bluuebunny/crossref_metadata_2025 huggingface dataset:
Multicentric endocrine mucin‐producing sweat gland carcinoma and mucinous carcinoma of the skin: A case report
Authors: Nishimoto Akana , Kuwahara Hiroaki , Ohashi Ryuji , Ansai Shin‐ichi
Published: October 2020

Endocrine mucin‐producing sweat gland carcinoma (EMPSGC) is a rare low‐grade sweat gland carcinoma. EMPSGC is thought to be a precursor to mucinous carcinoma of the skin (MCS). Since the first description of EMPSGC in 1997, only a few cases have been reported, and its etiology and mechanisms remain unknown. In this report, we describe a 71‐year‐old Japanese woman with two isolated EMPSGC and one MCS lesion on her face. She was simultaneously diagnosed with invasive ductal carcinoma of the breast. She had a history of uterine cancer of unknown histopathological diagnosis 24 years previously. The presence of in situ lesions confirmed by myoepithelial cells suggested that the cutaneous lesions were primary tumors. To the best of our knowledge, this is the first case of multiple primary EMPSGC/MCS tumors. Additionally, this might be the first case with multiple primary carcinomas including adnexal cutaneous tumors, breast cancer, and uterine cancer, which may share the common feature of expressing female hormonal receptors. This case indicates that EMPSGC/MCS may be triggered by a hormonal receptor abnormality, perhaps because of genetic defects. A larger number of reports examining this issue may be necessary to further assess our initial observations.
An innovative acute care based intervention to address the opioid crisis in a Canadian setting
Authors: Imtiaz Sameer , Hayashi Kanna , Nolan Seonaid
Published: October 2020

The ongoing opioid crisis has placed a considerable burden on acute care settings in North America. The present commentary outlines that the rising volume of patients with opioid‐related harms in acute care settings represents an often‐missed opportunity to address important health and social needs as well as facilitate access to addiction treatment services. It then describes an innovative, inter‐disciplinary model‐of‐care developed to address the needs of patients with a substance use disorder who present to the emergency department for medical care at St. Paul's Hospital in Vancouver, Canada.
Comment on “Differential Effects of the Temporal and Spatial Distribution of Audiovisual Stimuli on Cross‐Modal Spatial Recalibration”
Authors: Vroomen Jean , Stekelenburg Jeroen J.
Published: October 2020

Bruns et al. (2020) provide new research that suggests that the ventriloquism after‐effect (VAE: an enduring shift of the perceived location of a sound toward a previously seen visual stimulus) and multisensory enhancement (ME: an improvement in the precision of sound localization) may dissociate depending on the rate at which exposure stimuli are presented. They reported that the VAE, but not the ME, was diminished when exposure stimuli were presented at 10 Hz rather than at 2 Hz. To the authors, this suggested that different neural structures underlie the VAE and ME. In our view, however, this needs to be tested more extensively because alternative and simpler explanations have not yet been checked.
Can genetic polymorphisms predict response variability to anodal transcranial direct current stimulation of the primary motor cortex?
Authors: Pellegrini Michael , Zoghi Maryam , Jaberzadeh Shapour
Published: October 2020

Genetic mediation of cortical plasticity and the role genetic variants play in previously observed response variability to transcranial direct current stimulation (tDCS) have become important issues in the tDCS literature in recent years. This study investigated whether inter‐individual variability to tDCS was in‐part genetically mediated. In 61 healthy males, anodal‐tDCS (a‐tDCS) and sham‐tDCS were administered to the primary motor cortex at 1 mA for 10‐min via 6 × 4 cm active and 7 × 5 cm return electrodes. Twenty‐five single‐pulse transcranial magnetic stimulation (TMS) motor evoked potentials (MEP) were recorded to represent corticospinal excitability (CSE). Twenty‐five paired‐pulse MEPs were recorded with 3 ms inter‐stimulus interval (ISI) to assess intracortical inhibition (ICI) via short‐interval intracranial inhibition (SICI) and 10 ms ISI for intracortical facilitation (ICF). Saliva samples were tested for specific genetic polymorphisms in genes encoding for excitatory and inhibitory neuroreceptors. Individuals were sub‐grouped based on a pre‐determined threshold and via statistical cluster analysis. Two distinct subgroups were identified, increases in CSE following a‐tDCS (i.e. Responders) and no increase or even reductions in CSE (i.e. Non‐responders). No changes in ICI or ICF were reported. No relationships were reported between genetic polymorphisms in excitatory receptor genes and a‐tDCS responders. An association was reported between a‐tDCS responders and GABRA3 gene polymorphisms encoding for GABA‐A receptors suggesting potential relationships between GABA‐A receptor variations and capacity to undergo tDCS‐induced cortical plasticity. In the largest tDCS study of its kind, this study presents an important step forward in determining the contribution genetic factors play in previously observed inter‐individual variability to tDCS.
Episodic hyperCKaemia may be a feature of α‐methylacyl‐coenzyme A racemase deficiency
Authors: Krett B. , Straub V. , Vissing J.
Published: October 2020

α‐methylacyl‐CoA racemase (AMACR) deficiency is a rare disorder, affecting peroxisomal metabolism of pristanic acid, with ten published adult cases. We describe an AMACR deficiency case with a clinical presentation dominated by episodic hyperCKaemia, suggesting that myopathic features of AMACR should be considered.
DAS SUBJEKT DER LYRIK ODER: FÜR EINE PHILOLOGIE DER DUNKELHEIT – LYRIK ALS (EIN) PARADIGMA DER MODERNE
Authors: Emmrich Thomas
Published: October 2020

