bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Wells syndrome (eosinophilic cellulitis) after vaccination: A case report and review of the literature
Authors: Yu Ashley M. , Ito Shinya , Leibson Tom , Lavi Sasson , Fu Lisa W. , Weinstein Miriam , Skotnicki Sandra M.
Published: July 2018

A 4‐year‐old boy presented with erythematous vesicular plaques, ulceration, edema, and pruritus on the left foot and ankle 10 days after receiving the tetanus, diphtheria, pertussis, and polio; measles, mumps, rubella, and varicella; and hepatitis A/B vaccines. Biopsy showed eosinophilic infiltrates and flame figures, suggesting Wells syndrome. Patch testing showed a 1+ reaction to neomycin and aluminum hydroxide, with a recall reaction of Wells syndrome of the feet bilaterally. We report a rare case of pediatric Wells syndrome triggered by nonthimerosal vaccine components confirmed by patch testing.
Congenital‐type juvenile xanthogranuloma: A case series and literature review
Authors: Oza Vikash S. , Stringer Thomas , Campbell Caren , Hinds Brian , Chamlin Sarah L. , Frieden Ilona J. , Shah Sonal
Published: July 2018

Background/Objectives

Congenital juvenile xanthogranulomas are infrequently described in the medical literature. We report three previously unpublished cases and systematically review the literature to better characterize this variant.

Methods

We surveyed English‐language articles indexed in MEDLINE (1951‐March 2017) and EMBASE (1974‐March 2017) for cases of congenital‐onset juvenile xanthogranulomas confirmed on histopathology. Cases were divided into two categories: cutaneous only or cutaneous with systemic involvement.

Results

We identified 31 cases of congenital juvenile xanthogranulomas involving only the skin and 16 cases with systemic involvement. Congenital juvenile xanthogranulomas involving only the skin were large (> 3 cm), presented with various clinical morphologies, and showed signs of regression by 1 year of age. Atypical clinical presentations included exophytic tumors, infiltrative plaques, agminated plaques, and subcutaneous tumors. Complications included ulceration and anetodermic scarring. Infants with congenital cutaneous juvenile xanthogranulomas who also had systemic involvement typically had multiple cutaneous tumors and hepatic involvement and showed signs of spontaneous regression independent of treatment.

Conclusions

The medical literature supports that congenital juvenile xanthogranulomas behave in a fashion similar to that of juvenile xanthogranulomas of infancy or childhood. Congenital cutaneous juvenile xanthogranulomas with or without systemic involvement spontaneously regress. The varied clinical presentations in the skin may lead to misdiagnosis, inappropriate examination, and unnecessary treatments. Infants with multiple congenital cutaneous juvenile xanthogranulomas should be evaluated for systemic involvement, with a particular focus on the liver, because 72.2% of these children were found to have hepatic juvenile xanthogranulomas.
Sirolimus as initial therapy for kaposiform hemangioendothelioma and tufted angioma
Authors: Wang Huaijie , Guo Xinkui , Duan Yitao , Zheng Baijun , Gao Ya
Published: July 2018

Background

Sirolimus has been used to manage various complex vascular anomalies. Kaposiform hemangioendothelioma and tufted angioma may develop Kasabach‐Merritt phenomenon in infancy.

Methods

We retrospectively reviewed the clinical and laboratory data of eight patients with kaposiform hemangioendothelioma and tufted angioma who were initially treated using oral sirolimus in our center, including six with Kasabach‐Merritt phenomenon.

Results

Five girls and three boys seen between September 2012 and March 2015 were included. Age at initiation of sirolimus ranged from 30 days to 14 weeks (mean±SD 8.6 ± 3.5 weeks). Six of these eight patients had kaposiform hemangioendothelioma, and two had a tufted angioma. Platelet count before start of oral sirolimus ranged from 5 × 109/L to 189 × 109/L ((78.8 ± 65.2)×109/L) and fibrinogen level from 68 to 215 mg/dL (123.1 ± 50.5 mg/dL). All patients received standard doses of sirolimus (0.05 mg/kg orally, twice daily) as initial therapy. All patients with thrombocytopenia or hypofibrinogenemia reached a normal platelet count and a normal fibrinogen level within 3 to 4 weeks after sirolimus treatment. Length of treatment ranged from 12 to 79 weeks (39.9 ± 15.3 weeks). Two patients developed grade 2 oral mucositis during treatment.

Conclusion

Sirolimus as first‐line therapy shows great promise in the treatment of kaposiform hemangioendothelioma and tufted angioma.
Cerebrospinal fluid non‐pleocytosis in pediatric enteroviral meningitis: Large‐scale review
Authors: Song Ji Yeon , Nam Sang Ook , Kim Young A , Kim Kyung Min , Lyu Soo Young , Ko Ara , Kim Young Mi , Yeon Gyu Min , Lee Yun‐Jin
Published: July 2018

Background

Lack of cerebrospinal fluid (CSF) pleocytosis has been reported in some children with enteroviral meningitis (EVM). The aim of this paper was to investigate the clinical spectrum and related factors in EVM with CSF non‐pleocytosis.

Methods

The databases of children diagnosed with EVM on CSF polymerase chain reaction between 2011 and 2014 were retrospectively reviewed. CSF pleocytosis was defined at each age using the criteria. Clinical and laboratory variables were compared between patients with CSF pleocytosis and non‐pleocytosis.

