bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of dynamic ruptures generating seismic waves in a self-gravitating planet: An iterative coupling scheme and well-posedness
Authors: de Hoop Maarten , Kumar Kundan , Ye Ruichao
Published: November 2019

We study the solution of the system of equations describing the dynamical evolution of spontaneous ruptures generated in a prestressed elastic-gravitational deforming body and governed by rate and state friction laws. We propose an iterative coupling scheme based on a weak formulation with nonlinear interior boundary conditions, both for continuous time and with implicit discretization (backward Euler) in time. We regularize the problem by introducing viscosity. This guarantees the convergence of the scheme for solutions of the regularized problems in both cases. We also make precise the conditions on the relevant coefficients for convergence to hold.
Evaluating Effects of a Critical Micronutrient (24-Methylenecholesterol) on Honey Bee Physiology
Authors: Chakrabarti Priyadarshini , Lucas Hannah M , Sagili Ramesh R
Published: November 2019

Although poor nutrition is cited as one of the crucial factors in global pollinator decline, the requirements and role of several important nutrients (especially micronutrients) in honey bees are not well understood. Micronutrients, viz. phytosterols, play a physiologically vital role in insects as precursors of important molting hormones and building blocks of cellular membranes. There is a gap in comprehensive understanding of the impacts of dietary sterols on honey bee physiology. In the present study, we investigated the role of 24-methylenecholesterol—a key phytosterol—in honey bee nutritional physiology. Artificial diets with varying concentrations of 24-methylenecholesterol (0%, 0.1%. 0.25%, 0.5%, 0.75%, and 1% dry diet weight) were formulated and fed to honey bees in a laboratory cage experiment. Survival, diet consumption, head protein content, and abdominal lipid contents were significantly higher in dietary sterol-supplemented bees. Our findings provide additional insights regarding the role of this important sterol in honey bee nutritional physiology. The insights gleaned from this study could also advance the understanding of sterol metabolism and regulation in other bee species that are dependent on pollen for sterols, and assist in formulation of a more complete artificial diet for honey bees (Apis mellifera Linnaeus, 1758) (Hymenoptera: Apidae).
Is Banning Texturized Implants to Prevent Breast Implant-Associated Anaplastic Large Cell Lymphoma a Rational Decision? A Meta-Analysis and Cost-Effectiveness Study
Authors: Danilla Stefan V , Jara Rocio P , Miranda Felipe , Bencina Francisco , Aguirre Marcela , Troncoso Ekaterina , Erazo Cristian A , Andrades Patricio R , Sepulveda Sergio L , Albornoz Claudia R
Published: November 2019

Background

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an emergent disease that threatens patients with texturized breast implants. Major concerns about the safety of these implants are leading to global changes to restrict the utilization of this product. The principal alternative is to perform breast augmentation utilizing smooth implants, given the lack of association with BIA-ALCL. The implications and costs of this intervention are unknown.

Objectives

The authors of this study determined the cost-effectiveness of smooth implants compared with texturized implants for breast augmentation surgery.

Methods

A tree decision model was utilized to analyze the cost-effectiveness. Model input parameters were derived from published sources. The capsular contracture (CC) rate was calculated from a meta-analysis. Effectiveness measures were life years, avoided BIA-ALCL, avoided deaths, and avoided reoperations. A sensitivity analysis was performed to test the robustness of the model.

Results

For avoided BIA-ALCL, the incremental cost was $18,562,003 for smooth implants over texturized implants. The incremental cost-effectiveness ratio was negative for life years, and avoided death and avoided reoperations were negative. The sensitivity analysis revealed that to avoid 1 case of BIA-ALCL, the utilization of smooth implants would be cost-effective for a risk of developing BIA-ALCL equal to or greater than 1:196, and there is a probability of CC with smooth implants equal to or less than 0.096.

Conclusions

The utilization of smooth implants to prevent BIA-ALCL is not cost-effective. Banning texturized implants to prevent BIA-ALCL may involve additional consequences, which should be considered in light of higher CC rates and more reoperations associated with smooth implants than with texturized implants.
Population demography, genetic variation and reproductive biology of two rare and endangered Neoregelia species (Bromeliaceae)
Authors: Freitas Leandro , Ribeiro Priciane C C , Cancio Aline S , Machado Marco A , Sampaio Michelle C , Forzza Rafaela C , Viccini Lyderson F
Published: November 2019

Although plant demography, genetics and reproduction are inter-related processes, few studies on rare tropical plants have attempted to integrate them. We used an integrated approach to study two endangered Neoregelia spp. from the Brazilian Atlantic Forest. The floral phenotypes of N. ibitipocensis and N. oligantha are similar, and both species are visited and pollinated only by bumblebees. Flowers of N. ibitipocensis secrete copious nectar, which bees can access only by forcing the corolla to open, whereas flowers of N. oligantha are nectarless. Neoregelia ibitipocensis is self-incompatible and pollen-limited, whereas N. oligantha is self-compatible and sets fruits spontaneously. Population growth rates indicate an increasing population size for both species, although to a lesser extent for N. oligantha. Genetic diversity as a whole was moderate; Bayesian analysis indicated a spatially structured cluster for N. ibitipocensis populations, and genetic diversity was scattered across the distribution of N. oligantha. Despite these differences, vegetative reproduction via clonal growth was the main component of population structuring in both species. Limited seed production in N. ibitipocensis and the risk of genetic drift in N. oligantha seem to be the main threats to their persistence.
Rethinking Digital Democracy: From the Disembodied Discursive Self to New Materialist Corporealities
Authors: Asenbaum Hans
Published: November 2019

