bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic Q fever associated with systemic sclerosis
Authors: Jansen Anne F. M. , Raijmakers Ruud P. H. , van Deuren Marcel , Vonk Madelon C. , Bleeker‐Rovers Chantal P.
Published: May 2019

Background

After the Q fever outbreak in the Netherlands between 2007 and 2010, more than 300 patients with chronic Q fever have been identified. Some patients were also diagnosed with systemic sclerosis, a rare immune‐mediated disease. We aimed to increase awareness of concomitant chronic Q fever infection and systemic sclerosis and to give insight into the course of systemic sclerosis during persistent Q fever infection.

Materials and methods

Chronic Q fever patients were identified after the Dutch Q fever outbreak in 2007‐2010. Systemic sclerosis was diagnosed by a scleroderma expert and patients fulfilled the 2013 Classification Criteria for Systemic Sclerosis.

Results

Four cases presented with chronic Q fever, persistent Coxiella burnetii infection, shortly preceded or followed by the diagnosis of limited cutaneous systemic sclerosis. The three male patients of 60 years or older developed a relatively mild systemic sclerosis, which did not require immunosuppressive therapy during adequate treatment of the chronic Q fever infection. The 58‐year‐old female patient used immunosuppressives for her newly diagnosed systemic sclerosis at the time she likely developed a chronic Q fever infection.

Conclusions

In this case series, chronic Q fever preceding systemic sclerosis was associated with a mild course of systemic sclerosis without the necessity of immunosuppressive drugs, while chronic Q fever development due to immunocompromised state was associated with a more deteriorating course of systemic sclerosis.
Association of NFKB1 ‐94ATTG ins/del polymorphism (rs28362491) with pemphigus vulgaris
Authors: Chatzikyriakidou Anthoula , Kyriakou Aikaterini , Meltzanidou Parthena , Lambropoulos Alexandros , Patsatsi Aikaterini
Published: May 2019

Pemphigus vulgaris is a rare chronic blistering skin disease resulting from IgG autoantibodies directed against transmembrane desmosomal glycoprotein desmoglein 3 and is the most common form of pemphigus. Since interleukin‐1 receptor‐associated kinase (IRAK‐1)/nuclear factor‐kappa B (NF‐kappa B) pathway plays an essential role in the pathogenesis of autoimmune diseases, the aim of the present study was to explore the role of polymorphisms in three genes, named IRAK1 (rs3027898), NFKBIA (rs696) and NFKB1 (‐94ATTG insertion/deletion variant, ‐ rs28362491), in PV susceptibility. Forty‐four unrelated patients with PV (23 males) were enrolled in the study. Additionally, 77 ethnic matching healthy volunteers (45 males) with no personal or family history of chronic autoimmune or infectious diseases were studied. Strong statistical significant difference was observed between PV patients and controls for polymorphism ‐94 insertion/deletion ATTG in the promoter region of NFKB1 gene (P = 0.00005). Additional dedicated studies in larger groups of patients of various ethnicities are needed to replicate and confirm the preliminary findings.
Machine learning for the prediction of sunscreen sun protection factor and protection grade of UVA
Authors: Shim Jiyong , Lim Jun Man , Park Sun Gyoo
Published: May 2019

We report a prediction model for sunscreen sun protection factor (SPF) and protection grade of ultraviolet (UV) A (PA) based on machine learning. We illustrate with real clinical test results of UV protection ability of sunscreen for SPF and PA. With approximately 2200 individual clinical results for both SPF and PA level detection, individually, we were able to see that active ingredient information can provide accurate SPF and PA prediction rates through machine learning. Furthermore, we included four new factors—presence of pigment, concentration of pigment grade titanium dioxide, type of formulation and type of product—as additional information for the prediction model and were able to see increased prediction rates as results.
‘Seeing is believing’: a qualitative approach to studying the use of cone beam computed tomography in endodontics in Sweden
Authors: Mota de Almeida F. J. , Flygare L. , Knutsson K. , Wolf E.
Published: May 2019

Aim

To gain insight into the decision processes of dentists when requesting a cone beam computed tomography (CBCT) examination in endodontic settings.

Methodology

Fourteen dentists (eight female) 33–58 years of age (mean = 44) practising in Sweden were interviewed. Ten of the dentists were specialists in Endodontics. The absolute inclusion criterion was experience of referring patients for CBCT for endodontic reasons. The included dentists comprised a strategically selected diverse sample in terms of gender, age, work experience, educational background, location of practice, service affiliation and accessibility to CBCT. Data were obtained through semistructured interviews exposing the context of their last three self‐reported referrals. Dentists were encouraged to describe their experiences of the circumstances in their own words, aided by the interviewer's open‐ended questions. The interviews were audio‐recorded and transcribed verbatim. The text was analysed by qualitative content analysis.

Results

The manifest content was organized into three categories that were defined as visualization as a desire, facilitating tough decisions and allocating responsibility.

