bluuebunny/crossref_metadata_2025 huggingface dataset:
Colorectal cancer screening program using FIT: quality of colonoscopy varies according to hospital type
Authors: Portillo Isabel , Idigoras Isabel , Bilbao Isabel , Arana-Arri Eunate , Fernández-Landa María José , Hurtado Jose Luis , Sarasaqueta Cristina , Bujanda Luis ,   for the EUSKOLON study investigators
Published: May 2019

Background and study aims To compare the quality of colonoscopy in a population-based coordinated program of colorectal cancer screening according to type of hospital (academic or non-academic).

Patients and methods Consecutive patients undergoing colonoscopy after positive FIT (≥ 20 ug Hb/g feces) between January 2009 and September 2016 were prospectively included at five academic and seven non-academic public hospitals. Screening colonoscopy quality indicators considered were adenoma detection rate, cecal intubation rate, complications and bowel preparation quality.

Results A total of 48,759 patients underwent colonoscopy, 34,616 (80 %) in academic hospitals and 14,143 in non-academic hospitals. Among these cases, 19,942 (37.1 %) advanced adenomas and 2,607 (5.3 %) colorectal cancers (CRCs) were detected, representing a total of 22,549 (46.2 %) cases of advanced neoplasia. The adenoma detection rate was 64 %, 63.1 % in academic hospitals and 66.4 % in non-academic hospitals (P < 0.001). Rates of advanced adenoma detection, cecal intubation and adequate colonic preparation were 45.8 %, 96.2 % and 88.3 %, respectively, and in all cases were lower (implying worse quality care) in academic hospitals (45.3 % vs 48.7 %; odds ratio [OR] 0.87, 95 % confidence interval [CI] 0.84 – 0.91; 95.9 % vs 97 %; OR 0.48, 95 % CI 0.38 – 0.69; and 86.4 % vs 93 %; OR 0.48, 95 % CI 0.45 – 0.5; respectively; P < 0.001 in all cases). In 13 patients, all in the academic hospital group, CRC was diagnosed after colonoscopy (0.26 cases × 1000 colonoscopies). Rates of CRC treated by endoscopy were similar in both types of hospital (30 %). The rate of severe complication was 1.2 % (602 patients), with no significant differences by hospital type: bleeding occurred in 1/147 colonoscopies and perforation in 1/329. One patient died within 30 days after screening colonoscopy.

Conclusions The quality of colonoscopy was better in non-academic hospitals. The rate of detection of advanced neoplasia was higher in non-academic hospitals and correlated with the rate of post-colonoscopy CRC.
Peroral cholangioscopy by SpyGlass DS versus CHF-B260 for evaluation of the lateral spread of extrahepatic cholangiocarcinoma
Authors: Kanno Yoshihide , Koshita Shinsuke , Ogawa Takahisa , Masu Kaori , Kusunose Hiroaki , Sakai Toshitaka , Murabayashi Toji , Haegawa Sho , Kozakai Fumisato , Yonamine Keisuke , Kawakami Yujiro , Fujii Yuki , Horaguchi Jun , Noda Yutaka , Ito Kei
Published: May 2019

Background and study aims A newly developed peroral cholangioscopy (POCS) system, SpyGlassDS has high maneuverability. This study aimed to evaluate acceptability of the accuracy of SpyGlassDS accompanied by simultaneous POCS-guided biopsy compared with that of a traditional POCS scope, CHF-B260, to diagnose the lateral extent of extrahepatic cholangiocarcinoma (LEC).

Patients and methods Patients who underwent surgical resection after preoperative examinations to diagnose LEC were evaluated. POCS by CHF-B260 was performed if there was discrepancy between preceding fluoroscopy-guided biopsy findings and other examinations between January 2004 and September 2015 (group A, n = 56); and POCS plus POCS-guided mapping biopsy by SpyGlassDS was performed in all surgical candidates between October 2015 and December 2017 (group B, n = 20). The main outcome measure was the accuracy of overall preoperative diagnosis (OPD) of LEC defined based on all examinations, including POCS.

Results Accuracy of OPD for the liver side and the ampullary side was 93 % and 100 %, respectively, in group A, and 84 % and 100 %, respectively, in group B (P = 0.37 for the liver side; P, not available for the ampullary side). Diagnostic accuracy of simple optical evaluation by POCS for the liver side and the ampullary side was 83 % and 100 %, respectively, in group A, and 58 % and 88 %, respectively, in group B (P = 0.29 for the liver side; P = 0.40 for the ampullary side).

Conclusions POCS by SpyGlassDS was found to be acceptable and could be a standard approach for diagnosis of LEC.
Long-term outcomes of metachronous neoplasms in the ileal pouch and rectum after surgical treatment in patients with familial adenomatous polyposis
Authors: Tajika Masahiro , Tanaka Tsutomu , Ishihara Makoto , Hirayama Yutaka , Oonishi Sachiyo , Mizuno Nobumasa , Kuwahara Takamichi , Okuno Nozomi , Matsumoto Shinpei , Ooshiro Taihei , Kinoshita Takashi , Komori Koji , Bhatia Vikram , Hara Kazuo , Yatabe Yasushi , Niwa Yasumasa
Published: May 2019

Background and study aims Restorative proctocolectomy has become the most common surgical option for patients with familial adenomatous polyposis (FAP). However, adenomas and even carcinomas may develop in the ileal pouch over time. The aim of this study was to evaluate the long-term incidence and nature of ileal pouch or distal ileal adenomas and carcinomas in patients with FAP.

