bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Review of Sleep Architecture and Sleep Changes During Pregnancy
Authors: Sweet Lauren , Arjyal Sushrusha , Kuller Jeffrey A. , Dotters-Katz Sarah 
Published: April 2020

Importance
Poor sleep is widely recognized as a common complaint in pregnancy, and yet there are incomplete data on the exact nature of these complaints, what their implications for fetal and maternal health are, and how to best recognize and address these significant health issues.

Objectives
The purpose of this article is to review the current literature on the changes in objectively measured sleep parameters that occur during pregnancy, identify any possible trends, and discuss current implications for obstetric outcomes and treatments.

Evidence Acquisition
PubMed NCBI and Google Scholars database were searched for a variety of sleep-related terms, and articles were selected based on relevance to the topic and method of sleep pattern monitoring.

Results
Poor sleep is ubiquitous during pregnancy, and the relatively few studies evaluating the issue using objective polysomnography have small sample sizes. However, data suggests sleep architecture changes begin as early as the first trimester, and there is evidence that primigravid sleep structure never returns to prepregnancy levels after birth. In addition, cesarean delivery frequency, early labor, labor length, depression, gestational hypertension, and gestational diabetes all appear to be influenced by sleep changes. Current treatments are based on nonpregnant populations and may not be appropriate for the gravid patient.

Conclusions and Relevance
Disordered sleep is a more widespread and serious issue than most women are aware, and there are numerous obstetric and general health implications to cause clinician concern. More research is needed on both electroencephalography architecture changes and treatment options.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After participating in this activity, the provider should be better able to outline current literature regarding trimester-specific sleep architecture changes; describe the maternal and obstetric outcomes that poor sleep may contribute too; and identify current therapies for poor sleep during pregnancy.
Preoperative Nasal Swab Culture: Is It Beneficial in Preventing Postoperative Infection in Complicated Septorhinoplasty?
Authors: Moon Kyung-Chul , Jung Jae-Eun , Dhong Eun-Sang , Jeong Seong-Ho , Han Seung-Kyu 
Published: April 2020

Background:
Surgical-site infection following complicated septorhinoplasty may result in serious complications. Therefore, efforts to prevent surgical-site infections after complicated septorhinoplasty are important. The purpose of this study was to analyze the microbiological profile of preoperative nasal swab cultures and to evaluate the effect of antibiotic prophylaxis and topical antibiotic decolonization according to the antibiotic sensitivity results of surgical-site infections in complicated septorhinoplasty.

Methods:
This 10-year cohort study included the data on 437 consecutive patients who underwent complicated septorhinoplasty. The patients were categorized into three cohorts based on the time of preoperative nasal swab culture collection. Patients in cohort 1 did not undergo nasal swab cultures and received empirical antibiotics. Patients in cohort 2 underwent only one preoperative nasal swab culture and received microorganism-sensitive antibiotics. Patients in cohort 3 underwent repeated nasal swab cultures. The antibiotics were changed when microorganisms resistant to the empirical antibiotics were isolated. Microbiological data and the rates of surgical-site infection and inflammation were compared among the three cohorts.

Results:
Methicillin-sensitive Staphylococcus aureus was the most commonly isolated microorganism. In cohort 1, two (5 percent) and two (5 percent) patients experienced surgical-site infections and inflammation, respectively. In cohort 2, two (3 percent) and three (4 percent) patients experienced surgical-site infections and inflammation, respectively. In cohort 3, one (0.3 percent) and one (0.3 percent) patient experienced surgical-site infection and inflammation, respectively.

Conclusion:
The present study demonstrated that preoperative screening using repeated nasal swab cultures, followed by appropriate antibiotic prophylaxis and topical antibiotic decolonization, may reduce surgical-site infection in complicated septorhinoplasty.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Conservative Management of de Quervain Stenosing Tenosynovitis: Review and Presentation of Treatment Algorithm
Authors: Abi-Rafeh Jad , Kazan Roy , Safran Tyler , Thibaudeau Stephanie 
Published: April 2020

Background:
Nonsurgical management of de Quervain disease relies mainly on the use of oral nonsteroidal antiinflammatory drug administration, splint therapy, and corticosteroid injections. Although the latter is most effective, with documented success rates of 61 to 83 percent, there exists no clear consensus pertaining to conservative treatment protocols conferring the best outcomes. This article reports on all present conservative treatment modalities in use for the management of de Quervain disease and highlights specific treatment- and patient-related factors associated with the best outcomes.