Results

Of the 802 children of EVM, 25.4% (204/802) had CSF non‐pleocytosis. In particular, CSF non‐pleocytosis was found in 63.3% of the neonates versus in 22.2% of the children aged ≥1 year old, indicating that the ratio of CSF non‐pleocytosis had a negative correlation with age (P < 0.001). As the main symptoms, fever (91.8% vs 86.8%, P = 0.038), headache (80.3% vs 63.7%, P < 0.001), and vomiting (75.9% vs 61.8%, P < 0.001) were significantly more frequent in CSF pleocytosis than in CSF non‐pleocytosis. Patients with CSF non‐pleocytosis had much lower peripheral leukocytosis (10 656 ± 3,662 vs 12 403 ± 4,207/mm3, P = 0.014) and C‐reactive protein (0.7±0.8 vs 1.2±1.5 mg/dL, P < 0.001), and earlier lumbar puncture <24 h after onset (42.6% vs 21.4%, p<0.001). No significant difference during the summer and autumn months was seen between the two groups (76.9% vs 81.9%, P = 0.169).

Conclusion

CSF non‐pleocytosis in childhood EVM was frequently observed, especially in young infants, regardless of season. We propose that CSF PCR testing for enterovirus can be helpful to recognize EVM in children with CSF non‐pleocytosis.
Brute necessity
Authors: Van Cleve James
Published: July 2018

In a growing number of papers, one encounters arguments to the effect that certain philosophical views are objectionable because they would imply that there are necessary truths for whose necessity there is no explanation. That is, they imply that there are propositions p such that (a) it is necessary that p, but (b) there is no explanation why it is necessary that p. For short, they imply that there are “brute necessities.” Therefore, the arguments conclude, the views in question should be rejected in favor of rival views under which the necessities would be explained. This style of argument raises a number of important and difficult questions. Do necessary truths really require explanation? Are they not paradigms of truths that either need no explanation or automatically have one, being in some sense self‐explanatory? If some necessary truths do require or admit of explanation, what types of explanation, are available? Are some necessary truths explained by other necessary truths? Are some necessary truths self‐explanatory? Are all necessary truths either self‐explanatory or explained by others? Or are there some necessary truths that are truly brute? This article surveys several representative arguments from brute necessity as well as a variety of answers to the questions above, noting their bearing on arguments from bruteness.
Citizenship and work in global capitalism: From domination to aspiration
Authors: Paret Marcel
Published: July 2018

The sociology of citizenship emerged during an exceptional period in which workers benefitted from economic growth and gains in productivity. Yet the field grew against the backdrop of a market‐oriented global capitalism defined by high levels of precarious work, surplus labor, and economic insecurity. Tracing the evolution of global capitalism in the wake of World War II, and across the unequal regions of the world, I outline three different perspectives on the relationship between capitalism and work. These include an outdated and untenable perspective of citizenship as workplace product, a critical perspective of citizenship as worker domination, and an optimistic perspective of citizenship as aspiration and agency. The analysis suggests that citizenship represents an important terrain of struggle within global capitalism, simultaneously enabling patterns of domination and inspiring movements for liberation.
Unravelling the Global Wool Assemblage: Researching Place and Production Networks in the Global Countryside
Authors: Jones Laura , Heley Jesse , Woods Michael
Published: July 2018

This article applies an assemblage reading to the contemporary global woollen industry to demonstrate how assemblage thinking has value as a methodology for generating insights into the local impact of global economic restructuring; bridging concerns with the relationality of rural places and translocal production networks. Putting assemblage into research practice, we trace the interactions and interdependencies between human and non‐human, organic and inorganic, technical and natural components of the global wool assemblage from the entry point of Newtown in mid‐Wales. In so doing, we call attention to those critical moments in this schema that may be usefully exposed or explored via the concept of assemblage. Here we consider the agency of non‐human actors, as well as the biological, technological, regulatory and marketing regimes that seek to produce wool as a globally mobile commodity. Through their enrolment in these sets of relations, Welsh farmers are exposed to the effects of spatially dispersed and contingent dynamics. Using the example of wool we develop a broad argument for using a framework of assemblage alongside other critical theories as a means of grasping how rural societies, places and communities are negotiating change in the context of globalisation.
Uncovering the hidden content of layered documents by means of photoacoustic imaging
Authors: Tserevelakis George J. , Tsagkaraki Margarita , Siozos Panagiotis , Zacharakis Giannis
Published: July 2018

We introduce a novel diagnostic approach for the uncovering of hidden content in layered documents, based on a photoacoustic imaging set‐up with optimised acoustic detection parameters. By exploiting the laser‐induced ultrasound following the intense absorption of pulsed optical radiation by printed ink, this traditional biomedical imaging method is proven capable of revealing text characters buried under several layers of stacked paper sheets at high spatial resolution and excellent contrast levels. Such a remarkable performance benefits from the effective combination of strong light scattering by paper fibrils and the virtually unobstructed propagation of the generated ultrasonic waves through multiple layers, enabling thus the accurate recording of text, even in double‐sided prints, with minimum shadowing artefacts. The imaging effectiveness, the implementation simplicity, the robustness, and the relatively low‐cost features offered by the proposed photoacoustic modality are anticipated to contribute in its wide adoption by the preservation of cultural heritage community, as a powerful diagnostic tool for the in‐depth investigation of complex multilayered objects.
Revisiting penalty functions for environmental violations: Evidence from a developing country
Authors: Haque Nabil
Published: July 2018

