bluuebunny/crossref_metadata_2025 huggingface dataset:
Venous Thromboembolic Events after Total Knee Arthroplasty: Which Patients Are at a High Risk?
Authors: Dai Wen-Li , Lin Ze-Ming , Shi Zhan-Jun , Wang Jian
Published: May 2019

Venous thromboembolism (VTE; deep venous thrombosis and pulmonary embolism) is a known complication following primary total knee arthroplasty (TKA). The aim of this study was to investigate the trends of the incidence of VTE after primary TKA and identify associated risk factors for the occurrence of VTEs in a large cohort of TKA patients. We performed a retrospective study in which the Nationwide Inpatient Sample (NIS) database was used to identify all patients who underwent primary TKA over a period of 13 consecutive years (between 2002 and 2014) in the United States. The occurrence of a symptomatic VTE was identified with the use of ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis codes. A total of 1,460,901 primary TKA procedures were identified in the NIS from 2002 to 2014, and 12,944 of these patients were recorded as having 13,855 VTEs, consisting of 7,609 deep venous thromboses (0.52%) and 6,246 pulmonary emboli (0.43%). The overall VTE incidence in patients undergoing TKA in the United States from 2002 to 2014 was 0.89%. Patient-related risk factors for VTEs include an older age (odds ratio [OR]: 1.44; 95% confidence interval [CI]: 1.31–1.59), black race (OR: 1.34; 95% CI: 1.25–1.44), and Medicare insurance (OR: 1.18; 95% CI: 1.13–1.22). Most of the comorbidities were associated with an increased risk of VTE following TKA. Particularly, cardiac arrhythmias, coagulopathy, fluid and electrolyte disorders, pulmonary circulation disorders, and weight loss increased the risk of VTE by more than twofold. After adjusting for confounders, VTE was associated with a longer hospital stay (2.81 ± 0.02 day), increased costs (US$14,212.16 ± US$255.64), and higher mortality rate (OR: 13.04; 95% CI: 11.08–15.35). This nationally representative study of inpatients in the United States identified several independent risk factors for VTE perioperatively in TKA patients and provided evidence that VTE patients after TKA are likely to have worse results than non-VTE patients with regard to the length of hospital stay, hospital costs, and inhospital mortality. This is a level III, prognostic study.
Kinematic and Kinetic Waveform Changes of the Knee Joint Following a Mobile Bearing Total Knee Arthroplasty—Gait Analysis and Single Step Ascent
Authors: Apostolopoulos A. P. , Chronopoulos E. , Michos I. V. , Mastrokalos D. , Darras N. , Nikolaou V. S.
Published: May 2019

The objective of this study is to analyze the kinetic and kinematic changes of the osteoarthritic knee after a mobile bearing total knee arthroplasty. Kinematic and kinetic gait analysis of level walking was performed in 15 patients (eight female and seven male) with knee ostoarthritis. All patients were free of any neurological diseases that could affect their normal gait. Mean age was 68.6 ± 5.2 years, mean height 159.8 ± 6.9 cm, and mean weight was 78.5 ± 10.1 kg. Full body gait analysis was performed using the BioKin three-dimensional (3D) motion analysis system preoperatively and 9 months after total knee arthroplasty. A single-step ascending kinetic analysis and a plantar pressure distribution analysis were also performed in all patients. An increased average cadence (mean 99.39 step/min preoperatively and 104.64 step/min postoperatively; p = 0.152), step length (0.44 m preoperatively and 0.52 m postoperatively; p < 0.001), stride length (0.89 m preoperatively and 1.0 m postoperatively; p < 0.007), and walking velocity (0.73 m/sec preoperatively and 0.90 m/sec postoperatively; p = 0.005) were noted postoperatively and postoperatively. A decrease in the stance duration percentage and the knee adduction moment was also reported postoperatively. All patients showed a significant improvement of knee kinetics and kinematics after a mobile bearing total knee arthroplasty. Statistically significant differences were found in the step length, stride length, and walk velocity postoperatively. The knee adduction moment was also significantly reduced. Further research is warranted to determine the clinical relevance of these findings. This study is a prospective comparative one and reflects level II evidence.
Standing Needle Arthroscopy of the Metacarpophalangeal and Metatarsophalangeal Joint for Removal of Dorsal Osteochondral Fragmentation in 21 Horses
Authors: Bonilla Alvaro G.
Published: May 2019

Objective The aim of this study was to report the technique, experience and outcome of standing arthroscopic removal of dorsal osteochondral fragmentation of the metacarpophalangeal and metatarsophalangeal joint using a 1.2-mm needle arthroscope.

Study Design This was a prospective clinical study.

Materials and Methods All horses referred for standing arthroscopic removal of dorsoproximal first phalanx fragments or fragments embedded in the distal aspect of the synovial plica were included. Relevant information from the cases was recorded. Follow-up was obtained by a telephone questionnaire.

Results Twenty-one horses with a mean age of 4.5 years old were included. Osteochondral fragments removed were from the proximal margin of first phalanx in 18 horses (24 joints), in the synovial plica in 2 horses (2 joints) or free-floating fragment in 1 horse (1 joint). Fifteen out of twenty-one horses were unilaterally affected and 6/21 bilaterally. Fifteen out of twenty-seven affected joints were forelimbs and 12/27 hindlimbs. All articular structures within the dorsal recess of the joint were visible. The arthroscope was deemed easy to use and manoeuvre. Only minor complications occurred during the procedure. Surgery time was 15 to 20 minutes for most patients.

