisfied. Supervision/feedback/recognition adds to satisfaction at a higher rate for women (53%) than for men (29%). For both genders combined, work content, patient base, and autonomy had the highest average job satisfaction ratings.

CONCLUSION

Gender differences exist in practice patterns and job satisfaction of Mohs surgeons. This study demonstrates factors that could influence job satisfaction among female Mohs surgeons—knowledge that is important to individuals who lead, mentor, or supervise female Mohs surgeons.
A Retrospective Assessment of Postoperative Bleeding Complications in Anticoagulated Patients Following Mohs Micrographic Surgery
Authors: Eilers Robert E. , Goldenberg Alina , Cowan Natasha L. , Basu Pallavi , Brian Jiang Shang I.
Published: November 2017

BACKGROUND

A significant number of patients undergoing Mohs micrographic surgery (MMS) for skin cancer are treated with oral anticoagulants. The incidence of postoperative complications associated with new classes of oral anticoagulants remains largely unknown.

OBJECTIVE

To determine the incidence of postoperative complications in patients undergoing MMS on both traditional oral anticoagulants and new novel oral anticoagulants.

MATERIALS AND METHODS

A single-center retrospective chart review was performed for all patients treated with oral anticoagulants who underwent MMS between July 1, 2012 and June 30, 2015 at University of California, San Diego.

RESULTS

The data from this study demonstrated that patients treated with a novel oral anticoagulant at the time of MMS had a statistically significant greater risk for developing postoperative hemorrhagic complications compared to patients treated with traditional oral anticoagulants.

CONCLUSION

Dermatologic surgeons should manage both traditional oral anticoagulants and novel oral anticoagulants in a similar manner. Future studies are warranted.
Rhinophyma: A Treatment Review
Authors: Fink Caitlin , Lackey Jeffrey , Grande Donald J.
Published: November 2017

BACKGROUND

Rhinophyma is the overgrowth of sebaceous glands in nasal tissue and its etiology unclear. Without treatment, rhinophyma can be progressive and cause concern both with respect to function and cosmesis.

OBJECTIVE

The objective of this work is to describe treatment options for rhinophyma and their respective risks and benefits.

MATERIALS AND METHODS

A PubMed search was performed to include the terms “rhinophyma” and “treatment.”

RESULTS

Numerous physically destructive modalities exist for treatment of rhinophyma, falling primarily into 3 categories: mechanical destruction, directed electrical energy/radiofrequency, and directed laser energy.

CONCLUSION

There are multiple treatment modalities available to dermatologists for the treatment of rhinophyma. To the best of our knowledge, there are no randomized, prospective, control studies for any treatment, which makes it difficult to recommend a single treatment over another. Nonetheless, it is important to recognize that scarring and hypopigmentation most often occur on or near the nasal ala. Moreover, risks may increase if tissue destruction extends to the papillary dermis or pilosebaceous units are ablated.
Beneficial Effects of Angiotensin-(1–7) on CD34+ Cells From Patients With Heart Failure
Authors: Cole-Jeffrey Colleen T. , Pepine Carl J. , Katovich Michael J. , Grant Maria B. , Raizada Mohan K. , Hazra Sugata
Published: November 2017

The dysfunctional nature of CD34+ cells from patients with heart failure (HF) may make them unsuitable for autologous stem-cell therapy. In view of evidence that the vasoprotective axis of the renin–angiotensin system (RAS) improves CD34+ cell functions, we hypothesized that CD34+ cells from patients with HF will be dysfunctional and that angiotensin-(1–7) [Ang-(1–7)] would improve their function. Peripheral blood was collected from New York Heart Association class II-IV patients with HF (n = 31) and reference subjects (n = 16). CD34+ cell numbers from patients with HF were reduced by 47% (P < 0.05) and also displayed 76% reduction in migratory capacity and 56% (P < 0.05) lower production of nitric oxide. These alterations were associated with increases in RAS genes angiotensin-converting enzyme and AT2R (595%, P < 0.05) mRNA levels and 80% and 85% decreases in angiotensin-converting enzyme 2 and Mas mRNA levels, respectively. Treatment with Ang-(1–7) enhanced CD34+ cell function through increased migratory potential and nitric oxide production, and reduced reactive oxygen species generation. These data show that HF CD34+ cells are dysfunctional, and Ang-(1–7) improves their functions. This suggests that activation of the vasoprotective axis of the RAS may hold therapeutic potential for autologous stem-cell therapy in patients with HF.
Changes in sexual function among midlife women: “I’m older… and I’m wiser”
Authors: Thomas Holly N. , Hamm Megan , Hess Rachel , Thurston Rebecca C.
Published: November 2017

Objective:

Women experience a variety of changes at midlife that may affect sexual function. Qualitative research approaches can allow a deeper understanding of women's experiences. We conducted 20 individual interviews and three focus groups among sexually active women aged 45 to 60 years (total n = 39) to explore how sexual function changes during midlife.