Patients and methods This was a retrospective study of 47 FAP patients with Kock’s continent ileostomy (Kock) (n = 8), ileorectal anastomosis (IRA) (n = 13), and ileal pouch-anal anastomosis (IPAA) (n = 26). Patients were followed with a standardized protocol including chromoendoscopy and biopsies of visible polyps in the ileal pouch, distal ileum, and rectum every 6 to 12 months.

Results Median follow-up was 21.0 years. Overall risk of adenoma development was significantly higher in IRA patients, with incidence rates of 85 % and 100 % at 5 and 10 years’ follow-up, respectively, compared to pouch patients (Kock + IPAA) (P < 0.001). However, there was also a high frequency of adenomas in the ileal pouch mucosa, with rates of 12 %, 33 %, and 68 %, at 5, 10, and 20 years of follow-up, respectively. Maximum size of ileal pouch adenomas was significantly related to time since surgery (P = 0.0214). Six cases of advanced adenomas including two cases of adenocarcinomas developed in the ileal pouch mucosa.

Conclusions There is a significant incidence of adenoma(s) in the ileal pouch of FAP patients on long-term follow-up. Regular endoscopic surveillance is recommended, not only in IRA patients, but also in pouch patients after proctocolectomy.
Biomechanics of Upper Extremity Double Plating
Authors: Michel Philipp A. , Katthagen J. Christoph , Heilmann Lukas F. , Dyrna Felix , Schliemann Benedikt , Raschke Michael J.
Published: May 2019

Double plating (DP) is an established treatment modality in traumatology. For certain indications, such as open reduction and internal fixation of bicondylar tibial plateau fractures and distal humeral fractures, DP is standard of care in the clinical routine. However, the principles of DP can be transferred to other anatomic regions and indications. In the past years, DP has been brought more and more into focus. For revision cases, such as the treatment of fracture non-unions, DP seems generally useful. In anatomical locations with high torsional stress and bending forces, but also in regions with traction forces by muscles and tendons DP provides multiplanar stability and therefore seems to have biomechanical advantages. Usually two smaller implants can replace one larger implant. Thus, the number of points of fixation can be increased, the stability can be improved and soft-tissue irritations by bulky implants can be minimized. Along with the established indication and application at the distal humerus, there is biomechanical evidence in the current literature for DP of clavicle fractures and humeral shaft fractures. Furthermore, DP provides mechanical advantages in the treatment of certain proximal humeral fractures and olecranon fractures. This review of the literature summarizes the published literature on biomechanics of upper extremity DP.
Rechtliche Grenzen des (Online-) Marketings für Ärzte
Authors: Petersilie Frank
Published: May 2019

Das Online-Marketing von Ärztinnen und Ärzten muss sich an denselben werberechtlichen Regelungen wie konventionelles Marketing messen lassen. Hier sind v. a. die ärztliche Berufsordnung, das Heilmittelwerbegesetz und das Gesetz gegen unlauteren Wettbewerb relevant. Im Bereich des Online-Marketing kommen insbesondere noch daten- und persönlichkeitsrechtliche Aspekte hinzu. Trotz zunehmender Liberalisierungstendenzen gibt es nach wie vor nicht unerhebliche werberechtliche Grenzen, die in diesem Beitrag skizziert werden. Die relativ hohe Zahl der zitierten aktuellen Gerichtsurteile zeigt zudem, dass es zu allen Regelungen noch klärungsbedürftige Fragen gibt, die auch durch die oftmals sehr einzelfallbezogenen Urteile nicht immer abschließend beantwortet worden sind. Gleichwohl kann man festhalten, dass die rechtlichen Grenzen ärztlichen Marketings nie weiter waren als jetzt.
Head and Neck Reconstruction: Does Surgical Specialty Affect Complication Rates?
Authors: Drinane James J. , Drinane John , Nair Lakshmi , Patel Ashit
Published: May 2019

Background Reconstruction of head and neck defects resulting from resection of head and neck masses is performed by both plastic surgeons and otolaryngologists. The American College of Surgeons National Surgical Quality Improvement (NSQIP) database allows one to directly compare the outcomes for a given procedure based upon specialty. The purpose of this study is to compare outcomes and resource utilization of microvascular head and neck reconstruction between plastic surgery and otolaryngology.

Methods Institutional review board approval was obtained and NSQIP was queried from 2005 to 2015 with inclusion of Current Procedural Terminology codes for free tissue transfer performed for head and neck reconstruction. Outcomes were compared between cases having otolaryngology and plastic surgery as performing the free flap reconstruction.

Results During 2005 to 2015, a total of 2,322 flaps were performed, 893 by plastic surgery and 1,429 by otolaryngology. Average length of stay (LOS) was 13.7 and 11.4 days for plastic surgery and otolaryngology, respectively. It was found that plastic surgery performed more osteocutaneous flaps than otolaryngology. Higher rates of superficial surgical site infection, deep surgical site infections, wound dehiscence, myocardial infarction, bleeding complications, sepsis, unplanned return to the operating room, and unplanned readmission were observed for patients treated by otolaryngology (p < 0.05).