Conclusion

An overall theme (covering the latent content) was identified: A balance between clinical common sense and a ‘better safe than sorry’ attitude guides the use of CBCT in endodontic settings. Informants had high clinical standards, knowledge concerning radiation risks and good sense, which could compensate for their lack of knowledge of guidelines. The national radiation regulatory system was perceived to work as a slightly porous gatekeeper for over‐usage.
Structural transformation and tax efficiency
Authors: Cevik Serhan , Gottschalk Jan , Hutton Eric , Jaramillo Laura , Karnane Pooja , Sow Mousse
Published: May 2019

Structural transformation has resulted in an increasing share of services in output and employment in advanced and developing countries across the world. We analyse the impact of this shift into services on countries' efficiency in collecting the value‐added tax (VAT). The analysis is based on two alternative measures of VAT productivity: (a) the VAT C‐efficiency, using a broad panel of 134 countries over the period 1970–2014 and (b) the VAT gap using a more granular, proprietary data set that draws on the results of the International Monetary Fund's (IMF's) Revenue Administration‐Gap Analysis Program covering 24 countries over the period 2004–2016. We find that a higher share of services in aggregate value‐added reduces the VAT efficiency, and that this adverse effect is mainly a result of a rise of nontradable services which in turn contributes to a narrowing of the VAT base.
Fabrication and microstructure of perovskite CsPbCl3 nanocrystallized chalcogenide glass‐ceramics
Authors: Yu Mingqiang , Yu Xinlan , Long Nengbing , Lin Changgui
Published: May 2019

Transparent chalcogenide glass‐ceramics containing CsPbCl3 perovskite nanocrystals were prepared through an elaborated composition design of 80GeS2·5Ga2S3·15CsPbCl3. Large size distribution of CsPbCl3 nanocrystals is observed ranging from 10 to 200 nm. XRD, Raman spectra, and SEM techniques were employed to study the further microstructural evolution after thermal treatment. The precipitation of PbGeS3 and GeS2, together with CsPbCl3, was identified according to the XRD patterns and Raman spectra. This work is of guiding significance for future design of cesium lead halide perovskite nanocrystals in chalcogenide glass‐ceramics.
A new null model approach to quantify performance and significance for ecological niche models of species distributions
Authors: Bohl Corentin L. , Kass Jamie M. , Anderson Robert P.
Published: May 2019

Aim

Ecological niche modelling requires robust estimation of model performance and significance, but common evaluation approaches often yield biased estimates. Null models provide a solution but are rarely used in this field. We implemented an important modification to existing null model tests, evaluating null models with the same withheld records that were used to evaluate the real model. We built and evaluated models across a range of modelling scenarios and for various performance measures using the algorithm Maxent and the monk parakeet (Myiopsitta monachus).

Location

Native range in Southern America and global invasions predominantly in North/Central America and Europe.

Methods

We tested the ability of models built under 15 scenarios (five sets of calibration records and three settings that varied the level of model complexity) to predict spatially independent evaluation data in the invaded range (in effect, testing the models under spatial transfer). We quantified performance with measures of discriminatory ability and overfitting based on area under the receiver operating characteristic curve (AUC) and the omission error rate. We estimated null distributions of these measures and calculated effect size and significance. We determined how these estimates varied across modelling scenarios, comparing with two tests existing in the literature.

Results

Performance varied starkly across modelling scenarios. As expected, the measures of overfitting agreed with each other and provided different information than that of discriminatory ability. However, high performance per se did not show strong association with high effect size and significance.

Main Conclusions

Ecological niche models should be assessed with measures of effect size and significance based on appropriate null distributions, in contrast to several approaches existing in the literature. The proposed approach using independent evaluation data, implemented with our accompanying code and R package, allows such estimates for either the same or a different region/time period, and it merits use and continued development.
Investigation of the Secretory Pathway in Trichomonas vaginalis Argues against a Moonlighting Function of Hydrogenosomal Enzymes
Authors: Rada Petr , Kellerová Pavlína , Verner Zdeněk , Tachezy Jan
Published: May 2019

The enzymes pyruvate ferredoxin oxidoreductase (PFO), malic enzyme (ME), and the α‐ and β‐subunits of succinyl‐CoA synthetase (SCS) catalyze key steps of energy metabolism in Trichomonas vaginalis hydrogenosomes. These proteins have also been characterized as the adhesins AP120 (PFO), AP65 (ME), AP33, and AP51 (α‐ and β‐SCS), which are localized on the cell surface and mediate the T. vaginalis cytoadherence. However, the mechanisms that facilitate the targeting of these proteins to the cell surface via the secretory pathway and/or to hydrogenosomes are not known. Here we adapted an in vivo biotinylation system to perform highly sensitive tracing of protein trafficking in T. vaginalis. We showed that α‐ and β‐SCS are biotinylated in the cytosol and imported exclusively into the hydrogenosomes. Neither α‐ nor β‐SCS is biotinylated in the endoplasmic reticulum and delivered to the cell surface via the secretory pathway. In contrast, two surface proteins, tetratricopeptide domain‐containing membrane‐associated protein and tetraspanin family surface protein, as well as soluble‐secreted β‐amylase‐1 are biotinylated in the endoplasmic reticulum and delivered through the secretory pathway to their final destinations. Taken together, these results demonstrate that the α‐ and β‐SCS subunits are targeted only to the hydrogenosomes, which argues against their putative moonlighting function.
Oxygen isotope speedometry in granulite facies garnet recording fluid/melt–rock interaction (Sør Rondane Mountains, East Antarctica)
Authors: Higashino Fumiko , Rubatto Daniela , Kawakami Tetsuo , Bouvier Anne‐Sophie , Baumgartner Lukas P.
Published: May 2019