When Hölderlin argues in favour of modernity in the Querelle des Anciens et des Modernes, he rejects the claim that the highest form of art is tragedy and proclaims the primacy of poetry. However, Hölderlin frames a very different concept of poetry from Hegel, for instance, one of the most prominent representatives of the notion of subjectivity. For Hölderlin, poetry is not the medium of subjective self‐reassurance, but first and foremost the genre of memory, of patient endurance ‘when times are hard’ and of writing against ‘eccentric excitement’. It is through writing that he expects to achieve a revolution in future ‘modes of thought’. Hölderlin wants not only to define a poetics of genre for modernity but also to imbue it with an autonomous aesthetic profile, independent of the worn‐out language of tradition. This is why the language of modern poetry can only be one of obscuritas. This struggle for a genuinely modern mode of speaking leads to changes in the old modes, to alienation from them and, as a result, to the estrangement of recipients. Firstly, this article will reconstruct how the paradigmatic genre of modernity shifts from tragedy to poetry. Secondly, it will analyse Hölderlin's nexus between critiques of the subject and critiques of poetic language and then trace the paths that lead from it to Adorno.
The rise of Chinese foreign direct investment in the United States: Disentangling investment strategies of state‐owned and private enterprises
Authors: He Lisha , Jiang Ronghao , Bennett Mia M.
Published: October 2020

Over the last two decades, China's outward foreign direct investment (OFDI) has expanded rapidly. The country is now the world's second‐largest source of OFDI. China is often viewed as a monolithic investor, however, without sufficient attention to the differences between investments by state‐owned enterprises (SOEs) and private enterprises (PEs). To shed light on the internal complexity and heterogeneity of Chinese OFDI, we construct a panel dataset of investments in the U.S. across the 50 states and Washington, D.C. from 2005 to 2017, which we analyze using a spatial autoregressive model. We find clear evidence that the ownership structure of Chinese firms affects investment strategy and entry mode. Statistical analysis indicates that SOEs are more likely to pursue greenfield investment motivated by market‐seeking and resource‐seeking objectives, while PEs pursue mergers and acquisitions in order to obtain strategic assets. We also detect a positive and significant relationship between the presence of Chinese overseas communities and OFDI, with the strength of the correlation depending on ownership structure. Finally, we find that Chinese OFDI is spatially dependent, meaning that investments flow to states where they are already concentrated nearby.
Self‐care training using the Tablo hemodialysis system
Authors: Plumb Troy J. , Alvarez Luis , Ross Dennis L. , Lee Joseph J. , Mulhern Jeffrey G. , Bell Jeffrey L. , Abra Graham E. , Prichard Sarah S. , Chertow Glenn M. , Aragon Michael A.
Published: October 2020

Introduction

Recently published results of the investigational device exemption (IDE) trial using the Tablo hemodialysis system confirmed its safety and efficacy for home dialysis. This manuscript reports additional data from the Tablo IDE study on the training time required to be competent in self‐care, the degree of dependence on health care workers and caregivers after training was complete, and participants' assessment of the ease‐of‐use of Tablo.

Methods

We collected data on the time required to set up concentrates and the Tablo cartridge prior to treatment initiation. We asked participants to rate system setup, treatment, and takedown on a Likert scale from 1 (very difficult) to 5 (very simple) and if they had required any assistance with any aspect of treatment over the prior 7 days. In a subgroup of 15 participants, we recorded the number of training sessions required to be deemed competent to do self‐care dialysis.

Findings

Eighteen men and 10 women with a mean age of 52.6 years completed the study. Thirteen had previous self‐care experience using a different dialysis system. Mean set up times for the concentrates and cartridge were 1.1 and 10.0 minutes, respectively. Participants with or without previous self‐care experience had similar set‐up times. The mean ease‐of‐use score was 4.5 or higher on a scale from 1 to 5 during the in‐home phase. Sixty‐five percent required no assistance at home and on average required fewer than four training sessions to be competent in managing their treatments. Results were similar for participants with or without previous self‐care experience.

Conclusions

Participants in the Tablo IDE trial were able to quickly learn and manage hemodialysis treatments in the home, found Tablo easy to use, and were generally independent in performing hemodialysis.
Seeking or contributing? Evidence of knowledge sharing behaviours in promoting patients’ perceived value of online health communities
Authors: Guo Cui , Zhang Zhen , Zhou Junjie , Deng Zhaohua
Published: October 2020

Background

Health knowledge, as an important resource of online health communities (OHCs), attracts users to engage in OHCs and improve the traffics within OHCs, thereby promoting the development of OHCs. Seeking and contributing health knowledge are basic activities in OHCs and are helpful for users to solve their health‐related problems, improve their health conditions and thus influence their evaluation of OHCs (ie perceived value of OHCs). However, how do patients’ health knowledge seeking and health knowledge contributing behaviours together with other factors influence their perceived value of OHCs? We still have little knowledge.

Objective

In order to address the above gap, we root the current study in social cognitive theory and prior related literature on health knowledge sharing in OHCs and patients’ perceived value. We treat health knowledge seeking and health knowledge contributing behaviours as behavioural factors and structural social capital as an environmental factor and explore their impacts on patients’ perceived value of OHCs.

Design

We have built a theoretical model composed of five hypotheses. We have designed a questionnaire composed of four key constructs and then collected data via an online survey.

