bluuebunny/crossref_metadata_2025 huggingface dataset:
2D nanoporous membrane for cation removal from water: Effects of ionic valence, membrane hydrophobicity, and pore size
Authors: Köhler Mateus Henrique , Bordin José Rafael , Barbosa Marcia C.
Published: February 2018

Using molecular dynamic simulations, we show that single-layers of molybdenum disulfide (MoS2) and graphene can effectively reject ions and allow high water permeability. Solutions of water and three cations with different valencies (Na+, Zn2+, and Fe3+) were investigated in the presence of the two types of membranes, and the results indicate a high dependence of the ion rejection on the cation charge. The associative characteristic of ferric chloride leads to a high rate of ion rejection by both nanopores, while the monovalent sodium chloride induces lower rejection rates. Particularly, MoS2 shows 100% of Fe3+ rejection for all pore sizes and applied pressures. On the other hand, the water permeation does not vary with the cation valence, having dependence only with the nanopore geometric and chemical characteristics. This study helps us to understand the fluid transport through a nanoporous membrane, essential for the development of new technologies for the removal of pollutants from water.
Acoustic Luneburg lens using orifice-type metamaterial unit cells
Authors: Park Choon Mahn , Lee Sang Hun
Published: February 2018

A two-dimensional acoustic Luneburg lens that can be easily expanded into a three-dimensional sphere is fabricated. The required spatial distribution of the refractive index for this Luneburg lens is realized using the characteristics of orifice-type metamaterial unit cells. Typical characteristics of the resulting acoustic Luneburg lens, such as its aberration-free performance and capability for antipodal focusing of the lens for the incident plane waves, are investigated through experiments and simulations with the attenuation loss at frequencies that satisfy the homogeneous medium condition of the metamaterial. With the designed metamaterial, we achieved the minimum spot that lies within the classical diffraction limit at the focal point.
Frequency dependence of trapped flux sensitivity in SRF cavities
Authors: Checchin M. , Martinello M. , Grassellino A. , Aderhold S. , Chandrasekaran S. K. , Melnychuk O. S. , Posen S. , Romanenko A. , Sergatskov D. A.
Published: February 2018

In this letter, we present the frequency dependence of the vortex surface resistance of bulk niobium accelerating cavities as a function of different state-of-the-art surface treatments. Higher flux surface resistance per amount of trapped magnetic field—sensitivity—is observed for higher frequencies, in agreement with our theoretical model. Higher sensitivity is observed for N-doped cavities, which possess an intermediate value of the electron mean-free-path, compared to 120 °C and EP/BCP cavities. Experimental results from our study showed that the sensitivity has a non-monotonic trend as a function of the mean-free-path, including frequencies other than 1.3 GHz, and that the vortex response to the rf field can be tuned from the pinning regime to flux-flow regime by manipulating the frequency and/or the mean-free-path of the resonator, as reported in our previous studies. The frequency dependence of the trapped flux sensitivity to the amplitude of the accelerating gradient is also highlighted.
On the influence of the local maxima of total pressure on the current sheet stability to the kink-like (flapping) mode
Authors: Korovinskiy D. B. , Erkaev N. V. , Semenov V. S. , Ivanov I. B. , Kiehas S. A. , Ryzhkov I. I.
Published: February 2018

The stability of the Fadeev-like current sheet with respect to transversally propagating kink-like perturbations (flapping mode) is considered in terms of two-dimensional linear magnetohydrodynamic numerical simulations. It is found that the current sheet is stable when the total pressure minimum is located in the sheet center and unstable when the maximum value is reached there. It is shown that an unstable spot of any size enforces the whole sheet to be unstable, though the increment of instability decreases with the reduction of the unstable domain. In unstable sheets, the dispersion curve of instability shows a good match with the double-gradient (DG) model prediction. Here, the typical growth rate (short-wavelength limit) is close to the DG estimate averaged over the unstable region. In stable configurations, the typical frequency matches the maximum DG estimate. The dispersion curve of oscillations demonstrates a local maximum at wavelength ∼0.7 sheet half-width, which is a new feature that is absent in simplified analytical solutions.
Theory of ITG turbulent saturation in stellarators: Identifying mechanisms to reduce turbulent transport
Authors: Hegna C. C. , Terry P. W. , Faber B. J.
Published: February 2018

A three-field fluid model that allows for general three-dimensional equilibrium geometry is developed to describe ion temperature gradient turbulent saturation processes in stellarators. The theory relies on the paradigm of nonlinear transfer of energy from unstable to damped modes at comparable wavelength as the dominant saturation mechanism. The unstable-to-damped mode interaction is enabled by a third mode that for dominant energy transfer channels primarily serves as a regulator of the nonlinear energy transfer rate. The identity of the third wave in the interaction defines different scenarios for turbulent saturation with the dominant scenario depending upon the properties of the 3D geometry. The nonlinear energy transfer physics is quantified by the product of a turbulent correlation lifetime and a geometric coupling coefficient. The turbulent correlation time is determined by a three-wave frequency mismatch, which at long wavelength can be calculated from the sum of the linear eigenfrequencies of the three modes. Larger turbulent correlation times denote larger levels of nonlinear energy transfer and hence smaller turbulent transport. The theory provides an analytic prediction for how 3D shaping can be tuned to lower turbulent transport through saturation processes.
Quantum dynamics of ClH2O− photodetachment: Isotope effect and impact of anion vibrational excitation
Authors: Zhao Hailin , Xie Daiqian , Guo Hua
Published: February 2018