Conclusion This study shows plastic surgery patients have superior outcomes with regards to free tissue transfers of the head and neck when compared with otolaryngology patients. Although plastic surgery patients experienced a longer LOS, the significantly lower complication rate supports an overall more optimal resource utilization. Future studies may elucidate potential cost savings in patients treated by plastic surgery.
Subacute-Onset Afferent Ataxia in Childhood: A Case Report
Authors: Cecchin Vanessa , Pellegrin Serena , Parmeggiani Lucio , Pescollderungg Lydia , Mercolini Federico
Published: May 2019

Acute or subacute ataxia in young children is rare and, in most cases, the diagnosis of the underlying etiology can be challenging. An extensive number of possible causes must be considered when approaching a child with ataxia. We report the case of a 21-month-old girl with subacute-onset rapidly progressive ataxia, occurring few days after a gastrointestinal infection, without clear reduction of muscle strength in the limbs or other neurological signs. The development of a mild hyporeflexia of the lower limbs, thereafter, led to the suspicion of a Guillain–Barré syndrome (GBS) that was confirmed by appropriate investigations. This case confirms that a subacute afferent ataxia can be the main clinical symptom of GBS in young children, in whom this disease is rare and the diagnosis more challenging. Attention must be paid to the presence of other neurological signs that can lead to the diagnosis.
Democracy matters: a psychological perspective on the beneficial impact of democratic punishment systems in social dilemmas
Authors: Kesberg Rebekka , Pfattheicher Stefan
Published: May 2019

The implementation of punishment has proven a prominent solution to prevent the breakdown of cooperation in social dilemma situations. In fact, numerous studies show that punishment possibilities are effective in maintaining cooperative behavior. However, punishment is often not efficient in terms (a) of monetary benefits and in light of the fact (b) that punishment of cooperators (i.e., antisocial punishment) can occur. Still, recent research revealed that individuals vote for the implementation of such punishment systems. We address this contradiction by proposing that the benefits of democratic punishment systems in particular cannot be solely captured by monetary outcomes. Instead, the implementation of democratic punishment systems may enhance the psychological benefits of justice perceptions, satisfaction, and trust. Using iterated public goods games, the findings of the present study reveal not only higher cooperation levels and total payoffs in two different democratic punishment systems compared to other systems, but also higher justice perception, satisfaction, and trust. Furthermore, participants indicated the highest willingness to continue interactions in democratic punishment systems. Moreover, satisfaction, not monetary outcomes, was the best predictor of participants’ willingness to stay in a system. Therefore, we argue that the efficiency of democratic punishment systems cannot be measured solely in monetary outcomes but that psychological benefits must be considered.
The twenty-first century experimenting society: the four waves of the evidence revolution
Authors: White Howard
Published: May 2019

This paper presents a personal perspective–drawing especially on the author’s experience in international development—of the evidence revolution, which has unfolded in fours waves over the last 30 years: (1) the results agenda as part of New Public Management in the 1990s, (2) the rise of impact evaluations, notably randomized controlled trials (RCTs) since the early 2000s, (3) increased production of systematic reviews over the last ten years, and (4) moves to institutionalize the use of evidence through the emergence of knowledge brokering agencies, most notably the What Works movement in the United States and the United Kingdom. A fifth wave may come from the potential from AI, machine learning and Big Data. Each successive wave has built on the last, and together they comprise the supply side of the evidence architecture. To support the use of evidence demand side activities such as Evidence Needs Assessments and Use of Evidence Awards are proposed.
The principle of coaxial transmission line pulse transformer and square-wave response of it
Authors: Fan Xu-liang , Liu Sheng , Pan Ya-feng , Fan Hong-yan
Published: May 2019

Transmission line pulse transformers have been widely used in pulsed power technology. Traditional transmission line pulse transformers often use separate structures, which always introduces larger spurious parameters, and have lower voltage levels. In order to solve these problems, this note proposes a coaxial transmission line pulse transformer. A circular symmetric structure is used in the input and output ports of the coaxial transmission line pulse transformer, and there are no spurious parameters theoretically. Furthermore, this structure is suitable for hundreds of kilovolts high voltage applications. The structure and working principle of the coaxial transmission line pulse transformer are introduced in this note, and the circuit simulation research is conducted. The factors that affect the pulse transformation are analyzed. Furthermore, experimental studies of the square wave impulse response are conducted on an actual device. The result shows that the proposed coaxial transmission line pulse transformer can achieve the purpose of increasing the voltage amplitude while keeping the pulse waveform undistorted.
The Korteweg-de Vries equation on an interval
Authors: Himonas A. Alexandrou , Mantzavinos Dionyssios , Yan Fangchi
Published: May 2019

The initial-boundary value problem (IBVP) for the Korteweg-de Vries (KdV) equation on an interval is studied by extending a novel approach recently developed for the well-posedness of the KdV on the half-line, which is based on the solution formula produced via Fokas’ unified transform method for the associated forced linear IBVP. Replacing in this formula the forcing by the nonlinearity and using data in Sobolev spaces suggested by the space-time regularity of the Cauchy problem of the linear KdV gives an iteration map for the IBVP which is shown to be a contraction in an appropriately chosen solution space. The proof relies on key linear estimates and a bilinear estimate similar to the one used for the KdV Cauchy problem by Kenig, Ponce, and Vega.
Experimental study of energy transfer in double shell implosions
Authors: Merritt E. C. , Sauppe J. P. , Loomis E. N. , Cardenas T. , Montgomery D. S. , Daughton W. S. , Wilson D. C. , Kline J. L. , Khan S. F. , Schoff M. , Hoppe M. , Fierro F. , Randolph R. B. , Patterson B. , Kuettner L. , Sacks R. F. , Dodd E. S. , Wan W. C. , Palaniyappan S. , Batha S. H. , Keiter P. A. , Rygg J. R. , Smalyuk V. , Ping Y. , Amendt P.
Published: May 2019