Setting and participants

We have distributed the questionnaire in two Chinese OHCs. We obtained a sample of 352 valid responses that were completed by patients having a variety of conditions.

Results

The empirical results indicate that health knowledge seeking and health knowledge contributing have positive impacts on patients’ perceived value of OHCs. The impact of health knowledge seeking on patients’ perceived value of OHCs is greater than the impact of health knowledge contributing. In addition, structural social capital moderates the effects of health knowledge seeking and health knowledge contributing on patients’ perceived value of OHCs. It weakens the effect of health knowledge seeking but enhances the effect of health knowledge contributing on patients’ perceived value of OHCs.

Conclusions

These findings contribute to the literature on patients’ perceived value of OHCs and on the role of structural social capital in OHCs. For OHC managers, they should provide their users more opportunities to seek or contribute health knowledge in their communities.
Antiretroviral treatment outcomes among late HIV presenters initiating treatment with integrase inhibitors or protease inhibitors
Authors: Schuettfort G , Boekenkamp L , Cabello A , Cotter AG , De Leuw P , Doctor J , Górgolas M , Hamzah L , Herrmann E , Kann G , Khaykin P , Mallon PW , Mena A , Del Palacio Tamarit M , Sabin CA , Stephan C , Wolf T , Haberl AE
Published: October 2020

Objectives

The aim of the study was to investigate the efficacy and safety of first‐line antiretroviral therapy (ART) with integrase inhibitor (INI) or protease inhibitor (PI)‐based regimens in patients with low CD4 cell counts and/or an AIDS‐defining disease.

Methods

We conducted a retrospective, multicentre analysis to investigate discontinuation proportions and virological response in patients with CD4 cell counts < 200 cells/µL and/or AIDS‐defining disease when starting first‐line ART. Proportions of those discontinuing ART were compared using univariate analysis. Virological response was analysed using the Food & Drug Administration (FDA) snapshot analysis (HIV‐1 RNA < 50 HIV‐1 RNA copies/mL at week 48).

Results

Two hundred and eighteen late presenters were included in the study: 13.8% were women and 23.8% were of non‐European ethnicity, and the mean baseline CD4 count was 91 cells/µL (standard deviation 112 cells/µL). A total of 131 late presenters started on INI‐ and 87 on PI‐based treatment. It was found that 86.1% of patients treated with INIs and 81.1% of patients treated with PIs had a viral load < 50 copies/mL at week 48; proportions of discontinuation because of adverse events were 6.1% in the INI group and 11.5% in the PI group. No significant differences in discontinuation proportions were observed at week 12 or 48 between INI‐ and PI‐based regimens (P = 0.76 and 0.52, respectively). Virological response was equally good in those receiving INIs and those receiving PIs (86.1% vs. 81.1%, respectively; P = 0.36).

Conclusions

In a European cohort of late presenters starting first‐line INI or PI‐based ART regimens, there were no significant differences in discontinuation proportions or virological response at week 48.
TESTING PASSIVE VERSUS SYMMETRIC BELIEFS IN CONTRACTING WITH EXTERNALITIES
Authors: Zhang Daiqiang
Published: October 2020

This article provides identification and estimation methods for a model of contracting with externalities and imperfect information. In this model, one principal offers a contract of trade quantity to each of multiple agents, and the negotiated payment for each agent is determined via Nash bargaining. Beliefs matter due to the privacy of bilateral contracting and the externalities from the dependence of each agent's payoff on all agents' trade quantities. We provide a test to determine whether passive or symmetric beliefs fit a given data set better. The empirical results suggest the relevance of adopting the correct beliefs for policy evaluations.
Genomic characteristics revealed by targeted exon sequencing of testicular germ cell tumors in Japanese men
Authors: Matsumoto Takashi , Shiota Masaki , Uchiumi Takeshi , Ueda Shohei , Tsukahara Shigehiro , Toshima Takahiro , Matsumoto Shinya , Noda Nozomi , Eto Masatoshi , Kang Dongchon
Published: October 2020

Objective

To investigate the somatic mutation profiles of testicular germ cell tumors in Japanese men.

Methods

We analyzed the somatic missense mutation profile of testicular germ cell tumors among 21 Japanese men with seminoma (n = 14), pure embryonic carcinoma (n = 3) and mixed testicular germ cell tumor (n = 4) by targeted next‐generation sequencing of 409 cancer‐related genes covering 1.23 Mb of the genome.

Results

We identified a total of 22 missense mutations in 21 primary testicular germ cell tumor samples (0.89 mutations/Mb), of which seven mutations were confirmed to be absent from the germline. KIT:p.Asn822Tyr, KIT:p.Leu576Pro, PIK3CA:p.Glu542Lys and FBXW7:p.Arg505His were statistically and functionally potential. A total of 18 missense mutations were previously unknown in testicular germ cell tumors. PDGFRA amplification from one patient with seminoma was detected. KIT, BCR,PIK3CG, PIK3CA and PDGFRA mutations involved in aberrant signaling of the KIT–PI3K–AKT pathway was detected in 27.3% of detected mutations.