In situ analysis of a garnet porphyroblast from a granulite facies gneiss from Sør Rondane Mountains, East Antarctica, reveals discontinuous step‐wise zoning in phosphorus and large δ18O variations from the phosphorus‐rich core to the phosphorus‐poor rim. The gradually decreasing profile of oxygen isotope from the core (δ18O = ~15‰) to the rim (δ18O = ~11‰) suggests that the 18O/16O zoning was originally step‐wise, and modified by diffusion after the garnet rim formation at ~800°C and 0.8 GPa. Fitting of the 18O/16O data to the diffusion equation constrains a duration of the high‐T event (~800°C) to c. 0.5–40 Ma after the garnet rim formation. The low δ18O value of the garnet rim, together with the previously reported low δ18O values in metacarbonates, indicates regional infiltration, probably along a detachment fault, of low δ18O fluid/melt possibly derived from meta‐mafic to ultramafic rocks.
On the challenges of greyscale‐based quantifications using X‐ray computed microtomography
Authors: ZHANG YULAI , MOSTAGHIMI PEYMAN , ARMSTRONG RYAN T.
Published: May 2019

For X‐ray computed microtomography (μ‐CT) images of porous rocks where the grains and pores are not fully resolved, the greyscale values of each voxel can be used for quantitative calculations. This study addresses the challenges that arise with greyscale‐based quantifications by conducting experiments designed to investigate the sources of error/uncertainty. We conduct greyscale‐based calculations of porosity, concentration and diffusivity from various μ‐CT experiments using a Bentheimer sandstone sample. The dry sandstone is imaged overtime to test the variation of greyscale values over sequential scans due to instrumentation stability. The sandstone is then imaged in a dry and contrast‐agent saturated state at low resolution to determine a porosity map, which is compared to a porosity map derived from segmented high‐resolution data. Then the linearity of the relationship between the concentration of a contrast agent and its corresponding attenuation coefficient is tested by imaging various solutions of known concentration. Lastly, a diffusion experiment is imaged at low resolution under dynamic conditions to determine local diffusivity values for the sandstone, which is compared to values derived from direct pore‐scale simulations using high‐resolution data. Overall, we identify the main errors associated with greyscale‐based quantification and provide practical suggestions to alleviate these issues.

Lay Description

X‐ray computed microtomography (CT) imaging has become an important way to study the pore space of a porous medium. Using segmented images, we can build 3D pore space models for porous media and characterize the morphology and/or run simulations on the models. So, image segmentation is a critical image processing step. However, for low resolution images where image segmentation is not possible, grayscales are directly used for quantifications such as porosity and concentration calculations. Although these types of calculations have been widely accepted and used, the uncertainties and errors associated with grayscale‐based quantifications are not fully discussed. Here we specifically design experiments with X‐ray CT imaging to address the challenges that arise in grayscale‐based quantifications. For instance, in order to validate porosity calculation results from low resolution images (with the help of high attenuating tracer), high resolution images are also acquired, which serve as a benchmark. The errors associated with concentration calculation using grayscale values are also discussed. In addition, numerical simulations using grayscale values are performed on a diffusion experiment images with X‐ray CT. The problems that arise in dynamic imaging and the subsequent numerical simulations are discussed. The experiments, calculations and discussions provide a more comprehensive understanding on grayscale‐based quantifications and aid in designing better X‐ray CT experiments.
Efficacy of dermal redensification in chronoaged face: Quantitative volumetric assessment
Authors: D’Aloiso Cristina M. , Senzolo Marco
Published: May 2019

Background

Mesotherapy for chronoaged skin shows heterogeneous results.

Objectives

The aim of the study was to assess the efficacy of dermal redensification on the face and neck.

Methods

Patients with mild‐moderate‐severe chronoaging of face and neck were included and, every 14 days, treated with four sessions of dermal redensification, consisting of 1 mL of hyaluronic acid (15 mg/mL) plus a dermo‐restructuring complex. Skin improvements were analyzed at 8 weeks for amelioration by Wrinkle Severity Rating Scale and quantification of superficial wrinkles and texture by high‐resolution 3D camera. All patients underwent a self‐assessment questionnaire and Global Aesthetic Improvement Scale.

Results

Thirty‐six patients were enrolled (median age 55 [42‐67] years). Eight weeks after treatment all patients reported a significant improvement, being Global Aesthetic Improvement Scale ≥2 in 69% of the subjects. Patients’ perception of improvement of their skin quality was highly satisfactory in all items explored on the self‐assessment questionnaire relating to radiance, elasticity, texture, and smoothness. Subjects with fine and moderate/deep wrinkles had an improvement >25% and 50%, respectively. Quantification of wrinkles with filters for superficial plane (1 mm) showed a statistically significant median decrease, both in width (1.53 [1.41‐1.72] mm vs 1.27 [1.12‐1.34] P < 0.001) and depth (0.46 [0.27‐0.61] vs 0.12 [0.6‐0.18] P < 0.001). Indentation decreased by a median of 20%.