To understand what digital democracy is, this article suggests looking at the individual level of democratic subjectivity. Who is the democratic subject and how is it constituted in digital democracy? It revisits the poststructuralist-inspired debate about cyberdemocracy in the 1990s, which conceptualized the democratic subject as disembodied discursive self, reifying through textuality in cyberspace. In contrast, current debates on new materialism offer novel perspectives with attention to the materiality of bodies and things. New materialist thought has been fruitfully incorporated for social interaction online, but they have yet to be applied to political participation. By discussing three examples of political online participation in which users materialize their classed, raced, and gendered bodies, this article contributes to a novel understanding of embodied democratic subjectivity in the digital age.
Genetic Diversity of Composite Enterotoxigenic Staphylococcus epidermidis Pathogenicity Islands
Authors: Banaszkiewicz Sylwia , Calland Jessica K , Mourkas Evangelos , Sheppard Samuel K , Pascoe Ben , Bania Jacek
Published: November 2019

The only known elements encoding enterotoxins in coagulase-negative staphylococci are composite Staphylococcus epidermidis pathogenicity islands (SePIs), including SePI and S. epidermidis composite insertion (SeCI) regions. We investigated 1545 Staphylococcus spp. genomes using whole-genome MLST, and queried them for genes of staphylococcal enterotoxin family and for 29 ORFs identified in prototype SePI from S. epidermidis FRI909. Enterotoxin-encoding genes were identified in 97% of Staphylococcus aureus genomes, in one Staphylococcus argenteus genome and in nine S. epidermidis genomes. All enterotoxigenic S. epidermidis strains carried composite SePI, encoding sec and sel enterotoxin genes, and were assigned to a discrete wgMLST cluster also containing genomes with incomplete islands located in the same region as complete SePI in enterotoxigenic strains. Staphylococcus epidermidis strains without SeCI and SePI genes, and strains with complete SeCI and no SePI genes were identified but no strains were found to carry only SePI and not SeCI genes. The systematic differences between SePI and SeCI regions imply a lineage-specific pattern of inheritance and support independent acquisition of the two elements in S. epidermidis. We provided evidence of reticulate evolution of mobile elements that contain elements with different putative ancestry, including composite SePI that contains genes found in other coagulase-negative staphylococci (SeCI), as well as in S. aureus (SePI-like elements). We conclude that SePI-associated elements present in nonenterotoxigenic S. epidermidis represent a scaffold associated with acquisition of virulence-associated genes. Gene exchange between S. aureus and S. epidermidis may promote emergence of new pathogenic S. epidermidis clones.
The Mitogenome of Norway Spruce and a Reappraisal of Mitochondrial Recombination in Plants
Authors: Sullivan Alexis R , Eldfjell Yrin , Schiffthaler Bastian , Delhomme Nicolas , Asp Torben , Hebelstrup Kim H , Keech Olivier , Öberg Lisa , Møller Ian Max , Arvestad Lars , Street Nathaniel R , Wang Xiao-Ru
Published: November 2019

Plant mitogenomes can be difficult to assemble because they are structurally dynamic and prone to intergenomic DNA transfers, leading to the unusual situation where an organelle genome is far outnumbered by its nuclear counterparts. As a result, comparative mitogenome studies are in their infancy and some key aspects of genome evolution are still known mainly from pregenomic, qualitative methods. To help address these limitations, we combined machine learning and in silico enrichment of mitochondrial-like long reads to assemble the bacterial-sized mitogenome of Norway spruce (Pinaceae: Picea abies). We conducted comparative analyses of repeat abundance, intergenomic transfers, substitution and rearrangement rates, and estimated repeat-by-repeat homologous recombination rates. Prompted by our discovery of highly recombinogenic small repeats in P. abies, we assessed the genomic support for the prevailing hypothesis that intramolecular recombination is predominantly driven by repeat length, with larger repeats facilitating DNA exchange more readily. Overall, we found mixed support for this view: Recombination dynamics were heterogeneous across vascular plants and highly active small repeats (ca. 200 bp) were present in about one-third of studied mitogenomes. As in previous studies, we did not observe any robust relationships among commonly studied genome attributes, but we identify variation in recombination rates as a underinvestigated source of plant mitogenome diversity.
True-amplitude versus trace-normalized full waveform inversion
Authors: Wang Zhikai , Singh Satish C , Noble Mark
Published: November 2019