Conclusions

The present investigation identified a low mutation rate in testicular germ cell tumors among Asian patients, 18 novel mutations and PDGFRA amplification. Limitations of the present study are the small sample and missing normal DNA for some testicular germ cell tumors.
Tumor resistance mechanisms and their consequences on γδ T cell activation
Authors: Wesch Daniela , Kabelitz Dieter , Oberg Hans‐Heinrich
Published: October 2020

Human γδ T lymphocytes are predominated by two major subsets, defined by the variable domain of the δ chain. Both, Vδ1 and Vδ2 T cells infiltrate in tumors and have been implicated in cancer immunosurveillance. Since the localization and distribution of tumor‐infiltrating γδ T cell subsets and their impact on survival of cancer patients are not completely defined, this review summarizes the current knowledge about this issue. Different intrinsic tumor resistance mechanisms and immunosuppressive molecules of immune cells in the tumor microenvironment have been reported to negatively influence functional properties of γδ T cell subsets. Here, we focus on selected tumor resistance mechanisms including overexpression of cyclooxygenase (COX)‐2 and indolamine‐2,3‐dioxygenase (IDO)‐1/2, regulation by tumor necrosis factor‐related apoptosis‐inducing ligand (TRAIL)/TRAIL‐R4 pathway and the release of galectins. These inhibitory mechanisms play important roles in the cross‐talk of γδ T cell subsets and tumor cells, thereby influencing cytotoxicity or proliferation of γδ T cells and limiting a successful γδ T cell‐based immunotherapy. Possible future directions of a combined therapy of adoptively transferred γδ T cells together with γδ‐targeting bispecific T cell engagers and COX‐2 or IDO‐1/2 inhibitors or targeting sialoglycan‐Siglec pathways will be discussed and considered as attractive therapeutic options to overcome the immunosuppressive tumor microenvironment.
Costs of a clinical pathway with point‐of‐care testing during influenza epidemic in a Dutch hospital
Authors: Marbus Sierk D. , Lutgens Suzanne P. M. , van Gageldonk‐Lafeber Arianne B. , Hazenberg Eric H. L. C. M. , Hermans Mirjam H. A. , Suijkerbuijk Anita W. M.
Published: October 2020

Our study aim was to determine how a new clinical pathway, including PCR‐based influenza point‐of‐care test (POCT), influences the hospitalisation costs of patients suspected of influenza presenting at the emergency department of a Dutch hospital during two consecutive influenza epidemics (2016‐2017 and 2017‐2018). Compared to mean costs per patient of €3661 in 2016‐2017, the implementation of this new clinical pathway with influenza POCT in 2017 was associated with mean costs per influenza‐positive patient of €2495 in 2017‐2018 (P = .3). Our study suggests favourable economic results regarding a new clinical pathway with influenza POCT, reflecting a more efficient care of patients suspected of influenza presenting at the emergency department.
Factors contributing to reported medication administration incidents in patients’ homes – A text mining analysis
Authors: Härkänen Marja , Franklin Bryony Dean , Murrells Trevor , Rafferty Anne Marie , Vehviläinen‐Julkunen Katri
Published: October 2020

Aims

To describe the characteristics of medication administration (MA) incidents reported to have occurred in patients’ own homes (reporters’ profession, incident types, contributing factors, patient consequence, and most common medications involved) and to identify the connection terms related to the most common contributing factors based on free text descriptions.

Design

A retrospective study using descriptive statistical analysis and text mining.

Methods

Medication administration incidents (N = 19,725) reported to have occurred in patients’ homes between 2013–2018 in one district in Finland were analysed, describing the data by the reporters’ occupation, incident type, contributing factors, and patient consequence. SAS® Text Miner was used to analyse free text descriptions of the MA incidents to understand contributing factors, using concept linking.

Results

Most MA incidents were reported by practical (lower level) nurses (77.8%, N = 15,349). The most common category of harm was ‘mild harm’ (40.1%, N = 7,915) and the most common error type was omissions of drug doses (47.4%, N = 9,343). The medications most commonly described were Marevan [warfarin] (N = 2,668), insulin (N = 811), Furesis [furosemide] (N = 590), antibiotic (N = 446), and Panadol [paracetamol] (N = 416). The contributing factors most commonly reported were ‘communication and flow of information’ (25.5%, N = 5,038), ‘patient and relatives’ (22.6%, N = 4,451), ‘practices’ (9.9%, N = 1,959), ‘education and training’ (4.8%, N = 949), and ‘work environment and resources’ (3.0%, N = 598).

Conclusion

There is need for effective communication and clear responsibilities between home care patients and their relatives and health providers, about MA and its challenges in home environments. Knowledge and skills relating to safe MA are also essential.

Impact

These findings about MA incidents that have occurred in patients’ homes and have been reported by home care professionals demonstrate the need for medication safety improvement in home care.
Down‐regulated HDAC3 elevates microRNA‐495‐3p to restrain epithelial‐mesenchymal transition and oncogenicity of melanoma cells via reducing TRAF5
Authors: Ma Yanbo , Duan Jincheng , Hao Xiuyan
Published: October 2020