Environmental fines are effective means of bringing polluters under compliance by deterring them from future violations. The design of the fines is guided by policies informed by theories of firm behaviour and empirical records. In Bangladesh, there are no policies governing the penalty rates based on the type and seriousness of the violations. This study models the influence of factory level characteristics on environmental fines levied due to violation of regulations relating to surface water pollution. Textile factories were found to be fined at a higher rate compared to other sectors. It was also found that historical compliance records negatively influenced the penalty rates. However, even with this model it will be difficult to accurately assess the fine for an environmental violation. Though the results offer similarities and differences with other studies and established theories, certain anomalies highlight the regulatory gaps in terms of not having structured penalties appropriate for reported violations in Bangladesh.
Diversity in the genusRhabdias(Nematoda, Rhabdiasidae): Evidence for cryptic speciation
Authors: Müller Maria I. , Morais Drausio H. , Costa‐Silva Guilherme J. , Aguiar Aline , Ávila Robson W. , da Silva Reinaldo J.
Published: July 2018

Lungworms from the genusRhabdiasare common parasites of amphibians and reptiles distributed worldwide. To assess the diversity ofRhabdiasspp., we performed molecular analyses of 35 specimens sampled in different regions of Brazil. Molecular analyses were based on the internal transcribed spacer (ITS), large subunit (28S) ribosomal and the cytochrome oxidase I (COI) mitochondrial genes. DNA sequence divergence was compared among ribosomal and mitochondrial genes, analyses using the general mixed Yule‐coalescent (GMYC) method based on the COI gene were used to identify possible cryptic diversity, and phylogenetic analyses using concatenated ITS and 28S ribosomal genes were used to test the monophyly of Rhabdiasidae. We revealed five morphospecies:R.cf.stenocephala,R. breviensis,R. pseudosphaerocephalaand two new species,Rhabdiassp.4 andRhabdiassp.5. DNA sequence levels of divergence among genes ITS, 28S and COI were compared, and the efficiency of the molecular markers to identify species (ITS and COI) and lineages (COI) was tested. GMYC was assigned to 17 well‐supported clades (i.e., 17 species), and cryptic diversity was detected in the Neotropical region as evidenced by the multiple lineages inR. breviensisandR. pseudosphaerocephala. In addition, our results suggest evidence for host–parasite cophylogeny in theR. pseudosphaerocephalacomplex and dispersal events among their populations. Phylogenetic analyses supported the monophyly of Rhabdiasidae and improved the resolution of main clades.Rhabdias breviensisis closely related toRhabdiascf.africanus,Rhabdiascf. stenocephala,R. pseudosphaerocephala,Rhabdiassp.4 andRhabdiassp.5 grouping together in a main clade with Neotropical‐related species. The large geographical distribution appeared to be a phylogenetic pattern among the species ofRhabdiasfrom the neotropics.
Effectiveness of mindfulness-based arts interventions on psychological wellbeing and fatigue in adults with a physical illness: a systematic review protocol
Authors: Rieger Kendra L. , Lobchuk Michelle M. , Duff Miriam A. , Chernomas Wanda M. , Campbell-Enns Heather J. , Demczuk Lisa , Nicolas Suzanne , West Christina H.
Published: July 2018

Review question/objective:

The objective of this review is to synthesize evidence on the effectiveness of mindfulness-based arts interventions on psychological wellbeing and fatigue in adults with a physical illness.
Acute and non-lethal effects of coconut oil on predatory mite Typhlodromus ornatus (Acari: Phytoseiidae)
Authors: Freitas Giselle , Santos Maria Clezia , Lira Vanessa , Galvão Andreia , Oliveira Eugenio , Sena Filho José Guedes , Teodoro Adenir
Published: July 2018

Typhlodromus (Anthoseius) ornatus Denmark & Muma (Acari: Phytoseiidae) is one of the predatory mites associated with the coconut mite Aceria guerreronis (Acari: Eriophyidae), a serious coconut pest in Africa, Asia and America. Vegetable oils such as coconut oil have been shown to efficiently control A. guerreronis, however their side effects on predatory mites remain poorly investigated. Here, we evaluated the lethal and non-lethal effects of coconut oil on repellence and functional response of the predatory mite T. ornatus, a natural enemy of A. guerreronis. Based on LC50 estimates, coconut oil was over 6-fold less toxic to T. ornatusthan to its prey, A. guerreronis. Additional repellence and predation bioassays show that the coconut oil neither repels nor interferes in the functional response of T. ornatus preying upon A. guerreronis. According to our selectivity approach, the coconut oil is compatible with the predatory mite T. ornatus.
Block copolymer selectivity: A new dry etch approach for cylindrical applications
Authors: Sarrazin Aurelien , Posseme Nicolas , Pimenta-Barros Patricia , Barnola Sebastien , Gharbi Ahmed , Argoud Maxime , Tiron Raluca , Cardinaud Christophe
Published: July 2018

A critical challenge for directed self-assembly of block copolymers is the selectivity between the two polymer phases. Polystyrene-block-poly(methyl methacrylate) (PS-b-PMMA) is one of the most studied block-copolymers to reach sub-20 nm patterns. A very high PMMA/PS selectivity (>10:1) is required to conserve a sufficient PS pattern thickness allowing pattern transfer to sublayers. In this paper, the authors propose to develop a chemistry allowing a full PMMA removal without PS consumption. It is based on CO and CO-H2 cycles allowing to get a very high etch control. The proposed etch mechanisms have been understood thanks to x-ray photoelectron spectroscopy analyses performed on blanket wafers. Finally, this new etch process has been validated on the cylindrical PS-b-PMMA patterned structure.
Energy dissipation contributed on the machined depth via dynamic plowing lithography of atomic force microscopy
Authors: He Yang , Yan Yongda , Geng Yanquan , Fang Zhuo
Published: July 2018