Conclusions All fragments were successfully removed and needle arthroscopy allowed a thorough evaluation of the dorsal aspect of the joint. The technique offers an alternative for standing fetlock arthroscopy for surgeons concerned about equipment damage or portability.
Initial Assessment, Debridement, and Decision Making in the Salvage of Severely Injured Lower Extremity
Authors: Sabapathy S. Raja , Venkatramani Hari , Mohan Monusha
Published: May 2019

An open fracture with extensive skin and soft tissue loss is considered as a severely injured lower extremity. Advances in rapid transport, resuscitation, skeletal fixation, and microsurgical techniques to cover large soft tissue and bone defects have made possible the salvage of these severely injured limbs. Salvage exercise is skill and resource intensive and could take a long time frame. The goal of management is to obtain painless independent weight bearing walking in a time frame and cost that the patient can afford.

Decisions taken and the quality of care provided on day 1 determine the ultimate success. Inappropriate decisions and treatment lead to increased morbidity and secondary amputation. Infection is the commonest complication. Limb salvage scores are helpful to predict salvage and guide the sequence of treatment. Once the decision is taken for salvage, debridement, early skeletal fixation, and soft tissue cover are the key to success.
Dialkylation of Ethyl 4-(Het)aryl-3-oxobutanoates as a Route to 5-(2-Oxoethyl)cyclopentenones
Authors: Lvov Andrey G. , Zakharov Alexey V. , Lyssenko Konstantin A. , Kachala Vadim V. , Shirinian Valerii Z.
Published: May 2019

An unexplored ability of the long-known chemical transformation, Borsche’s cyclopentenone synthesis (the construction of a 1,4-diketone with subsequent base-induced cyclization), is reported. Double alkylation of ethyl 4-(het)aryl-3-oxobutanoates with 2-bromo-1-(het)arylethanones, with subsequent alkali treatment, provides access to cyclopentenones substituted with a 2-oxoethyl group at the 5-position. These products might serve as valuable synthons for heterocyclization, and this feature was demonstrated by synthesis of 4H-cyclopenta[b]thiophene derivatives.
Pulse plating of Ni–B/WC nanocomposite coating and study of its corrosion and wear resistance
Authors: Hosseini Mir Ghasem , Ahmadiyeh Somayeh , Rasooli Ali
Published: May 2019

The aim of this study is to investigate the impact of WC content on the properties of the Ni–B/WC nanocomposites deposited by the pulse method. It is obtained that, although by addition of WC nanoparticles to the bath in initial steps (WC 4 and 8 g l−1), the grain size was increased and hence mechanical and electrochemical properties got worse, but at the higher amount of WC (WC 12 g l−1), due to the formation of the fine and packed structures, the great corrosion and wear resistance was achieved. The corrosion resistance of the Ni–B/WC12 g l−1 coating is 59,967 Ω and wear weight loss is 2.1 mg cm−2 with the friction coefficient of 0.64.
Unified total synthesis of amorfrutins A and C via the Claisen rearrangement
Authors: Fujita Tadafumi , Kuwahara Shigefumi , Ogura Yusuke
Published: May 2019

A concise, unified total synthesis of the two prenylated aromatic polyketides amorfrutins A and C, which exhibit various medicinally important biological profiles such as antimicrobial, PPARγ modulating and quorum sensing inhibitory activities, has been achieved from commercially available 3,5-dimethoxybenzaldehyde in 38% and 10% overall yields through nine and ten steps, respectively. The key transformation for the synthesis of amorfrutin A was the Claisen rearrangement of a mono-O-(1,1-dimethylallyl)resorcinol derivative to install the C3-prenyl substituent, while that for the synthesis of amorfrutin C was the double Claisen rearrangement of a di-O-(1,1-dimethylallyl)resorcinol derivative to introduce the two prenyl groups at the C3 and C5 positions all at once.
“Maid’s Day Off”: Leisured Domesticity in the Mid-Twentieth-Century United States
Authors: Heinz Annelise
Published: May 2019

At the height of the mid-twentieth-century domestic revival, middle-class Jewish women created forms of “leisured domesticity,” marked by temporary female-only recreational spaces in their family-centered arenas. In contrast to other forms of recreation, with mahjong second-generation Jewish women gained an entitlement to peer-oriented leisure in the site of domestic labor: the home. Based on extensive oral histories, Heinz argues that consistent cultural patterns emerged around mahjong. These commonalities created a widespread culture that reached its height in the postwar years of upward mobility, experienced in particularly pronounced ways by Jewish Americans. Although the culture of mahjong could reinforce women’s domestic roles as much as undermine them, the weekly mahjong ritual demanded a temporary reallocation of household labor. Understandings of postwar life have largely been shaped by a duality between what defined an idealized domesticity in theory (devoted mothers in family-centered middle-class homes) and the ways that women resisted or were excluded from these norms. In contrast, the practices of leisured domesticity illuminate a multidimensional reality. Mahjong-playing mothers neither overthrew nor fully acquiesced to the powerful norms of postwar American “model” domesticity. Creating a widely accepted rhythm of women’s recreation made domesticity more livable by carving out patterns of leisure within it.
Study on Diagnostic Values of Astrocyte Elevated Gene 1 (AEG-1) and Glypican 3 (GPC-3) in Hepatocellular Carcinoma
Authors: Cao Wenqing , Sharma Meenal , Imam Rami , Yu Jiangzhou
Published: May 2019

Objectives

To investigate the diagnostic potential of AEG-1 and GPC-3 in hepatocellular carcinoma (HCC).