Methods:
A systematic search was performed using the PubMed database using appropriate search terms; two independent reviewers evaluated retrieved articles using strict inclusion and exclusion criteria.

Results:
A total of 66 articles met the inclusion criteria for review, consisting of 22 articles reporting on outcomes following a single conservative treatment modality, eight articles reporting on combined treatment approaches, 13 articles directly comparing different conservative treatment regimens, and 23 case reports.

Conclusions:
A multimodal approach using splint therapy and corticosteroid injections appears to be more beneficial than either used in isolation. Although there exists some evidence showing that multipoint injection techniques and multiple injections before surgical referral may provide benefit over a single point injection technique and a single injection before surgery, corticosteroid use is not benign and should thus be performed with caution. Ultrasound was proven valuable in the visualization of an intercompartmental septum, and ultrasound-guided injections were shown to both be more accurate and confer better outcomes. Several prior and concurrent medical conditions may affect conservative treatment outcome. A Level I to II evidence-based treatment protocol is recommended for the optimal nonsurgical management of de Quervain disease.
The Attachments of the Breast to the Chest Wall: A Dissection Study
Authors: Gaskin Kathryn M. , Peoples Gregory E. , McGhee Deirdre E. 
Published: April 2020

Background:
The anatomical descriptions of the attachments of the female breast to the chest wall vary in their structure, location, and terminology within the published literature.

Methods:
A dissection study of the attachments of the breast to the chest wall was conducted on 18 female embalmed breasts in the coronal (n = 15) and sagittal planes (n = 3).

Results:
Perimeter, posterior wall, and horizontal septum attachments were observed. The perimeter along its entire length was attached to the chest wall. Regional and anatomical variation was observed in this structure and location. Sharp dissection was required to remove it from the chest wall, in contrast to the blunt dissection required to remove the posterior wall and horizontal septum attachments.

Conclusions:
The breast attaches to the chest wall along its entire perimeter, posterior wall, and horizontal septum, with the perimeter functioning as the primary anchor of the breast to the chest wall. The structure of the perimeter attachment is both periosteal and fascial and requires sharp dissection to remove it from the chest wall. The fascial structures of the posterior wall and horizontal septum require blunt dissection only. The structure of the perimeter has regional variation, and its location on the chest wall has anatomical variation. Detailed anatomical descriptions and illustrations are supported by photographic evidence of cadaver dissections in two planes. Clinical and anatomical terminology are linked, with clinical implications for medical anatomy education, breast modeling, and breast surgery.
Complex Linkage Disequilibrium Effects in HLA-DPB1 Expression and Molecular Mismatch Analyses of Transplantation Outcomes
Authors: Shieh Mengkai , Hayeck Tristan J. , Dinh Anh , Duke Jamie L. , Chitnis Nilesh , Mosbruger Timothy , Morlen Ryan P. , Ferriola Deborah , Kneib Carolina , Hu Taishan , Huang Yanping , Monos Dimitri S. 
Published: April 2020

Background.
HLA molecular mismatch (MM) is a risk factor for de novo donor-specific antibody (dnDSA) development in solid organ transplantation. HLA expression differences have also been associated with adverse outcomes in hematopoietic cell transplantation. We sought to study both MM and expression in assessing dnDSA risk.

Methods.
One hundred three HLA-DP-mismatched solid organ transplantation pairs were retrospectively analyzed. MM was computed using amino acids (aa), eplets, and, supplementarily, Grantham/Epstein scores. DPB1 alleles were classified as rs9277534-A (low-expression) or rs9277534-G (high-expression) linked. To determine the associations between risk factors and dnDSA, logistic regression, linkage disequilibrium (LD), and population-based analyses were performed.