Conclusions

The synergic effects of hyaluronic acid and dermo‐restructuring complex show an objective amelioration of skin texture, wrinkles, and self‐evaluation of skin appearance.
Local and regional scale habitat heterogeneity contribute to genetic adaptation in a commercially important marine mollusc (Haliotis rubra) from southeastern Australia
Authors: Miller Adam D. , Hoffmann Ary A. , Tan Mun Hua , Young Mary , Ahrens Collin , Cocomazzo Michael , Rattray Alex , Ierodiaconou Daniel A. , Treml Eric , Sherman Craig D. H.
Published: May 2019

Characterising adaptive genetic divergence among conspecific populations is often achieved by studying genetic variation across defined environmental gradients. In marine systems this is challenging due to a paucity of information on habitat heterogeneity at local and regional scales and a dependency on sampling regimes that are typically limited to broad longitudinal and latitudinal environmental gradients. As a result, the spatial scales at which selection processes operate and the environmental factors that contribute to genetic adaptation in marine systems are likely to be unclear. In this study we explore patterns of adaptive genetic structuring in a commercially‐ harvested abalone species (Haliotis rubra) from southeastern Australia, using a panel of genome‐wide SNP markers (5,239 SNPs), and a sampling regime informed by marine LiDAR bathymetric imagery and 20‐year hindcasted oceanographic models. Despite a lack of overall genetic structure across the sampling distribution, significant genotype associations with heterogeneous habitat features were observed at local and regional spatial scales, including associations with wave energy, ocean current, sea surface temperature, and geology. These findings provide insights into the potential resilience of the species to changing marine climates and the role of migration and selection on recruitment processes, with implications for conservation and fisheries management. This study points to the spatial scales at which selection processes operate in marine systems and highlights the benefits of geospatially‐informed sampling regimes for overcoming limitations associated with marine population genomic research.
The association between near‐infrared spectroscopy assessment of microvascular reactivity and flow‐mediated dilation is disrupted in individuals at high risk for cardiovascular disease
Authors: Vieira de Oliveira Gustavo , Soares Rogério Nogueira , Volino‐Souza Mônica , Murias Juan Manuel , Alvares Thiago Silveira
Published: May 2019

Objective

This study aimed to evaluate the correlation between the NIRS‐derived reperfusion slope and %FMD in the arm of healthy and at high risk for CVD individuals.

Methods

Twelve healthy (24 ± 4 years) and twelve at high risk for cardiovascular disease (65 ± 11 years) individuals participated in the study. The individuals were submitted to a conduit artery FMD followed by a NIRS‐VOT microvascular function test in the arm. Microvascular responsiveness was calculated as the forearm reperfusion slope, and macrovascular function was assessed as the percent of change in FMD (%FMD) of the brachial artery.

Results

There was a significant correlation between reperfusion slope and %FMD (R = 0.61, P < 0.05) in the healthy group; however, no significant correlation between FMD and reperfusion slope (R = −0.21, P > 0.05) was found in individuals at high risk for CVD.

Conclusion

The correlation between NIRS‐derived reperfusion slope and %FMD was disrupted in the arm of individuals at high risk for cardiovascular disease compared to healthy individuals. The findings of the present study reinforce the importance of examining vascular function at microvasculature and conduit artery level, especially in populations with risk factors for CVD.
Comparison of fks gene mutations and minimum inhibitory concentrations for the detection of Candida glabrata resistance to micafungin: A systematic review and meta‐analysis
Authors: Bienvenu Anne‐Lise , Leboucher Gilles , Picot Stephane
Published: May 2019

Candida resistance to antifungals impaired invasive candidiasis outcome. In a context of echinocandin resistance development, we aimed to evaluate the association between phenotypic resistance to micafungin and fks mutations of Candida glabrata. For this systematic review and meta‐analysis, we searched MEDLINE, Scopus and Web of Science for reports published up to December 2017. Studies of C glabrata candidiasis with minimum inhibitory concentrations (MIC) determination of micafungin and fks genotyping were included. Reviews, studies not using reference methods, non‐glabrata Candida, experimental isolates and undetailed mutations were excluded. Two authors independently assessed the eligibility of articles and extracted data. The main outcome was the diagnostic accuracy of fks mutations compared to micafungin MIC for C glabrata, measured as fixed‐effect odd ratio. Heterogeneity was calculated with the I2 statistic. This study is registered with PROSPERO (CRD42018082023). Twenty‐four studies were included in the meta‐analysis. Pooled analysis found that S663P (OR 7.25, 95% CI 3.50‐15.00; P < 0.00001), S629P (OR 3.70, 1.64‐8.33; P = 0.002) and F659del (OR 5.66, 1.22‐26.18; P = 0.03) were associated with increased risk of having a resistant isolate according to authors' interpretation of MICs. In sensitivity analysis based on new CLSI clinical breakpoints, the ORs for S663P and S629P remained significant. Genotyping of isolates of C glabrata for S663P and S629P mutations is an effective alternative to micafungin susceptibility tests. Relevant molecular markers of drug resistance will significantly improve the management of C glabrata infections.
Effect of soil nutrients, neighbor identities and root separation types on intra‐ and interspecific interaction among three clonal plant species
Authors: Jaafry Syed Wajahat Husain , Li Dezhi , Fan Zhihua , Liu Lu , Wei Xiaoyu , Yang Tingjun , Sun Yuming , Zhu Yingyang , Li Lingling , Ren Zixing , Kong Rongpei
Published: May 2019