Methods

AEG-1 and GPC-3 immunohistochemistry were performed on HCC, adjacent nontumor tissue (ANT), and dysplastic nodules (DN).

Results

H score of AEG-1 or GPC-3 in HCC was significantly higher than in ANT or DN. In HCC, 92% and 54% showed AEG-1 and GPC-3 positivity, respectively. In ANT, 16.2% were AEG-1 and 7.6% GPC-3 positive. AEG-1 staining was mostly diffuse, whereas GPC-3 frequently showed focal staining. AEG-1 alone showed high sensitivity but low specificity and accuracy. GPC-3, on the other hand, showed high specificity but low sensitivity and accuracy. Combination of both stains boosted the sensitivity, specificity, and accuracy to 94.6%, 89.5%, and 90.5%, respectively, when only diffuse staining was considered as positive.

Conclusions

AEG-1 or GPC-3 alone seemed not an ideal marker for HCC. The combination of AEG-1 and GPC-3 might improve early diagnosis of HCC.
Fighting the Public Health Burden of AIDS With the Human Pegivirus
Authors: Greenhalgh Scott , Schmidt Rebecca , Day Troy
Published: May 2019

Highly active antiretroviral therapy has revolutionized the battle against human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). From its current global rollout, HIV/AIDS morbidity and mortality has been greatly reduced, yet there exists substantial interest in the development of new therapies to further mitigate the HIV/AIDS health burden and to inhibit any fallout from the development of antiretroviral drug resistance. One potential intervention is the human pegivirus (HPgV). HPgV is not known to cause disease, and most remarkably it is shown to delay the progression of HIV to AIDS. However, the health benefit of increasing HPgV prevalence in the community of HIV-infected men remains unknown at the public health level. We evaluated the utility of HPgV biovaccination for mitigating the HIV/AIDS health burden using mathematical models. Importantly, our work considers the potential concern that HPgV will, itself, evolve to become disease-causing by permitting mutant disease-causing HPgV strains to potentially arise during treatment. Our findings show that HPgV biovaccination rates of 12.5%–50% annually could prevent 4.2–23.6 AIDS incidences and 3.3–18.8 AIDS deaths, and could save 2.9–18.6 disability-adjusted life years per 1,000 people. Together, these findings indicate that HPgV biovaccination could be an effective therapy for reducing HIV/AIDS morbidity and mortality, and thus warrants further exploration.
PRODIGY-crystal: a web-tool for classification of biological interfaces in protein complexes
Authors: Jiménez-García Brian , Elez Katarina , Koukos Panagiotis I , Bonvin Alexandre Mjj , Vangone Anna
Published: May 2019

Distinguishing biologically relevant interfaces from crystallographic ones in biological complexes is fundamental in order to associate cellular functions to the correct macromolecular assemblies. Recently, we described a detailed study reporting the differences in the type of intermolecular residue–residue contacts between biological and crystallographic interfaces. Our findings allowed us to develop a fast predictor of biological interfaces reaching an accuracy of 0.92 and competitive to the current state of the art. Here we present its web-server implementation, PRODIGY-CRYSTAL, aimed at the classification of biological and crystallographic interfaces. PRODIGY-CRYSTAL has the advantage of being fast, accurate and simple. This, together with its user-friendly interface and user support forum, ensures its broad accessibility.

Availability and implementation

PRODIGY-CRYSTAL is freely available without registration requirements at https://haddock.science.uu.nl/services/PRODIGY-CRYSTAL.
Trust-Based Secure Routing in Mobile Ad Hoc Network Using Hybrid Optimization Algorithm
Authors: Mukhedkar Moresh Madhukar , Kolekar Uttam
Published: May 2019

Routing in mobile ad hoc networks (MANETs) is a hectic challenge due to the dynamic nature of the network. The provisional communication links are assured due to the infrastructure-independent capability of MANET, but with no proper centralized monitoring process, which makes routing in MANETs with respect to the security and trust a major issue. Thus, the paper introduces Advanced Encryption Standard-enabled Trust-based Secure Routing protocol based on the proposed Dolphin Cat Optimizer (AES-TDCO), which is an energy and trust-aware routing protocol. The proposed Dolphin Cat Optimizer is engaged in the optimal route selection based on the modeled objective function based on the trust factors, recent trust, historical trust, direct and indirect trust in addition to delay, distance and link lifetime. The Dolphin Cat Optimizer is the integration of Dolphin Echolocation and Cat Swarm Optimization algorithm that inherits the faster global convergence. The simulation using 75 nodes revealed that the proposed routing protocol acquired the maximal throughput, minimal delay, minimal packet drop and detection rate of 0.6531, 0.0107, 0.3267 and 0.9898 in the absence of network attacks and 0.7693, 0.0112, 0.3605 and 0.9961 in the presence of the network attacks.
Dropout with Tabu Strategy for Regularizing Deep Neural Networks
Authors: Ma Zongjie , Sattar Abdul , Zhou Jun , Chen Qingliang , Su Kaile
Published: May 2019