Full waveform inversion (FWI) is a powerful method to estimate high-resolution physical parameters of the subsurface by iteratively minimizing the misfit between the observed and synthetic seismic data. Standard FWI algorithms measure seismic misfit between amplitude-preserved seismic data (true-amplitude FWI). However, in order to mitigate the variations in sources and recording systems acquired on complex geological structures and the physics that cannot be modelled using an approximation of the seismic wave equation, the observed and synthetic seismic data are normalized trace-by-trace and then used to perform FWI. Trace-by-trace normalization removes the amplitude effects related to offset variations and only keeps the phase information. Furthermore, trace-by-trace normalization changes the true amplitude difference because of different normalization factors used for the corresponding synthetic and observed traces. In this paper, we study the performance of true-amplitude FWI and trace-normalized-residual-based FWI in the time domain. The misfit function of trace-normalized-residual-based FWI is defined such that the adjoint source used in gradient calculation is the trace-normalized seismic residual. We compare the two inversion schemes with synthetic seismic data simulated on laterally invariant models and the more complex 2-D Marmousi model. In order to simulate realistic scenarios, we perform the elastic FWI ignoring attenuation to noisy seismic data and to the synthetic data modelled using a viscoelastic modelling scheme. Comparisons of seismic data and adjoint sources show that trace-by-trace normalization increases the magnitude of seismic data at far offsets, which are usually more cycle-skipped than those at near offsets. The inverted results on linear-gradient models demonstrate that trace-by-trace normalization increases the non-linearity of FWI, so an initial model with sufficient accuracy is required to guarantee the convergence to the global minimum. The inverted results and the final seismic residuals computed using seismic data without trace-by-trace normalization demonstrate that true-amplitude FWI provides inverted models with higher accuracy than trace-normalized-residual-based FWI, even when the unknown density is updated using density–velocity relationship in inversion or in the presence of noise and complex physics, such as attenuation.
Gannets are not attracted to fishing vessels in Iceland—potential influence of a discard ban and food availability
Authors: Clark Bethany L , Vigfúsdóttir Freydís , Jessopp Mark J , Burgos Julian M , Bodey Thomas W , Votier Stephen C
Published: November 2019

Fisheries produce large amounts of waste, providing food subsidies for scavengers. Discards influence seabird movement, demography and community structure, but little is known about seabird–fishery interactions where discarding is banned. Here, we investigate how northern gannets Morus bassanus respond to fishing vessels in Iceland, where discarding commercial species is illegal, but birds may still access bait, offal, or catch. We GPS-tracked 82 foraging trips for 36 breeding gannets from two colonies (Skrúður and Hellisey) and obtained time-matched vessel locations. We classified bird behaviour using Hidden Markov Models and then tested the effect of vessel distance on behavioural state-switching using multi-state Markov models. Fishing vessels were present during 94% of foraging trips. However, the likelihood of gannets switching from travelling to foraging was unaffected by vessel proximity, regardless of gear type or activity. When encountering vessels, gannets rarely foraged but instead were more likely to continue travelling. When controlling for population size, gannet foraging trips at both colonies were shorter than expected, suggesting favourable conditions. The lack of behavioural responses to vessels among Icelandic gannets is likely driven by the discard ban and availability of pelagic fishes. Our findings have implications for understanding bycatch risk and the consequences of discard reforms.
Reducibility of Schrödinger Equation on the Sphere
Authors: Feola Roberto , Grébert Benoît
Published: November 2019

In this article we prove a reducibility result for the linear Schrödinger equation on the sphere $\mathbb{S}^n$ with quasi-periodic in time perturbation. Our result includes the case of unbounded perturbation that we assume to be of order strictly less than $1/2$ and satisfying some parity condition. As far as we know, this is one of the few reducibility results for an equation in more than one dimension with unbounded perturbations. Letus note that, surprisingly, our result does not require the use of the pseudo-differential calculus although the perturbation is unbounded.
Using elastic nets to estimate frailty burden from routinely collected national aged care data
Authors: Moldovan Max , Khadka Jyoti , Visvanathan Renuka , Wesselingh Steve , Inacio Maria C
Published: November 2019

Objectives

To (1) use an elastic net (EN) algorithm to derive a frailty measure from a national aged care eligibility assessment program; (2) compare the ability of EN-based and a traditional cumulative deficit (CD) based frailty measures to predict mortality and entry into permanent residential care; (3) assess if the predictive ability can be improved by using weighted frailty measures.

Materials and Methods

A Cox proportional hazard model based EN algorithm was applied to the 2003–2013 cohort of 903 996 participants for selecting items to enter an EN based frailty measure. The out-of-sample predictive accuracy was measured by the area under the curve (AUC) from Cox models fitted to 80% training and validated on 20% testing samples.

Results

The EN approach resulted in a 178-item frailty measure including items excluded from the 44-item CD-based measure. The EN based measure was not statistically significantly different from the CD-based approach in terms of predicting mortality (AUC 0.641, 95% CI: 0.637–0.644 vs AUC 0.637, 95% CI: 0.634–0.641) and permanent care entry (AUC 0.626, 95% CI: 0.624–0.629 vs AUC 0.627, 95% CI: 0.625–0.63). However, the weighted EN based measure statistically outperforms the weighted CD measure for predicting mortality (AUC 0.774, 95% CI: 0.771–0.777 vs AUC 0.757, 95% CI: 0.754–0.760) and permanent care entry (AUC 0.676, 95% CI: 0.673–0.678 vs AUC 0.671, 95% CI: 0.668–0.674).