Advances in target fabrication have made double shell capsule implosions a viable platform to study burning fusion plasmas. Central to the double shell capsule is a high-Z (e.g., Au) metal pusher that accesses the volume-burn regime by reducing radiative losses through radiation trapping and compressing a uniform fuel volume at reduced velocities. A double shell implosion relies on a series of energy transfer processes starting from x-ray absorption by the outer shell, followed by transfer of kinetic energy to an inner shell, and finally conversion of kinetic energy to fuel internal energy. We present simulation and experimental results on momentum transfer to different layers in a double shell. We also present the details of the development of the NIF cylindrical hohlraum double shell platform including an imaging shell design with a mid-Z inner shell necessary for imaging the inner shell shape and the trajectory with the current 2DConA platform capability. We examine 1D energy transfer between shell layers using trajectory measurements from a series of surrogate targets; the series builds to a complete double shell layer by layer, isolating the physics of each step of the energy transfer process. The measured energy transfer to the foam cushion and the inner shell suggests that our radiation-hydrodynamics simulations capture most of the relevant collision physics. With a 1 MJ laser drive, the experimental data indicate that 22% ± 3% of the ablator kinetic energy couples into inner shell KE, compared to a 27% ± 2% coupling in our xRAGE simulations. Thus, our xRAGE simulations match experimental energy transfer to ∼5%, without inclusion of higher order 2D and 3D effects.
In situ detection of hot-electron-induced photocatalytic reduction using Au@Ag, Au@Ag2S, and Au@SiO2 core-shell nanoparticles
Authors: Zhang Kaixuan , Xu Na , Jia Mengyu , Li Ruoping , Huang Mingju
Published: May 2019

Noble-metal-based surface-enhanced Raman spectroscopy (SERS) substrates can be employed as catalysts capable of generating hot electrons to drive chemical reactions of target molecules adsorbed on their surface. However, the localized surface plasmons excited from pure noble metals generally exhibit relatively low hot-electron utilization efficiency with the reactants owing to charge carrier recombination. This problem can be solved by integrating heterogeneous structures with the noble metal. Herein, we describe the fabrication of bifunctional SERS substrates by constructing Au@Ag, Au@Ag2S, and Au@SiO2 core-shell nanoparticles and evaluate the effects of the three heterostructures (Au cores encapsulated by shells composed of metal, semiconductor, or insulator) on the hot-electron transfer efficiency by in situ monitoring of the catalytic dimerization of p-nitrophenol to form p,p′-dimercaptoazobenzene under 632.8 nm laser illumination. The developed SERS strategy opens up new opportunities for exploring hot-electron-induced reactions as well as providing a useful reference for photocatalyst selection.
Optical chimera in light polarization
Authors: Uy Chi-Hak , Weicker Lionel , Rontani Damien , Sciamanna Marc
Published: May 2019

Light polarization is an inherent property of the coherent laser output that finds applications, for example, in vision, imaging, spectroscopy, cosmology, and communications. We report here on light polarization dynamics that repeatedly switches between a stationary state of polarization and an irregularly pulsating polarization. The reported dynamics is found to result from the onset of chimeras. Chimeras in nonlinear science refer to the counterintuitive coexistence of coherent and incoherent dynamics in an initially homogeneous network of coupled nonlinear oscillators. The existence of chimera states has been evidenced only recently in carefully designed experiments using either mechanical, optomechanical, electrical, or optical oscillators. Interestingly, the chimeras reported here originate from the inherent coherent properties of a commercial laser diode. The spatial and temporal properties of the chimeras found in light polarization are controlled by the laser diode and feedback parameters, leading, e.g., to multistability between chimeras with multiple heads and to turbulent chimeras.
Multiple non-diffracting beams by reflective surface based on admittance superposition
Authors: Liu Dawei , Guo Shaohui , Wu Jiawen , Yang Wenfeng
Published: May 2019

A method to produce multiple nondiffracting beams by a reflective metasurface is introduced. The reflective metasurface is realized by admittance superposition modulation. Only one artificial admittance surface can generate a single nondiffracting beam. The admittance superposition of multiple surfaces will produce multiple beams, which can propagate in different directions with good nondiffracting properties. Finally, the metasurface is fabricated and experimentally tested, and the results demonstrate that the design is logical. The multiple nondiffracting beams may have potential applications in imaging, multipoint communications, and object detection and identification.
Electron paramagnetic resonance centers and defects in β-Ga2O3
Authors: Kish Stacy W.
Published: May 2019

New experimental and theoretical study of electron paramagnetic resonance centers and defect configurations in β-Ga 2 O 3 .
Artifact-free method of measuring spin-orbit torque
Authors: Johnson-Groh Mara
Published: May 2019