Dropout has been proven to be an effective technique for regularizing and preventing the co-adaptation of neurons in deep neural networks (DNN). It randomly drops units with a probability of p during the training stage of DNN to avoid overfitting. The working mechanism of dropout can be interpreted as approximately and exponentially combining many different neural network architectures efficiently, leading to a powerful ensemble. In this work, we propose a novel diversification strategy for dropout, which aims at generating more different neural network architectures in less numbers of iterations. The dropped units in the last forward propagation will be marked. Then the selected units for dropping in the current forward propagation will be retained if they have been marked in the last forward propagation, i.e., we only mark the units from the last forward propagation. We call this new regularization scheme Tabu dropout, whose significance lies in that it does not have extra parameters compared with the standard dropout strategy and is computationally efficient as well. Experiments conducted on four public datasets show that Tabu dropout improves the performance of the standard dropout, yielding better generalization capability.
Predictors of 18F-sodium fluoride uptake in patients with stable coronary artery disease and adverse plaque features on computed tomography angiography
Authors: Kwiecinski Jacek , Dey Damini , Cadet Sebastien , Lee Sang-Eun , Tamarappoo Balaji , Otaki Yuka , Huynh Phi T , Friedman John D , Dweck Mark R , Newby David E , Yun Mijin , Chang Hyuk-Jae , Slomka Piotr J , Berman Daniel S
Published: May 2019

Aims

In patients with stable coronary artery disease (CAD) and high-risk plaques (HRPs) on coronary computed tomography angiography (CTA), we sought to define qualitative and quantitative CTA predictors of abnormal coronary 18F-sodium fluoride uptake (18F-NaF) by positron emission tomography (PET).

Methods and results

Patients undergoing coronary CTA were screened for HRP. Those who presented with ≥3 CTA adverse plaque features (APFs) including positive remodelling; low attenuation plaque (LAP, <30 HU), spotty calcification; obstructive coronary stenosis ≥50%; plaque volume >100 mm3 were recruited for 18F-NaF PET. In lesions with stenosis ≥25%, quantitative plaque analysis and maximum 18F-NaF target to background ratios (TBRs) were measured. Of 55 patients, 35 (64%) manifested coronary 18F-NaF uptake. Of 68 high-risk lesions 49 (70%) had increased PET tracer activity. Of the APFs, LAP had the highest sensitivity (39.4%) and specificity (98.3%) for predicting 18F-NaF uptake. TBR values were higher in lesions with LAP compared to those without [1.6 (1.3–1.8) vs. 1.1 (1.0–1.3), P = 0.01]. On adjusted multivariable regression analysis, LAP (both qualitative and quantitative) was independently associated with plaque TBR [LAP qualitative: β = 0.47, 95% confidence interval (CI) 0.30–0.65; P < 0.001] and (LAP volume: β = 0.20 per 10 mm3, 95% CI 0.13–0.27; P < 0.001).

Conclusion

In stable CAD patients with HRP, LAP is predictive of 18F-NaF coronary uptake, but 18F-NaF is often seen in the absence of LAP. If 18F-NaF uptake is shown to be associated with adverse outcomes and becomes clinically used, the presence of LAP may define patients who would not benefit from the added testing.
Biocontrol effect of Kluyveromyces lactis on aflatoxin expression and production in Aspergillus parasiticus
Authors: Ghanbari Rooholla , Rezaie Sassan , Noorbakhsh Fatemeh , Khaniki Gholamreza Jahed , Soleimani Mina , Aghaee Ebrahim Molaee
Published: May 2019

Aspergillus parasiticus is one of the most common fungi able to produce aflatoxins, which are naturally occurring carcinogenic substances. This study evaluated the effects of the safe yeast, Kluyveromyces lactis, on fungal growth, aflatoxin production and expression of aflR gene in A. parasiticus. Antifungal susceptibility was evaluated by exposing A. parasiticus to different amounts of K. lactis, and aflatoxin production was measured using high-performance liquid chromatography. Expression of the aflR gene was determined by measuring the cognate aflR mRNA level by quantitative real-time reverse-transcription polymerase chain reaction assay. The growth of A. parasiticus was inhibited by 7 days of incubation at 30°C with a minimum population of 1.5 × 105 CFU/ml of K. lactis, which also suppressed expression of the A. parasiticus aflR gene, reducing the total production of aflatoxins by 97.9% and aflatoxins B1, B2, G1 and G2 by 97.8, 98.6, 98 and 94%, respectively. Accordingly, K. lactis could be considered as a potential biocontrol agent against toxigenic molds in food and animal feed.
Not all animals need a microbiome
Authors: Hammer Tobin J , Sanders Jon G , Fierer Noah
Published: May 2019