Photodetachment of the ClH2O− anion is investigated using full-dimensional quantum mechanics on accurate potential energy surfaces of both the anion and neutral species. Detailed analysis of the photoelectron spectrum and the corresponding wavefunctions reveals that the photodetachment leads to, in the product channel of the exothermic HCl + OH → Cl + H2O reaction, the formation of numerous Feshbach resonances due apparently to slow energy transfer from H2O vibrational modes to the dissociation coordinate. These long-lived resonances can be grouped into two broad peaks in the low-resolution photoelectron spectrum, which is in good agreement with available experiments, and they are assigned to the ground and first excited OH stretching vibrational manifolds of H2O complexed with Cl. In addition, effects of isotope substitution on the photoelectron spectrum were small. Finally, photodetachment of the vibrationally excited ClH2O− in the ionic hydrogen bond mode is found to lead to Feshbach resonances with higher stretching vibrational excitations in H2O.
Modelling the Effect of Conformation on Hydrogen-Atom Abstraction from Peptides
Authors: Chan Bun , Radom Leo
Published: February 2018

Computational quantum chemistry is used to examine the effect of conformation on the kinetics of hydrogen-atom abstraction by HO• from amides of glycine and proline as peptide models. In accord with previous findings, it is found that there are substantial variations possible in the conformations and the corresponding energies, with the captodative effect, hydrogen bonding, and solvation being some of the major features that contribute to the variations. The ‘minimum-energy-structure-pathway’ strategy that is often employed in theoretical studies of peptide chemistry with small models certainly provides valuable fundamental information. However, one may anticipate different reaction outcomes in structurally constrained systems due to modified reaction thermodynamics and kinetics, as demonstrated explicitly in the present study. Thus, using a ‘consistent-conformation-pathway’ approach may indeed be more informative in such circumstances, and in this regard theory provides information that would be difficult to obtain from experimental studies alone.
Climate for women in climate science: Women scientists and the Intergovernmental Panel on Climate Change
Authors: Gay-Antaki Miriam , Liverman Diana
Published: February 2018

Significance

Women in science face barriers to professional advancement. One of the most important forums for international climate science is the Intergovernmental Panel on Climate Change, where there has been a slow increase in the proportion of women authors since the first assessment in 1990. Our survey of more than 100 female Intergovernmental Panel on Climate Change authors explores their experience and perceptions, the barriers to their full participation that they identify, and recommendations for improvements. While we find that some women reported a positive experience, others felt women were poorly represented and heard and encountered barriers beyond their gender including race, nationality, command of English, and discipline. The study contributes to the larger literature on gender and science and provides recommendations for greater inclusion.
Digital signaling network drives the assembly of the AIM2-ASC inflammasome
Authors: Matyszewski Mariusz , Morrone Seamus R. , Sohn Jungsan
Published: February 2018

Significance

The complexity of biological signaling pathways parallels the design of modern electronic circuits. The AIM2-ASC inflammasome is a filamentous signaling platform that plays an essential role in defense against foreign dsDNA arising from invading pathogens. Currently, the design principles of the AIM2-ASC “signaling circuit” remain poorly understood. Here, we found that the assembly of the AIM2-ASC inflammasome filters short dsDNA as noise at each signaling step. dsDNA induces hysteresis, and the assembly generates multistage, virtually infinite signal amplification. Moreover, an array of positive feedback loops reinforces the assembly. Together with a quantitative model of the assembly pathway, we demonstrate that an ultrasensitive digital circuit drives the assembly of the AIM2-ASC inflammasome on foreign dsDNA.
Intensity and duration of TCR signaling is limited by p38 phosphorylation of ZAP-70
T293
and destabilization of the signalosome
Authors: Giardino Torchia Maria Letizia , Dutta Debjani , Mittelstadt Paul R. , Guha June , Gaida Matthias M. , Fish Kamonwan , Barr Valarie A. , Akpan Itoro O. , Samelson Lawrence E. , Tagad Harichandra D. , Debnath Subrata , Miller Jenkins Lisa M. , Appella Ettore , Ashwell Jonathan D.
Published: February 2018

Significance

Activation of T cells via their antigen receptor (TCR) and the formation of a multimolecular signaling complex in or near the plasma membrane is a key initial event in the generation of an immune response. Here we find that p38, a serine/threonine kinase activated by TCR signaling, in turn phosphorylates its upstream tyrosine kinase ZAP-70. This results in a decrease in the size and longevity of the TCR signaling complex, limiting T cell effector responses. Therefore, cross-talk between an upstream and downstream kinase in the signaling complex itself generates a negative feedback loop that may limit excessive T cell responses.
Capicua controls Toll/IL-1 signaling targets independently of RTK regulation
Authors: Papagianni Aikaterini , Forés Marta , Shao Wanqing , He Shuonan , Koenecke Nina , Andreu María José , Samper Núria , Paroush Ze’ev , González-Crespo Sergio , Zeitlinger Julia , Jiménez Gerardo
Published: February 2018