In this study, the atomic force microscopy tip-based dynamic plowing lithography approach is employed to scratch on the poly(methyl methacrylate) thin-film surface. A theoretical model is established based on the relationship between the tip energy dissipation and material removal volume, and the corresponding experiments are also conducted. Both the theoretical and experimental results show that the drive amplitude is proportional to the square of the machined depth of the nanoscale grooves. The mean deviations between the predicted and experimental depths are less than 10%. It is also indicated that the scratching velocity in the range of 0.01–80 μm/s is proportional to the square of the depth (1/h2), and the mean deviations between the predicted and experimental depths are also less than 7%. In addition, based on the above conclusions, a uniform ripple with desired dimensions can be achieved successfully by overlapping the machined nanogrooves. The wavelength and amplitude of the ripples are determined by controlling the feature size of nanogrooves.
Sheep as a Potential Source of Zoonotic Cryptosporidiosis in China
Authors: Mi Rongsheng , Wang Xiaojuan , Huang Yan , Mu Guodong , Zhang Yehua , Jia Haiyan , Zhang Xiaoli , Yang Heng , Wang Xu , Han Xiangan , Chen Zhaoguo
Published: July 2018

Cryptosporidium
is an important zoonotic parasite that causes diarrhea in humans and animals worldwide. Previous studies suggested geographic differences in the distribution of
Cryptosporidium
species in sheep. However, molecular characterization studies of
Cryptosporidium
species in sheep have been carried out in only a few provinces in China, and the limited data available do not reflect the real situation. In this study, five districts, covering most areas where sheep are bred in China, were selected for examination of
Cryptosporidium
species, and
Cryptosporidium
infections were detected at all farms assessed, suggesting that
Cryptosporidium
is widespread in sheep in China. We also found geographic differences in the distribution of
Cryptosporidium
species but did not detect any differences between sheep age groups or seasons. Subtyping analyses showed that all of the subtypes identified in this study have been reported in humans, suggesting that sheep may be a potential source of zoonotic cryptosporidiosis.
Thiaminase I Provides a Growth Advantage by Salvaging Precursors from Environmental Thiamine and Its Analogs in Burkholderia thailandensis
Authors: Sannino David R. , Kraft Clifford E. , Edwards Katie A. , Angert Esther R.
Published: July 2018

The function of thiaminase I has remained a long-standing, unsolved mystery. The enzyme is only known to be produced by a small subset of microorganisms, although thiaminase I activity has been associated with numerous plants and animals, and is implicated in thiamine deficiencies brought on by consumption of organisms containing this enzyme. Genomic and biochemical analyses have shed light on potential roles for the enzyme. Using the genetically amenable thiaminase I-producing soil bacteriumBurkholderia thailandensis, we were able to demonstrate that thiaminase I helps salvage precursors from thiamine derivatives in the environment and degrades thiamine to its precursors, which are preferentially used byB. thailandensisauxotrophs. Our study establishes a biological role for this perplexing enzyme and provides insight into the complicated nature of thiamine metabolism. It also establishesB. thailandensisas a robust model system for studying thiamine metabolism.
Quantitative PCR Analysis of Gut Disease-Discriminatory Phyla for Determining Shrimp Disease Incidence
Authors: Yu Weina , Cao Jinxuan , Dai Wenfang , Qiu Qiongfen , Xiong Jinbo
Published: July 2018

Current studies have identified gut microbial signatures of host health using high-throughput sequencing (HTS) techniques. However, HTS is still expensive and time-consuming and requires a high technical ability, thereby impeding its application in routine monitoring in aquaculture. Hence, it is necessary to seek an alternative strategy to overcome these shortcomings. Herein, we establish a qPCR-based approach to detect the relative abundances of gut disease-discriminatory phyla, which in turn afford independent variables to quantitatively determine the incidence and onset of shrimp disease. Notably, there is a high consistency between the accuracies of disease diagnosis achieved by qPCR and HTS. This applicable technique makes important progress toward defining a diseased state in shrimp and toward solving an important animal health management-driven economic problem.
Pol-Driven Replicative Capacity Impacts Disease Progression in HIV-1 Subtype C Infection
Authors: Ojwach Doty B. A. , MacMillan Daniel , Reddy Tarylee , Novitsky Vladimir , Brumme Zabrina L. , Brockman Mark A. , Ndung'u Thumbi , Mann Jaclyn K.
Published: July 2018

Identification of viral mutations that compromise HIV's ability to replicate may aid rational vaccine design. However, while certain escape mutations in Gag have been shown to reduce HIV replication and influence clinical progression, less is known about the consequences of mutations that naturally arise in other HIV proteins. Pol is a highly conserved protein, but the impact of Pol function on HIV disease progression is not well defined. Here, we generated recombinant viruses using the RT-integrase region of Pol derived from HIV-1C-infected individuals with recent and chronic infection and measured their ability to replicate
in vitro
. We demonstrate that RT-integrase-driven replication ability significantly impacts HIV disease progression. We further show evidence of immune-mediated attenuation in RT-integrase and identify specific polymorphisms in RT-integrase that significantly decrease HIV-1 replication ability, suggesting which Pol epitopes could be explored in vaccine development.
Orbital precession modulates interannual rainfall variability, as recorded in an Early Pleistocene speleothem
Authors: Hopley Philip J. , Weedon Graham P. , Brierley Chris M. , Thrasivoulou Christopher , Herries Andy I.R. , Dinckal Ada , Richards David A. , Nita Dan C. , Parrish Randall R. , Roberts Nick M. W. , Sahy Diana , Smith Claire L.
Published: July 2018