A new study discovers how to measure spin-orbit torque free from artifacts by utilizing photoelastic modulation and balanced detection.
Pulsed laser module based on a high-power semiconductor laser for the spectral range 1500 – 1600 nm
Authors: Bobretsova Yu.K. , Veselov D.A. , Voronkova N.V. , Slipchenko S.O. , Strelets V.A. , Bogdanovich M.V. , Shpak P.V. , Ladugin M.A. , Marmalyuk A.A. , Pikhtin N.A.
Published: May 2019

A laser source for bleaching passive Q-switches of erbium-ytterbium lasers is developed and studied. The developed and studied compact pulsed module (peak power exceeding 10 W in a pulse with a duration of 1 μs at a wavelength around 1550 nm) is made on the basis of a semiconductor lasers with an ultra-narrow waveguide integrated with a pulsed pump card. To optimise the output laser characteristics, a series resistance was used in the laser pump circuit. The powers of the free-space and fibre-coupled modules at a temperature of 25 °C are 15 and 12 W, respectively, at a pulse shape close to rectangular.
Australian Forest Woods
Authors: Lake Morris
Published: May 2019

Australian Forest Woods describes about 130 of the most significant Australian forest trees and their wood. The introductory sections introduce the reader to the uniqueness and usefulness of forest trees. The book examines the forest tree species and their wood with photographs, botanical descriptions and a summary of the characteristics of the wood. A section on wood identification includes fundamental information on tree growth and wood structure.
With over 900 images, this is the most comprehensive guide ever written on Australian forest woods, both for the amateur and the professional wood enthusiast. Macrophotographs of the wood are shown in association with a physical description of wood characteristics, which will aid identification. This technique was developed by Jean-Claude Cerre, France, and his macrophotographs are included in the book.
Finding Resilience
Authors: Walker Brian
Published: May 2019

Floods, fires, famines, epidemics and disasters of all kinds are on the increase, and as their frequency rises so does the call for greater resilience. But what does that mean? The word is used differently in psychology, ecology, economics and engineering and runs the risk of becoming meaningless jargon. This would be most unfortunate because, if we are to successfully navigate very real and dangerous global trends, it is resilience that needs to be understood and fostered.
Finding Resilience is international in scope and unravels how ecosystems, societies and people cope with disturbance and adversity. An authoritative but plain English account which is based on the experiences of researchers, the fascinating stories from around the world reveal what resilience is, how it works in different kinds of systems, how it is expressed, and how it can be gained and lost.
Comparative transcriptome analysis reveals unique genetic adaptations conferring salt tolerance in a xerohalophyte
Authors: Chai Wei-Wei , Wang Wen-Ying , Ma Qing , Yin Hong-Ju , Hepworth Shelley R. , Wang Suo-Min
Published: May 2019

Most studies on salt tolerance in plants have been conducted using glycophytes like Arabidopsis thaliana (L.) Heynh., with limited resistance to salinity. The xerohalophyte Zygophyllum xanthoxylum (Bunge) Engl. is a salt-accumulating desert plant that efficiently transports Na+ into vacuoles to manage salt and exhibits increased growth under salinity conditions, suggesting a unique transcriptional response compared with glycophytes. We used transcriptome profiling by RNA-seq to compare gene expression in roots of Z. xanthoxylum and A. thaliana under 50 mM NaCl treatments. Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) metabolic pathway analysis suggested that 50 mM NaCl was perceived as a stimulus for Z. xanthoxylum whereas a stress for A. thaliana. Exposure to 50 mM NaCl caused metabolic shifts towards gluconeogenesis to stimulate growth of Z. xanthoxylum, but triggered defensive systems in A. thaliana. Compared with A. thaliana, a vast array of ion transporter genes was induced in Z. xanthoxylum, revealing an active strategy to uptake Na+ and nutrients from the environment. An ascorbate-glutathione scavenging system for reactive oxygen species was also crucial in Z. xanthoxylum, based on high expression of key enzyme genes. Finally, key regulatory genes for the biosynthesis pathways of abscisic acid and gibberellin showed distinct expression patterns between the two species and auxin response genes were more active in Z. xanthoxylum compared with A. thaliana. Our results provide an important framework for understanding unique patterns of gene expression conferring salt resistance in Z. xanthoxylum.
Adaptable microfluidic system for single-cell pathogen classification and antimicrobial susceptibility testing
Authors: Li Hui , Torab Peter , Mach Kathleen E. , Surrette Christine , England Matthew R. , Craft David W. , Thomas Neal J. , Liao Joseph C. , Puleo Chris , Wong Pak Kin
Published: May 2019

Significance

Drug-resistant pathogens are one of the major global health risks. However, conventional antimicrobial susceptibility testing (AST) approaches, which typically rely on overnight culture to isolate bacteria, require 3–5 days. Despite rapid pathogen identification techniques having been developed, the ability to rapidly determine bacteria susceptibility represents an unmet need in clinical microbiology. Existing rapid AST techniques are often designed based on a small panel of bacteria and the system neither provides information about the bacterial species nor distinguishes polymicrobial samples. By incorporating an adaptable microfluidic design, we demonstrate a phenotypic AST system that rapidly determines the existence of bacteria, classifies major classes of bacteria, detects polymicrobial samples, and identifies antimicrobial susceptibility directly from clinical samples at the single-cell level.
Evidence for Fe-Si-O liquid immiscibility at deep Earth pressures
Authors: Arveson Sarah M. , Deng Jie , Karki Bijaya B. , Lee Kanani K. M.
Published: May 2019