The HMG-box protein Capicua (Cic) is a conserved transcriptional repressor that functions downstream of receptor tyrosine kinase (RTK) signaling pathways in a relatively simple switch: In the absence of signaling, Cic represses RTK-responsive genes by binding to nearly invariant sites in DNA, whereas activation of RTK signaling down-regulates Cic activity, leading to derepression of its targets. This mechanism controls gene expression in both
Drosophila
and mammals, but whether Cic can also function via other regulatory mechanisms remains unknown. Here, we characterize an RTK-independent role of Cic in regulating spatially restricted expression of Toll/IL-1 signaling targets in
Drosophila
embryogenesis. We show that Cic represses those targets by binding to suboptimal DNA sites of lower affinity than its known consensus sites. This binding depends on Dorsal/NF-κB, which translocates into the nucleus upon Toll activation and binds next to the Cic sites. As a result, Cic binds to and represses Toll targets only in regions with nuclear Dorsal. These results reveal a mode of Cic regulation unrelated to the well-established RTK/Cic depression axis and implicate cooperative binding in conjunction with low-affinity binding sites as an important mechanism of enhancer regulation. Given that Cic plays a role in many developmental and pathological processes in mammals, our results raise the possibility that some of these Cic functions are independent of RTK regulation and may depend on cofactor-assisted DNA binding.
Cryo-EM structure of the bacterial actin AlfA reveals unique assembly and ATP-binding interactions and the absence of a conserved subdomain
Authors: Usluer Gülsima D. , DiMaio Frank , Yang Shun Kai , Hansen Jesse M. , Polka Jessica K. , Mullins R. Dyche , Kollman Justin M.
Published: February 2018

Significance

Actin filaments are dynamic cytoskeletal elements that assemble upon ATP binding. Actin homologs are present in all domains of life, and all share a similar 3D structure of the assembling subunit, but evolutionary changes to the subunit have generated many different actin filament structures. The filament structure of the bacterial actin AlfA, which positions plasmids—small, circular DNA molecules that encode important genes—ensures that each daughter cell receives at least one copy at cell division. AlfA is different from all other actins in two critical ways: it binds to ATP in a unique way and it is missing a quarter of the conserved structural core. These differences explain unusual AlfA assembly dynamics that underlie its ability to move plasmids.
hMENA is a key regulator in endothelin-1/β-arrestin1–induced invadopodial function and metastatic process
Authors: Di Modugno Francesca , Caprara Valentina , Chellini Lidia , Tocci Piera , Spadaro Francesca , Ferrandina Gabriella , Sacconi Andrea , Blandino Giovanni , Nisticò Paola , Bagnato Anna , Rosanò Laura
Published: February 2018

Significance

Discovering new targets and novel determinants of metastatic spread is an unmet need in ovarian cancer, which is plagued by high rates of recurrence. Endothelin-1 receptors (ET-1R), belonging to the G-protein–coupled receptor family, represent important targets critically involved in malignant progression. Here we identify a mechanistic link between ET-1R and the actin regulatory protein hMENA/hMENAΔv6 through the specific interaction with the multifunctional protein β-arrestin1 (β-arr1), which initiates signaling cascades as part of the molecular complex crucial for invadopodial maturation and malignant dissemination. Targeting ET-1R by using macitentan, a Food and Drug Administration-approved antipulmonary arterial hypertension drug, can impair the β-arr1–mediated signaling network controlling ovarian cancer progression and therefore represents a therapeutic option for ovarian cancer patients.
STING-dependent translation inhibition restricts RNA virus replication
Authors: Franz Kate M. , Neidermyer William J. , Tan Yee-Joo , Whelan Sean P. J. , Kagan Jonathan C.
Published: February 2018

Significance

In mammalian cells, a protein called STING (stimulator of IFN genes) is typically viewed as a factor dedicated to defense strategies induced by DNA viruses. The antiviral activities of STING are linked to its ability to induce the expression of genes that combat viral replication cycles. In our study, we have discovered a transcription-independent function for STING in the restriction of viruses that contain RNA genomes. We found that cells lacking STING are sensitive to RNA virus infections and that during these infections, STING inhibits the translation machinery to prevent viral protein synthesis. This study therefore establishes that STING has dual functions in host defense, regulating antiviral gene expression or interfering with translation, to restrict replication of distinct classes of viruses.
Flexible usage and social function in primate vocalizations
Authors: Cheney Dorothy L. , Seyfarth Robert M.
Published: February 2018

Significance

When compared with humans, nonhuman primates have small vocal repertoires that show little acoustic modification during development. These limitations pose a dilemma for those interested in the evolution of language. Recent research, however, suggests that monkeys and apes show an extensive ability to modify their use of calls in different social contexts. Many vocalizations function to facilitate social interaction by reducing the uncertainty about the signaler’s intentions and likely behavior. Such interactions help to establish and maintain the social bonds that increase reproductive success. For scientists interested in the evolutionary transition from nonlinguistic communication to language, a logical starting point should be social interactions between long-lived individuals who interact repeatedly and for whom long-term social bonds are of paramount importance.
Poldip2 is an oxygen-sensitive protein that controls PDH and αKGDH lipoylation and activation to support metabolic adaptation in hypoxia and cancer
Authors: Paredes Felipe , Sheldon Kely , Lassègue Bernard , Williams Holly C. , Faidley Elizabeth A. , Benavides Gloria A. , Torres Gloria , Sanhueza-Olivares Fernanda , Yeligar Samantha M. , Griendling Kathy K. , Darley-Usmar Victor , San Martin Alejandra
Published: February 2018