It is often taken for granted that all animals host and depend upon a microbiome, yet this has only been shown for a small proportion of species. We propose that animals span a continuum of reliance on microbial symbionts. At one end are the famously symbiont-dependent species such as aphids, humans, corals and cows, in which microbes are abundant and important to host fitness. In the middle are species that may tolerate some microbial colonization but are only minimally or facultatively dependent. At the other end are species that lack beneficial symbionts altogether. While their existence may seem improbable, animals are capable of limiting microbial growth in and on their bodies, and a microbially independent lifestyle may be favored by selection under some circumstances. There is already evidence for several ‘microbiome-free’ lineages that represent distantly related branches in the animal phylogeny. We discuss why these animals have received such little attention, highlighting the potential for contaminants, transients, and parasites to masquerade as beneficial symbionts. We also suggest ways to explore microbiomes that address the limitations of DNA sequencing. We call for further research on microbiome-free taxa to provide a more complete understanding of the ecology and evolution of macrobe-microbe interactions.
Schizosaccharomyces osmophilus sp. nov., an osmophilic fission yeast occurring in bee bread of different solitary bee species
Authors: Brysch-Herzberg Michael , Tobias Andrea , Seidel Martin , Wittmann Rupert , Wohlmann Elke , Fischer Reinhard , Dlauchy Dénes , Peter Gabor
Published: May 2019

Eight yeast strains that asexually reproduce by cell fission were isolated from bee bread of different solitary bees in Germany. DNA sequence analysis revealed that the strains shared the same sequence in the D1/D2 domain of the nuclear large subunit (LSU) rRNA gene with a strain that was previously isolated from a fig snack from Spain. The closest related type strain was that of Schizosaccharomyces octosporus, which showed 98.2% sequence similarity (11 substitutions) with the new strains. By clone sequence analysis of the internal transcribed spacer (ITS) region (ITS1, 5.8S rDNA, and ITS2) a total of nine different copy types were identified. The new strains differed from S. octosporus by approximately 31% in the ITS region. Sequence analysis of the RNAse P gene further supported the description of a new species. The strains isolated during this study show some phenotypic characteristics that separate them from the closest related species, S. octosporus and S. cryophilus. Since all strains showed true osmophily the name of the new species is S. osmophilus (holotype: CBS 15793T; isotype: CLIB 3267 T = NCAIM Y.02225 T, MycoBank no.: MB829586).
A National Longitudinal Study of Partnered Sex, Relationship Quality, and Mental Health Among Older Adults
Authors: Zhang Yan , Liu Hui
Published: May 2019

Objectives

We worked from a life course perspective to examine the relationship between partnered sex and older adults’ trajectories of mental health as well as the potential mediating role of relationship quality in this association.

Method

We analyzed nationally representative data from three waves of the National Social Life, Health, and Aging Project (2005/2006 to 2015/2016). The sample included 1,911 married and cohabiting respondents aged 57 to 85 at the baseline survey. We examined four factors related to partnered sex: being sexually active, sexual frequency, feeling okay with sexual frequency, and sexual quality. Mental health was measured by self-rated poor mental health, unhappiness, and psychological distress. The relationship quality measures considered both relationship support and relationship strain.

Results

Results from mixed-effects models suggest that being sexually active, having sex more frequently, feeling okay with sexual frequency, and reporting better sexual quality were all related to better mental health outcomes. Relationship quality partially explained the effects of sex on mental health.

Discussion

This study highlights the importance of sex for mental health and relationship quality among older adults. The findings have implications for health policy and programs that seek to promote healthy aging.
Vertical land motion in the Southwest and Central Pacific from available GNSS solutions and implications for relative sea levels
Authors: Ballu Valérie , Gravelle Médéric , Wöppelmann Guy , de Viron Olivier , Rebischung Paul , Becker Mélanie , Sakic Pierre
Published: May 2019

Coastal populations are impacted by relative sea level variations, which consist both of absolute sea level variations and of vertical land motions. This paper focuses on the Southwest and Central Pacific region, a recognized vulnerable region to sea level rise and where a large range of vertical land motion dynamics is observed. We analyse vertical displacement rates obtained from Global Navigation Satellite Systems (GNSS) by different analysis centres. We study the role played by modelled parameters, such as step discontinuities (due to equipment changes, earthquakes, etc.), in the position time-series analysis. We propose a new modelling approach based on a joint inversion of GNSS position time-series from different analysis centres. The final uncertainty on the vertical land motion rates is estimated as a combination of the uncertainty due to the GNSS data processing itself and the uncertainty due to the stability of the reference frame in which the GNSS data are expressed. We find that the dominant trend in the Southwest and Central Pacific is a moderate subsidence, with an average rate of −1.1 mm yr–1, but significant variations are observed, with displacement rates varying from an uplift of 1.6 ± 0.3 mm yr–1 to a subsidence of −5.4 ± 0.3 mm yr–1. Taking into account the geodynamic context, we assess, for each station, the relevance of current estimates of linear vertical displacement rate and uncertainty for forecasting future coastal sea levels.
Towards health equity and social justice: an applied framework of decolonization in health promotion
Authors: Chandanabhumma P Paul , Narasimhan Subasri
Published: May 2019

The pursuit of health equity and social justice lie at the heart of community-empowered health promotion practice. However, there is a need to address the colonial legacy and its contributions to health inequities. The process of decolonization is essential to eliminating the mechanisms that contributed to such inequities. To this end, we propose an Applied Decolonial Framework for Health Promotion that integrates decolonial processes into health promotion practice. We present characteristics of the framework, its values for health promotion transformations and considerations for using the framework in health promotion practice. The framework will help health promotion stakeholders attend to colonizing structures within the field and engage with communities to achieve social justice and health equity.
Utility of radiation-free imaging for initial evaluation of pectus excavatum
Authors: Scalabre Aurélien , Maniouloux Floriane , Vermersch Sophie , Patoir Arnaud , Haddad Elie , Lopez Manuel , Varlet François , Tiffet Olivier
Published: May 2019

OBJECTIVES

The OrtenBodyOne scanner is a radiation-free, 3-dimensional imaging system recently developed for evaluation of the severity of pectus excavatum (PE). The goal of this study was to evaluate the utility of this new imaging system compared with that of computed tomography (CT) for the evaluation of the severity of PE.