Results.
A high-risk AA:GX (recipient:donor) expression combination (X = A or G) demonstrated strong association with HLA-DP dnDSA (P = 0.001). MM was also associated with HLA-DP dnDSA when evaluated by itself (eplet P = 0.007, aa P = 0.003, Grantham P = 0.005, Epstein P = 0.004). When attempting to determine the relative individual effects of the risk factors in multivariable analysis, only AA:GX expression status retained a strong association (relative risk = 18.6, P = 0.007 with eplet; relative risk = 15.8, P = 0.02 with aa), while MM was no longer significant (eplet P = 0.56, aa P = 0.51). Importantly, these risk factors are correlated, due to LD between the expression-tagging single-nucleotide polymorphism and polymorphisms along HLA-DPB1.

Conclusions.
The MM and expression risk factors each appear to be strong predictors of HLA-DP dnDSA and to possess clinical utility; however, these two risk factors are closely correlated. These metrics may represent distinct ways of characterizing a common overlapping dnDSA risk profile, but they are not independent. Further, we demonstrate the importance and detailed implications of LD effects in dnDSA risk assessment and possibly transplantation overall.
Enhanced recovery after surgery (ERAS) protocols is extremely beneficial in liver surgeries – A metaanalysis
Authors: Vasavada Bhavin , Patel Hardik 
Published: April 2020

ABSTRACTBACKGROUNDEnhanced recovery after surgery (ERAS) programs aim to improve postoperative outcomes.. This metaanalysis aims to evaluate the impact of ERAS programmes on outcomes following liver surgeries.METHODSEMBASE, MEDLINE, PubMed and the Cochrane Database were searched for studies comparing outcomes in patients undergoing liver surgery utilizing ERAS principles with those patients receiving conventional care. The primary outcome was occurrence of 30 day morbidity and mortality. Secondary outcomes included length of stay, functional recovery, readmission rates,time to pass flatus,blood loss and hospital costs.RESULTSTen articles were included in the metaanalysis. 30 days morbidity and mortality was significantly less in ERAS group.Hospital stay, time to pass flatus, time to complete recovery and hospital costs were also significantly reduced due to ERAS protocols. Blood loss and readmission rates were also significantly less in ERAS group.CONCLUSIONSThe adoption of ERAS protocols significantly reduced morbidity, mortality hospital stay, readmission rates, time to recovery, hospital costs, time to pass flatus, blood loss and readmission rates.
GABA AND GLUTAMATE CHANGES IN PEDIATRIC MIGRAINE
Authors: Bell Tiffany , Stokoe Mehak , Khaira Akashroop , Webb Megan , Noel Melanie , Amoozegar Farnaz , Harris Ashley D 
Published: April 2020

AbstractDespite migraine being one of the top five most prevalent childhood diseases, a lack of knowledge about pediatric migraine limits effective treatment strategies; standard adult pharmaceutical therapies are less effective in children and can carry undesirable side-effects. Non-pharmacological therapies have shown some success in adults; however, to appropriately apply these in children we need to understand pediatric migraine’s underlying biology. One theory is that migraine results from an imbalance in cortical excitability. Magnetic resonance spectroscopy (MRS) studies show changes in GABA and glutamate levels (the primary inhibitory and excitatory neurotransmitters in the brain, respectively) in multiple brain regions. Although there is indirect evidence of abnormal excitability in pediatric migraine, GABA and glutamate levels have yet to be assessed.The purpose of this study was to measure levels of GABA and glutamate in the thalamus, sensorimotor cortex and visual cortex of children with migraine using MRS. We found that children with migraine and aura had significantly lower glutamate levels in the visual cortex as compared to control children, opposite to results seen in adults. Additionally, we found significant correlations between metabolite levels and migraine characteristics; higher GABA levels were associated with a higher migraine burden. We also found that higher glutamate in the thalamus and higher GABA/Glx ratios in the sensorimotor cortex were associated with duration since diagnosis, i.e., having migraines longer. Lower GABA levels in the sensorimotor cortex were associated with being closer to their next migraine attack. Together this indicates that GABA and glutamate disturbances occur early in migraine pathophysiology and emphasizes that evidence from adults with migraine cannot be immediately translated to paediatric sufferers. This highlights the need for further mechanistic studies of migraine in children, to aid in the development of more effective treatments.
VIBRIO CHOLERAE ADAPTS TO SESSILE AND MOTILE LIFESTYLES BY CYCLIC DI-GMP REGULATION OF CELL SHAPE
Authors: Fernandez Nicolas L. , Nhu Nguyen T. Q. , Hsueh Brian Y. , Franklin Joshua L. , Dufour Yann S. , Waters Christopher M. 
Published: April 2020