Significance

The present work establishes that the addition of the prosthetic group lipoic acid to catabolic enzymes is a dynamically regulated posttranslational modification that increases metabolic plasticity under hypoxia and in cancer cells. We show that that the polymerase-δ interacting protein 2 (Poldip2) is an oxygen-sensitive protein that regulates the lipoylation and activation of the pyruvate and α-ketoglutarate dehydrogenase complexes. Additionally, our work reveals that mitochondrial peptidases participate in an integrated response needed for metabolic adaptation. This study positions Poldip2 as a key regulator of mitochondrial function and cell metabolism.
Payments for watershed ecosystem services: mechanism, progress and challenges
Authors: Feng Danyang , Wu Wenliang , Liang Long , Li Li , Zhao Guishen
Published: February 2018

Introduction:
Payment for watershed ecosystem services (PWES), a policy instrument for compensating for the externality of watershed ecosystem/environmental services, has gained in policy importance in China over the past two decades. Many scholars and researchers have contributed to the conceptualization of this policy framework by developing operational mechanisms as well as compensation standards for PWES.

Outcomes:
This article reviews 27 PWES schemes piloted in China and in 10 other countries, with a particular emphasis on successful cases of land-use conversion programs, such as the Paddy Land to Dry Land Program and Sloping Land Conversion Program that have been implemented in China.

Discussion:
By comparing different cases, the authors attempt to answer the following questions: what were the ecological and institutional contexts in which these schemes were established and how did they work? What were the actual efficiencies and impacts of these piloted schemes? Which scheme worked better in certain ecological, socio- economic, and institutional contexts?

Conclusion:
Based on case studies, the authors draw the following conclusions about Chinese PWES: (1) to establish an acceptable standard for a PWES program, it is necessary to estimate the economic and social costs regarding the livelihoods of households; (2) multi-stakeholder negotiation mechanism for PWES, including intermediaries, such as the local government, NGO/NPOs, village committees, and user associations, should be used; (3) ES, non-market services, should acquire positive externalities to accomplish an optimal win–win pattern concerning both environmental goals and the livelihoods of local resource users.
Obese Hypertensive Men Have Lower Circulating Proatrial Natriuretic Peptide Concentrations Despite Greater Left Atrial Size
Authors: Asferg Camilla L , Andersen Ulrik B , Linneberg Allan , Goetze Jens P , Jeppesen Jørgen L
Published: February 2018

BACKGROUND

Obese persons have lower circulating natriuretic peptide (NP) concentrations. It has been proposed that this natriuretic handicap plays a role in obesity-related hypertension. In contrast, hypertensive patients with left atrial enlargement have higher circulating NP concentrations. On this background, we investigated whether obese hypertensive men could have lower circulating NP concentrations despite evidence of pressure-induced greater left atrial size.

METHODS

We examined 98 obese men (body mass index [BMI] ≥ 30.0 kg/m2) and 27 lean normotensive men (BMI 20.0–24.9 kg/m2). All men were healthy, medication free, with normal left ventricular ejection fraction. We measured blood pressure using 24-hour ambulatory blood pressure (ABP) recordings. Hypertension was defined as 24-hour ABP ≥ 130/80 mm Hg, and normotension was defined as 24-hour ABP < 130/80 mm Hg. We determined left atrial size using echocardiography, and we measured fasting serum concentrations of midregional proatrial NP (MR-proANP).

RESULTS

Of the 98 obese men, 62 had hypertension and 36 were normotensive. The obese hypertensive men had greater left atrial size (mean ± SD: 28.7 ± 6.0 ml/m2) compared with the lean normotensive men (23.5 ± 4.5 ml/m2) and the obese normotensive men (22.7 ± 5.1 ml/m2), P < 0.01. Nevertheless, despite evidence of pressure-induced greater left atrial size, the obese hypertensive men had lower serum MR-proANP concentrations (median [interquartile range]: 48.5 [37.0–64.7] pmol/l) compared with the lean normotensive men (69.3 [54.3–82.9] pmol/l), P < 0.01, whereas the obese normotensive men had serum MR-proANP concentrations in between the 2 other groups (54.1 [43.6–62.9] pmol/l).

CONCLUSIONS

Despite greater left atrial size, obese hypertensive men have lower circulating MR-proANP concentrations compared with lean normotensive men.
Techniques to Ensure Accurate Targeting for Delivery of Awake Laser Interstitial Thermotherapy
Authors: Laurent Dimitri , Oliveria Seth F , Shang Michael , Bova Frank , Freedman Rachel , Rahman Maryam
Published: February 2018

BACKGROUND

Magnetic resonance imaging (MRI) guided laser interstitial thermal therapy (LITT) is an emerging neurosurgical treatment modality that is typically performed under general anesthesia. We describe a novel workflow developed at the University of Florida to deliver LITT in conscious patients without the use of general anesthesia.

OBJECTIVE

To describe a novel workflow for LITT implementation in the awake patient with equivalent treatment results when compared to procedures performed under general anesthesia.