In natural environments, plants frequently interact with both heterospecific and conspecific neighbors. The intensity of belowground plant interaction with neighboring species commonly varies with the availability of soil nutrients in the habitats. According to classical ecological theory, competition between conspecific neighbors may be more severe than competition between unrelated species due to the similar nutrient requirements of close relatives, especially when nutrients are scarce in the habitat. However, many recent studies have shown the opposite pattern, and suggested an alternative mechanism based on species recognition. Taking Zoysia sinica as the focal species, we conducted a controlled experiment to test the results of intraspecific and interspecific interactions among three clonal species Zoysia sinica, Zoysia japonica and Alternanthera philoxeroides, which represent a conspecific, a close relative and a distant relative of the focal species, respectively, and at different root treatments (no separation NS, clone separation CS and ramet separation RS) and two nutrient levels. The results showed that Z. sinica recognized conspecific plants in the NS and CS treatments, and did not show above or belowground competition with these. The performance of the focal plant (Z. sinica) was better when it was grown with a conspecific neighbor as compared to all other types of neighbors. In all root separation treatments, the competition was more intense when Z. sinica grew with a close relative (Z. japonica) than when growing with a distant relative (A. philoxeroides). Generally, competition between plants was more intense at the high nutrient level than at the low nutrient level, suggesting that both soil nutrients and a species recognition mechanism play a significant role for the intra‐ and interspecific interaction and fitness of these three neighboring clonal species.
What is the fate of xylem‐transported CO2 in Kranz‐type C4 plants?
Authors: Stutz Samantha S. , Hanson David T.
Published: May 2019

High concentrations of dissolved inorganic carbon in stems of herbaceous and woody C3 plants exit leaves in the dark. In the light, C3 species use a small portion of xylem‐transported CO2 for leaf photosynthesis. However, it is not known if xylem‐transported CO2 will exit leaves in the dark or be used for photosynthesis in the light in Kranz‐type C4 plants.

Cut leaves of Amaranthus hypochondriacus were placed in one of three solutions of [NaH13CO3] dissolved in KCl water to measure the efflux of xylem‐transported CO2 exiting the leaf in the dark or rates of assimilation of xylem‐transported CO2* in the light, in real‐time, using a tunable diode laser absorption spectroscope.

In the dark, the efflux of xylem‐transported CO2 increased with increasing rates of transpiration and [13CO2*]; however, rates of 13Cefflux in A. hypochondriacus were lower compared to C3 species. In the light, A. hypochondriacus fixed nearly 75% of the xylem‐transported CO2 supplied to the leaf.

Kranz anatomy and biochemistry likely influence the efflux of xylem‐transported CO2 out of cut leaves of A. hypochondriacus in the dark, as well as the use of xylem‐transported CO2* for photosynthesis in the light. Thus increasing the carbon use efficiency of Kranz‐type C4 species over C3 species.
Proteomic and lipidomic analyses of the Arabidopsis atg5 autophagy mutant reveal major changes in endoplasmic reticulum and peroxisome metabolisms and in lipid composition
Authors: Havé Marien , Luo Jie , Tellier Frédérique , Balliau Thierry , Cueff Gwendal , Chardon Fabien , Zivy Michel , Rajjou Loic , Cacas Jean‐Luc , Masclaux‐Daubresse Céline
Published: May 2019

Autophagy is a universal mechanism in eukaryotic cells that facilitates the degradation of unwanted cell constituents and is essential for cell homeostasis and nutrient recycling.

The salicylic acid‐independent effects of autophagy defects on leaf metabolism were determined through large‐scale proteomic and lipidomic analyses of atg5 and atg5/sid2 mutants under different nitrogen and sulfur growth conditions.

Results revealed that irrespective of the growth conditions, plants carrying the atg5 mutation presented all the characteristics of endoplasmic reticulum (ER) stress. Increases in peroxisome and ER proteins involved in very long chain fatty acid synthesis and β‐oxidation indicated strong modifications of lipid metabolism. Lipidomic analyses revealed changes in the concentrations of sphingolipids, phospholipids and galactolipids. Significant accumulations of phospholipids and ceramides and changes in GIPCs (glycosyl‐inositol‐phosphoryl‐ceramides) in atg5 mutants indicated large modifications in endomembrane‐lipid and especially plasma membrane‐lipid composition. Decreases in chloroplast proteins and galactolipids in atg5 under low nutrient conditions, indicated that chloroplasts were used as lipid reservoirs for β‐oxidation in atg5 mutants.

In conclusion, this report demonstrates the strong impact of autophagy defect on ER stress and reveals the role of autophagy in the control of plant lipid metabolism and catabolism, influencing both lipid homeostasis and endomembrane composition.
Trends of Opioid Use Disorder Among Hospitalized Patients With Chronic Pain
Authors: Orhurhu Vwaire , Olusunmade Mayowa , Urits Ivan , Viswanath Omar , Peck Jacquelin , Orhurhu Mariam Salisu , Adekoya Peju , Hirji Sameer , Sampson John , Simopoulos Thomas , Jatinder Gill
Published: May 2019

Background

Patients with chronic pain treated with opioids are at an increased risk for opioid misuse or opioid use disorder (OUD). Recent years have seen a stark increase in abuse, misuse, and diversion of prescription opioid medications. The aim of this study was to investigate trends in changing rates of opioid use disorder among patients with chronic pain.

