bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-cycle electromechanical aging of dielectric elastomer actuators with carbon-based electrodes
Authors: de Saint-Aubin C A , Rosset S , Schlatter S , Shea H 
Published: December 2017

Abstract
We present high-cycle aging tests of dielectric elastomer actuators (DEAs) based on silicone elastomers, reporting on the time-evolution of actuation strain and of electrode resistance over millions of cycles. We compare several types of carbon-based electrodes, and for the first time show how the choice of electrode has a dramatic influence on DEA aging. An expanding circle DEA configuration is used, consisting of a commercial silicone membrane with the following electrodes: commercial carbon grease applied manually, solvent-diluted carbon grease applied by stamping (pad printing), loose carbon black powder applied manually, carbon black powder suspension applied by inkjet-printing, and conductive silicone-carbon composite applied by stamping. The silicone-based DEAs with manually applied carbon grease electrodes show the shortest lifetime of less than 105 cycles at 5% strain, while the inkjet-printed carbon powder and the stamped silicone-carbon composite make for the most reliable devices, with lifetimes greater than 107 cycles at 5% strain. These results are valid for the specific dielectric and electrode configurations that were tested: using other dielectrics or electrode formulations would lead to different lifetimes and failure modes. We find that aging (as seen in the change in resistance and in actuation strain versus cycle number) is independent of the actuation frequency from 10 Hz to 200 Hz, and depends on the total accumulated time the DEA spends in an actuated state.
Temporal variability in offspring quality and individual reproductive output in a broadcast-spawning marine fish
Authors: Roney Nancy E , Oomen Rebekah A , Knutsen Halvor , Olsen Esben M , Hutchings Jeffrey A 
Published: December 2017

AbstractThe protracted spawning period of broadcast-spawning marine fishes has potential to generate considerable variability in metrics of individual reproductive output. We undertook a temporally detailed genetic study of larvae produced by Atlantic cod (Gadus morhua) from two spatially proximate populations spawning under controlled semi-natural conditions over 94 days. Based on daily samples of larvae (n = 4489 in total), we document fine-scaled temporal changes in, and correlates of, offspring phenotype and reproductive output (egg batches produced or fertilized). Larval length and standardized yolk-sac volume declined 11 and 49% over the spawning period, respectively. The adaptive significance of these trends is unclear. Longer, heavier females produced longer, better-provisioned larvae. Body size affected the number of egg batches to which an individual contributed genetically but not spawning duration. Males contributed gametes to a greater number of egg batches (19.5 vs. 9.2), and spawned over a longer period of time (48.9 vs. 30.8 days), than females. After accounting for body size and condition, egg batch number and spawning duration differed between adjacent populations separated by &lt; 10 km. Our work highlights the need to understand the environmental and adaptive causes of temporal variability in offspring quality and its consequences to individual fitness and per capita population growth in batch-spawning fishes.
Tolerability profile of the current antifungal armoury
Authors: Mourad Ahmad , Perfect John R 
Published: December 2017

AbstractThe tolerability of available antifungal agents is essential to the final outcome of the management of invasive mycoses. There are limited classes of antifungal agents for use, and they can have serious direct toxicities and/or drug–drug interactions. In this review, we examine the common toxicities noted for antifungal agents and attempt to both identify the issues around the adverse events and provide clinical context for their occurrence in these fragile patients.
Human Amniotic Membrane for the Prevention of Intradural Spinal Cord Adhesions: Retrospective Review of its Novel Use in a Case Series of 14 Patients
Authors: Walker Corey T , Godzik Jakub , Kakarla U Kumar , Turner Jay D , Whiting Alexander C , Nakaji Peter 
Published: December 2017

Abstract

BACKGROUND
Tethering after spinal surgery is caused by adhesions that arise from intradural tissue manipulation. Microsurgical detethering is the only treatment for symptomatic patients, but retethering occurs commonly and no treatment is widely available to prevent this complication.

OBJECTIVE
To apply human amniotic membrane (HAM) grafts, which are immune-privileged and known to possess antifibrogenic properties, in patients requiring microsurgical detethering. For this first-in-human use, we evaluated the safety and potential efficacy of these grafts for preventing retethering.