Interannual variability of African rainfall impacts local and global communities, but its past behavior and response in future climate projections are poorly understood. This is primarily due to short instrumental records and a lack of long high-resolution palaeoclimate proxy records. Here we present an annually resolved 91,000 year Early Pleistocene record of hydroclimate from the early hominin-bearing Makapansgat Valley, South Africa. Changes in speleothem annual band thickness are dominated by precession over four consecutive orbital cycles with strong millennial-scale periodicity. The frequency of interannual variability (2.0–6.5 yr oscillations) does not change systematically, yet its amplitude is modulated by the orbital forcing. These long-term characteristics of interannual variability are reproduced with transient climate model simulations of water balance for South Africa from the Late Pleistocene to Recent. Based on these results, we suggest that the frequency of interannual variations in southern African rainfall is likely to be stable under anthropogenic warming, but that the size of year-to-year variations may increase. We see an orbitally forced increase in the amplitude of interannual climate variability between 1.8 Ma and 1.7 Ma coincident with the first evidence for the Acheulean stone tool technology.
Effect of Electroacupuncture at ST36 on the Intestinal Mucosal Mechanical Barrier and Expression of Occludin in a Rat Model of Sepsis
Authors: Zhang Zhirong , Shi Ying , Cai Danli , Jin Shuifang , Zhu Chen , Shen Yingying , Feng Wen , Jiang Ronglin , Wang Lingcong
Published: July 2018

Objective

To observe the effect of electroacupuncture (EA) at ST36 on the intestinal mucosal mechanical barrier and expression of the tight junction (TJ) protein, occludin, in a rat model of sepsis.

Methods

60 male Wistar rats were randomly divided into six groups (n=10 rats each): Control, Control+EA, CLP (caecal ligation and puncture), CLP+EA, CLP+Sham-EA, and Sham-CLP. Rats of the CLP, CLP+EA and CLP+Sham-EA groups underwent CLP modeling of sepsis; those in the Sham-CLP underwent sham surgery and those in the Control and Control+EA groups remained unoperated. Rats in the CLP+EA and Control+EA groups received verum EA at ST36 and rats in the CLP+Sham-EA groups received EA at non-traditional acupuncture points. After three days, serum D-lactate concentrations were measured and ileal mucosa was collected for haematoxylin and eosin staining, morphological observation and Chiu's scoring. The intestinal epithelial cells were observed under transmission electron microscopy (TEM), while protein expression of occludin was measured by immunohistochemistry and Western blotting.

Results

TJs of the Control, Sham-CLP and Control+EA groups were continuous under TEM but discontinuous in the CLP, CLP+EA and CLP+Sham-EA groups. Plasma D-lactate levels were significantly higher in the CLP, CLP+EA and CLP+Sham-EA groups compared with the Control, Sham-CLP and Control+EA groups (P<0.01). Protein expression of occludin, reflected by immunohistochemistry scores (IHS) and the results of Western blotting, were significantly reduced in the CLP, CLP+EA and CLP+Sham-EA groups when compared with the Control, Sham-CLP and Control+EA groups (P<0.01). Compared with the CLP group, the IHS and Western blotting results of the CLP+EA group were both significantly higher (P<0.05), while those of the CLP+Sham-EA group were similar to the CLP group.

Conclusions

Electrical stimulation at ST36 in rats with sepsis can increase protein expression of occludin, reduce serum D-lactate levels and increase permeability of the intestinal barrier.
Diabetes Shared Care Program (DSCP) and risk of infection mortality: a nationwide cohort study using administrative claims data in Taiwan
Authors: Chen Cheng-Han , Ma Sheng-Hsiang , Hu Sung-Yuan , Chang Chia-Ming , Chiang Jen-Huai , Hsieh Vivian Chia-Rong , Yen David Hung-Tsang , How Chorng-Kuang , Hsieh Ming-Shun
Published: July 2018

Objective

The Diabetes Shared Care Program (DSCP) is an integrated care model in Taiwan that has been proven to improve the care quality of patients with diabetes. We aimed to evaluate the efficacy of DSCP in decreasing the hospital mortality of infectious diseases.

Methods

From 1 662 929 patients with type 2 diabetes newly diagnosed between 1999 and 2013, we retrieved a total of 919 patients who participated in the DSCP with the first hospitalisation for an infectious disease as the study cohort and 9190 propensity score-matched patients with type 2 diabetes who did not participate as the comparison.

The efficacy of DSCP was evaluated via the following comparisons between the DSCP and non-DSCP cohorts: hospital mortality, 1-year medical cost prior to and during the hospitalisation, and complications, such as receiving mechanical ventilation and intensive care unit admission. The ratio (OR) for hospital mortality of the DSCP participants was calculated by logistical regression. Further stratification analyses were conducted to examine which group of patients with type 2 diabetes benefited the most from the DSCP during hospitalisation for infectious diseases.