Conclusions

The weighted EN and CD-based measures demonstrated similar prediction performance. The CD-based measure items are relevant to frailty measurement and easier to interpret. We recommend using the weighted and unweighted CD-based frailty measures.
Cusp or core? Revisiting the globular cluster timing problem in Fornax
Authors: Meadows Noah , Navarro Julio F , Santos-Santos Isabel , Benítez-Llambay Alejandro , Frenk Carlos
Published: November 2019

We use N-body simulations to revisit the globular cluster (GC) ‘timing problem’ in the Fornax dwarf spheroidal (dSph). In agreement with earlier work, we find that, due to dynamical friction, GCs sink to the centre of dark matter haloes with a cuspy inner density profile but ‘stall’ at roughly 1/3 of the core radius (rcore) in haloes with constant-density cores. The time-scales to sink or stall depend strongly on the mass of the GC and on the initial orbital radius, but are essentially the same for either cuspy (Navarro–Frenk–White) or cored haloes normalized to have the same total mass within rcore. Arguing against a cusp on the basis that GCs have not sunk to the centre is thus no different from arguing against a core, unless all clusters are today at $\sim(1/3)\,r_{\rm core}$. This would imply a core radius exceeding ∼3 kpc, much larger than seems plausible in any core-formation scenario. (The average projected distance of Fornax GCs is 〈RGC, Fnx〉 ∼ 1 kpc and its effective radius is ∼700 pc.) A simpler explanation is that Fornax GCs have only been modestly affected by dynamical friction, as expected if clusters started orbiting at initial radii of the order of ∼1–2 kpc, just outside Fornax’s present-day half-light radius but well within the tidal radius imprinted by Galactic tides. This is not entirely unexpected. Fornax GCs are significantly older and more metal-poor than most Fornax stars, and such populations in dSphs tend to be more spatially extended than their younger and more metal-rich counterparts. Contrary to some earlier claims, our simulations further suggest that GCs do not truly ‘stall’ at $\sim 0.3\, r_{\rm core}$, but rather continue decaying towards the centre, albeit at reduced rates. We conclude that dismissing the presence of a cusp in Fornax based on the spatial distribution of its GC population is unwarranted.
Searching for volcanic activity and a mercury-like exosphere of the super-Earth HD3167 b
Authors: Guenther Eike W , Kislyakova Kristina G
Published: November 2019

HD3167 b is a transiting super-Earth that has a density which is consistent with a rocky composition. The planet is exposed to strong radiation, intense stellar wind, and likely strong tidal forces and induction heating. According to theory, planets that are so close to the star should have an atmosphere like Mercury but much more extended and denser. Other theories predict that such planets have a lava lake on their surfaces and exhibit an enormous volcanic activity. We have calculated the heating by electromagnetic induction to estimate if it can drive significant volcanic activity at HD3167 b and shown that for some magnetic fields the heating can be substantial. HD3167 is an ideal target to search for the exosphere of a planet, and signs of volcanic activity. We observed the planet in- and out-of transit with Ultraviolet and Visual Échelle Spectrograph in order to search for presence of lines originating from the exosphere of the planet such as the $\rm Na\, D_{1,2}$ and Ca ii H&K lines as well as numerous [S II], [S III], and [O III] lines that are tracers of volcanic activity. We derived upper limits for the ratios of the line fluxes to the stellar flux. The upper limits that we derived are $I_{p,\lambda }/I_{*,\lambda }=1.5\, 10^{-3}$ for the Ca ii H&K lines, and $I_{p,\lambda }/I_{*,\lambda }=7.2\, 10^{-4}$ and $I_{p,\lambda }/I_{*,\lambda }=3.3\, 10^{-4}$ for the $\rm NaD_{1,2}$ lines, respectively. The fact that our upper limits correspond to previous detections in 55 Cnc e shows that not all super-Earth show these lines all the time and that they might be variable. we took the text from the GAIA, SIMBAD and APPLAUSE web-pages.
Formation of compact systems of super-Earths via dynamical instabilities and giant impacts
Authors: Poon Sanson T S , Nelson Richard P , Jacobson Seth A , Morbidelli Alessandro
Published: November 2019

The NASA’s Kepler mission discovered ∼700 planets in multiplanet systems containing three or more transiting bodies, many of which are super-Earths and mini-Neptunes in compact configurations. Using N-body simulations, we examine the in situ, final stage assembly of multiplanet systems via the collisional accretion of protoplanets. Our initial conditions are constructed using a subset of the Kepler five-planet systems as templates. Two different prescriptions for treating planetary collisions are adopted. The simulations address numerous questions: Do the results depend on the accretion prescription?; do the resulting systems resemble the Kepler systems, and do they reproduce the observed distribution of planetary multiplicities when synthetically observed?; do collisions lead to significant modification of protoplanet compositions, or to stripping of gaseous envelopes?; do the eccentricity distributions agree with those inferred for the Kepler planets? We find that the accretion prescription is unimportant in determining the outcomes. The final planetary systems look broadly similar to the Kepler templates adopted, but the observed distributions of planetary multiplicities or eccentricities are not reproduced, because scattering does not excite the systems sufficiently. In addition, we find that ∼1 per cent of our final systems contain a co-orbital planet pair in horseshoe or tadpole orbits. Post-processing the collision outcomes suggests that they would not significantly change the ice fractions of initially ice-rich protoplanets, but significant stripping of gaseous envelopes appears likely. Hence, it may be difficult to reconcile the observation that many low-mass Kepler planets have H/He envelopes with an in situ formation scenario that involves giant impacts after dispersal of the gas disc.
Impact of 1/f noise on cosmological parameter constraints for SKA intensity mapping
Authors: Chen T , Battye R A , Costa A A , Dickinson C , Harper S E
Published: November 2019