METHODS

Patients treated for PE from April 2015 to January 2017 with available CT and OrtenBodyOne data were included. Correlations between indexes calculated from CT and from OrtenBodyOne were determined by applying the non-parametric Spearman correlation procedure with a Bonferroni correction to adjust for multiple comparisons.

RESULTS

Forty men (90.9%) and 4 women (9.1%), 20 with symmetrical (45.5%) and 24 with asymmetrical PE (54.5%), were included. The median age was 16.1 years (range 4.3–63.5 years). The following measures and indexes acquired using OrtenBodyOne and CT were significantly correlated: pectus depth (r = 0.84; P = 0.002), anthropometric index (r = 0.81; P = 0.002) and asymmetry index (r = 0.67; P = 0.002). The correlation between the CT Haller index and the external Haller index was only significant for symmetrical PE (r = 0.57; P = 0.008).

CONCLUSIONS

The OrtenBodyOne imaging system can be used to evaluate the severity of symmetrical PE using the external Haller index. Asymmetry and anthropometric indexes are more reliable for the evaluation of asymmetrical PE. Measures can be repeated throughout treatment while avoiding unnecessary irradiation.
RICK/RIP2 is a NOD2-independent nodal point of gut inflammation
Authors: Watanabe Tomohiro , Minaga Kosuke , Kamata Ken , Sakurai Toshiharu , Komeda Yoriaki , Nagai Tomoyuki , Kitani Atsushi , Tajima Masaki , Fuss Ivan J , Kudo Masatoshi , Strober Warren
Published: May 2019

Previous studies have shown that inhibition of receptor-interacting serine/threonine kinase (RICK) (also known as RIP2) results in amelioration of experimental colitis. This role has largely been attributed to nucleotide-binding oligomerization domain 2 (NOD2) signaling since the latter is considered a major inducer of RICK activation. In this study, we explored the molecular mechanisms accounting for RICK-mediated inhibition of inflammatory bowel disease (IBD). In an initial series of studies focused on trinitrobenzene sulfonic acid (TNBS)-colitis and dextran sodium sulfate (DSS)-colitis we showed that down-regulation of intestinal RICK expression in NOD2-intact mice by intra-rectal administration of a plasmid expressing RICK-specific siRNA was accompanied by down-regulation of pro-inflammatory cytokine responses in the colon and protection of the mice from experimental colitis. Somewhat surprisingly, intra-rectal administration of RICK-siRNA also inhibited TNBS-colitis and DSS-colitis in NOD2-deficient and in NOD1/NOD2-double deficient mice. In complementary studies of humans with IBD we found that expression of RICK, cellular inhibitor of apoptosis protein 2 (cIAP2) and downstream signaling partners were markedly increased in inflamed tissue of IBD compared to controls without marked elevations of NOD1 or NOD2 expression. In addition, the increase in RICK expression correlated with disease activity and pro-inflammatory cytokine responses. These studies thus suggest that NOD1- or NOD2-independenent activation of RICK plays a major role in both murine experimental colitis and human IBD.
Ensemble method–based extraction of medication and related information from clinical texts
Authors: Kim Youngjun , Meystre Stéphane M
Published: May 2019

Objective

Accurate and complete information about medications and related information is crucial for effective clinical decision support and precise health care. Recognition and reduction of adverse drug events is also central to effective patient care. The goal of this research is the development of a natural language processing (NLP) system to automatically extract medication and adverse drug event information from electronic health records. This effort was part of the 2018 n2c2 shared task on adverse drug events and medication extraction.

Materials and Methods

The new NLP system implements a stacked generalization based on a search-based structured prediction algorithm for concept extraction. We trained 4 sequential classifiers using a variety of structured learning algorithms. To enhance accuracy, we created a stacked ensemble consisting of these concept extraction models trained on the shared task training data. We implemented a support vector machine model to identify related concepts.

Results

Experiments with the official test set showed that our stacked ensemble achieved an F1 score of 92.66%. The relation extraction model with given concepts reached a 93.59% F1 score. Our end-to-end system yielded overall micro-averaged recall, precision, and F1 score of 92.52%, 81.88% and 86.88%, respectively. Our NLP system for adverse drug events and medication extraction ranked within the top 5 of teams participating in the challenge.