METHODS
We retrospectively reviewed the medical records of all patients who required detethering surgery and received an HAM graft between 2013 and 2016 at our institution after various previous intradural spinal surgeries. In all 14 cases, intradural lysis of adhesions was achieved, an HAM graft was sewn in place intradurally, and a dural patch was closed in a watertight fashion over the graft.

RESULTS
Fourteen patients had received HAM grafts to prevent retethering. All patients had at least 6 mo of follow-up (mean follow-up, 14 mo). Retethering was noted in only 1 patient. Surgical re-exploration showed that the retethering occurred caudal to the edge of the HAM graft, with no tethering underneath the original graft. No complications were attributed specifically to the HAM graft placement.

CONCLUSION
This first-in-human series provides evidence that HAM grafts are a safe and potentially efficacious method for preventing retethering after microsurgical intradural lysis of adhesions. These results lay the groundwork for further prospective controlled trials in patients with this difficult-to-treat pathology.
Organophosphorus Compounds at 80: Some Old and New Issues
Authors: Costa Lucio G 
Published: December 2017

AbstractOne of the major classes of pesticides is that of the organophosphates (OPs). Initial developments date back almost 2 centuries but it was only in the mid-1940s that OPs reached a prominent status as insecticides, a status that, albeit declining, is still ongoing. OPs are highly toxic to nontarget species including humans, the primary effects being an acute cholinergic toxicity (responsible for thousands of poisoning each year) and a delayed polyneuropathy. Several issues of current debate and investigation on the toxicology of OPs are discussed in this brief review. These include (1) possible additional targets of OPs, (2) OPs as developmental neurotoxicants, (3) OPs and neurodegenerative diseases, (4) OPs and the “aerotoxic syndrome,” (5) OPs and the microbiome, and (6) OPs and cancer. Some of these issues have been debated and studied for some time, while others are newer, suggesting that the study of the toxicology of OPs will remain an important scientific and public health issue for years to come.
Microvascular Permeability after an Acute and Chronic Salt Load in Healthy Subjects
Authors: Rorije Nienke M. G. , Olde Engberink Rik H. G. , Chahid Youssef , van Vlies Naomi , van Straalen Jan P. , van den Born Bert-Jan H. , Verberne Hein J. , Vogt Liffert 
Published: December 2017

Abstract

Background
Sodium-induced microcirculatory changes, endothelial surface layer alterations in particular, may play an important role in sodium-mediated blood pressure elevation. However, effects of acute and chronic sodium loading on the endothelial surface layer and microcirculation in humans have not been established. The objective of this study was to assess sodium-induced changes in blood pressure and body weight as primary outcomes and also in microvascular permeability, sublingual microcirculatory dimensions, and urinary glycosaminoglycan excretion in healthy subjects.

Methods
Twelve normotensive males followed both a low-sodium diet (less than 50 mmol/day) and a high-sodium diet (more than 200 mmol/day) for eight days in randomized order, separated by a crossover period. After the low-sodium diet, hypertonic saline (5 mmol sodium/liter body water) was administered intravenously in 30 min.

Results
Both sodium interventions did not change blood pressure. Body weight increased with 2.5 (95% CI, 1.7 to 3.2) kg (P < 0.001) after dietary sodium loading. Acute intravenous sodium loading resulted in increased transcapillary escape rate of 125I-labeled albumin (2.7 [0.1 to 5.3] % cpm · g−1 · h–1; P = 0.04), whereas chronic dietary sodium loading did not affect transcapillary escape rate of 125I-labeled albumin (−0.03 [−3.3 to 3.2] % cpm · g−1 · h–1; P = 1.00), despite similar increases of plasma sodium and osmolality. Acute intravenous sodium loading coincided with significantly increased plasma volume, as assessed by the distribution volume of albumin, and significantly decreased urinary excretion of heparan sulfate and chondroitin sulfate. These changes were not observed after dietary sodium loading.

Conclusions
Our results suggest that intravenous sodium loading has direct adverse effects on the endothelial surface layer, independent of blood pressure.
Physiologic Evaluation of Ventilation Perfusion Mismatch and Respiratory Mechanics at Different Positive End-expiratory Pressure in Patients Undergoing Protective One-lung Ventilation
Authors: Spadaro Savino , Grasso Salvatore , Karbing Dan Stieper , Fogagnolo Alberto , Contoli Marco , Bollini Giacomo , Ragazzi Riccardo , Cinnella Gilda , Verri Marco , Cavallesco Narciso Giorgio , Rees Stephen Edward , Volta Carlo Alberto 
Published: December 2017

Abstract

Background
Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects of positive end-expiratory pressure and low VT during one-lung ventilation.