MicroRNAs (miRNAs) are emerging biomarkers in biological processes and the role of miR‐495‐3p has been identified in melanoma, while the detailed molecular mechanisms remain to be further explored. We aim to explore the effect of histone deacetylase 3 (HDAC3) and miR‐495‐3p on epithelial‐mesenchymal transition (EMT) and oncogenicity of melanoma cells by regulating tumour necrosis factor receptor‐associated factor 5 (TRAF5). Levels of HDAC3, miR‐495‐3p and TRAF5 in melanoma tissues and pigmented nevus tissues were determined, and the predictive roles of HDAC3 and miR‐495‐3p in prognosis of melanoma patients were measured. The melanoma cells were screened and transfected with relative oligonucleotides and plasmids, and the expression of HDAC3, miR‐495‐3p and TRAF5, and phenotypes of melanoma cells were gauged by a series of assays. The relations between HDAC3 and miR‐495‐3p, and between miR‐495‐3p and TRAF5 were confirmed. HDAC3 and TRAF5 were increased while miR‐495‐3p was decreased in melanoma cells and tissues, and the low expression of miR‐495‐3p as well as high expression of HDAC3 indicated a poor prognosis of melanoma patients. Inhibited HDAC3 elevated miR‐495‐3p to suppress EMT and oncogenicity of melanoma cells by reducing TRAF5. HDAC3 particularly bound to miR‐495‐3p and TRAF5 was the target gene of miR‐495‐3p. Our results revealed that down‐regulated HDAC3 elevates miR‐495‐3p to suppress malignant phenotypes of melanoma cells by inhibiting TRAF5, thereby repressing EMT progression of melanoma cells. This study may provide novel targets for melanoma treatment.
Exosomes mediate an epithelial‐mesenchymal transition cascade in retinal pigment epithelial cells: Implications for proliferative vitreoretinopathy
Authors: Zhang Yao , Wang Kaizhe , Pan Jiabin , Yang Shuai , Yao Haipei , Li Min , Li Hui , Lei Hetian , Jin Haiying , Wang Fang
Published: October 2020

Exosomes have recently emerged as a pivotal mediator of many physiological and pathological processes. However, the role of exosomes in proliferative vitreoretinopathy (PVR) has not been reported. In this study, we aimed to investigate the role of exosomes in PVR. Transforming growth factor beta 2 (TGFß‐2) was used to induce epithelial‐mesenchymal transition (EMT) of retinal pigment epithelial (RPE) cells, as an in vitro model of PVR. Exosomes from normal and EMTed RPE cells were extracted and identified. We incubated extracted exosomes with recipient RPE cells, and co‐cultured EMTed RPE cells and recipient RPE cells in the presence of the exosome inhibitor GW4869. Both experiments suggested that there are further EMT‐promoting effects of exosomes from EMTed RPE cells. MicroRNA sequencing was also performed to identify the miRNA profiles in exosomes from both groups. We identified 34 differentially expressed exosomal miRNAs (P <. 05). Importantly, miR‐543 was found in exosomes from EMTed RPE cells, and miR‐543‐enriched exosomes significantly induced the EMT of recipient RPE cells. Our study demonstrates that exosomal miRNA is differentially expressed in RPE cells during EMT and that these exosomal miRNAs may play pivotal roles in EMT induction. Our results highlight the importance of exosomes as cellular communicators within the microenvironment of PVR.
Peculiar blood flow profiles among placental chorionic villous vessels of an abnormally thick placenta in a case of systemic lupus erythematosus characterized using microvascular imaging
Authors: Inoue Asami , Horinouchi Takashi , Yoshizato Toshiyuki , Kojiro‐Sanada Sakiko , Kozuma Yutaka , Ushijima Kimio
Published: October 2020

We present a patient with systemic lupus erythematosus receiving long‐term steroid therapy, who had myometrial thinning, markedly thickened placenta, and fetal growth restriction (FGR). Blood flow profiles of the myometrium, decidua and placental villous vessels (VV) were described using superb microvascular imaging (SMI) at 35 weeks' gestation. Images showed no decidual blood flow underneath the placenta sitting on a thin myometrium and sparse VV distribution and non‐visualization of peripheral VV flow. Emergency cesarean hysterectomy was performed at 36 weeks. Histological findings showed missing decidua on the thin myometrium, which indicated placenta accreta spectrum, and massive perivillous fibrin deposition and increased numbers of syncytial knots in the placenta. We speculated that the thick placenta and peculiar VV flow profiles resulted from congestion of the intervillous space and intervillous underperfusion/low intraplacental oxygenation, respectively, resulting in FGR. Superb microvascular imaging is useful for diagnosing placenta accreta spectrum and understanding the pathophysiology of thick placenta and FGR.
Pain complications of oral implants: Is that an issue?
Authors: Conti Paulo César Rodrigues , Bonjardim Leonardo Rigoldi , Stuginski‐Barbosa Juliana , Costa Yuri Martins , Svensson Peter
Published: October 2020

The use of oral implants as a form of replacing missing teeth in partial or total edentulous patients is considered the gold standard in oral rehabilitation. Although considered a history of success in contemporary dentistry, surgical complications may occur, as excessive bleeding, damage to the adjacent teeth and mandibular fractures. Persistent pain and abnormal somatosensory responses after the surgery ordinary healing time are also potential problems and may lead to the development of a condition named posttraumatic trigeminal neuropathic pain (PTNP). Though relatively rare, PTNP has a profound impact on patient’s quality of life. Appropriated previous image techniques, effective anaesthetic procedures and caution during the surgical procedure and implant installation are recommended for the prevention of this condition. In case of the PTNP, different management modalities, including antidepressant and membrane stabilizer medications, as well as peripheral strategies, as the use of topical medication and the botulin toxin are presented and discussed.
Women's HIV disclosure to the dentist: Does frequent contact matter?
Authors: Parish Carrigan L. , Feaster Daniel J. , Pereyra Margaret R. , Alcaide Maria L. , Weber Kathleen M. , Cohen Mardge H. , Levin Susanna , Gustafson Deborah , Merenstein Daniel , Aouizerat Bradley E. , Donohue Jessica , Webster‐Cyriaque Jennifer , Wingood Gina , Kempf Mirjam‐Colette , Metsch Lisa R.
Published: October 2020

Objectives

Research has shown inconsistent patterns of patients' HIV serostatus disclosure to their dentists. Common barriers to disclosure have included confidentiality concerns, fear of treatment refusal, and discrimination. This study evaluated the prevalence of HIV serostatus disclosure to the dentist, whether the frequency of dental care utilization is associated with disclosure, and reasons for nondisclosure among women living with HIV.