Methods:

Interviews and focus groups were conducted by a trained facilitator using a semistructured guide. All data were audio-recorded and transcribed. Two investigators used a subsample of data to iteratively develop a codebook. The primary investigator coded all data. A second investigator coded a randomly selected 25% of interviews. Codes regarding changes in sexual function were examined and key themes emerged.

Results:

The mean age was 52, and most women were peri- or postmenopausal. Fifty-four per cent of women were white, 36% black, and 10% of another race. Participants discussed positive and negative changes in sexual function. The most common negative changes were decreased frequency of sex, low libido, vaginal dryness, and anorgasmia. Participants attributed negative changes to menopause, partner issues, and stress. Most participants responded to negative changes with adaptation, including changing sexual behavior and prioritizing different aspects of sex. Participants also reported positive changes, attributed to higher self-confidence, increased self-knowledge, and better communication skills with aging.

Conclusions:

In this qualitative study, women described experiencing both positive and negative changes in sexual function during midlife. When negative changes occurred, women often adapted behaviorally and psychologically. Providers should recognize that each woman's experience is unique and nuanced, and they should provide tailored care regarding sexual function at midlife.
Cross-cultural validation of the Modified Falls Efficacy Scale in Serbian community-dwelling women at risk for osteoporotic fracture
Authors: Aleksic Jelena , Zvekic-Svorcan Jelena , Vujasinovic Stupar Nada , Jeremic Ivica , Grgurevic Anita
Published: November 2017

Objective:

Cross-cultural validation of the Serbian version of the Modified Falls Efficacy Scale (MFES).

Methods:

This cross-sectional study involved 257 women aged 65 years and above who were referred for dual-energy x-ray absorptiometry examination at the Railway Healthcare Institute in Belgrade, Serbia, between January and April 2016. Data collection comprised of a sociodemographic questionnaire and Geriatric Depression Scale-Short Form (GDS-SF) questionnaire, and data related to fractures, level of physical activity, use of medications that can increase the risk of falls, and frequency of falls in the past 12 months. None of the study participants had been previously treated for osteoporosis. The internal consistency of the questionnaire items was assessed via Cronbach's alpha, whereas the interclass correlation coefficient (ICC) was used to calculate test-retest reliability based on the sample of 257 women. We also evaluated concurrent, convergent, and construct validity.

Results:

Cronbach's alpha for the total assay score was 0.98. Correlations among the items ranged from 0.84 to 0.93. While ICC for the scale as a whole was 0.99 (95% confidence interval 0.98-0.99), ICC pertaining to individual items ranged from 0.82 to 0.99. Concurrent validity analysis revealed a significant positive correlation between MFES scores and the reported level of physical activity (ρ = 0.34; P < 0.01). Convergent validity was tested through the ratio of MFES and sociodemographic variables. The findings indicated presence of a significant negative correlation between the MFES scores and age (ρ = −0.32; P < 0.01), age of menopause onset (ρ = −0.16; P = 0.01), and GDS-SF scores (ρ = −0.12; P = 0.04), and positive correlation between MFES and the level of social activity (ρ = 0.22; P < 0.01). Significant differences were noted between the MFES scores of participants who had no history fractures and those who did (U = 5277.50; P < 0.01), and between scores of women who reported falling in the past 12 months and those who did not (U = 4968.50; P < 0.01). Similarly, significant differences (P < 0.01) in the scores pertaining to each MFES item were observed between women who had experienced falls in the past (n = 101) and those who had not (n = 156).

Conclusion:

The Serbian version of the MFES is a reliable and valid instrument that can be used in both clinical practice and research to describe and measure self-perceived fear of falling in older individuals.
Increased cardiac and stroke death risk in the first year after discontinuation of postmenopausal hormone therapy
Authors: Venetkoski Minttu , Savolainen-Peltonen Hanna , Rahkola-Soisalo Päivi , Hoti Fabian , Vattulainen Pia , Gissler Mika , Ylikorkala Olavi , Mikkola Tomi S.
Published: November 2017

Objective:

The aim of the study was to evaluate the risk of cardiac and stroke deaths in women who discontinue postmenopausal hormone therapy (HT).

Methods:

We analyzed the risk of death due to cardiac (n = 5,204) and cerebrovascular (n = 3,434) causes in Finnish women who discontinued systemic HT during 1994 to 2013 (n = 432,775). The risks were compared with those in the age-matched female background population and with those in age-matched HT users. Women diagnosed with cardiac or cerebrovascular events within 1 year before discontinuation of HT were excluded (n = 8,711).