METHODS

For trajectories near a post of the Cosman-Roberts-Wells (CRW) frame (Integra LifeSciences, Plainsboro, New Jersey), we used preoperative MRI imaging to 3-dimensional-print a patient-specific mask with a trajectory guide to indicate the planned entry point during headframe placement. Otherwise, routine headframe placement and stereotactic registration were performed. Stereotactic biopsy and placement of the cranial bolt were performed in a standard neurosurgical operating room. The patient was transferred to a diagnostic MRI suite and positioned in the MRI scanner using beanbags and a custom molded thermoplastic mask. LITT was delivered with the patient conscious in the MRI scanner according to the manufacturer's recommendations. We collected patient demographics, treatment time, length of stay, and calculated preoperative tumor volume and postoperative ablation volumes.

RESULTS

Ten sequential patients were treated with LITT from January 2016 until March 2017. The average preoperative tumor volume was 6.9 cm3. The average tissue volume ablated was 18.3 cm3. The mean operative time was 31 min (standard deviation [SD] 10 min) and mean time with laser delivery in MRI was 79 min (SD 27 min). The mean length of stay was 1.4 d (SD 0.9). There were no major complications.

CONCLUSION

Using trajectory preplanning, customized face masks, and noninvasive head immobilization, LITT can be delivered to patients safely and accurately without general anesthesia.
Clinical Criteria of Central Sensitization in Chronic Pelvic and Perineal Pain (Convergences PP Criteria): Elaboration of a Clinical Evaluation Tool Based on Formal Expert Consensus
Authors: Levesque Amélie , Riant Thibault , Ploteau Stéphane , Rigaud Jérôme , Labat Jean-Jacques ,   Convergences PP Network, Amarenco Gérard , Attal Nadine , Bautrant Eric , Marc Beer Gabel , Cervigni Mauro , Chelimsky Thomas , Farmer Melissa , Adela Giamberardino Maria , Greenslade Gareth , Hughes John , Lord Marie Josée , Marchand Serge , Messelink Bert , Moyal Barracco Micheline , Tu Franck F , Usandizaga Elio Ràmon , Vancaillie Thierry , Vincent Katy , Watier Alain
Published: February 2018

Background

The evaluation of chronic pelvic and perineal pain (CPP) is often complex. The patient’s description of the pain often appears to be disproportionate to the limited findings on physical examination and/or complementary investigations. The concept of central sensitization may allow better understanding and management of patients with CPP.

Objective

The aim of this study was to elaborate a clinical evaluation tool designed to simply identify sensitization in pelvic pain.

Methods

A list of 63 items was submitted to 22 international CPP experts according to the Delphi method.

Results

Ten clinical criteria were adopted for the creation of a clinical evaluation tool: 1) pain influenced by bladder filling and/or urination, 2) pain influenced by rectal distension and/or defecation, 3) pain during sexual activity, 4) perineal and/or vulvar pain in response to normally nonpainful stimulation, 5) pelvic trigger points (e.g., in the piriformis, obturator internus, and/or levator ani muscles), 6) pain after urination, 7) pain after defecation, 8) pain after sexual activity, 9) variable (fluctuating) pain intensity and/or variable pain distribution, 10) migraine or tension headaches and/or fibromyalgia and/or chronic fatigue syndrome and/or post-traumatic stress disorder and/or restless legs syndrome and/or temporomandibular joint dysfunction and/or multiple chemical sensitivity.

Conclusions

 This process resulted in the elaboration of a clinical evaluation tool designed to identify and appropriately manage patients with CPP comprising a sensitization component.
Long-term Scar Quality after Treatment of Standardized Partial-Thickness Skin Graft Donor Sites
Authors: Schulz Alexandra , Rothermund Irene , Lefering Rolf , Fuchs Paul Christian , Schiefer Jennifer
Published: February 2018

BACKGROUND:

The long-term aesthetic appearance of scars is of great importance to patients. Biobrane (Smith and Nephew, Fort Worth, Texas), a biosynthetic skin dressing, is a successfully established dressing for the treatment of superficial wounds. A new silk barrier dressing (Dressilk; Prevor, Moulin de Verville, France) has also shown good results in wound healing. This study evaluated the long-term scar quality of superficial wounds treated with these dressings.

METHODS:

From February 2012 to May 2013, 11 patients with burns in need of skin grafting received donor site treatment. Study authors dressed 2 adjacent, standardized, partial-thickness skin graft donor sites on each participant with Biobrane or Dressilk. Scar formation on both treated areas was compared 24 months after initial application using subjective and objective assessment methods.

RESULTS:

Independent of treatment, the majority of the patients described scar quality similar to normal skin using subjective and objective evaluation tools. However, for scar perfusion, significantly lower oxygen saturation was shown in both treated areas compared with untreated skin.