Methods
Data from 41 patients studied during general anesthesia for thoracic surgery were collected and analyzed. Shunt fraction, high V/Q and respiratory mechanics were measured at positive end-expiratory pressure 0 cm H2O during bilateral lung ventilation and one-lung ventilation and, subsequently, during one-lung ventilation at 5 or 10 cm H2O of positive end-expiratory pressure. Shunt fraction and high V/Q were measured using variation of inspired oxygen fraction and measurement of respiratory gas concentration and arterial blood gas. The level of positive end-expiratory pressure was applied in random order and maintained for 15 min before measurements.

Results
During one-lung ventilation, increasing positive end-expiratory pressure from 0 cm H2O to 5 cm H2O and 10 cm H2O resulted in a shunt fraction decrease of 5% (0 to 11) and 11% (5 to 16), respectively (P < 0.001). The Pao
2/Fio2
ratio increased significantly only at a positive end-expiratory pressure of 10 cm H2O (P < 0.001). Driving pressure decreased from 16 ± 3 cm H2O at a positive end-expiratory pressure of 0 cm H2O to 12 ± 3 cm H2O at a positive end-expiratory pressure of 10 cm H2O (P < 0.001). The high V/Q ratio did not change.

Conclusions
During low VT one-lung ventilation, high positive end-expiratory pressure levels improve pulmonary function without increasing high V/Q and reduce driving pressure.
Recent developments in systemic lupus erythematosus pathogenesis and applications for therapy
Authors: Lo Mindy S. , Tsokos George C. 
Published: December 2017

Purpose of review
Systemic lupus erythematosus (SLE) pathogenesis is complex. Aberrancies of immune function that previously were described but not well understood are now becoming better characterized, in part through recognition of monogenic cases of lupus-like disease.

Recent findings
We highlight here recent descriptions of metabolic dysfunction, cytokine dysregulation, signaling defects, and DNA damage pathways in SLE. Specifically, we review the effects of signaling abnormalities in mammalian target of rapamycin, Rho kinase, Bruton's tyrosine kinase, and Ras pathways. The importance of DNA damage sensing and repair pathways, and their influence on the overproduction of type I interferon in SLE are also reviewed.

Summary
Recent findings in SLE pathogenesis expand on previous understandings of broad immune dysfunction. These findings have clinical applications, as the dysregulated pathways described here can be targeted by existing and preclinical therapies.
Minimally Invasive Lateral Lumbar Interbody Fusion for Adult Spinal Deformity
Authors: Park Hyung-Youl , Ha Kee-Yong , Kim Young-Hoon , Chang Dong-Gune , Kim Sang-il , Lee Jae-Won , Ahn Joo-Hyun , Kim Jong-Bin 
Published: December 2017

Study Design.
A retrospective cohort study.

Objective.
To evaluate the clinical and radiological efficacies of supplementing minimally invasive lateral lumbar interbody fusion (LLIF) with open posterior spinal fusion (PSF) in adult spinal deformity (ASD).

Summary of Background Data.
Minimally invasive techniques have been increasingly applied for surgery of ASD. Few reports have been published that directly compare LLIF combined with PSF to conventional PSF for ASD.

Methods.
To evaluate the advantages of minimally invasive LLIF for ASD, patients who underwent minimally invasive LLIF followed by open PSF (combined group) were compared with patients who only underwent PSF (only PSF group). The clinical and radiological outcomes for deformity correction and indirect decompression were assessed. The occurrence of proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) were also evaluated.

Results.
No significant differences were observed in the clinical outcomes of the Oswestry Disability Index (ODI), visual analog scale, and major complications including reoperations between the groups. No additional advantage was found for coronal deformity correction, but the restoration of lumbar lordosis in the combined group was significantly higher postoperatively (15.3° vs. 8.87°, P = 0.003) and last follow-up (6.69° vs. 1.02°, P = 0.029) compared to that of the only PSF group. In the subgroup analysis for indirect decompression for the combined group, a significant increase of canal area (104 vs. 122 mm2) and foraminal height (16.2 vs. 18.5 mm) was noted. The occurrence of PJK or PJF was significantly higher in the combined group than in the only PSF group (P = 0.039).