Methods

The National Inpatient Sample (NIS) database identified chronic pain admissions with OUD from 2011 to 2015. Patients were identified from the NIS database using International Classification of Diseases (9th and 10th revisions) diagnosis codes for chronic pain and OUD. Annual estimates and trends were determined for OUD, patient characteristics, OUD among subgroups of chronic pain conditions, and discharge diagnosis.

Results

We identified 10.3 million patients with chronic pain. Of these, 680,631 patients were diagnosed with OUD. The number of patients with OUD increased from 109,222 in 2011 to 172,680 in 2015 (P < 0.001). Similarly, there were upward trends of OUD among females (53.2% to 54.5%; P = 0.09), patients 65 to 84 years of age (11.8% to 17%; P < 0.001), Medicare‐insured patients (39.5% to 46.0%; P < 0.01), patients with low annual household incomes (27.8% to 33.3%; P < 0.001), and patients with cannabinoid use disorder (7.2% to 8.3%; P = 0.01). The prevalence of OUD increased from 2011 to 2015 in patients with chronic regional pain syndrome (5.53% to 7.46%; P = 0.01) and spondylosis (1.32% to 1.81%; P < 0.001).

Conclusions

These findings suggest that the prevalence of OUD increased substantially from 2011 to 2015. Disparities of OUD with increasing opioid use among vulnerable populations including women, those with Medicare insurance, tobacco use disorder, and low annual income should be explored further.
Shared preventive factors associated with relapse after a response to electroconvulsive therapy in four major psychiatric disorders
Authors: Omori Wataru , Itagaki Kei , Kajitani Naoto , Abe Hiromi , Okada‐Tsuchioka Mami , Okamoto Yasumasa , Takebayashi Minoru
Published: May 2019

Aim

The efficacy of electroconvulsive therapy (ECT) has been established in psychiatric disorders but the high rate of relapse is a critical problem. The current study sought preventative factors associated with relapse after a response to ECT in a continuum of four major psychiatric disorders.

Methods

The records of 255 patients with four psychiatric disorders (83 unipolar depression, 60 bipolar depression, 91 schizophrenia, 21 schizoaffective disorder) were retrospectively reviewed.

Results

The relapse‐free rate of all patients at 1 year was 56.3% in the four psychiatric disorders without a difference. As a result of univariate analysis, three items could be considered as preventative factors associated with relapse: a small number of psychiatric symptom episodes before an acute course of ECT, the use of mood stabilizers, and the use of maintenance ECT. Multivariate analysis was performed, keeping age, sex, and diagnosis constant in addition to the three items, and small number of psychiatric symptom episodes before an acute course of ECT (P = 0.003), the use of lithium (P = 0.025), the use of valproate (P = 0.027), and the use of maintenance ECT (P = 0.001) were found to be significant preventative measures against relapse.

Conclusion

The use of mood stabilizers, such as lithium and valproate, and maintenance ECT could be shared preventive factors associated with relapse after a response to ECT in four major psychiatric disorders.
Does Negative Group Information Moderate Ideological Identity? An Experimental Test
Authors: Amira Karyn
Published: May 2019

Objective

This study tests whether Americans moderate their ideological identity when exposed to news reports that present ideological activists negatively. I hypothesize that certain people will be more likely to do this: high self‐monitors and those with “issue constraint” (consistency in issue positions).

Method

Two survey experiments are conducted to test these hypotheses: one with a nationally representative sample and one with an online sample.

Results

Despite evidence that people moderate or opt out of other political identities in similar scenarios, I find no evidence this happens for ideological identification. This was the case even when the dependent variable was altered in the second experiment, making it easier for subjects to opt out of the identity.

Conclusion

These null findings provide evidence that dislodging people from ideological labels is difficult at this point in time. Ideology scholars should continue to test how resilient these identities are with different designs and manipulations.
In‐hospital postoperative infection after heart transplantation: Risk factors and development of a novel predictive score
Authors: Fernández‐Ugidos Paula , Barge‐Caballero Eduardo , Gómez‐López Rocío , Paniagua‐Martin María J. , Barge‐Caballero Gonzalo , Couto‐Mallón David , Solla‐Buceta Miguel , Iglesias‐Gil Carmen , Aller‐Fernández Vanesa , González‐Barbeito Miguel , Vázquez‐ Rodríguez Jose Manuel , Crespo‐Leiro María G.
Published: May 2019

Introduction

Infection is one of the most significant complications following heart transplantation (HT). The aim of this study was to identify specific risk factors for early postoperative infections in HT recipients, and to develop a multivariable predictive model to identify HT recipients at high risk.

Methods

A single‐center, observational, and retrospective study was conducted. The dependent variable was in‐hospital postoperative infection. We examined demographic and epidemiological data from donors and recipients, surgical features, and adverse postoperative events as independent variables. Backwards, stepwise multivariable logistic regression with a P‐value < 0.05 was used to identify clinical factors independently associated with the risk of in‐hospital postoperative infections following HT.

Results

Six hundred seventy‐seven patients were included in this study. During the in‐hospital postoperative period, 348 episodes of infection were diagnosed in 239 (35.9%) patients. Seven variables were identified as independent clinical predictors of early postoperative infection after HT: history of diabetes mellitus, previous sternotomy, preoperative mechanical ventilation, primary graft failure, major surgical bleeding, use of mycophenolate mofetil, and use of itraconazole. Based on the results of multivariable models, we constructed a 7‐variable (8‐point) score to predict the risk of in‐hospital postoperative infection in HT recipients, which showed a reasonable ability to predict the risk of in‐hospital postoperative infection in this population. Prospective external validation of this new score is warranted to confirm its clinical applicability.

