bluuebunny/crossref_metadata_2025 huggingface dataset:
Perkutane dilatative Tracheotomie – Schritt für Schritt
Authors: Merten Michaela , Sattler Peter , Karagiannidis Christian
Published: April 2019

Bedside percutaneous dilatational tracheostomy has become one of the most commonly used interventions in ICU medicine. Different techniques have been developed, but guidance of percutaneous dilatational tracheostomy by video bronchoscope has been suggested to be clinically reasonable for direct visualization. The current Step-by-Step tutorial gives a detailed instruction of the procedure with visualization of every single step offering tips and pitfalls of the procedure.
Aszites und erhöhte Nierenretentionsparameter bei einer 25-jährigen Frau
Authors: Löbermann Micha , Witte Maria , Nowak Holger , Reisinger Emil
Published: April 2019

Anamnese und klinischer Befund 25-jährige Patientin mit akuten dysurischen Beschwerden, 3 Monate zuvor war eine komplikationslose Spontangeburt erfolgt.

Untersuchungen Es zeigte sich ein zunehmender Aszites und laborchemische Zeichen eines akuten Nierenversagens.

Diagnose Hohe Kreatininwerte im Aszites ließen auf eine Fistelung von Urin in den Peritonealraum schließen.

Therapie und Verlauf Im Rahmen einer explorativen Laparotomie konnte eine kleine Blasenläsion geschlossen werden.

Folgerungen Spontane Rupturen der Harnblase sind selten und können sich klinisch als Aszites mit laborchemischen Hinweisen für ein akutes Nierenversagen darstellen. Die Ursachenabklärung kann sich schwierig gestalten.
Die primäre chologene Diarrhö in einer gastroenterologischen Praxis
Authors: Wenzel Henrich
Published: April 2019

Die primäre chologene Diarrhö (PCD) wurde bei ihrer Erstbeschreibung 1976 als sehr seltene Erkrankung angesehen, heute wird die Inzidenz auf > 1 % geschätzt. Das diagnostische Instrumentarium ist unterschiedlich verfügbar und es gibt in Deutschland keine einheitliche Empfehlung zur Diagnostik. Die PCD wird immer noch zu selten diagnostiziert.

Seit Anfang der 90er Jahre haben wir die Probebehandlung mit Colestyramin und anschließende Bestätigung durch den Gallensäureresorptionstest (SeHCAT-Test) mit einer 7-Tage-Retention von 20 % als Schwellenwert zum Nachweis der chologenen Diarrhö (CD) in unser diagnostisches Vorgehen aufgenommen.

Ausgewertet werden konnten 70 Patienten mit positiver Probebehandlung zwischen April 1991 und März 2017, von denen 60 mit SeHCAT-Test untersucht wurden. Nicht aufgenommen wurden Patienten mit CD Typ 1 oder Typ 3, ausgenommen Z. n. Cholezystektomie.

85 % (35/41) der Patienten mit PCD blieben bei einer Nachbeobachtungszeit von median 8,3 (1 – 23,6) Jahren behandlungsbedürftig, davon nahmen 68,6 % (24/35) Colestyramin, 31,4 % (11/35) andere Antidiarrhoika. 14,6 % (6/41) berichteten eine Spontanremission nach median 2,9 (0,7 – 5,7) Jahren.

In der Gruppe von Patienten mit CD nach Cholezystektomie waren 82 % (8/11) nach median 7,7 (1 – 24,5) Jahren weiter behandlungsbedürftig, 8 nahmen Colestyramin, ein Patient keine Medikamente, zwei Spontanremissionen.

Alle acht Patienten mit normalem SeHCAT-Test (7-Tage-Retention > 20 %) wurden nach median 3,6 (1,2 – 6,3) Monaten wieder beschwerdefrei.

Auch 70 % (7/10) der Patienten ohne Bestätigung durch den SeHCAT-Test waren nach median 4,3 (3,7 – 18,3) Jahren weiter behandlungsbedürftig.