Results

The DSCP cohort had a lower hospital mortality rate than the non-DSCP participants (2.18% vs 4.82%, p<0.001). The total medical cost during the hospitalisation was lower in the DSCP cohort than in the non-DSCP cohort (NT$72 454±30 429 vs NT$86 385±29 350) (p=0.006). In the logistical regression model, the DSCP participants exhibited a significantly decreased adjusted OR for hospital mortality (adjusted OR=0.42, 95% CI 0.26 to 0.66, p=0.0002). The efficacy of the DSCP was much more prominent in male patients with type 2 diabetes and in patients with lower incomes.

Conclusion

Participation in the DSCP was associated with a lower risk of hospital mortality for infectious diseases.
How does the UK childcare energy-balance environment influence anthropometry of children aged 3–4 years? A cross-sectional exploration
Authors: Hesketh Kathryn R , Benjamin-Neelon Sara E , van Sluijs Esther M F
Published: July 2018

Objectives

To assess the association between time spent in care, the childcare energy-balance environment, and preschool-aged children’s body mass index z-score (z-BMI), waist-to-height ratio (WHR) and sum of skinfold thickness (SST).

Design

Cross-sectional study.

Setting and participants

Children aged 3–4 years were recruited from 30 childcare centres in Cambridgeshire (UK) in 2013.

Main outcome measures

Objectively measured height and weight was used to calculate z-BMI; waist circumference and height were used to generate WHR; subscapular and tricep skinfolds were used to calculate SST. Associations between childcare attendance, the nutrition, physical activity, and overall childcare environment, and three anthropometric outcomes were explored using two-level hierarchical regression models, adjusting for demographic and family based confounders.

Results

Valid data were available for 196 children (49% female). Time spent in care, the nutrition, physical activity and overall childcare environment were not associated with children’s z-BMI, WHR and SST.

Conclusions

Childcare environment and level of attendance were not associated with UK preschool-aged children’s anthropometry. The childcare environment has been central to intervention efforts to prevent/reduce early childhood obesity, yet other factors, including child-level, family level, wider environmental and policy-level factors warrant substantial attention when considering obesity prevention strategies for young children.
Comparison at the first prenatal visit of the maternal dietary intakes of smokers with non-smokers in a large maternity hospital: a cross-sectional study
Authors: O’Malley Eimer G , Cawley Shona , Reynolds Ciara M E , Kennedy Rachel A K , Molloy Anne , Turner Michael J
Published: July 2018

Objectives

Using detailed dietary and supplement questionnaires in early pregnancy, we compared the dietary intakes of micronutrients and macronutrients at the first prenatal visit of women who reported continuing to smoke during pregnancy with the intakes of women who were non-smokers.

Design

Cross-sectional study conducted between June 2014 and March 2016.

Setting

Stand-alone tertiary maternity hospital in an urban setting with approximately 8000 deliveries per year.

Participants

Women were recruited at their convenience after sonographic confirmation of an ongoing singleton pregnancy (n=502). Detailed dietary and supplement information was available for 398 women. Women <18 years and those who did not speak English fluently were excluded.

Primary and secondary outcome measures

The differences in dietary micronutrients and macronutrients and maternal folate levels between women who continued to smoke in pregnancy compared with non-smokers.

Results

Of the 502 women, the mean age was 30.5 (SD 5.6) years, 42.5% were nulliparas, 19.2% were obese and 398 (79.3%) completed the questionnaire satisfactorily. In the 50 (12.6%) current smokers, the micronutrients magnesium, iron, carotene and copper were lower (all p<0.005) whereas sodium and chloride were higher compared with the 348 (87.4%) non-smokers. Smokers reported lower intakes of dietary total folate (p=0.006) compared with non-smokers (i.e., dietary folate equivalents; intake from natural and fortified dietary sources) (p=0.005). Smokers also reported lower intakes of fibre than non-smokers (13.1 g (IQR 7.7) vs 16.3 g (IQR 8.5), p<0.001). The dietary intakes of former smokers compared favourably with non-smokers.

Conclusions

We found that women who continue to smoke during pregnancy have serious dietary inadequacies which could potentially aggravate fetal growth restriction associated with direct toxicity from cigarettes. This provides a further reason to promote smoking cessation interventions in pregnancy, and highlights the need for dietary and supplementation interventions in women who continue to smoke.
EMR-based handoff tool improves completeness of internal medicine residents’ handoffs
Authors: Tisdale Rebecca L , Eggers Zac , Shieh Lisa
Published: July 2018

Background

The majority of adverse events in healthcare involve communication breakdown. Physician-to-physician handoffs are particularly prone to communication errors, yet have been shown to be more complete when systematised according to a standardised bundle. Interventions that improve thoroughness of handoffs have not been widely studied.

Aim

To measure the effect of an electronic medical record (EMR)-based handoff tool on handoff completeness.

Intervention

This EMR-based handoff tool included a radio button prompting users to classify patients as stable, a ‘watcher’ or unstable. It automatically pulled in EMR data on the patient’s 24-hour vitals, common lab tests and code status. Finally, it provided text boxes labelled ‘Active Issues’, ‘Action List (To-Dos)’ and ‘If/Then’ to fill in.

Implementation and evaluation

Written handoffs from general and specialty (haematology, oncology, cardiology) Internal Medicine resident-run inpatient wards were evaluated on a randomly chosen representative sample of days in April and May 2015 at Stanford University Medical Center, focusing on a predefined set of content elements. The intervention was then implemented in June 2015 with postintervention data collected in an identical fashion in August to September 2016.

Results

Handoff completeness improved significantly (p<0.0001). Improvement in inclusion of illness severity was notable for its magnitude and its importance in establishing a consistent mental model of a patient. Elements that automatically pulled in data and those prompting users to actively fill in data both improved.