Conclusions

In‐hospital postoperative infection is a common complication after HT, affecting 35% of patients who underwent this procedure at our institution. Diabetes mellitus, previous sternotomy, preoperative mechanical ventilation, primary graft failure, major surgical bleeding, use of mycophenolate mofetil, and itraconazole were all independent clinical predictors of early postoperative infection after HT.
The Control Space for Knock Mitigation in Two-Stroke Engines for 10–25 kg Remotely Piloted Aircraft
Authors: Ausserer Joseph K. , Polanka Marc D. , Litke Paul J. , Baranski Jacob A.
Published: May 2019

Interest is growing in converting commercially available, two-stroke spark-ignition engines from motor gasoline to low-anti-knock-index fuel such as diesel and Jet A, where knock-limited operation is a significant consideration. Previous efforts have examined the knock limits for small two-stroke engines and explored the effect of engine controls such as equivalence ratio, combustion phasing, and cooling on engine operation during knock-free operation on high octane number fuel. This work culminates the research begun in those efforts, investigating the degree of knock-mitigation achievable through varying equivalence ratio, combustion phasing, and engine cooling on three small (28, 55, and 85 cm3 displacement) commercially available two-stroke spark-ignition engines operating on a 20 octane number blend of iso-octane and n-heptane. Combustion phasing had the largest effect; a 10 deg retardation in the CA50 mass-fraction burned angle permitted an increase in throttle that yielded a 9–11% increase in power. Leaning the equivalence ratio from 1.05 to 0.8 resulted in a 10% increase in power; enriching the mixture from 1.05 to 1.35 yielded a 6–7% increase in power but at the cost of a 25% decrease in fuel-conversion efficiency. Varying the flow rate of cooling air over the engines had a minimal effect. The results indicate that the addition of aftermarket variable spark timing and electronic fuel-injection systems offer substantial advantages for converting small, commercially available two-stroke engines to run on low-anti-knock-index fuels.
Outcomes of outborn extremely preterm neonates admitted to a NICU with respiratory distress
Authors: Fang Jennifer L , Mara Kristin C , Weaver Amy L , Clark Reese H , Carey William A
Published: May 2019

Objective

To compare the risk of mortality and morbidity between outborn and propensity score-matched inborn extremely preterm neonates.

Setting

Multiple neonatal intensive care units (NICU) across the USA.

Patients

Singleton neonates born at 22–29 weeks’ gestation with no major anomalies who were admitted to a NICU and discharged between 2000 and 2014. Outborn neonates were restricted to those who transferred into a NICU on the day of birth.

Methods

The association between inborn-outborn status and the time-to-event outcomes of in-hospital mortality and necrotising enterocolitis (NEC) were assessed using Cox proportional hazards regression. Logistic regression was used to assess the remaining secondary outcomes: retinopathy of prematurity requiring treatment (tROP), chronic lung disease (CLD), periventricular leucomalacia (PVL) and severe intraventricular haemorrhage (IVH). Since outborn status was not random, we used 1:1 propensity score matching to reduce the imbalance in illness severity.

Results

There were 59 942 neonates (7991 outborn) included in the study. Outborn neonates had poorer survival than inborns and higher rates of NEC, severe IVH, tROP and PVL. Inborn-outborn disparities in mortality were reduced over the study period. When analysing the matched cohort (6524 matched pairs), outborns were less likely to die in-hospital compared with inborns (HR 0.84, 95% CI 0.77 to 0.91). However, outborns experienced higher rates of NEC (HR 1.14, 95% CI 1.04 to 1.25), severe IVH (OR 1.52, 95% CI 1.38 to 1.68), tROP (OR 1.45, 95% CI 1.25 to 1.69) and CLD (OR 1.12, 95% CI 1.01 to 1.24).

Conclusion

Additional research is needed to understand the contributors to increased morbidity for outborn extremely preterm neonates and identify interventions that mitigate this risk.
Incidental ancient schwannoma of the posterior mediastinum in a young male: a rare scenario
Authors: Shanmugasundaram Gouthaman , Thangavel Periyasamy , Venkataraman Balasubramanian , Barathi Gunabooshanam
Published: May 2019

Ancient schwannoma is a distinctive type of schwannoma occurring mostly in the retroperitoneum. The presentation in the posterior mediastinum is rare. The term ‘ancient’ represents a group of neurogenic tumours showing degenerative changes with marked nuclear atypia. A 26-year-old man was incidentally detected to have an upper mediastinal mass lesion in the chest X-ray. MRI chest revealed a mixed signal intensity lesion in the left side upper para spinal region of the posterior mediastinum. The patient underwent left posterior thoracotomy and excision of the mass was done. Postoperative period was uneventful. The histopathological feature was typical of Ancient schwannoma. The patient is on regular follow-up and disease free until.
Unusual case of a giant lung abscess initially misdiagnosed and treated as an empyema
Authors: Carvalho Joana Sofia , Marques Diogo Paixão , Oliveira Inês , Vieira Ana Cláudia
Published: May 2019