We investigate the impact of 1/f noise on cosmology for an intensity mapping survey with SKA1-MID Band 1 and Band 2. We use a Fisher matrix approach to forecast constraints on cosmological parameters under the influence of 1/f noise, adopting a semi-empirical model from an earlier work, which results from the residual 1/f noise spectrum after applying a component separation algorithm to remove smooth spectral components. Without 1/f noise, the projected constraints are $4{{\ \rm per\ cent}}$ on w0, $1{{\ \rm per\ cent}}$ on h, $2{{\ \rm per\ cent}}$ on bH i using Band 1+Planck, and $3{{\ \rm per\ cent}}$ on w0, $0.5{{\ \rm per\ cent}}$ on h, $2{{\ \rm per\ cent}}$ on bH i using Band 2+Planck. A representative baseline 1/f noise degrades these constraints by a factor of ∼1.5 for Band 1+Planck, and ∼1.2 for Band 2+Planck. On the power spectrum measurement, higher redshift and smaller scales are more affected by 1/f noise, with minimal contamination comes from z ≲ 1 and ℓ ≲ 100. Subject to the specific scan strategy of the adopted 1/f noise model, one prefers a correlation in frequency with minimized spectral slope, a low knee frequency, and a large telescope slew speed in order to reduce its impact.
Epigenetic modification of cytosines fine tunes the stability of i-motif DNA
Authors: Wright Elisé P , Abdelhamid Mahmoud A S , Ehiabor Michelle O , Grigg Melanie C , Irving Kelly , Smith Nicole M , Waller Zoë A E
Published: November 2019

i-Motifs are widely used in nanotechnology, play a part in gene regulation and have been detected in human nuclei. As these structures are composed of cytosine, they are potential sites for epigenetic modification. In addition to 5-methyl- and 5-hydroxymethylcytosine modifications, recent evidence has suggested biological roles for 5-formylcytosine and 5-carboxylcytosine. Herein the human telomeric i-motif sequence was used to examine how these four epigenetic modifications alter the thermal and pH stability of i-motifs. Changes in melting temperature and transitional pH depended on both the type of modification and its position within the i-motif forming sequence. The cytosines most sensitive to modification were next to the first and third loops within the structure. Using previously described i-motif forming sequences, we screened the MCF-7 and MCF-10A methylomes to map 5-methylcytosine and found the majority of sequences were differentially methylated in MCF7 (cancerous) and MCF10A (non-cancerous) cell lines. Furthermore, i-motif forming sequences stable at neutral pH were significantly more likely to be epigenetically modified than traditional acidic i-motif forming sequences. This work has implications not only in the epigenetic regulation of DNA, but also allows discreet tunability of i-motif stability for nanotechnological applications.
mRNA regions where 80S ribosomes pause during translation elongation in vivo interact with protein uS19, a component of the decoding site
Authors: Babaylova Elena S , Gopanenko Alexander V , Bulygin Konstantin N , Tupikin Alexey E , Kabilov Marsel R , Malygin Alexey A , Karpova Galina G
Published: November 2019

In eukaryotic ribosomes, the conserved protein uS19, formerly known as S15, extends with its C-terminal tail to the decoding site. The cross-linking of uS19 to the A site codon has been detected using synthetic mRNAs bearing 4-thiouridine (s4U) residues. Here, we showed that the A-site tRNA prevents this cross-linking and that the P site codon does not contact uS19. Next, we focused on determining uS19-mRNA interactions in vivo by applying the photoactivatable-ribonucleoside enhancing cross-linking and immunoprecipitation method to a stable HEK293 cell line producing FLAG-tagged uS19 and grown in a medium containing s4U. We found that when translation was stopped by cycloheximide, uS19 was efficiently cross-linked to mRNA regions with a high frequency of Glu, Lys and, more rarely, Arg codons. The results indicate that the complexes, in which the A site codon is not involved in the formation of the mRNA-tRNA duplex, are present among the cycloheximide-arrested 80S complexes, which implies pausing of elongating ribosomes at the above mRNA regions. Thus, our findings demonstrate that the human ribosomal protein uS19 interacts with mRNAs during translation elongation and highlight the regions of mRNAs where ribosome pausing occurs, bringing new structural and functional insights into eukaryotic translation in vivo.
Risk of hyperkalemia from renin–angiotensin–aldosterone system inhibitors and factors associated with treatment discontinuities in a real-world population
Authors: Wetmore James B , Yan Heng , Horne Laura , Peng Yi , Gilbertson David T
Published: November 2019

Background

Hyperkalemia rates in renin–angiotensin–aldosterone system (RAAS) inhibitor users, and factors associated with treatment interruptions and cessations, have not been explored in a large, population-wide database.

Methods

RAAS inhibitor users were identified in the linked UK Clinical Practice Research Datalink-Hospital Episodes Statistics data set, 2009–15. Treatment interruptions (no active prescription followed by reappearance) and cessations were determined. Hyperkalemia (serum K+>5.5 mmol/L) rates were calculated and factors associated with interruptions and cessations modeled using time-varying Cox regression, including hyperkalemia (as a time-dependent variable).

Results

Among 434 027 RAAS inhibitor users, the hyperkalemia rate was 1.30 (95% confidence interval 1.28–1.32) per 100 patient-years. Of 73.7% of patients who experienced off-treatment periods, 57.6% experienced interruption only, 7.5% cessation only and 8.6% both. Within 1 year of initiating RAAS inhibitor treatment, approximately one-third of the patients experienced interruption or cessation. Hazard ratios for patients with severe hyperkalemia were 1.10 (10.5–1.16) for interruptions and 3.37 (3.25–3.50) for cessation. Compared with no chronic kidney disease (CKD), risk of interruption was 1.20 (1.16–1.25) and 1.57 (1.44–1.72) for Stages 4 and 5, respectively, and of cessation was 2.20 (2.07–2.33) and 2.87 (2.56–3.22). Risk of interruption increased for patients with heart failure or diabetes [1.04 (1.02–1.05); 1.13 (1.12–1.14), respectively] but the risk of cessation decreased [0.85 (0.82–0.87); 0.92 (0.90–0.94)].