CONCLUSIONS:

Comparatively, the 2 wound dressings showed similar results, making silk dressings an interesting alternative to biosynthetic ones.
Buprenorphine Treatment for Adolescents and Young Adults With Opioid Use Disorders: A Narrative Review
Authors: Borodovsky Jacob T. , Levy Sharon , Fishman Marc , Marsch Lisa A.
Published: February 2018

In the past decade, a new cohort of adolescents and young adults with opioid use disorders (OUD) has emerged. While medications and psychosocial treatments are available, few adolescents and young adults with OUD can access and remain in treatment. Effective, practical, and scalable treatment paradigms for this young population are needed. Buprenorphine is a medication with unique pharmacological and regulatory characteristics that make it a promising component of adolescent and young adult OUD treatment models. Three randomized controlled trials and multiple observational studies have evaluated the use of buprenorphine to treat this population. However, data from these studies have not been consolidated into an up-to-date summary that may be useful to clinicians. The objective of this narrative review is to inform clinical practice by summarizing results of primary and secondary analyses from randomized controlled clinical trials and observational studies that have evaluated the use of buprenorphine to treat adolescents and young adults with OUD. Based on results from these studies, we encourage the conceptualization of OUD among youth as a chronic medical condition requiring a long-term management strategy. This includes treatment with buprenorphine in conjunction with medication-prescribing protocols that do not necessarily require daily clinic attendance for observed medication adherence. However, more study of treatment delivery models, addressing such issues as medication adherence and intensity requirements, is needed to determine practices that optimize outcomes for youth.
Anxiety Sensitivity Physical and Cognitive Concerns in Relation to Smoking-oriented Cognition: An Examination Among Treatment-seeking Adults Who Smoke
Authors: Langdon Kirsten J. , Bakhshaie Jafar , Lopez Alicia , Tavakoli Niloofar , Garey Lorra , Raines Amanda M. , Kauffman Brooke Y. , Schmidt Norman B. , Zvolensky Michael J.
Published: February 2018

Objectives:

Elevated levels of anxiety sensitivity (AS; fear of anxiety and internal sensations) is highly common among adults who smoke, and contributes to several maladaptive smoking beliefs and behaviors. AS is comprised of 3 empirically established factors, relating to fears of social concerns, fears of physical symptoms, and fears of cognitive dyscontrol. Relatively few studies have examined how these 3 subscales pertain to smoking processes. The aim of the present investigation was to examine, among treatment-seeking adults who smoke, the interactive effects of AS-physical and cognitive concerns in relation to: perceived barriers to smoking cessation; smoking-related negative reinforcement expectancies; and smoking-related avoidance and inflexibility.

Methods:

Participants included 470 adults who smoke (47.8% female; mean age 37.2, SD 13.5), who were recruited to participate in a smoking-cessation treatment study. At the baseline assessment, participants completed self-report measures, including the Anxiety Sensitivity Index-3, Barriers to Cessation Scale, Smoking Consequences Questionnaire, and Avoidance and Inflexibility Scale.

Results:

Results indicated that after controlling for the effects of sex, cigarette dependence, alcohol problems, tobacco-related medical illness, current axis 1 disorder, and AS-social concerns, a significant interaction emerged, such that the association between AS-cognitive concerns and the studied smoking-based cognitions were stronger among lower levels of AS-physical concerns (but not higher physical concerns).

Conclusions:

The current findings suggest that it may be beneficial to provide specialized smoking-cessation interventions for certain subgroups of adults who smoke, such as those with different AS profiles, to promote healthier beliefs about quitting.
Management of Behçet's disease
Authors: Alibaz-Oner Fatma , Sawalha Amr H. , Direskeneli Haner
Published: February 2018

Purpose of review

Current treatment modalities in Behçet's disease will be summarized in light of new studies published within the last 2 years.

Recent findings

There is an increasing interest in the treatment of refractory mucocutaneous symptoms of Behçet's disease, and results were quite promising with apremilast, anakinra, and ustekinumab. Data from large case series confirmed both the efficacy and safety of tumor necrosis factor-α inhibitors for the treatment of refractory major organ manifestations such as ocular, neurologic, vascular, and gastrointestinal involvement. In refractory ocular disease, long-term results also confirmed the efficacy and safety of interferon-α. Interleukin-1 inhibitors and tocilizumab seem to be alternative options in patients with refractory ocular involvement.

Prospective and controlled studies for the management of major organ involvement in Behçet's disease are still limited. Data from primarily retrospective studies confirmed better outcomes of major organ involvement with tumor necrosis factor-α inhibitors and interferon-α. There were also acceptable results with interleukin-1 inhibitors for the management of refractory ocular disease, and with apremilast, anakinra, and ustekinumab for refractory mucocutaneous involvement.
Evaluation of Intramedullary Fixation for Pediatric Femoral Shaft Fractures in Developing Countries
Authors: Chen Andrew T. , Morris William Z. , Zirkle Lewis G. , Liu Raymond W.
Published: February 2018

Objectives:

To report the clinical results after treatment of pediatric femoral shaft fractures with the SIGN Fracture Care International (SIGN) pediatric and standard fin nails.

Design:

Retrospective review of prospectively collected data.

Setting:

Sixteen global SIGN centers from 2003 to 2013.

Patients/Participants:

One hundred twelve pediatric patients who sustained a diaphyseal pediatric femoral shaft fracture.

Intervention:

Intramedullary fixation with the standard or pediatric SIGN nail.

Main Outcome Measurements:

Main outcome measurements include clinical and radiographic healing and postoperative complications.