Conclusion

This study demonstrated that a stacked ensemble with a search-based structured prediction algorithm achieved good performance by effectively integrating the output of individual classifiers and could provide a valid solution for other clinical concept extraction tasks.
Proteomic Identification of Immune-Related Silkworm Proteins Involved in the Response to Bacterial Infection
Authors: Chen Shiyi , Dong Zhaoming , Ren Xiu , Zhao Dongchao , Zhang Yan , Tang Muya , Han Jiaxuan , Ye Lin , Zhao Ping
Published: May 2019

Bombyx mori (Lepidoptera: Bombycidae) is an important economic insect and a classic Lepidopteran model system. Although immune-related genes have been identified at a genome-wide scale in the silkworm, proteins involved in immune defense of the silkworm have not been comprehensively characterized. In this study, two types of bacteria were injected into the silkworm larvae, Gram-negative Escherichia coli (Enterobacteriales: Enterobacteriaceae), or Gram-positive Staphylococcus aureus (Bacillales: Staphylococcaceae). After injection, proteomic analyses of hemolymph were performed by liquid chromatography—tandem mass spectrometry. In total, 514 proteins were identified in the uninduced control group, 540 were identified in the E. coli-induced group, and 537 were identified in the S. aureus-induced group. Based on Uniprot annotations, 32 immunological recognition proteins, 28 immunological signaling proteins, and 21 immunological effector proteins were identified. We found that 127 proteins showed significant upregulation, including 10 immunological recognition proteins, 4 immunological signaling proteins, 11 immunological effector proteins, and 102 other proteins. Using real-time quantitative polymerase chain reaction in the fat body, we verified that immunological recognition proteins, signaling proteins, and effector proteins also showed significant increases at the transcriptional level after infection with E. coli and S. aureus. Five newly identified proteins showed upregulation at both protein and transcription levels after infection, including 30K protein, yellow-d protein, chemosensory protein, and two uncharacterized proteins. This study identified many new immune-related proteins, deepening our understanding of the immune defense system in B. mori. The data have been deposited to the iProX with identifier IPX0001337000.
The doctor as jailer: medical detention of non-psychiatric patients
Authors: Kersten Charles
Published: May 2019

Most states empower doctors to detain psychiatric patients if they pose a danger to themselves or others due to a mental illness; however, they do not cover patients whose mental status is dangerously altered due to a non-psychiatric illness, for example, an electrolyte imbalance. Physicians generally handle these ‘medically incapacitated’ patients by saying they lack capacity to decide to leave against medical advice. The medical and legal literature does not address the legal basis for a doctor to effectively trap a patient in the hospital. This article analyzes the laws of California to show how and under what circumstances such a detention could be justified; in doing so, it provides guidance for a legally sound policy for holding ‘medically incapacitated’ patients.
Is There a Problem With False Hope?
Authors: Musschenga Bert
Published: May 2019

This article offers a general discussion of the concept of false hope. Its ultimate aim is to clarify the meaning and the relevance of that concept for medicine and medical research. In the first part (Sections I–V), the concept of hope is discussed. I argue that hope is more than a combination of a desire and a belief about the probability that the desire will be fulfilled. Imagination and anticipation are as well components of hope. I also discuss if hope implies orientation to action. In the second part (Sections VI–VIII), I examine the concept of false hope. I show that hope is false if it cannot be justified epistemically. There is, I argue, an intimate relation between false hope and ignorance. Hope is justified—“realistic”—when the hoping person knows and accepts experts’ judgement about the probability of hope fulfillment. I then argue that what matters for evaluating a person’s hope is not only whether it is realistic, but also whether it is reasonable in the light of the aim and goals that a person strives for in (the remainder of) his life. Part three (Sections IX and X) goes into the question of what is morally wrong about having or causing false hope. In the fourth part (Sections XI and XII), the relevance is shown of the insights from the previous parts for the debate on false hope in medicine and clinical research.
Protecting endemic seed plants on the Tibetan Plateau under future climate change: migration matters
Authors: Yan Yujing , Tang Zhiyao
Published: May 2019

Aims

Climate change in the near future may become a major threat to high-altitude endemics by greatly altering their distribution. Our aims are to (i) assess the potential impacts of future climate change on the diversity and distribution of seed plants endemic to the Tibetan Plateau and (ii) evaluate the conservation effectiveness of the current National Nature Reserves (NNRs) in protecting the endemic plants in the face of climate change.

Methods

We projected range shifts of 993 endemic species to the years 2050 and 2070 under two representative concentration pathway scenarios using an ensemble species distribution modeling framework and evaluated range loss, species-richness change and coverage of the current conservation network considering two dispersal scenarios.

Important Findings

In a full-dispersal scenario, 72–81% of the species would expand their distribution by 2070, but 6–20% of the species would experience >30% range loss. Most species would shift to the west. The projected species net richness would increase across the region on average. In a no-dispersal scenario, 15–59% of the species would lose >30% of their current habitat by 2070. Severe species loss may occur in the southeastern and the eastern peripheral plateau. Seventeen percent of species ranges are covered by the NNRs on average and may increase in the future if species disperse freely. We found a significant difference of species redistribution patterns between different dispersal scenarios and highlighted the importance of migration in this region.
An Analysis of Charlie’s Law and Alfie’s Law
Authors: Benbow David I
Published: May 2019

The Charlie Gard and Alfie Evans cases were high-profile cases involving disagreements between the parents of young infants and medical practitioners, which have given impetus to pre-existing calls for law reform that have been rebranded as ‘Charlie’s Law’ and ‘Alfie’s Law’. I argue against the proposal to replace the best interest test, which is currently determinative in such contentious cases, with a significant harm test, as it would render UK law divergent from international law. I also employ critical theory to rebut the notion that parents are the best decision makers and refute criticisms of clinicians (who reflexively acknowledged the limits of medicine). I utilise theories of distributive justice to demonstrate that legal reform may exacerbate unfairness, and case law to show that it may be unworkable. Nonetheless, I apply critical and Foucauldian theory to critique the lack of patient and public empowerment within the NHS and I endorse the proposal to ensure that mediation is offered in contentious cases, as this may empower patients and their carers. I also aver that the best interests test should be informed by clearer criteria regarding the allocation of finite resources, which the public should influence via the democratisation of the NHS.
The effect of tides on the Sculptor dwarf spheroidal galaxy
Authors: Iorio G , Nipoti C , Battaglia G , Sollima A
Published: May 2019