Significance

Earth’s outer core is composed of a liquid iron alloy with up to 10% of unknown light elements, likely silicon, oxygen, sulfur, carbon, or hydrogen. The release of these light elements upon freezing of the solid iron inner core plays an important role in sustaining Earth’s magnetic field, but the exact chemical makeup of the core is widely debated. In this paper, we perform high-pressure, high-temperature melting experiments and first-principles simulations on iron alloys containing silicon and oxygen and find that two distinct liquids form at high pressures. The presence of immiscible liquids may explain a seismically observed stratified layer atop the outer core and suggests that an Fe-Si-O composition can explain multiple observations of the outer core.
Analyzing the features of material nonlinearity evaluation in a rectangular aluminum beam using Rayleigh waves: theoretical and experimental study
Authors: Masurkar Faeez , Tse Peter
Published: May 2019

This study proposes a new parameter to evaluate the material nonlinearity in a thick Aluminum (Al) beam having rectangular cross section using Rayleigh waves. This parameter yields a true value of material nonlinearity using the amplitudes of Rayleigh wave harmonics, in contrast to the relative value yielded by the conventional nonlinearity parameter β′. The Rayleigh wave harmonics are generated in a thick Al 1100 specimen through experiments to estimate its inherent material nonlinearity. This inherent nonlinearity is embedded in the material via lattice elasticity and reckoned using the higher order elastic coefficients. With this experimental investigation, it is found that the accurate evaluation of material nonlinearity is highly dependent on the tone burst cycles in the excitation signal. It is also found that there is a small amount of contribution to the material nonlinearity parameter from the imaginary part of the shear wave component. Furthermore, the relationship between material nonlinearity evaluated using the proposed parameter, excitation frequency, propagation distance, and tone burst cycles in the excitation signal have been unveiled. After knowing these relationships, the material nonlinearity evaluated using the proposed parameter is compared with that obtained from a physics-based nonlinearity parameter containing higher order elastic coefficients. The deviation between the results is minimal. Thus, with the use of amplitudes of harmonics of the Rayleigh wave generated through the experiments, the proposed parameter can evaluate the true material nonlinearity of thick Al beams with fair accuracy.
Longevity, climate sensitivity, and conservation status of wetland trees at Black River, North Carolina
Authors: Stahle D W , Edmondson J R , Howard I M , Robbins C R , Griffin R D , Carl A , Hall C B , Stahle D K , Torbenson M C A
Published: May 2019

Bald cypress trees over 2,000-years old have been discovered in the forested wetlands along Black River using dendrochronology and radiocarbon dating. The oldest bald cypress yet documented is at least 2,624-years old, making Taxodium distichum the oldest-known wetland tree species, the oldest living trees in eastern North America, and the fifth oldest known non-clonal tree species on earth. The annual ring-width chronology developed from the ancient Black River bald cypress trees is positively correlated with growing season precipitation totals over the southeastern United States and with atmospheric circulation over the Northern Hemisphere, providing the longest exactly-dated climate proxy yet developed in eastern North America. The Nature Conservancy owns 6,400 ha in their Black River Preserve and the North Carolina legislature is considering establishment of a Black River State Park, but ancient forested wetlands are found along most of this 106 km stream and remain threatened by logging, water pollution, and sea level rise.
Asymptotic convergence for a class of inverse mean curvature flows in ℝⁿ⁺¹
Authors: Chen Li , Mao Jing , Tu Qiang , Wu Di
Published: May 2019

We consider star-shaped, strictly mean convex and closed hypersurfaces expanding by a class of inverse mean curvature flows in

R

n
+
1

\mathbb {R}^{n+1}

, and we prove that this evolution exists for all time and the evolving hypersurfaces converge smoothly to a round sphere after rescaling.
Cost-effectiveness of Hepatitis C Virus Treatment Models for People Who Inject Drugs in Opioid Agonist Treatment Programs
Authors: Gutkind Sarah , Schackman Bruce R , Morgan Jake R , Leff Jared A , Agyemang Linda , Murphy Sean M , Akiyama Matthew J , Norton Brianna L , Litwin Alain H , Linas Benjamin P
Published: May 2019

Background

Many people who inject drugs in the United States have chronic hepatitis C virus (HCV). On-site treatment in opiate agonist treatment (OAT) programs addresses HCV treatment barriers, but few evidence-based models exist.

Methods

We evaluated the cost-effectiveness of HCV treatment models for OAT patients using data from a randomized trial conducted in Bronx, New York. We used a decision analytic model to compare self-administered individual treatment (SIT), group treatment (GT), directly observed therapy (DOT), and no intervention for a simulated cohort with the same demographic characteristics of trial participants. We projected long-term outcomes using an established model of HCV disease progression and treatment (hepatitis C cost-effectiveness model: HEP-CE). Incremental cost-effectiveness ratios (ICERs) are reported in 2016 US$/quality-adjusted life years (QALY), discounted 3% annually, from the healthcare sector and societal perspectives.