Conclusion.
LLIF has advantages of indirect decompression and greater improvements of sagittal correction compared to only posterior surgery. LLIF should be conducted considering the above-mentioned benefits and complications including PJK or PJF in ASD.

Level of Evidence: 4
Functional Limitations Due to Stiffness After Long-Level Spinal Instrumented Fusion Surgery to Correct Lumbar Degenerative Flat Back
Authors: Choi Jeong-Hoon , Jang Jee-Soo , Yoo Kyong-Suk , Shin Jong-Mog , Jang Il-Tae 
Published: December 2017

Study Design.
A retrospective analysis of functional limitations due to stiffness after long-level spinal instrumented fusion surgery to correct lumbar degenerative flat back was performed.

Objective.
To analysis the functional limitations in patients treated surgically for adult lumbar degenerative flat back (ALDFB) with long-level instrumented fusion to the sacrum or pelvis.

Summary of Background Data.
Long-level instrumented fusion for ALDFB decreases back pain and spinal deformity. On the contrary, this surgery considerably eliminates spinal range of motion. This may have the potential to impair function and ability to perform activities of daily living (ADLs).

Methods.
Consecutive 44 patients who underwent long-level instrumented fusion to the sacrum or pelvis for ALDFB were retrospectively included in this study. All patients were followed up for a minimum of 13 months. The Lumbar Stiffness Disability Index for Korean Lifestyle and Oswestry Disability Index were administered and analyzed to assess the impact of spinal stiffness on daily living. Cohorts were defined based on the upper instrumented vertebrae (above T10 [group 1] or below L1 [group 2]) and lower instrumented vertebrae (S1 pedicle screw [group S] or iliac bolt screw [group I]).

Results.
All patients showed deteriorated postoperative ADLs compared to preoperative values. Group 1 showed deterioration postoperatively compared to group 2. Group 1 showed deteriorated postoperative ADLs compared to preoperative values. In group 2, question 5 and 7 showed deterioration postoperatively compared to preoperative values, and question 2 and 10 showed improvement postoperatively compared to preoperative values. Group I showed deterioration postoperatively compared to group S.

Conclusion.
This study will hopefully allow surgeons to provide patients with ALDFB with a more informed explanation of expected surgery effects on specific ADLs.

Level of Evidence: 3
Postoperative Emergency Department Utilization and Hospital Readmission After Cervical Spine Arthrodesis
Authors: Derman Peter B. , Lampe Lukas P. , Pan Ting Jung , Salzmann Stephan N. , Kueper Janina , Girardi Federico P. , Lyman Stephen , Hughes Alexander P. 
Published: December 2017

Study Design.
Retrospective state database analysis.

Objective.
To quantify the 30- and 90-day emergency department (ED) utilization and inpatient readmission rates after primary cervical arthrodesis, to stratify these findings by surgical approach, and to describe risk factors and conditions precipitating these events.

Summary of Background Data.
Limited data exist on ED utilization and hospital readmission rates after cervical spine arthrodesis.

Methods.
The New York State all-payer health-care database was queried to identify all 87,045 patients who underwent primary subaxial cervical arthrodesis from 1997 through 2012. Demographic data and clinical information were extracted. Readmission data were available for the entire study period, whereas ED utilization data collection began later and was therefore analyzed starting in 2005. Incidences of these events within 30 and 90 days of discharge as well as trends over time were tabulated. The conditions prompting these encounters were also collected. Data were analyzed with respect to surgical approach.

Results.
The hospital readmission rate was 4.2% at 30 days and 6.2% at 90 days postoperatively. Approximately 6.2% of patients were managed in the ED without inpatient admission within 30 days and 11.3% within 90 days of surgery. The most common conditions prompting such events were dysphagia or dysphonia, respiratory complications, and infection. ED utilization and readmission rates were lowest after anterior surgeries. A preoperative Charlson Comorbidity Index of 1 or greater and traumatic pathologies were associated with increased risk of subsequent ED utilization or hospital readmission. Thirty-day hospital readmission rates declined after 2010, whereas 30-day ED utilization continued to increase.

Conclusion.
Patient comorbidities, traumatic pathologies, and surgical approach are associated with increased postoperative complications. Anterior procedures carry the lowest risk, followed by posterior and then circumferential. Awareness of these findings should help to encourage development of strategies to minimize the rate of postoperative ED utilization and hospital readmission.