Results:

The mean age of the pediatric fin patients was 9.4 years (4–15) and 11.2 years (4–18) for the standard fin patients. Painless weight bearing was achieved in 94.7% and 94.5% of the patients at the last follow-up. In total, 23 patients had repeat surgery for the removal of implant. Failure of implant with bending of the nail and/or a valgus or varus deformity (>10 degrees) was noted in 7/57 (12.3%) of the patients treated with the pediatric fin nail, of which 6/7 were >10 years old. Five of these 7 patients were classified as technical errors attributed to inadequate nail diameter, length, or initial malreduction. No complications were noted at any age in the standard fin nail group.

Conclusions:

In resource-poor settings, SIGN pediatric fin and standard fin nails seem to be an effective treatment option for femoral shaft fractures. In patients with larger canals, the surgeon should consider using the standard fin nail for improved stability and to minimize potential complications.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Outcomes of Early Surgical Intervention in Geriatric Proximal Femur Fractures Among Patients Receiving Direct Oral Anticoagulation
Authors: Franklin Nathan A. , Ali Ashley H. , Hurley Richard K. , Mir Hassan R. , Beltran Michael J.
Published: February 2018

Objective:

To evaluate the prehospital use of direct oral anticoagulant (DOAC) agents on the outcomes of early surgical fixation of a geriatric hip fracture.

Design:

Case control study.

Setting:

Two academic Level 1 trauma centers.

Intervention:

Early (<48 h) surgical fixation of a geriatric proximal femur fracture.

Patients:

Nineteen patients receiving Pradaxa (dabigatran), Eliquis (apixaban), or Xarelto (rivaroxaban) who underwent surgery between 2010 and 2015 and 74 control patients.

Main Outcome Measurements:

Time to surgery, transfusion rates, changes in hemoglobin levels, postoperative complications, readmission rates, and survival out to 1 year.

Results:

There were no differences in transfusions, changes in hemoglobin levels, wound complications, or survival at any time point. Patients on DOAC had a longer delay to reach the operating room (28.9 h v 21.4 h P = 0.03) and were more likely to undergo readmission within 30 days (21% vs. 5.3% P = 0.05). No readmissions occurred for a complication of the surgical site, bleeding, or a venous thromboembolic event.

Conclusions:

Geriatric patients with hip fractures receiving DOAC before admission did not demonstrate worse outcomes with early surgical intervention. The increased readmission rate in this population seems attributable to the underlying cardiac conditions for which the patients were receiving anticoagulation. These results suggest that the delay recommended for patients using a DOAC before elective procedures may be unwarranted in the surgically urgent setting of a hip fracture. Additional studies will be necessary for appropriate meta-analysis.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
The Impact of Acute Organ Dysfunction on Long-Term Survival in Sepsis*
Authors: Schuler Alejandro , Wulf David A. , Lu Yun , Iwashyna Theodore J. , Escobar Gabriel J. , Shah Nigam H. , Liu Vincent X.
Published: February 2018

Objectives:

To estimate the impact of each of six types of acute organ dysfunction (hepatic, renal, coagulation, neurologic, cardiac, and respiratory) on long-term mortality after surviving sepsis hospitalization.

Design:

Multicenter, retrospective study.

Settings:

Twenty-one hospitals within an integrated healthcare delivery system in Northern California.

Patients:

Thirty thousand one hundred sixty-three sepsis patients admitted through the emergency department between 2010 and 2013, with mortality follow-up through April 2015.

Interventions:

None.

Measurements and Main Results:

Acute organ dysfunction was quantified using modified Sequential Organ Failure Assessment scores. The main outcome was long-term mortality among sepsis patients who survived hospitalization. The estimates of the impact of each type of acute organ dysfunction on long-term mortality were based on adjusted Cox proportional hazards models. Sensitivity analyses were conducted based on propensity score–matching and adjusted logistic regression. Hospital mortality was 9.4% and mortality was 31.7% at 1 year. Median follow-up time among sepsis survivors was 797 days (interquartile range: 384–1,219 d). Acute neurologic (odds ratio, 1.86; p < 0.001), respiratory (odds ratio, 1.43; p < 0.001), and cardiac (odds ratio, 1.31; p < 0.001) dysfunction were most strongly associated with short-term hospital mortality, compared with sepsis patients without these organ dysfunctions. Evaluating only patients surviving their sepsis hospitalization, acute neurologic dysfunction was also most strongly associated with long-term mortality (odds ratio, 1.52; p < 0.001) corresponding to a marginal increase in predicted 1-year mortality of 6.0% for the presence of any neurologic dysfunction (p < 0.001). Liver dysfunction was also associated with long-term mortality in all models, whereas the association for other organ dysfunction subtypes was inconsistent between models.

Conclusions:

Acute sepsis-related neurologic dysfunction was the organ dysfunction most strongly associated with short- and long-term mortality and represents a key mediator of long-term adverse outcomes following sepsis.
Impact of Tourette Syndrome on School Measures in a Nationally Representative Sample
Authors: Claussen Angelika H. , Bitsko Rebecca H. , Holbrook Joseph R. , Bloomfield Jeanette , Giordano Kathy
Published: February 2018

Objective:

Children with Tourette syndrome (TS) are at risk for a variety of co-occurring conditions and learning and school problems. The purpose of this study was to determine the impact of TS and co-occurring conditions on school measures.