Conclusion

A simple EMR-based handoff tool providing a mix of frameworks for completion and automatic pull-in of objective data improved handoff completeness. This suggests that EMR-based interventions may be effective at improving handoffs, possibly leading to fewer medical errors and better patient care.
Improving postpartum care in a large hospital in New Delhi, India
Authors: Chopra Mona , Arora Neerja , Sinha Shailja , Holschneider Silvia , Livesley Nigel
Published: July 2018

Despite recent progress, the maternal mortality ratio (MMR) in India remains high at 174 per 100 000 live births. Bhagwan Mahavir Hospital (BMH) is a secondary level hospital in New Delhi. In 2013, five women died in BMH’s postpartum ward. In January 2014, a United States Agency for International Development-funded team met with BMH staff to help improve their system for providing postpartum care to prevent maternal deaths. The hospital staff formed a quality improvement (QI) team and, between January and December 2014, collected data, conducted root cause analyses to understand why postpartum women were dying and tested and adapted small-scale changes using plan-do-study-act cycles to delivery safer postpartum care. Changes included reorganising the ward to reduce the time it took nurses to assess women and educating women and their relatives about common danger signs. The changes led to an increase in the number of women who were identified with complications from two out of 1667 deliveries (0.12%) between January and May 2014 to 74 out of 3336 deliveries (2.2%) between July and December 2014. There were no deaths on the postpartum ward in 2014 compared with five deaths in 2013 but the reduction was not sustained after the hospital started accepting sick patients from other hospitals in 2015. QI approaches can improve the efficiency of care and contribute to improved outcomes. Additional strategies are required to sustain improvements.
Myocarditis in systemic lupus erythematosus diagnosed by18F-fluorodeoxyglucose positron emission tomography
Authors: Perel-Winkler Alexandra , Bokhari Sabahat , Perez-Recio Thania , Zartoshti Afshin , Askanase Anca , Geraldino-Pardilla Laura
Published: July 2018

Objectives

Cardiovascular diseaseand heart failure (CHF) are leading causes of death in systemic lupus erythematosus (SLE). The underlying mechanisms for increased CHF in SLE are unclear but myocardial inflammation and lupus myocarditis (LM) may play a role. We propose that18F-fluorodeoxyglucose–positron emission tomography (18F-FDG–PET)/CT can help diagnose LM.

Methods

This report describes eight patients with presumed LM; five patients were evaluated due to active cardiorespiratory symptoms and three patients were participating in a pilot study to determine the prevalence of subclinical myocarditis in SLE. Clinical characteristics, laboratory and cardiac testing including electrocardiography (ECG), transthoracic echocardiogram (TTE), coronary artery evaluation as well as18F-FDG–PET/CT imaging are discussed.

Results

Four patients were African American and the others were Hispanic. Half presented with chest pain; 37% had dyspnoea and 25% were asymptomatic. The median SLE Disease Activity Index (SLEDAI-2K) was 5 (2–18) and SLICC Damage Index (SDI) 0.5 (0–5). The median troponin level was 0.08 ng/mL (0–0.9). The most common ECG findings were non-specific ST-T wave abnormalities (n=5). Fifty per cent of the patients had a decreased ejection fraction on TTE and all patients had diffuse myocardial FDG uptake on18F-FDG–PET/CT consistent with myocardial inflammation.

Conclusion

This case series is the first to describe the use of18F-FDG–PET/CT in the diagnosis of LM and discuss the clinical characteristics and cardiac findings of eight patients with LM supporting the role for cardiac18F-FDG–PET/CT in its diagnosis.
Intraspecific mitogenomics of three marine species-at-risk: Atlantic, spotted, and northern wolffish (Anarhichasspp.)
Authors: Lait Linda A. , Carr Steven M.
Published: July 2018

High-resolution mitogenomics of within-species relationships can answer such phylogeographic questions as how species survived the most recent glaciation, as well as identify contemporary factors such as physical barriers, isolation, and gene flow. We examined the mitogenomic population structure of three at-risk species of wolffish: Atlantic (Anarhichas lupus), spotted (A. minor), and northern (A. denticulatus). These species are extensively sympatric across the North Atlantic but exhibit very different life history strategies, a combination that results in concordant and discordant patterns of genetic variation and structure. Wolffish haplogroups were not structured geographically: Atlantic and spotted wolffish each comprised three shallow clades, whereas northern wolffish comprised two deeper but unstructured lineages. We suggest that wolffish species survived in isolation in multiple glacial refugia, either refugia within refugia (Atlantic and spotted wolffish) or more distant refugia (northern wolffish), followed by secondary admixture upon post-glacial recolonisation of the North Atlantic.
Multicolor barium molybdate phosphors doped with Re3+ (Re = Eu, Sm, Tb, Dy) via solid-state method: Synthesis and characterizations
Authors: Wang Liyong , Guo Xiaoqing , Song Qingwei , Li Jia , Wang Xue , Wang Nan , Li Yanze , Han Yuanyuan , Jia Guang
Published: July 2018