Methods

We administered a cross‐sectional oral health survey to 1,526 women living with HIV in the Women's Interagency HIV Study including questions regarding HIV serostatus disclosure to dentists. Logistic regression models were used to analyze the association between dental care utilization (at least annually versus less than annually) and HIV serostatus disclosure to dentists.

Results

Overall, 83 percent of women reported that they disclosed their HIV serostatus to their dentist. The most common reasons for nondisclosure were: a) the dentist did not ask, b) believing that the dentist did not need to know, and c) not having a consistent dentist. In the multivariable logistic regression model, at least annual dental care utilization, compared to less than annual, led to a 59 percent reduction in the odds of HIV nondisclosure to the dentist.

Discussion

Study findings highlight that dentists who see their patients infrequently should consider methods for overcoming barriers to HIV nondisclosure and the possibility that their patient's HIV serostatus is undisclosed. Educating women living with HIV about how disclosure to dentists is a critical component of their dental assessment and treatment, and how preventive dental treatment can improve overall health outcomes, is important.
Developmental stages in microbiota, bile acids, and clostridial species in healthy puppies
Authors: Blake Amanda B. , Cigarroa Annalis , Klein Hannah L. , Khattab Mohammad R. , Keating Theresa , Van De Coevering Patti , Lidbury Jonathan A. , Steiner Jörg M. , Suchodolski Jan S.
Published: October 2020

Background

The fecal microbiota, fecal bile acid concentrations, and abundance of Clostridium perfringens and Clostridium difficile are altered in acute and chronic gastrointestinal disease in adult dogs. However, less is known in young puppies.

Hypothesis/Objectives

To determine composition of the fecal microbiota, assess development of fecal bile acid profiles, and determine the abundance of Clostridial species in puppies, young adult dogs, and adult dogs.

Animals

Healthy puppies from a whelping kennel (n = 53) and healthy client‐owned dogs <1 year old (n = 20) were separated into 6 age groups, then compared to client‐owned dogs over 1 year of age (n = 13).

Methods

Prospective observational study. Naturally voided fecal samples were analyzed by quantitative polymerase chain reaction to measure bacterial abundances. Fecal bile acids were quantified using gas chromatography‐mass spectrometry.

Results

Puppies up to 5 to 6 weeks of age had increased Dysbiosis Index (median [min‐max]: 5.39 [1.32‐8.6], P < .001), increased abundance of C. difficile (4.1 [0.01‐4.85] log DNA, P < .001), decreased secondary bile acid concentrations (0.61 [0.28‐5.06] μg/mg, P = .006), and decreased abundance of C. hiranonis (0.84 [0.01‐6.71], P = .005) compared to adult dogs (−4.62 [−8.36 to −0.61], 0.01 [0.01‐0.01], 4.12 [0.32‐8.94], and 6.02 [5.06‐7.00], respectively). Secondary bile acid concentration positively correlated with C. hiranonis abundance (ρ = 0.77; P < .001).

Conclusions and Clinical Importance

The increase in secondary bile acids and simultaneous decrease of C. difficile and C. perfringens after 5 to 6 weeks of age warrants further investigation into regulatory impacts that secondary bile acids could have on clostridial species in dogs.
Impatiens bakthangensis sp. nov. (Balsaminaceae): a new species from Sikkim, India
Authors: Gogoi Rajib , Sherpa Norbu , Chhetri Geetamani
Published: October 2020

Impatiens bakthangensis sp. nov. a new species of Impatiens is described from the Bakthang area of Gangtok, East district of Sikkim (northeast India). With its distinctly bucciniform lower sepals, the new species is similar to I. duclouxii and I. discolor with which it has previously been confused, but differs in several floral characters. Detailed descriptions, distribution and discussion of ecology are provided, along with colour photographs.
A Promised Value Approach to Optimal Monetary Policy*
Authors: Hills Timothy , Nakata Taisuke , Sunakawa Takeki
Published: October 2020

This paper characterizes optimal commitment policy in the New Keynesian model using a recursive formulation of the central bank's infinite‐horizon optimization problem in which promised inflation and output gap – as opposed to lagged Lagrange multipliers – act as pseudo‐state variables. Our recursive formulation is motivated by (Kydland, F. and Prescott, E. C. (1980). Journal of Economic Dynamics and Control Vol. 2, pp. 79–91). Using three well‐known variants of the model – one featuring inflation bias, one featuring stabilization bias and one featuring a lower bound constraint on nominal interest rates – we show that the proposed formulation sheds new light on the nature of the intertemporal trade‐off facing the central bank.
Cardiac sympathetic activation and parasympathetic withdrawal during psychosocial stress exposure in 6‐month‐old infants
Authors: Ritz Thomas , Schulz Stefan M. , Rosenfield David , Wright Rosalind J. , Bosquet Enlow Michelle
Published: October 2020