Mit der Probebehandlung allein steht die Diagnose einer CD auf schwachen Füßen. Sie ist aber ubiquitär verfügbar und sollte im diagnostischen Algorithmus der chronischen Diarrhö einen festen Platz haben, wenn andere Verfahren nicht zur Verfügung stehen. Durch den primären Einsatz des SeHCAT-Tests ist nach aktueller Literatur eine deutlich höhere diagnostische Ausbeute zu erwarten und eine Einsparung unnötiger Folgeuntersuchungen möglich. Die therapeutischen Konsequenzen sind wegen der bekannten Limitationen des Colestyramin jedoch begrenzt. Eine besser verträgliche und zugelassene Alternative für Colestyramin wird dringend benötigt.
Gesundheitsbedingte Repatriierungsrate philippinischer Seefahrer
Authors: Westerhoff Nicola
Published: April 2019

Täglich setzt sich der Seemann den Risiken und Gefahren des offenen Meeres aus. Eine hohe Arbeitsbelastung an langen Arbeitstagen, eine dauerhaft hohe körperlicher Belastung, wechselnde Schichten und Schlafentzug erhöhen das Risiko von körperlichen und psychischen Erkrankungen. Bislang wurde der Einfluss der Aufenthaltsdauer an Bord auf die Gesundheit/Arbeitsfähigkeit und einer sich anschließenden Repatriierung kaum untersucht.
Wie wir stationäre Routinedaten im Rahmen der
Versorgungsforschung nutzen können
Authors: Baierlein Jochen , Leibinger Philipp , Zacharowski Kai , Meybohm Patrick
Published: April 2019

Zielsetzung Anhand der Daten des Statistischen Bundesamtes und den
Qualitätsberichten der Krankenhäuser liegen prinzipiell große Datenmengen vor,
die die stationäre Versorgungssituation beschreiben. Es soll aufgezeigt werden,
welche analytischen Möglichkeiten anhand dieser Datensätze gegeben sind und
welche Vor- und Nachteile mit diesen einhergehen.

Methodik Die Datensätze wurden von den zuständigen Institutionen für die
Jahre 2007–2016 (DRG-Statistik) bzw. für die Jahre 2012–2016 (Qualitätsberichte)
bezogen und aufbereitet, um diese anschließend anhand verschiedener Kriterien zu
beschreiben und zu beurteilen. Des Weiteren wurden anhand zweier klinischer
Auswertungsbeispiele (OPS 8–918: Multimodale Schmerztherapie und OPS 8–800:
Transfusion von Vollblut, Erythrozytenkonzentrat und Thrombozytenkonzentrat)
verschiedene Auswertungen vorgenommen, um Analysepotentiale und Limitationen
aufzuzeigen.

Ergebnis Anhand der Qualitätsberichte und der Daten des Statistischen
Bundesamtes können sowohl die Leistungsentwicklungen der Krankenhäuser als auch
die Fallzahlentwicklungen nach Patientenherkunft auf regionaler Ebene (Stadt-
und Landkreisebene) dargestellt werden. So zeigt sich bei der Multimodalen
Schmerztherapie ein Fallzahlzuwachs zwischen 2012 und 2016 von 45 %, bei den
Transfusionen hingegen kann zwischen 2013 und 2016 ein jährlicher Rückgang von
3,5 % gezeigt werden. Durch Überlagerung der beiden Datensätze können zudem
Versorgungslücken aufgezeigt werden, d. h. Gebiete identifiziert werden, in
denen Leistungen benötigt aber nicht angeboten werden.

Schlussfolgerung Bei beiden Datensätzen handelt es sich nahezu um
Vollerhebungen, die sich aus analytischer Sicht gut ergänzen und für
Auswertungen zusammengeführt werden können. Es ist möglich, die Versorgungslage
verschiedener Indikationen transparent darzustellen, deren Entwicklung
aufzuzeigen und Hinweise zu Optimierungspotentialen zu geben. Mit diesen kann
die Versorgungssituation bestimmter stationärer Leistungen sowohl angebotsseitig
(Krankenhäuser) als auch nachfrageseitig (Patienten) transparent dargestellt
werden.
Colitis ulcerosa: Kann eine Modulation der intestinalen Mikrobiota eine langfristige Remission bedingen?
Authors: Stallmach Andreas , Grunert Philip , Pieper Dietmar , Steube Arndt
Published: April 2019