Results

For those assigned to SIT, we projected 89% would ever achieve a sustained viral response (SVR), with 7.21 QALYs and a $245 500 lifetime cost, compared to 22% achieving SVR, with 5.49 QALYs and a $161 300 lifetime cost, with no intervention. GT was more efficient than SIT, resulting in 0.33 additional QALYs and a $14 100 lower lifetime cost per person, with an ICER of $34 300/QALY, compared to no intervention. DOT was slightly more effective and costly than GT, with an ICER > $100 000/QALY, compared to GT. In probabilistic sensitivity analyses, GT and DOT were preferred in 91% of simulations at a threshold of <$100 000/QALY; conclusions were similar from the societal perspective.

Conclusions

All models were associated with high rates of achieving SVR, compared to standard care. GT and DOT treatment models should be considered as cost-effective alternatives to SIT.
Hepatitis C Virus RNA Levels Following Virologic Failure With Direct-acting Antivirals: Implications for Lower Sensitivity Diagnostic Assays
Authors: Harrington Patrick R , Komatsu Takashi E , Sun Hengrui , Naeger Lisa K
Published: May 2019

We analyzed post-treatment hepatitis C virus (HCV) RNA levels from 330 subjects who experienced virologic failure in clinical trials of direct-acting antivirals. We demonstrated that 97% had post-treatment Week 12 HCV RNA >10 000 IU/mL, above reported sensitivity limits of novel diagnostic assays being considered for simplified HCV treatment monitoring.
Immunometabolic function of cholesterol in cardiovascular disease and beyond
Authors: Yvan-Charvet Laurent , Bonacina Fabrizia , Guinamard Rodolphe Renè , Norata Giuseppe Danilo
Published: May 2019

Inflammation represents the driving feature of many diseases, including atherosclerosis, cancer, autoimmunity and infections. It is now established that metabolic processes shape a proper immune response and within this context the alteration in cellular cholesterol homeostasis has emerged as a culprit of many metabolic abnormalities observed in chronic inflammatory diseases. Cholesterol accumulation supports the inflammatory response of myeloid cells (i.e. augmentation of toll-like receptor signalling, inflammasome activation, and production of monocytes and neutrophils) which is beneficial in the response to infections, but worsens diseases associated with chronic metabolic inflammation including atherosclerosis. In addition to the innate immune system, cells of adaptive immunity, upon activation, have also been shown to undergo a reprogramming of cellular cholesterol metabolism, which results in the amplification of inflammatory responses. Aim of this review is to discuss (i) the molecular mechanisms linking cellular cholesterol metabolism to specific immune functions; (ii) how cellular cholesterol accumulation sustains chronic inflammatory diseases such as atherosclerosis; (iii) the immunometabolic profile of patients with defects of genes affecting cholesterol metabolism including familial hypercholesterolaemia, cholesteryl ester storage disease, Niemann–Pick type C, and immunoglobulin D syndrome/mevalonate kinase deficiency. Available data indicate that cholesterol immunometabolism plays a key role in directing immune cells function and set the stage for investigating the repurposing of existing ‘metabolic’ drugs to modulate the immune response.
Separating different individual effects in a panel data model
Authors: Amsler Christine , Schmidt Peter
Published: May 2019

In this paper we consider a panel data model with individual effects that are arbitrarily correlated with the explanatory variables. The effects are composed as the sum of two different interpretable components, such as inefficiency versus heterogeneity in a production frontier setting, or ability versus socioeconomic background in an earnings function, or genetics versus environment in an epidemiological analysis. We wish to predict the two components separately. This is made possible by assuming that there are observables that are correlated with the first component but not with the second, and other observables that are correlated with the second component but not with the first. This can be true in terms of either simple correlations or partial correlations.
Species co-occurrence and environmental factors and their effect on the distribution of forest birds in mature forests
Authors: Andradas Mikel Xabier , Arizaga Juan , Rodríguez-Pérez Javier
Published: May 2019

Measures of species co-occurrence, as a proxy of biotic interactions, may be as important as environmental factors when explaining the distribution of many species. We assessed the relative effect of both species co-occurrence and environmental factors in predicting the occurrence (presence/absence) of woodpeckers and passerines in mature forests of the Northern Iberian Peninsula. We hypothesized that woodpecker occurrence would affect the occurrence of passerines. We calculated the occurrence of woodpecker species using models that included environmental factors aggregated at three spatial scales (200, 500 and 1,000-m2). The occurrence of passerine species was then modelled by using either species co-occurrence (including the occurrence of woodpecker species) or environmental factors at the 200-m2 cell scale. The occurrence of five out of nine passerine species was best explained by the co-occurrence of woodpeckers alone, whereas the occurrence of the remaining passerines was best explained using a combination of species co-occurrence (i.e. woodpeckers and/or other passerines) and environmental factors. In Southern Europe, woodpeckers are expanding their distribution in line with forest maturation, and this could increase the diversity of bird communities in forest systems.
Persistent Salmonella enterica Serovar Typhimurium Infection Induces Protease Expression During Intestinal Fibrosis
Authors: Ehrhardt Katrin , Steck Natalie , Kappelhoff Reinhild , Stein Stephanie , Rieder Florian , Gordon Ilyssa O , Boyle Erin C , Braubach Peter , Overall Christopher M , Finlay B Brett , Grassl Guntram A
Published: May 2019

Background

Intestinal fibrosis is a common and serious complication of Crohn’s disease characterized by the accumulation of fibroblasts, deposition of extracellular matrix, and formation of scar tissue. Although many factors including cytokines and proteases contribute to the development of intestinal fibrosis, the initiating mechanisms and the complex interplay between these factors remain unclear.