We report the case of a 66-year-old man with dental infection who presented to our emergency department complaining of a 3-month medical history of chest pain and productive cough, in association with malaise, fever, weight loss and anaemia. His chest radiograph showed a nearly total opacification of the right hemithorax and chest ultrasound findings were suggestive of empyema, subsequently confirmed by a chest CT. The patient started appropriate treatment. A follow-up chest CT performed to rule out bronchopleural fistula revealed a large lung abscess. The patient had the final diagnosis of a giant lung abscess, which was initially thought to be an empyema because of the clinical and radiologic similarities with this entity. The initial misdiagnosis led to prompt percutaneous drainage of the lung abscess in addition to antibiotherapy and respiratory physiotherapy with a good final outcome, which suggests the efficacy of this approach in similar cases.
Post-traumatic intercostal and diaphragm hernias following a sneezing episode
Authors: Kelley Jesse K , Biesterveld Ben E , White Peter T , Vercruysee Gary A
Published: May 2019

Trauma and sneeze-induced or cough-induced intercostal and diaphragm hernias are both rare phenomena, especially in combination. Management of these hernias is not well described, and there is no good evidence to guide operative management. Here we describe a rare presentation of coexisting intercostal and diaphragm hernias and surgical management with primary repair via a thoracotomy.
Does soft tissue balancing using intraoperative pressure sensors improve clinical outcomes in total knee arthroplasty? A protocol of a multicentre randomised controlled trial
Authors: MacDessi Samuel J , Bhimani Aziz , Burns Alexander W R , Chen Darren B , Leong Anthony K L , Molnar Robert B , Mulford Jonathan S , Walker Richard M , Harris Ian A , Diwan Ashish , Wood Jil A
Published: May 2019

Introduction

Soft tissue imbalance is considered to be a major surgical cause of dissatisfaction following total knee arthroplasty (TKA). Surgeon-determined manual assessment of ligament tension has been shown to be a poor determinant of the true knee balance state. The recent introduction of intraoperative sensors, however, allows surgeons to precisely quantify knee compartment pressures and tibiofemoral kinematics, thereby optimising coronal and sagittal plane soft tissue balance. The primary hypothesis of this study is that achieving knee balance with use of sensors in TKA will improve patient-reported outcomes when compared with manual balancing.

Methods and analysis

A multicentred, randomised controlled trial will compare patient-reported outcomes in 222 patients undergoing TKA using sensor-guided balancing versus manual balancing. The sensor will be used in both arms for purposes of data collection; however, surgeons will be blinded to the pressure data in patients randomised to manual balancing. The primary outcome will be the change from baseline to 1 year postoperatively in the mean of the four subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS4) that are most specific to TKA recovery: pain, symptoms, function and knee-related quality of life. Secondary outcomes will include the surgeon’s capacity to determine knee balance, radiographic and functional measures and additional patient-reported outcomes. Normality of data will be assessed, and a Student’s t-test and equivalent non-parametric tests will be used to compare differences in means among the two groups.

Ethics and dissemination

Ethics approval was obtained from South Eastern Sydney Local Health District, Approval (HREC/18/POWH/320). Results of the trial will be presented at orthopaedic surgical meetings and submitted for publication in a peer-reviewed journal.

Trial registration number

ACTRN#12618000817246
Faecal immunochemical testing (FIT) in symptomatic patients: what are we missing?
Authors: Farrugia Alexia , Widlak Monika , Evans Charles , Smith Stephen Charles , Arasaradnam Ramesh
Published: May 2019

Objective

Faecal immunochemical test (FIT) shows promise as a non-invasive triage test for colorectal cancer (CRC) in the symptomatic population. The aim of this study was to assess the use of FIT within the recent NG12 and DG30 National Institute for Health and Care Excellence (NICE) guidelines.

Design

A single-centre prospective study of patients referred to University Hospitals Coventry and Warwickshire NHS Trust via the 2-week wait (TWW) pathway between January 2015 and March 2016 was conducted. 612 patients were reviewed, of which 519 were found to meet the NG12 criteria and 79 met the DG30 criteria. Data included age, sex, symptoms, colonoscopy or CT colonography, histology and FIT results.

Main outcome measures

FIT was performed in all patients and sensitivity, specificity, positive predictive value and negative predictive value, with 95% CI, for cancers and adenomas within each pathway (TWW, NG12 and DG30) was calculated.

Results

CRC sensitivity in TWW pathway patients, NG12 and DG30 group was 86.84% (95% CI 71.91% to 95.59%), 84.85% (95% CI 68.1% to 94.89%) and 100% (95% CI 47.82% to 100%), respectively. Specificity was 82.23% (95% CI 78.85% to 85.27%), 81.28% (95% CI 77.52% to 84.65%) and 91.89% (95% CI 83.18% to 96.97%), respectively. Adenoma sensitivity in the groups was 30.69% (95% CI 29.9% to 40.66%), 30.77% (95% CI 21.51% to 41.32%) and 25% (95% CI 3.19% to 65.09%), respectively.

Conclusion

Use of FIT within the remit of the NG12 NICE guidelines shows a high sensitivity and specificity and may be an effective triage tool when considering whether to perform investigations. However, there is still a miss rate. FIT within DG30 has excellent sensitivity and improved specificity; however, DG30 targets lower risk groups and accounts for only 13% of the entire referrals for suspected cancer. Therefore, managing the larger, higher risk NG12 group may require the addition of another test or marker to ensure that CRC is not missed.