Infant autonomic reactivity to stress is a potential predictor of later life health complications, but research has not sufficiently examined sympathetic activity, controlled for effects of physical activity and respiration, or studied associations among autonomic adjustments, cardiac activity, and affect in infants. We studied 278 infants during the repeated Still‐Face Paradigm, a standardized stressor, while monitoring cardiac activity (ECG) and respiratory pattern (respiratory inductance plethysmography). Video ratings of physical activity and affect were also performed. Respiratory sinus arrhythmia (RSA) and T‐wave amplitude (TWA) served as noninvasive indicators of cardiac parasympathetic and sympathetic activity, respectively. Responses were compared between infants who completed two still‐face exposures and those who terminated after one exposure due to visible distress. Findings, controlled for physical activity, showed robust reductions in respiration‐adjusted RSA and TWA, with more tonic attenuation of TWA. Infants completing only one still‐face trial showed more pronounced autonomic changes and less recovery from stress. They also showed elevated minute ventilation, suggesting hyperventilation. Both reductions in adjusted RSA and TWA contributed equally to heart rate changes and were associated with higher negative and lower positive affect. These associations were more robust in the group of distressed infants unable to complete both still‐face trials. Thus, cardiac sympathetic activation and parasympathetic withdrawal are part of the infant stress response, beyond associated physical activity and respiration changes. Their association with cardiac chronotropy and affect increases as infants' distress level increases. This excess reactivity to social stress should be examined as a predictor of future cardiovascular disease.
Cyberbullying and cybervictimization among preadolescents: Does time perspective matter?
Authors: Longobardi Claudio , Gullotta Giulia , Ferrigno Serena , Jungert Tomas , Thornberg Robert , Settanni Michele
Published: October 2020

Time perspective has been recognized as an important psychological dimension with a pervasive and powerful influence on human behavior. To the authors’ knowledge, no studies have focused on the relationship between time perspective and cyberbullying behavior. The first aim of this research is to fill this gap by investigating the relationship between different time perspectives and both cyberbullying and cybervictimization among 6th to 8th grade students. The second objective was to investigate the relationship between time perspective, cyberbullying behaviors, peer problems, and the quality of relationship with teachers. A sample consisting of 403 students aged between 11 and 14 years from Italian middle schools (56% females, mean age = 12.2 years) were recruited. Participants filled in a self‐report questionnaire measuring cyberbullying and cybervictimization as well as the Time Perspective questionnaire. The analyses showed the presence of significant correlations between time perspective and both cyberbullying and cybervictimization. In particular, cybervictimization showed a quite large positive correlation with a past‐negative orientation and a negative correlation with past‐positive orientation. Instead, the involvement in active cyberbullying was positively correlated with a past‐negative orientation and negatively correlated with future orientation. The findings advance the understanding of psychological factors influencing cyberbullying during early adolescence and suggest the importance of past‐positive and past‐negative orientations in accounting for both active cyberbullying and cybervictimization. As expected, future orientation appeared to represent a protective factor against involvement in cyberbullying behaviors.
False‐negative solid‐phase platelet crossmatch results due to prozone phenomenon
Authors: Horton Rachel K. , Zuccarelli Micah D. , Wakefield Laurie L. , DiGuardo Margaret A. , Gandhi Manish J. , Juskewitch Justin E.
Published: October 2020

Background

Prozone is a known phenomenon affecting immunoassays causing falsely low or negative results when excess target is present in the test system. For assays used to evaluate immune‐mediated platelet (PLT) transfusion refractoriness, prozone‐like phenomenon has been described in solid‐phase human leukocyte antigen (HLA) antibody testing and can be mitigated by diluting samples or pretreating samples with ethylenediaminetetraacetic acid (EDTA) or dithiothreitol. Prozone phenomenon has not yet been described in solid‐phase red blood cell (RBC) adherence PLT crossmatch assays.

Case Report

A 40‐year‐old female with myeloid sarcoma and PLT transfusion refractoriness underwent repeated solid‐phase PLT crossmatches; however, crossmatch‐compatible PLTs units did not yield adequate PLT count responses. Class I HLA antibody testing with neat, diluted, and EDTA‐pretreated serum demonstrated significant prozone‐like effect and the presence of numerous high strength HLA antibodies. Based on this HLA antibody profile, HLA antigen–negative PLTs gave an adequate PLT count response. It was noted that the HLA types of her crossmatch‐compatible PLTs were incompatible with her HLA antibody profile (eg, HLA‐A2). With ABO‐identical, HLA‐A2–positive PLT units, a solid‐phase PLT crossmatch was repeated using undiluted and diluted EDTA plasma. Undiluted EDTA plasma demonstrated negative or weakly positive PLT crossmatches while the diluted EDTA plasma demonstrated strongly positive PLT crossmatches.