Methods:

Parent-reported data from the 2007–2008 and 2011–2012 National Survey of Children's Health were combined (n = 129,353 children aged 6–17 yrs). Parent report of health care provider diagnosis of TS; co-occurring mental, emotional, and behavioral conditions; learning and language conditions; and school measures were assessed. School measures included type of school, individual education plan (IEP), number of school days missed, school problems, doing well in school, doing homework, and repeating a grade. Children with TS were compared with those who never had TS on school measures accounting for co-occurring conditions.

Results:

After adjusting for demographics, compared with children without TS, children currently with TS were more likely to have an IEP, have a parent contacted about school problems, and not complete homework. After further adjusting for co-occurring conditions, only IEP status remained statistically significant. Compared with children with mild TS, children with moderate or severe TS were more likely to have an IEP, repeat a grade, encounter school problems, and not care about doing well in school.

Conclusion:

Tourette syndrome severity and co-occurring conditions are associated with school challenges and educational service needs. Awareness among health care providers, teachers and parents of the potential challenges related to both TS and co-occurring conditions would help to best support the child's education.
Efficacy of misoprostol before diagnostic hysteroscopy in postmenopausal women: a randomized clinical trial
Authors: Nakano Fabiana Y. , Yela Daniela A. , Pinto Joao P.L. , Riegas Talita , Benetti-Pinto Cristina L. , Pedro Adriana Orcesi , Paiva Lucia Helena Costa
Published: February 2018

Objective:

To evaluate pain and determine the efficacy of misoprostol, compared with placebo, for postmenopausal women before diagnostic hysteroscopy.

Methods:

This randomized, double-blind, placebo-controlled clinical trial included 158 postmenopausal women who received either 200 μg of misoprostol or placebo through the vaginal route before diagnostic hysteroscopy (79 women/group). The primary outcome was pain assessment (presence and intensity) during the four steps of hysteroscopy: cervical grasping with a Pozzi tenaculum forceps immediately before hysteroscopy, during hysteroscopy, during performance of the endometrial biopsy, and postprocedure. The secondary outcomes were duration of the procedure, need for additional cervical dilatation, complications, and adverse effects.

Results:

Mean ages of the women were 62 ± 8.2 years and 60 ± 7.3 years in the misoprostol and placebo groups, respectively. Abnormal bleeding (misoprostol group, 45.6%; placebo, 43%) and endometrial thickening (54.4% in the misoprostol group and 57% in the placebo group) were the most common indications for the examination in both groups (P = 0.49). There was no significant difference between groups in the pain intensity of the four steps of the procedure. The duration of hysteroscopy was similar in both groups (misoprostol group, 2.5 ± 2.7 minutes; placebo, 2.1 ± 1.6 minutes; P = 0.43). Additional cervical dilatation was needed in 11 women in the misoprostol group versus 9 in the placebo group (P = 0.63). In both groups, there was no significant difference in terms of complications. Adverse effects were reported by 25.3% of women using misoprostol (vaginal bleeding, 11.3%; cramping, 12.6%; diarrhea, 2.5%; 1 woman reported both vaginal bleeding and cramping). In the placebo group, only 2.5% of women developed adverse effects (P < 0.0001).

Conclusion:

Misoprostol does not reduce pain intensity, the duration of the procedure, or need for additional cervical dilatation, and causes more adverse effects when used in postmenopausal women before diagnostic hysteroscopy.
Grieving With Humor
Authors: Robalo Nunes Inês , José Helena , Capelas Manuel Luís
Published: February 2018

The aim of this study was to explore the relationship between humor and professional grief. Findings confirm that these are not independent phenomena. Using humor as a coping mechanism emerged as a response to death-related work. Likewise, positive attitudes toward humor seem to alleviate the distress associated with end-of-life care.
Perspectives of Oncology Nurses on Complementary and Alternative Medicine in Turkey
Authors: Gok Metin Zehra , Izgu Nur , Karadas Canan , Arikan Donmez Ayse
Published: February 2018

In Turkey, between 22.1% and 84.1% of patients with cancer use complementary and alternative medicine (CAM). However, few CAM-related studies have focused on the perspective of oncology nurses. This study aimed to determine the knowledge, attitudes, and practices of Turkish oncology nurses regarding CAM. A descriptive cross-sectional survey of 127 participants was conducted in Ankara, Turkey. A semistructured questionnaire including characteristics, knowledge, attitudes, and practices of oncology nurses toward CAM was administered to participants. We found that more than half of nurses (54.0%) surveyed had no information on CAM modalities. Most oncology nurses (81.1%) used audiovisual media sources to obtain CAM information. Many nurses (81.3%) reported not using any CAM in cancer care, and only 26.8% recommended CAM to patients. Most nurses used CAM to accelerate wound healing (19.7%) and to manage symptoms, including constipation and diarrhea (8.8%) and anxiety (7.9%). Music (52.8%), massage (49.6%), and exercise (48.8%) were stated to be beneficial. Important barriers to use CAM for patients with cancer involved a lack of knowledge (60.6%); needing physician approval to apply any CAM methods to patients (52.1%); legal and institutional issues (47.2%); and limited educational, training, or certificate programs (44.1%). There is a need for increased knowledge about CAM by oncology nurses, considering their vital role in symptom management of patients with cancer. This can be achieved through solving legal and institutional problems, structured and comprehensive education/training programs, and the integration of CAM therapy into cancer care guidelines.