Results:

Women younger than 60 years at discontinuation of HT showed a significantly increased risk of cardiac death (after ≤5 y of HT exposure, standardized mortality ratio [SMR] 1.52, 95% CI 1.13-2.00; after >5 y of exposure, SMR 2.08, 95% CI 1.44-2.90) and stroke death (after ≤5 y of exposure, SMR 2.62, 95% CI 2.07-3.28; after >5 y of exposure, SMR 3.22, 95% CI 2.29-4.40) during the first year after treatment as compared with age-matched female background population. When compared with HT users, elevations in risks of cardiac and stroke deaths were even higher. Increased mortality risks were limited to the first post-HT year because increases in risks vanished or markedly decreased when the follow-up time was extended over more than 1 year.

Conclusions:

Discontinuation of postmenopausal HT may be associated with increased risk of cardiac and stroke death in the first posttreatment year. Further investigation is required to evaluate causality of the observed associations.
Association of age at menarche with obesity and hypertension among southwestern Chinese women: a new finding
Authors: Liu Gang , Yang Yuan , Huang Wei , Zhang Nan , Zhang Fan , Li Ge , Lei Han
Published: November 2017

Objectives:

The purpose of this study was to assess the association of the age at menarche with obesity and hypertension among southwestern Chinese women.

Methods:

Participants in a cross-sectional study were required to recall and complete a standard self-reporting questionnaire, including age at menarche and lifestyle habits. Cardiovascular risk factors were obtained from the questionnaire or a physical examination. The main outcomes were obesity and hypertension. The association was examined by binary logistic regression and birth cohort. Odds ratios for adiposity and hypertension were computed across menarcheal ages.

Results:

A cohort of 7,119 women with a mean age of 44.7 years was included in the study. After adjustments, odds ratios (and 95% confidence interval) for obesity across menarcheal age categories (≤11, 12-13, 14-15, 16-17, ≥18) were 3.75 [1.35-10.41], 1.15 [0.90-1.48], 1 (referent), 0.92 [0.75-1.12], and 0.74 [0.58-0.96], respectively (P
trend < 0.001). For hypertension, they were 0.38 [0.13-1.08], 1.03 [0.80-1.33], 1 (referent), 1.21 [0.98-1.49], and 1.39 [1.08-1.80], respectively (P
trend = 0.03). After adjustment by birth cohort, age at menarche was not associated with obesity but was still positively associated with hypertension.

Conclusions:

This study is the first to report that, among southwestern Chinese women, a late menarche tends to be associated with a high risk of hypertension, but with a low risk of obesity. The association between menarche and obesity tends to differ among birth cohorts. Knowledge of the menarcheal history could be a preventive marker for cardiovascular disease.
Combining Follicular Unit Extraction and Scalp Micropigmentation for the Cosmetic Treatment of Alopecias
Authors: Rassman William , Pak Jae , Kim Jino
Published: November 2017

Two relatively new modalities, follicular unit extraction (FUE) and scalp micropigmentation have changed the treatment of hair loss, to reduce the number of procedures and the total costs of the hair restoration process. These 2 modalities augment each other when treating patients with thinning hair and balding. The explosion of FUE procedures (which reflected 52.6% of the hair transplant procedures performed in 2016, up from 48.5%) and the appearance of more and more new physicians offering hair restoration technologies employing FUE have caused a 20% annual growth in this industry over the past few years. This article reviews the use of FUE and scalp micropigmentation when used in combination.
Designing a Fibular Flow-Through Flap with a Proximal Peroneal Perforator-Free Flap for Maxillary Reconstruction
Authors: Trinh Becky B. , French Brooke , Khechoyan David Y. , Deleyiannis Frederic W.-B.
Published: November 2017

Reconstruction of a composite maxillary defect is frequently performed with a fibular osteocutaneous free flap to address both the bony and mucosal defect. If during the harvest of the fibula a distal skin perforator is not present due to vascular variations, reconstruction can potentially be done using the soleus muscle for filling of the palatal mucosal defect. An additional challenge arises when the accompanying skin paddle that has been harvested is not perfused, but the fibula remains viable. This case report describes salvage following loss of the skin paddle in an osteocutaneous fibular free flap by designing a fibular flow-through flap using a proximal peroneal perforator free flap. The use of this second free flap allows a skin paddle to be positioned on the distal fibular segment, provides a surgical backup, and limits the donor sites to the same extremity.
Genetic Overview of Syndactyly and Polydactyly
Authors: Ahmed Humayun , Akbari Hossein , Emami Abdolhasan , Akbari Mohammad R.
Published: November 2017