AbstractThe cell morphology of rod-shaped bacteria is determined by the rigid net of peptidoglycan forming the cell wall. WhileV. choleraegrows into a curved shape under most conditions, straight rods have been observed. However, the signals and regulatory pathways controlling cell shape transitions inV. choleraeand the benefits of switching between rod and curved shape have not been determined. We demonstrate that cell shape inV. choleraeis regulated by the bacterial second messenger cyclic dimeric guanosine monophosphate (c-di-GMP) by repressing expression ofcrvA, a gene encoding an intermediate filament-like protein necessary for curvature formation inV. cholerae.This regulation is mediated by the transcriptional cascade that also induces production of biofilm matrix components, indicating that cell shape is coregulated withV. cholerae’s induction of sessility. Wild-typeV. choleraecells adhering to a surface lose their characteristic curved shape to become as straight as cells lackingcrvAwhile genetically engineering cells to maintain high curvature reduced microcolony formation and biofilm density. Conversely, straightV. choleraemutants have reduced speed when swimming using flagellar motility in liquid. Our results demonstrate regulation of cell shape in bacteria is a mechanism to increase fitness in planktonic or biofilm lifestyles.
TANGO1 membrane helices create a lipid diffusion barrier at curved membranes
Authors: Raote Ishier , Ernst Andreas M. , Campelo Felix , Rothman James E. , Pincet Frederic , Malhotra Vivek 
Published: April 2020

AbstractWe have previously shown TANGO1 organises membranes at the interface of the endoplasmic reticulum (ER) and ERGIC/Golgi (Raote et al., 2018). TANGO1 corrals retrograde membranes at ER exit sites to create an export conduit. Here the retrograde membrane is, in itself, an anterograde carrier. This mode of forward transport necessitates a mechanism to prevent membrane mixing between ER and the retrograde membrane. TANGO1 has an unusual membrane helix organisation, composed of one membrane-spanning helix (TM) and another that penetrates the inner leaflet (IM). We have reconstituted these membrane helices in model membranes and shown that TM and IM together reduce the flow of lipids at a region of defined shape. We have also shown that the helices align TANGO1 around an ER exit site. We suggest this is a mechanism to prevent membrane mixing during TANGO1-mediated transfer of bulky secretory cargos from the ER to the ERGIC/Golgi via a tunnel.
A design of resonant inelastic X-ray scattering (RIXS) spectrometer for spatial- and time-resolved spectroscopy
Authors: Chuang Yi-De , Feng Xuefei , Glans-Suzuki Per-Anders , Yang Wanli , Padmore Howard , Guo Jinghua 
Published: April 2020

The optical design of a Hettrick–Underwood-style soft X-ray spectrometer with Wolter type 1 mirrors is presented. The spectrometer with a nominal length of 3.1 m can achieve a high resolving power (resolving power higher than 10000) in the soft X-ray regime when a small source beam (<3 µm in the grating dispersion direction) and small pixel detector (5 µm effective pixel size) are used. Adding Wolter mirrors to the spectrometer before its dispersive elements can realize the spatial imaging capability, which finds applications in the spectroscopic studies of spatially dependent electronic structures in tandem catalysts, heterostructures, etc. In the pump–probe experiments where the pump beam perturbs the materials followed by the time-delayed probe beam to reveal the transient evolution of electronic structures, the imaging capability of the Wolter mirrors can offer the pixel-equivalent femtosecond time delay between the pump and probe beams when their wavefronts are not collinear. In combination with some special sample handing systems, such as liquid jets and droplets, the imaging capability can also be used to study the time-dependent electronic structure of chemical transformation spanning multiple time domains from microseconds to nanoseconds. The proposed Wolter mirrors can also be adopted to the existing soft X-ray spectrometers that use the Hettrick–Underwood optical scheme, expanding their capabilities in materials research.
Dynamic analysis of a double-helical geared rotor system with oil-film bearing
Authors: Chen Ying-Chung , Yang Tsung-Hsien , Choi Siu-Tong 
Published: April 2020