Conclusions

Risk of RAAS inhibitor interruption and cessation increased as CKD stage progressed. Efforts targeting reasons for interruptions and, especially, cessations, such as hyperkalemia prevention, could decrease off-treatment periods for patients who would otherwise benefit, such as those with CKD, heart failure or diabetes.
Religion in Interesting Times: Contesting Form, Function, and Future
Authors: Beyer Peter
Published: November 2019

Religion in our world is not just a contested category, it is also one which does political work, having implications for the distribution of power in society. Classifying social action and symbols as religion or as something else, above all culture or spirituality, has political implications and is used to carry out political struggles. Starting from two concrete contemporary examples drawn from the Canadian context having to do with smudging and the crucifix, the article argues that the historical form that religion has taken functioned in earlier modern centuries as a way of favourably distributing power to religion’s carriers; but that with the progressive development of secular forms of power, religion has progressively been moving towards become a form that is mostly neutral in terms of social power distribution but can also be a source of power loss, these through interrelated processes of privatization, pluralization, and voluntarization. In current circumstances, therefore, in order for what is or was religious form to preserve or regain its erstwhile function for privileged power distribution, one sees attempts in various instances to dissolve religion into other categories and forms; here the prime instances are (national) culture and (instrumental) spirituality. If this process continues and counter-movements do not succeed, then this points to the progressive deinstitutionalisation of religion in the future, its dissolution into collective culture and personal spirituality, while maintaining its religious form in smaller local and transnational organizations and movements.
Effect of Intratracheal Instillation of ZnO Nanoparticles on Acute Lung Inflammation Induced by Lipopolysaccharides in Mice
Authors: Wang Ping , Zhang Lin , Liao Yanxia , Du Juan , Xu Mengying , Zhao Wen , Yin Shuxian , Chen Guilan , Deng Yu , Li Yiran , Xue Xue , Yang Yiming , Hu Guodong , Chen Yinghua
Published: November 2019

Although studies have shown toxic effects of zinc oxide (ZnO) particles following inhalation, additional effects on injured lungs, which are characterized by dysfunction of the alveolar-capillary barriers, remain uncharacterized. To explore these additional effects, nano-sized ZnO (nZnO) and bulk-sized ZnO were applied to lipopolysaccharide (LPS)-challenged mouse lungs, which were used as a disease model of acute lung inflammation. An elevated Zn2+ concentration was detected in lung tissue after LPS plus nZnO exposure. Exposure to nZnO in LPS-challenged mice resulted in higher total cell number, proportion of neutrophils, and total protein level in bronchoalveolar lavage fluid. Intratracheal instillation of nZnO intensively aggravated LPS-induced lung inflammation that was accompanied by enhanced expression of interleukin-1β, interleukin-6, monocyte chemotactic protein-1α, and granulocyte-macrophage colony stimulating factor. Catalase, glutathione, and total superoxide dismutase levels were significantly decreased, and the malondialdehyde level was obviously increased in the LPS plus nZnO group. 8-Hydroxyguanosine, a marker for DNA damage, was highly concentrated in the lungs from the LPS plus nZnO group. Furthermore, nZnO increased lung apoptosis in an acute lung inflammation model. Taken together, this evidence indicates that nZnO aggravates lung inflammation related to LPS. This enhancement effect may be mediated via oxidative stress, which can lead to DNA damage and apoptosis. This work is important because of the ever-increasing exposure of people to ZnO nanoparticles in industry. The identification of the toxic effects of nZnO and possible mechanisms revealed in this study provide valuable information for future studies.
Hepatic Injury Caused by the Environmental Toxicant Vinyl Chloride is Sex-Dependent in Mice
Authors: Wahlang Banrida , Hardesty Josiah E , Head Kimberly Z , Jin Jian , Falkner Keith C , Prough Russell A , Cave Matthew C , Beier Juliane I
Published: November 2019

Vinyl chloride (VC), a common industrial chemical, has been associated with hemangiosarcoma and toxicant-associated steatohepatitis (TASH) in men working at rubber-production plants. Our group previously demonstrated that chronic VC inhalation at environmentally relevant levels (< 1 ppm) in male mice exacerbated hepatic injury caused by high-fat diet (HFD) feeding. Because VC studies on TASH have only been performed in male models, the objective of this study is to examine VC inhalation in female mice in the context of TASH mechanisms. Male and female C57Bl/6 mice were fed either a low-fat diet or HFD and exposed to VC or room air using an inhalation chamber, for 12 weeks (6 h, 5 days/week); and plasma and liver samples were collected after euthanasia. Compared with males, females were less susceptible to HFD+VC-induced obesogenic effects demonstrated by lower body weight and fat composition. Histological analysis revealed that whereas VC exacerbated HFD-induced steatosis in males, this effect was absent in females. In addition, females were more resistant to VC-induced hepatic inflammation whereas males had increased liver weights and higher hepatic Tnfα mRNA levels. Systemic markers of hepatic injury, namely alanine aminotransaminase and thrombin/antithrombin levels were increased by HFD+VC co-exposures only in males. In addition, females did not show significant cell death as previously reported in males. Taken together, the results suggested that VC inhalation led to sex-dependent liver and metabolic toxicity. This study implicated the importance of assessing sex differences in environmental basic science and epidemiologic studies to better identify at-risk populations in both men and women.
The Profits of Wisdom: The Impact of a Business Support Program in Tanzania
Authors: Bardasi Elena , Gassier Marine , Goldstein Markus , Holla Alaka
Published: November 2019