Das Verständnis der Colitis ulcerosa (CU) ist in den letzten Dekaden stetig gewachsen; unterschiedliche Therapiekonzepte sind für verschiedene Krankheitssituationen standardisiert. In der Pathogenese wird der gastrointestinalen Mikrobiota, Umweltfaktoren, überschießenden immunologischen Reaktionen und genetischen Faktoren eine immer größere Bedeutung zugeordnet. So zeigen zahlreiche klinische Beobachtungen eine enge Verbindung zwischen einer dysbiotischen Mikrobiota und der Erstmanifestation und dem Verlauf der CU an. Vor dem Hintergrund, dass genetische Faktoren und inflammatorische Reaktionen die Mikrobiota selber verändern können ist aber nicht klar, was Ursache und Folge ist. Der Fäkale Mikrobiom Transfer (FMT) ist der drastischste Eingriff um eine dysbiotische Mikrobiota zu normalisieren. Mittlerweile ist ein FMT eine akzeptierte Behandlung der rezidivierenden Clostridioides difficile-Infektion; zahlreiche Fallserien und kontrollierte Studien untersuchen dieses Konzept auch bei Patienten mit CU. Vor diesem Hintergrund erfolgt eine Zusammenfassung der aktuellen Literatur bezüglich Effektivität und Sicherheit. Mögliche Limitationen und offene Fragen werden diskutiert, um das Konzept des FMT zur Therapie der CU zu verbessern. Ohne Zweifel sind dringend weitere kontrollierte Studien notwendig; ein FMT sollte bei CU nicht außerhalb dieser erfolgen.
Reduced Mannose-Binding Lectin-Associated Serine Protease (MASP)-1 is Associated with Disturbed Coagulation in Septic Shock
Authors: Larsen Julie Brogaard , Laursen Mathies Appel , Hvas Christine Lodberg , Larsen Kim Michael , Thiel Steffen , Hvas Anne-Mette
Published: April 2019

Background Activation of the complement system is part of the dysregulated immune response in sepsis. The mannose-binding lectin-associated serine proteases (MASP)-1 and -2 activate the lectin pathway of the complement system. Besides, these proteins can activate coagulation in vitro. However, the role of the lectin pathway proteins in the development of sepsis-related disseminated intravascular coagulation (DIC) is only sparsely investigated.

Aim This article investigates the association between lectin pathway proteins and coagulation disturbances in septic shock patients.

Materials and Methods We included 36 septic shock patients from the intensive care unit, Aarhus University Hospital, Denmark. Blood samples were obtained within 24 hours after admission (day 1), and subsequently on day 2 and day 3. Plasma concentrations of mannose-binding lectin (MBL), H-ficolin, M-ficolin, CL-L1, CL-K1, MASP-1, -2 and -3, MBL-associated proteins of 19 and 44 kDa as well as complement factor C3dg were assessed. Standard coagulation parameters, thrombin generation, thrombin–anti-thrombin (TAT) complex and pro-thrombin fragment 1 + 2 were measured. Sequential Organ Failure Assessment (SOFA) score, DIC score and 30-day mortality were assessed.

Results Reduced MASP-1 plasma concentration was associated with DIC score ≥5 (p = 0.02), impaired thrombin generation (p = 0.03) and lower plasma TAT complex levels (p = 0.03). No association was found between lectin pathway proteins and SOFA score or 30-day mortality.

Conclusion Reduced MASP-1 concentrations were associated with impaired coagulation in septic shock patients. This indicates that increased MASP-1 activation and consumption is associated with the more severe coagulation disturbances in sepsis and points to a possible role for MASP-1 in sepsis-related DIC.
Quantum informational properties of the Landau–Streater channel
Authors: Filippov Sergey N. , Kuzhamuratova Ksenia V.
Published: April 2019

We study the Landau–Streater quantum channel Φ:B(Hd)↦B(Hd), whose Kraus operators are proportional to the irreducible unitary representation of SU(2) generators of dimension d. We establish SU(2) covariance for all d and U(3) covariance for d = 3. Using the theory of angular momentum, we explicitly find the spectrum and the minimal output entropy of Φ. Negative eigenvalues in the spectrum of Φ indicate that the channel cannot be obtained as a result of Hermitian Markovian quantum dynamics. Degradability and antidegradability of the Landau–Streater channel is fully analyzed. We calculate classical and entanglement-assisted capacities of Φ. Quantum capacity of Φ vanishes if d = 2, 3 and is strictly positive if d ⩾ 4. We show that the channel Φ ⊗ Φ does not annihilate entanglement and preserves entanglement of some states with Schmidt rank 2 if d ⩾ 3.
Phraseology in teenage language in Spanish, English and Norwegian
Authors: Jørgensen Annette Myre , Olza Inés
Published: April 2019