Level of Evidence: 3
Dynamic Fluctuation of Truncal Shift Parameters During Quiet Standing in Healthy Young Individuals
Authors: Kato So , Fok Kai Lon , Lee Jae W. , Masani Kei 
Published: December 2017

Study Design.
Retrospective analysis.

Objective.
To describe the dynamic fluctuation of truncal shift parameters during quiet standing in healthy young individuals using biomechanical analyses.

Summary of Background Data.
Coronal decompensation (CD) and sagittal vertical axis (SVA) are the key radiographic parameters to assess static truncal stability, with the known cut-off value of 4 cm for SVA in determining severity of spinal deformity. These values are obtained at a specific moment during quiet standing, when the posture innately changes. Thus, unassessed truncal sway could potentially compromise the reliability of these measurements.

Methods.
Previously obtained biomechanical data with 11 male, healthy participants aged 16 to 29 were used to quantify the dynamic sway of standing posture. The participants were instructed to quietly stand with surface reflective markers for 130 seconds. The midpoint of bilateral acromia was used as a surrogate for C7 vertebral body. The time series of coronal and sagittal shifts of C7 to sacrum were measured as quasi-coronal decompensation (CD) and quasi-sagittal vertical axis (SVA) to simulate CD and SVA on radiographs. A force platform was also used to measure the center of pressure (COP) displacement.

Results.
The group averages of the dynamic sway range were 20.2 ± 4.1 mm (range: 15.1–28.6) in the sagittal plane (quasi-SVA) and 9.8 ± 3.2 mm (range: 5.5–15.2) in the coronal plane (quasi-CD). There were significant correlations between quasi-CD sway and medial-lateral COP velocity (Pearson r = 0.65, P = 0.03), as well as between quasi-SVA sway and COP sway area (r = 0.65, P = 0.03).

Conclusion.
Given the considerable fluctuation of quasi-SVA and quasi-CD during quiet standing, the reliability of radiographic measurement using CD and SVA at a specific moment can be substantially compromised. The assessment based on the currently proposed cut-off values should be interpreted with caution, and repeat examinations are warranted.

Level of Evidence: 4
Can Early Patient-reported Outcomes Be Used to Identify Patients at Risk for Poor 1-Year Health Outcomes After Lumbar Laminectomy With Arthrodesis?
Authors: Purvis Taylor E. , Neuman Brian J. , Riley Lee H. , Skolasky Richard L. 
Published: December 2017

Study Design.
Prospective cohort.

Objective.
Determine A) between-patient variability in patient-reported outcomes (PROs) at four postoperative time points; B) within-patient correlation of 1-year PROs with PROs at three earlier time points; and C) ability of early PROs to predict 1-year PROs after lumbar laminectomy with arthrodesis.

Summary of Background Data.
It is unclear whether early PROs can help identify patients at risk for poor health outcomes.

Methods.
Between 2015 and 2016, we assessed pre- and postoperative back pain, leg pain, disability, physical health, and mental health in 146 patients. We examined PRO variability between patients and correlations within patients during the first postoperative year. For early (≤3-mo) and 1-year PROs, we examined concordance between experiencing a minimal important difference (MID) early and at 1 year and odds of experiencing a 1-year MID given early absence of a MID.

Results.
Postoperatively, we found increasing between-patient variability of PROs. For individual patients, we found moderate to strong between-assessment correlations (intraclass correlations) between repeated PROs (back pain, 0.47; leg pain, 0.51; disability, 0.47; physical health, 0.63; mental health, 0.53). Early MIDs were experienced for back pain (57%), leg pain (52%), physical health (38%), disability (34%), and mental health (16%). Concordance was moderate for leg pain (0.48), mental health (0.46), disability (0.38), back pain (0.36), and physical health (0.25). In patients without an early MID, odds of experiencing a MID at 1 year were low for physical health (odds ratio [OR] = 0.33), back pain (OR = 0.30), leg pain (OR = 0.14), and disability (OR = 0.11) but not mental health (OR = 0.50).

Conclusion.
Although postoperative recovery is variable, early PROs can identify patients at risk for poor 1-year outcomes and may help tailor care during the first year after lumbar laminectomy with arthrodesis.

Level of Evidence: 2