Business training programs in low-income settings have shown only limited impacts on firm revenues and profits, particularly for female entrepreneurs. A randomized design was used to compare the impacts of two types of business training programs targeting women with established small businesses in urban Tanzania. The basic version relied on in-class sessions to strengthen the participants’ managerial and technical skills. In the enhanced version, training was supplemented by visits from business coaches to the sites of participants’ activities, as well as other services tailored to their individual needs. The basic training had no impact on business practices or outcomes. The enhanced training positively impacted the adoption of new practices but had no effects on revenue or profits. However, the average masks large heterogeneous effects: only more experienced entrepreneurs benefited from the program. This finding suggests that more careful targeting can improve the impact of business training programs.
The Analgesic Effects of Intrathecal Morphine in Comparison With Ultrasound-Guided Transversus Abdominis Plane Block After Caesarean Section: A Randomised Controlled Trial at a Ugandan Regional Referral Hospital
Authors: Kwikiriza A. , Kiwanuka J.K. , Firth P.G. , Hoeft M.A. , Modest V.E. , Ttendo S.S.
Published: November 2019

(Anaesthesia. 2019;74:167–173)

Worldwide, cesarean section is the most frequently performed major surgery. However, most research regarding anesthesia and postoperative analgesia for cesarean section has been performed in high-income countries that have extensive health care resources. In comparison, low-income and middle-income countries have markedly fewer resources for health care in general and postoperative nursing care specifically. This study was performed to compare analgesic outcomes after cesarean section. At a hospital in Southwestern Uganda where this study was undertaken, most of the basic postoperative nursing care after cesarean section is provided by family or friends of the patient. The current study was performed to compare outcomes when intrathecal morphine or transversus abdominis plane (TAP) block was used to provide postcesarean pain control in a resource-limited setting.
Successful Treatment of Chronic Lower Extremity Ulcers with Allogeneic Platelet-Rich Plasma and Artificial Dermis: A Case Report
Authors: Zhao Qiannan , Ma Yuanyuan , Lu Yuquan , Chai Yuan , Zhou Yuemin
Published: November 2019

Hydroxyurea is an oral medication associated with painful, nonhealing ulcers, for which there is no effective treatment but permanent discontinuation of hydroxyurea. The authors present a case of leg ulcers that likely occurred as a result of hydroxyurea use in a patient with essential thrombocythemia. Topical treatment with allogeneic platelet-rich plasma and artificial dermis completely healed the leg ulcers without hydroxyurea cessation.
The Impact of Extracorporeal Shock Wave Therapy on Microcirculation in Diabetic Feet: A Pilot Study
Authors: Yang Jong-Phil , Lee Ye-Na , Son Ji Won , Han Seung-Kyu
Published: November 2019

BACKGROUND

Patients with diabetic foot commonly experience vascular insufficiency and compromised tissue perfusion. Extracorporeal shockwave therapy (ESWT) reportedly promotes wound healing and angiogenesis, but clinical studies on the effect of ESWT on angiogenesis are scarce and the exact mechanism remains unclear.

OBJECTIVE

To investigate the effect of ESWT on cutaneous microcirculation in diabetic feet.

METHODS

Ten patients with diabetic feet received ESWT twice weekly for a total of six sessions. Transcutaneous partial oxygen pressure (Tcpo
2) and cutaneous blood flow were measured before and after ESWT.

MAIN RESULTS

The treated feet showed statistically significant improvements in the mean Tcpo
2 (P < .01) and cutaneous blood flow level (P < .05) compared with control feet. In treated feet, Tcpo
2 increased by 19.6%, from 41.4 ± 9.9 to 49.5 ± 8.7 mm Hg (P < .05). In control feet, Tcpo
2 decreased by 11.6%, from 39.5 ± 14.0 to 34.9 ± 14.5 mm Hg (P = .059). The average cutaneous blood flow level of treated feet before ESWT was 36.9 ± 25.6, which increased to 48.3 ± 32.4 AU after ESWT (30.9% increase; P = .646). In control feet, the cutaneous blood flow level decreased from 80.5 ± 36.7 to 60.4 ± 38.8 AU, a decrease of 25.0% (P = .241).

CONCLUSIONS

These results demonstrate that ESWT may have beneficial effects on microcirculation in diabetic feet.
Interpreters in healthcare
Authors: Salavati Darya , Lindholm Fanny , Drevenhorn Eva
Published: November 2019

Purpose:

This study explored nursing experiences using interpreters in primary healthcare settings.

Methods:

Eight nurses in southern Sweden were subjected to semistructured interviews. The responses were divided into three categories using content analysis: interpreter influence, challenges, and strategies.

Results:

Despite using an interpreter to minimize language barriers, nurses do not achieve the same level of person-centered care as those who speak the same language as their patients, but translation services remain a useful communication tool for patient care.