PurposeThis paper aims to study a dynamic analysis of a double-helical geared rotor system with oil-film bearing.Design/methodology/approachA finite element model of a double-helical geared rotor system with oil-film bearing is developed, in which a rigid mass is used to represent the gear and the Timoshenko beam finite element represents the shaft; the equations of motion are obtained by applying Lagrange’s equation. Natural frequencies, Campbell diagram, lateral responses, axial responses, bearing stiffness coefficients, bearing damping coefficients and bearing force are investigated.FindingsNatural frequencies and Campbell diagram of a double-helical geared rotor system with oil-film bearing are investigated. An increased helical angle enhanced the axial response of the system and reduced its lateral response. The distance between the node and bearing affected the lateral response magnitude on the node. The farther away the gear pair was from the central part of the shaft, the higher the system’s resonance frequency became. The different gear pair position has a significant influence on the bearing stiffness coefficient and bearing force, but it just has a little effect on the bearing damping coefficient.Practical implicationsThe model of a double-helical geared rotor system with oil-film bearing is established in this paper. The dynamic characteristics of a double-helical geared rotor system with oil-film bearing are investigated. The numerical results of this study can be used as a reference for subsequent personnel research.Originality/valueAlthough the dynamics characteristics of geared rotor bearing system have been reported in some literature, the dynamic analysis of a double-helical geared rotor-bearing system is still rarely investigated. This paper showed some novel results that lateral and axial response results are obtained by the different helical angle and different gear positions. In the future, it makes valuable contributions for further development of dynamic analysis of a double-helical geared rotor-bearing system.
Characteristics of a co-flowing jet with varying lip thickness and constant velocity ratio
Authors: R. Naren Shankar , S. Kevin Bennett , N. Dilip Raja , K. Sathish Kumar 
Published: April 2020

Purpose
This study aims to analyze co-flowing jets (CFJs) with constant velocity ratio (VR) and varying primary nozzle lip thickness (LT) to find a critical LT in CFJs below which mixing enhances and beyond which mixing inhibits.

Design/methodology/approach
CFJs were characterized with a constant VR and varying LTs. A single free jet with a diameter equal to that of a primary nozzle of the CFJ was used for characteristic comparison. Numerical simulation is carried out and is validated with the experimental results.

Findings
The results show that within a critical limit, the mixing enhanced with an increase in LT. This was signified by a reduction in potential core length (PCL). Beyond this limit, mixing inhibited leading to the elongation of PCL. This limit was controlled by parameters such as LT and constant VR. A new region termed as influential wake zone is identified.

Practical implications
In this study, the VR is maintained constant and bypass ratio (BR) was varied from low value to very high values. Presently, subsonic commercial turbo fan operates under low to ultra-high BR. Hence the present study becomes vital to the current scenario.

Originality/value
To the best of the authors’ knowledge, this is the first effort to find the critical value of LT for a constant VR for compressible co-flow jets. The CFJs with constant VR and varying LT have not been studied in the past. The present study focuses on finding a critical LT below which mixing enhances and above which mixing inhibits.
Water cycle algorithm-based PID controller for AVR
Authors: Pachauri Nikhil 
Published: April 2020

Purpose
In a power system, the purpose of automatic voltage regulator (AVR) is the voltage control of synchronous generator. Power system stability and security depends on the AVR.

Design/methodology/approach
The present work is concentrated on the precise terminal voltage control of AVR system and simultaneously maintaining the stability of the system. Therefore, an optimal proportional–integral–derivative (PID) controller is proposed. An optimization technique inspired from Mother Nature, i.e. water cycle algorithm (WCA) is used to evaluate the optimum parameter values of PID controller leading to WCA-tuned PID (WCA-PID). The performance of WCA-PID is compared with other controller reported in the literature.

Findings
Simulation results show that WCA-PID regulates the terminal voltage more preciously and accurately in comparison to other controller. Further, it is more robust toward parametric uncertainty, set-point tracking and disturbance rejection in comparison to other controller reported in the literature.

Originality/value
The work is not published anywhere else.