Syndactyly and polydactyly—respectively characterized by fused and supernumerary digits—are among the most common congenital limb malformations, with syndactyly presenting at an estimated incidence of 1 in 2,000–3,000 live births and polydactyly at a frequency of 1 in approximately 700–1,000 live births. Despite their relatively regular manifestation in the clinic, the etiologies of syndactyly and polydactyly remain poorly understood because of their phenotypic and genetic diversity. Further, even though concrete knowledge of genotypic links has been established for some variants of syndactyly and polydactyly, there appears to be no single comprehensive published summary of all syndromic and nonsyndromic syndactyly and polydactyly presentations, and there is decidedly no resource that maps all syndromic and nonsyndromic syndactylies and polydactylies to their genetic bases. This gap in the literature problematizes comprehensive carrier screening and prenatal diagnosis and complicates novel diagnostic attempts. This review thus attempts to collect all that is known about the genetic bases of syndromic and nonsyndromic syndactylies and polydactylies, as well as to highlight the dactyly manifestations for which no genetic bases are as yet known. Then, having established a summation of existing and missing knowledge, this work briefly outlines the diagnostic techniques that a genetics-reinforced understanding of syndactyly and polydactyly could inform.
Superficial Soft-Tissue Sarcomas Rarely Require Advanced Soft-Tissue Reconstruction following Resection
Authors: Eward William C. , Lazarides Alexander L. , Griffin Anthony M. , O’Donnell Patrick W. , Sternheim Amir , O’Neill Anne , Hofer Stefan O. , Ferguson Peter C. , Wunder Jay S.
Published: November 2017

Objective:

Soft-tissue sarcomas are most frequently located deep within myofascial compartments. Superficial soft-tissue sarcomas (S-STS) are relatively less common and may be managed differently than deep sarcomas because generous resection margins are often possible without sacrificing critical structures. We sought to investigate the frequency and types of soft-tissue reconstructive procedures that are required following excision of S-STS.

Methods:

We reviewed 457 consecutively treated patients with S-STS with a minimum 2-year follow-up from our prospectively maintained database between 1989 and 2009.

Results:

Mean follow-up was 10.5 years (range, 2–23). Four hundred twenty-one tumors (91%) were excised with negative margins, 38 (8.3%) had microscopically positive margins, and three (0.7%) had grossly positive margins. One patient required an amputation. In 271 (58%) patients, the wounds were closed primarily. In comparison, 93 patients (20%) required a rotation flap, 70 (15%) required a split-thickness skin graft, and 23 (5%) underwent a free tissue transfer (ie, advanced reconstructive procedure). The overall complication rate was 12%, although 43% of patients undergoing free tissue transfer developed complications (P = 0.04). An unplanned excision before referral to our center was a risk factor for local recurrence (P = 0.03) when residual tumor was recovered in the reexcision specimen pathologically.

Conclusions:

Although concern about the morbidity associated with a free tissue transfer (ie, advanced reconstructive procedure) may potentially limit the adequacy of resection in some patients with S-STS, the results of this study showed that the majority of patients had complete excisions with negative margins and primary closure. Obtaining a negative margin when excising a known or suspected S-STS rarely requires an advanced reconstructive procedure and almost never results in loss of limb.
Outcome of Therapeutic Keratoplasty in Hopeless Microbial Keratitis Cases Otherwise Advised Evisceration
Authors: Jain Rajat , Bhutia Karma L. , Mohan Neha , Gupta Col K. C. , Ghai Ashwani
Published: November 2017

Purpose:

To study the outcome of therapeutic keratoplasty in severe microbial keratitis cases otherwise advised evisceration.

Methods:

A retrospective, single-center clinical audit included 28 patients with severe microbial keratitis presenting from April 2014 to April 2016. Patients with microbial keratitis either affecting more than 2 quadrants of the limbus and/or cases with infections involving more than 180 mm2 of the cornea who were advised evisceration by more than one ophthalmologist were included. Cases with endophthalmitis were excluded. At 3 months, the outcome was “success” if resolution of infection occurred without recurrence and evisceration was not required. Success was termed “complete” if best vision was 6/24 or better and “partial” otherwise. The outcome was termed a “failure” if infection recurred in the graft or the eye was eviscerated.

Results:

Mean age of the patients (male:female, 17:11) was 49.5 years, and the mean duration of symptoms before surgery was 28.6 days. Evisceration was required in 2/28 cases. The outcome was “success” in 22/28 cases (78.6%)—complete (10/22); partial (12/22)—and “failure” in 6/28 cases. The outcome was poorer in general in fungal keratitis (n = 16) than bacterial keratitis (n = 7).

Conclusions:

Primary evisceration is best avoided in infections limited to the anterior segment. Even in hopeless cases, every eye deserves a fair chance.