Conclusion:

Communication through an interpreter is an inevitability for healthcare professionals, and formal education is recommended to improve nurses' utilization of these services.
Use of MRI assisting the diagnosis of pediatric medial condyle fractures of the distal humerus
Authors: Zhou Weizheng , Yu Jinghang , Wang Shiqi , Zhang Lijun , Li Lianyong
Published: November 2019

The aim of this study was to describe the radiographic appearance and to evaluate the elbow function with the Mayo elbow performance score (MEPS) in children with medial condyle fracture of the distal humerus (MCFH) who were treated surgically. During the period of 2011–2017, a total of 10 patients (three boys, seven girls) were retrospectively reviewed after obtaining institutional review board approval. All patients underwent open reduction and percutaneous pinning fixation. The average age at the time of injury was 7.7 years (range: 4.0–12.5 years), and the mean follow up was 43.9 months (range: 8.1–67.1 months). The clinical and radiographic outcomes of medial condyle fracture were retrospectively evaluated. Among 10 patients, half were diagnosed with MCFH initially by the radiograph, four out of 10 patients had their diagnosis confirmed with the aid of MRI, and an intraoperative diagnosis was made in only one individual. The average humeral-ulnar angles of the injured and noninjured sides were 9.7° ± 5.3° and 9.3° ± 4.7°, respectively (P = 0.679). The average MEPSs of the injured and noninjured sides were 95.5 ± 2.8 and 96.5 ± 2.4 points, respectively (P = 0.168). In this retrospectively evaluated cohort submitted to surgical management of medial condyle fracture of the distal humerus, MRI has been proven beneficial assisting the diagnosis and allowing effective joint restoration with mid-term good functional outcome.
Deep neural network-assisted computed tomography diagnosis of metastatic lymph nodes from gastric cancer
Authors: Gao Yuan , Zhang Zheng-Dong , Li Shuo , Guo Yu-Ting , Wu Qing-Yao , Liu Shu-Hao , Yang Shu-Jian , Ding Lei , Zhao Bao-Chun , Li Shuai , Lu Yun
Published: November 2019

Background:

Artificial intelligence-assisted image recognition technology is currently able to detect the target area of an image and fetch information to make classifications according to target features. This study aimed to use deep neural networks for computed tomography (CT) diagnosis of perigastric metastatic lymph nodes (PGMLNs) to simulate the recognition of lymph nodes by radiologists, and to acquire more accurate identification results.

Methods:

A total of 1371 images of suspected lymph node metastasis from enhanced abdominal CT scans were identified and labeled by radiologists and were used with 18,780 original images for faster region-based convolutional neural networks (FR-CNN) deep learning. The identification results of 6000 random CT images from 100 gastric cancer patients by the FR-CNN were compared with results obtained from radiologists in terms of their identification accuracy. Similarly, 1004 CT images with metastatic lymph nodes that had been post-operatively confirmed by pathological examination and 11,340 original images were used in the identification and learning processes described above. The same 6000 gastric cancer CT images were used for the verification, according to which the diagnosis results were analyzed.

Results:

In the initial group, precision-recall curves were generated based on the precision rates, the recall rates of nodule classes of the training set and the validation set; the mean average precision (mAP) value was 0.5019. To verify the results of the initial learning group, the receiver operating characteristic curves was generated, and the corresponding area under the curve (AUC) value was calculated as 0.8995. After the second phase of precise learning, all the indicators were improved, and the mAP and AUC values were 0.7801 and 0.9541, respectively.

Conclusion:

Through deep learning, FR-CNN achieved high judgment effectiveness and recognition accuracy for CT diagnosis of PGMLNs.

Trial Registration:

Chinese Clinical Trial Registry, No. ChiCTR1800016787; http://www.chictr.org.cn/showproj.aspx?proj=28515.
First-line atezolizumab plus chemotherapy in treatment of extensive small cell lung cancer: a cost-effectiveness analysis from China
Authors: Li Ling-Yu , Wang Hong , Chen Xiao , Li Wen-Qian , Cui Jiu-Wei
Published: November 2019

Background:

IMpower 133 trial first confirmed the efficacy and safety of adding atezolizumab or placebo to first-line treatment with chemotherapy in patients with extensive-stage small-cell lung cancer (SCLC). While, overprice limited its broad use in clinical. The aim of this study was to evaluate the cost-effectiveness of atezolizumab plus chemotherapy in treatment of extensive SCLC as first line in China.

Methods:

A Markov model was established by extracting data from the IMpower 133 trial with untreated extensive SCLC patients. Utility values were obtained from published studies, and the costs were acquired from real world and literature. Additionally, sensitivity analyses based on a willingness-to-pay (WTP) threshold were performed to identify the uncertain parameters of Markov model.

Results:

Total costs of atezolizumab group were $48,129, while cost of chemotherapy alone was just $12,920 in placebo group. The quality-adjusted life-years (QALYs) in atezolizumab group was just 0.072 higher than that in placebo group (0.858 QALYsvs. 0.786 QALYs). The cost-effectiveness ratio between atezolizumab combination with chemotherapy and chemotherapy alone was $489,013/QALY in China. The net benefit of placebo group was significantly higher than atezolizumab group. One-way sensitivity analyses highlighted that utilities of the progression-free survival (PFS) and progression disease state in placebo group were the most influential parameter.

Conclusions:

Atezolizumab combination therapy was not more cost-effective than chemotherapy alone at a WTP threshold of $25,929/QALY in China.