Methods

Chronic infection of mice with Salmonella enterica serovar Typhimurium was used to induce intestinal fibrosis. A murine protease-specific CLIP-CHIP microarray analysis was employed to assess regulation of proteases and protease inhibitors. To confirm up- or downregulation during fibrosis, we performed quantitative real-time polymerase chain reaction (PCR) and immunohistochemical stainings in mouse tissue and tissue from patients with inflammatory bowel disease. In vitro infections were used to demonstrate a direct effect of bacterial infection in the regulation of proteases.

Results

Mice develop severe and persistent intestinal fibrosis upon chronic infection with Salmonella enterica serovar Typhimurium, mimicking the pathology of human disease. Microarray analyses revealed 56 up- and 40 downregulated proteases and protease inhibitors in fibrotic cecal tissue. Various matrix metalloproteases, serine proteases, cysteine proteases, and protease inhibitors were regulated in the fibrotic tissue, 22 of which were confirmed by quantitative real-time PCR. Proteases demonstrated site-specific staining patterns in intestinal fibrotic tissue from mice and in tissue from human inflammatory bowel disease patients. Finally, we show in vitro that Salmonella infection directly induces protease expression in macrophages and epithelial cells but not in fibroblasts.

Conclusions

In summary, we show that chronic Salmonella infection regulates proteases and protease inhibitors during tissue fibrosis in vivo and in vitro, and therefore this model is well suited to investigating the role of proteases in intestinal fibrosis.
Endocrine Disruption Alters Developmental Energy Allocation and Performance in Rana temporaria
Authors: Ruthsatz Katharina , Dausmann Kathrin H , Reinhardt Steffen , Robinson Tom , Sabatino Nikita M , Peck Myron A , Glos Julian
Published: May 2019

Environmental change exposes wildlife to a wide array of environmental stressors that arise from both anthropogenic and natural sources. Many environmental stressors with the ability to alter endocrine function are known as endocrine disruptors, which may impair the hypothalamus–pituitary–thyroid axis resulting in physiological consequences to wildlife. In this study, we investigated how the alteration of thyroid hormone (TH) levels due to exposure to the environmentally relevant endocrine disruptor sodium perchlorate (SP; inhibitory) and exogenous L-thyroxin (T4; stimulatory) affects metabolic costs and energy allocation during and after metamorphosis in a common amphibian (Rana temporaria). We further tested for possible carry-over effects of endocrine disruption during larval stage on juvenile performance. Energy allocated to development was negatively related to metabolic rate and thus, tadpoles exposed to T4 could allocate 24% less energy to development during metamorphic climax than control animals. Therefore, the energy available for metamorphosis was reduced in tadpoles with increased TH level by exposure to T4. We suggest that differences in metabolic rate caused by altered TH levels during metamorphic climax and energy allocation to maintenance costs might have contributed to a reduced energetic efficiency in tadpoles with high TH levels. Differences in size and energetics persisted beyond the metamorphic boundary and impacted on juvenile performance. Performance differences are mainly related to strong size-effects, as altered TH levels by exposure to T4 and SP significantly affected growth and developmental rate. Nevertheless, we assume that juvenile performance is influenced by a size-independent effect of achieved TH. Energetic efficiency varied between treatments due to differences in size allocation of internal macronutrient stores. Altered TH levels as caused by several environmental stressors lead to persisting effects on metamorphic traits and energetics and, thus, caused carry-over effects on performance of froglets. We demonstrate the mechanisms through which alterations in abiotic and biotic environmental factors can alter phenotypes at metamorphosis and reduce lifetime fitness in these and likely other amphibians.
Rights and Relationships: Rhetorics of Religious Freedom among English Evangelicals
Authors: McIvor Méadhbh
Published: May 2019

This paper uses evangelical reflections on the meaning of “rights” to explore the juridification of religion in contemporary England. Drawing on sixteen months of participatory fieldwork with evangelicals in London, I argue that English evangelicals’ critiques of Christian-interest litigation reflect the interaction of local theologies with developments in the law’s regulation of religion, developments that have contributed to the relativization of Protestant Christianity even as historic church establishment is maintained. Through an exploration of the tension between the goals of (rights-based) individualism and (Christian) relationalism as they concern the law, I show how litigation can affect religious subjectivity even in the absence of a personal experience with the pageantry of the court.
Penalizing cartels—a spectrum of regimes
Authors: Katsoulacos Yannis , Motchenkova Evgenia , Ulph David
Published: May 2019

There has been much discussion by both academics and policymakers of the most appropriate way of penalizing cartels taking account of both the effects of different penalty regimes on welfare as well as various implementation considerations such as ease/cost of implementation and transparency/legal certainty. Consequently there now exists a range of proposed penalty regimes—including two put forward by ourselves. While these can all seem like very distinct regimes, in this article we show that they can usefully be thought of as lying along a spectrum, inter-connected by the idea of trying to penalize cartels in relation to the damage they cause. They differ in their informational requirements, and in particular whether some key factors needed to calculate the penalty are case-specific or an average across a wide range of cases. Subtle differences in what information is required and how it is used can sometimes cause significant changes in either the welfare or implementation properties of regimes. This new perspective may provide a helpful way of organizing the discussion about the pros and cons of the different proposals.