Barium molybdate (BMO) powders doped with Re[Formula: see text] (Eu, Sm, Tb, Dy) were successfully synthesized by the solid-state reaction with the assistance of polyvinyl alcohol (PVA). The effects of the reaction conditions and activator ions on the structural and luminescence properties of BMO were extensively investigated. The results of powder X-ray diffraction (XRD) and Raman spectra exhibited the structures of the phosphors, which demonstrate that the Eu[Formula: see text] have been effectively doped into the BaMoO4 (BMO) lattice. The factors of PVA amount, Eu[Formula: see text]-doped concentration and different dopants on phosphor samples were investigated via photoluminescence (PL) measurements. The as-synthesized samples degrade as a two-step degradation by thermogravimetric analysis. BMO phosphors show strong multicolor emission with different dopant RE[Formula: see text] ions: red–orange (Eu[Formula: see text]), red (Sm[Formula: see text]), green (Tb[Formula: see text]) and green–yellow (Dy[Formula: see text]) under ultraviolet excitation, which may find potential applications in light phosphor powders, light-emitting diodes (LEDs) and device in photochemical field.
Role of σR2 + γRμνTμν model on anisotropic polytropes
Authors: Sharif M. , Waseem Arfa
Published: July 2018

This paper analyzes the anisotropic stellar evolution governed by polytropic equation-of-state in the framework of [Formula: see text] gravity, where [Formula: see text]. We construct the field equations, hydrostatic equilibrium equation and trace equation to obtain their solutions numerically under the influence of [Formula: see text] gravity model, where [Formula: see text] and [Formula: see text] are arbitrary constants. We examine the dependence of various physical characteristics such as radial/tangential pressure, energy density, anisotropic factor, total mass and surface redshift for specific values of the model parameters. The physical acceptability of the considered model is discussed by verifying the validity of energy conditions, causality condition and adiabatic index. We also study the effects arising due to strong nonminimal matter-curvature coupling on anisotropic polytropes. It is found that the polytropic stars are stable and their maximum mass point lies within the required observational Chandrasekhar limit.
Generalized inverses and their relations with clean decompositions
Authors: Zhu Huihui , Zou Honglin , Patrício Pedro
Published: July 2018

An element [Formula: see text] in a ring [Formula: see text] is called clean if it is the sum of an idempotent [Formula: see text] and a unit [Formula: see text]. Such a clean decomposition [Formula: see text] is said to be strongly clean if [Formula: see text] and special clean if [Formula: see text]. In this paper, we prove that [Formula: see text] is Drazin invertible if and only if there exists an idempotent [Formula: see text] and a unit [Formula: see text] such that [Formula: see text] is both a strongly clean decomposition and a special clean decomposition, for some positive integer [Formula: see text]. Also, the existence of the Moore–Penrose and group inverses is related to the existence of certain ∗-clean decompositions.
Magnitude Variation of Arterial Blood Pressure Measured Using Holo–Hilbert Spectral Analysis
Authors: Lee Jia-Hua , Hsiao Tzu-Chien , Chang Chia-Chi , Hsu Hung-Yi
Published: July 2018

Arterial blood pressure (ABP) is one of the most crucial cardiovascular indicators in clinical practice. Hilbert–Huang transform (HHT) has been performed on ABP signals and resulted in ABP variability. The instantaneous P-wave interval variation had been further examined with baroreflex sensitivity. However, the instantaneous magnitude variation of ABP signal is still unclear with the pulse pressure (PP) variability. In 2016, Holo–Hilbert spectral analysis (HHSA) extended the HHT method for identifying the amplitude-modulated (AM) characteristics of signals. This method was applied to investigate the magnitude variation of ABP signal during different respiratory manipulations in this study. The results indicated that the AM parts were moderately correlated with PP series and corresponding respiratory patterns. The [Formula: see text]-values on PP series are [Formula: see text], and [Formula: see text] for spontaneous breathing, six-cycle breathing, and hyperventilation, respectively. The values on respiratory patterns are [Formula: see text], and [Formula: see text] for spontaneous breathing, six-cycle breathing, and hyperventilation, respectively. This study concludes that ABP signal with HHSA presents the corresponding PP series, the respiratory-related activities, and the respiratory effect on PP variability. This is the first demonstration of the magnitude variation of ABP signal and further research in this area is warranted.
Structural and thermal evolution of the South Tibetan Detachment shear zone in the Mt Everest region, from the 1933 sample collection of L. R. Wager
Authors: Waters David J. , Law Richard D. , Searle Michael P. , Jessup Micah J.
Published: July 2018

Microstructural and petrological data from >60 samples, collected by L.R. Wager in 1933, have been used alongside existing data to investigate temperature gradients and deformational style in four profiles across the South Tibetan Detachment shear zone, over a north–south distance of 35 km in the Mt Everest area, east-central Himalaya. The ductile shear zone, defined on petrographic criteria, extends for
c.
900 m beneath the brittle Qomolangma Detachment (QD). New thermobarometry from the north flank of Mt Everest reveals a gradient from 440°C at the QD down to samples recording peak conditions around 650°C, 5.5 kbar. The upper limit of leucogranite sheets forms an approximately isothermal surface at 600–650°C within the developing shear zone. The recrystallized grain size of quartz shows a systematic increase down-section in four transects. Profiles of deformation temperature reveal gradients of up to 200°C km
−1
whose formation and preservation required a combination of processes: a shear zone active for a short period (≤18–15.5 Ma) at high strain rates, with a component of vertical shortening, and a contribution of latent heat from emplacement of sheeted granites. The likely horizontal displacement was >40 km, with up to 10 km of vertical exhumation.
Routes to rights: internet architecture and values in times of ossification and commercialization
Authors: ten Oever Niels , Beraldo Davide
Published: July 2018

This article discusses the consequences of the commercialization and evolution of the Internet infrastructure, and how it affects our ability to exercise human rights online.