Conclusion

The prozone phenomenon can cause false‐negative results in solid‐phase RBC adherence PLT crossmatch assays, which can be mitigated with sample dilution. In immune‐mediated PLT transfusion–refractory patients with high‐strength HLA antibodies, sample dilution should be considered to correctly identify compatible PLT inventory.
The effects of services trade policies. Introduction to the special issue
Authors: Egger Peter H. , Schwarzer Johannes
Published: October 2020

This is the introduction to the special issue on services trade policy.
Stent-Induced Vascular Remodeling in Two-Step Stent-Assisted Coiling Treatment of Brain Aneurysms: A Closer Look Into the Hemodynamic Changes During the Stent Healing Period
Authors: Santos Gabriel B. , Oliveira Iago , Gasche José L. , Militzer Julio , Baccin Carlos E.
Published: October 2020

Stenting has become an important adjunctive tool for assisting coil embolization in complex-shaped intracranial aneurysms. However, as a secondary effect, stent deployment has been related to both immediate and delayed remodeling of the local vasculature. Recent studies have demonstrated that this phenomenon may assume different roles depending on the treatment stage. However, the extent of such event on the intra-aneurysmal hemodynamics is still unclear; especially when performing two-step stent-assisted coiling (SAC). Therefore, we performed computational fluid dynamics (CFD) analysis of the blood flow in four bifurcation aneurysms focusing on the stent healing period found in SAC as a two-step maneuver. Our results show that by changing the local vasculature, the intra-aneurysmal hemodynamics changes considerably. However, even though changes do occur, they were not consistent among the cases. Furthermore, by changing the local vasculature not only the shear levels change but also the shear distribution on the aneurysm surface. Additionally, a geometric analysis alone can mislead the estimation of the novel hemodynamic environment after vascular remodeling, especially in the presence of mixing streams. Therefore, although the novel local vasculature might induce an improved hemodynamic environment, it is also plausible to expect that adverse hemodynamic conditions might occur. This could pose a particularly delicate condition since the aneurysm surface remains completely exposed to the novel hemodynamic environment during the stent healing period. Finally, our study emphasizes that vascular remodeling should be considered when assessing the hemodynamics in aneurysms treated with stents, especially when evaluating the earlier stages of the treatment process.
An Inertant Elastic Metamaterial Plate With Extra Wide Low-Frequency Flexural Band Gaps
Authors: Fang Xiang , Chuang Kuo-Chih , Jin Xiao-Ling , Wang Dan-Feng , Huang Zhi-Long
Published: October 2020

Arranging inerter arrays in designing metamaterials can achieve low-frequency vibration suppression even with a small configuration mass. In this work, we investigate flexural wave bandgap properties of an elastic metamaterial plate with periodic arrays of inerter-based dynamic vibration absorbers (IDVAs). By extending the plane wave expansion (PWE) method, the inertant elastic metamaterial plate is explicitly formulated in which the interactions of the attached IDVAs and the host plate are considered. Due to the additional degree-of-freedom induced by each IDVA, multiple band gaps are obtained. Along the ΓX direction, the inertant elastic metamaterial plate exhibits two locally resonant (LR) band gaps and one Bragg (BG) band gap. In contrast, along the ΓM direction, two adjacent LR band gaps are obtained. Detailed parametric analyses are conducted to investigate the relationships between the flexural wave bandgap properties and the structural inertant parameters. With a dissipative mechanism added to the IDVAs, extremely wide band gaps in different directions can be further generated. Finally, by adopting an effective added mass technique in the finite element method, displacement transmission and vibration modes of a finite inertant elastic metamaterial plate are obtained. Our investigation indicates that the proposed inertant elastic metamaterial plate has extra-wide low-frequency flexural band gaps and therefore has potential applications in engineering vibration prohibition.
Decentralized PID Controller Design for SOFC-GT
Authors: Emami Tooran , Tsai Alex , Tucker David
Published: October 2020

This paper presents a performance of a 300 kW Solid Oxide Fuel Cell Gas Turbine (SOFC-GT) pilot power plant simulator under an area of selection of the Proportional Integral Derivative (PID) controller coefficients that satisfies the stability, gain and phase margins. The performance of turbine speed and the fuel cell mass flow rate is controlled by the set of PID controller coefficients from this area. The input to the subsystems power plant are the electric load and cold air valve. The decentralized controllers are designed for each subsystems performance individually as a Single Input Single Output (SISO) system. Two of subsystem plants are the transfer functions of turbine speed over the electric load and the cold air valve. The other two subsystem plants are the transfer functions of fuel cell mass flow rate over the electric load and the cold air bypass valve. The flexibility to have an area to select PID controller coefficients is beneficial to SOFC-GT plant due to the wide range of operations and internal parameter interactions. Designing the PID controller for the specific phase and gain margins increase the reliability and robustness of the SOFC-GT with multiple uncertain parameters. The practical implementation of this methodology is presented through the software environment.
Comparison of Trapezoidal Secondary Reflectors of a Linear Fresnel Reflector
Authors: López-Núñez Oscar A. , Alfaro-Ayala J. Arturo , Ramírez-Minguela J. J. , Crespo-Quintanilla Jesus A.
Published: October 2020

The Linear Fresnel Reflector (LFR) is a promising solar concentrating technology because of its simple design and its low cost compared with others concentrating solar technologies. There are different geometrical parameters that can affect the performance of the LFR specially in the trapezoidal secondary reflector. In this work, a comparison between four different geometries of the secondary reflector of an LFR by means of Computational Fluid Dynamics (Ansys Fluent®) is carried out. It is taking into account the variation of the tilt angle of 45°, 50°, 60° and 70° in the trapezoidal geometry with a constant aperture and a constant height. The comparison is made in terms of the absorbed radiation flux in the absorber tube and the entropy generation rate in a global and local way considering an LFR with 25 mirrors. The entropy generation rate considers the phenomena of viscous dissipation, heat transfer and radiation by means of a user-defined function. The trapezoidal geometry of 60° presents an absorbed radiation flux value of 4085.9 W/m2 with a total entropy generation rate of 0.043 W/K with a thermal efficiency value of 0.284. The results of this CFD model can be applied to obtain a better performance of LFRs.