Dwarf spheroidal galaxies (dSphs) appear to be some of the most dark matter (DM)-dominated objects in the Universe. Their dynamical masses are commonly derived using the kinematics of stars under the assumption of equilibrium. However, these objects are satellites of massive galaxies (e.g. the Milky Way) and thus can be influenced by their tidal fields. We investigate the implication of the assumption of equilibrium focusing on the Sculptor dSph by means of ad hoc N-body simulations tuned to reproduce the observed properties of Sculptor following the evolution along some observationally motivated orbits in the Milky Way gravitational field. For this purpose, we used state-of-the-art spectroscopic and photometric samples of Sculptor’s stars. We found that the stellar component of the simulated object is not directly influenced by the tidal field, while ${\approx } 30\!-\!60{{\ \rm per\ cent}}$ of the mass of the more diffuse DM halo is stripped. We conclude that, considering the most recent estimate of the Sculptor proper motion, the system is not affected by the tides and the stellar kinematics represents a robust tracer of the internal dynamics. In the simulations that match the observed properties of Sculptor, the present-day dark-to-luminous mass ratio is ≈6 within the stellar half-light radius (≈0.3 kpc) and >50 within the maximum radius of the analysed data set (≈1.5○, ≈2 kpc).
Delicate structural coordination of the Severe Acute Respiratory Syndrome coronavirus Nsp13 upon ATP hydrolysis
Authors: Jia Zhihui , Yan Liming , Ren Zhilin , Wu Lijie , Wang Jin , Guo Jing , Zheng Litao , Ming Zhenhua , Zhang Lianqi , Lou Zhiyong , Rao Zihe
Published: May 2019

To date, an effective therapeutic treatment that confers strong attenuation toward coronaviruses (CoVs) remains elusive. Of all the potential drug targets, the helicase of CoVs is considered to be one of the most important. Here, we first present the structure of the full-length Nsp13 helicase of SARS-CoV (SARS-Nsp13) and investigate the structural coordination of its five domains and how these contribute to its translocation and unwinding activity. A translocation model is proposed for the Upf1-like helicase members according to three different structural conditions in solution characterized through H/D exchange assay, including substrate state (SARS-Nsp13-dsDNA bound with AMPPNP), transition state (bound with ADP-AlF4−) and product state (bound with ADP). We observed that the β19–β20 loop on the 1A domain is involved in unwinding process directly. Furthermore, we have shown that the RNA dependent RNA polymerase (RdRp), SARS-Nsp12, can enhance the helicase activity of SARS-Nsp13 through interacting with it directly. The interacting regions were identified and can be considered common across CoVs, which provides new insights into the Replication and Transcription Complex (RTC) of CoVs.
Optimizing Warnings on E-Cigarette Advertisements
Authors: King Jessica L , Lazard Allison , Reboussin Beth A , Ranney Leah , Cornacchione Ross Jennifer , Wagoner Kimberly G , Sutfin Erin L
Published: May 2019

Introduction

We examined the effect of visual optimizations on warning text recall.

Methods

We used Amazon’s Mechanical Turk to recruit 1854 young adult (18–34 years) electronic cigarette (e-cigarette) users or susceptible nonusers. We conducted a between-subjects 3 × 2 × 2 experiment to examine the influence of color (black text on white background [BW] vs. black on yellow [BY] vs. yellow on black [YB]), shape (rectangle vs. novel), and signal word (presence vs. absence of the word “warning”). We randomized participants to view one of 12 warnings on a fictional e-cigarette advertisement. We coded open-ended recall responses into three categories: (1) recalled nothing, (2) recalled something, (3) recalled the concept. We examined main effects on warning text recall using multinomial regression. We examined differences in attention, perceived message effectiveness, and appeal.

Results

Those exposed to BW or BY warnings were more likely than those exposed to YB to recall something (AOR = 1.6, AOR = 1.5, respectively) or the concept (OR = 1.4, BW). Those exposed to novel shape (44.7% novel vs. 37.9% rectangle; p = .003) or color (44.5% BY vs. 41.9% YB vs. 37.5% BW; p = .04) warnings were more likely to report attention to the warning. In aided recall, those exposed to the signal word were more likely than those not exposed to select the correct response (64.0% vs. 31.3%; p < .0001). We did not find differences for message effectiveness or appeal.

Conclusions

Visual optimizations such as color may influence warning text recall and should be considered for new warnings. Research should continue exploring variations for advertisement warnings to maximize attention to warning text.

Implications

This study examines the impact of visual optimizations on recall of the US Food and Drug Administration-mandated e-cigarette advertisement warning text. We found that color might influence warning text recall, but we did not find effects for shape or signal word. It is possible the newly mandated e-cigarette advertisement warnings, which are required to occupy at least 20% of the advertisement, are currently novel enough to attract attention. Future research should examine optimizations following implementation of the new advertisement warnings.