A set of phraseological units that convey disagreement in Spanish, English and Norwegian teenage language are
observed from three perspectives in this paper: the phraseological, the pragmatic-discursive and the contrastive perspective. The
underlying assumption of the analysis is that the expression of disagreement in these terms among young people takes on certain
pragmatic nuances. The Madrid Oral Corpus of Teenage Talk (COLAm), the COLT-corpus (Corpus of London Teenage Talk) and the
UNO-corpus of Young Norwegian speakers (Ungdomsspråk i Norden, Oslo) enable a comparison of the use of these phraseological units
expressing disagreement among teenagers across these three languages.
Comparative Study of Tiger Identification Using Template Matching Approach based on Edge Patterns
Authors: Hariyanto E , Iqbal M , Siahaan A P U , Saragih K S , Batubara S
Published: April 2019

The presence of tigers in residential areas as predators was a threat to humans and their livestock. Through digital image processing, these animals could be identified by matching line patterns on the skin as a characteristic of the tiger using the template matching method, namely comparing the similarities between the lines pattern in the reference image with the main image. However, the presence of plant leaves and shrubs with various shapes could disguise tiger skin line patterns so that it could affect the accuracy of identification results. In this paper, we conducted a comparative study to identify tigers based on edge lines which were then processed using three edge detection method namely Canny, Laplacian and Sobel. The results of each operator were further processed using template matching algorithm to get the accuracy of object identification (tiger).
GSE spectra in uni-directional quantum systems
Authors: Akila Maram , Gutkin Boris
Published: April 2019

Generically, spectral statistics of spinless systems with time reversal invariance (TRI) and chaotic dynamics are well-described by the Gaussian orthogonal ensemble (GOE). However, if an additional symmetry is present, the spectrum can be split into independent sectors which statistics depend on the type of the group’s irreducible representation. In particular, this allows for the construction of TRI quantum graphs with spectral statistics characteristic of the Gaussian symplectic ensembles (GSE). To this end one usually has to use groups admitting pseudo-real irreducible representations. In this paper we show how GSE spectral statistics can be realized in TRI systems with simpler symmetry groups lacking pseudo-real representations. As an application, we provide a class of quantum graphs with only C
4 rotational symmetry possessing GSE spectral statistics.
Is the Bombali virus pathogenic in humans?
Authors: Martell Henry J , Masterson Stuart G , McGreig Jake E , Michaelis Martin , Wass Mark N
Published: April 2019

Motivation

The potential of the Bombali virus, a novel Ebolavirus, to cause disease in humans remains unknown. We have previously identified potential determinants of Ebolavirus pathogenicity in humans by analysing the amino acid positions that are differentially conserved (specificity determining positions; SDPs) between human pathogenic Ebolaviruses and the non-pathogenic Reston virus. Here, we include the many Ebolavirus genome sequences that have since become available into our analysis and investigate the amino acid sequence of the Bombali virus proteins at the SDPs that discriminate between human pathogenic and non-human pathogenic Ebolaviruses.

Results

The use of 1408 Ebolavirus genomes (196 in the original analysis) resulted in a set of 166 SDPs (reduced from 180), 146 (88%) of which were retained from the original analysis. This indicates the robustness of our approach and refines the set of SDPs that distinguish human pathogenic Ebolaviruses from Reston virus. At SDPs, Bombali virus shared the majority of amino acids with the human pathogenic Ebolaviruses (63.25%). However, for two SDPs in VP24 (M136L, R139S) that have been proposed to be critical for the lack of Reston virus human pathogenicity because they alter the VP24-karyopherin interaction, the Bombali virus amino acids match those of Reston virus. Thus, Bombali virus may not be pathogenic in humans. Supporting this, no Bombali virus-associated disease outbreaks have been reported, although Bombali virus was isolated from fruit bats cohabitating in close contact with humans, and anti-Ebolavirus antibodies that may indicate contact with Bombali virus have been detected in humans.

Availability and implementation

Data files are available from https://github.com/wasslab/EbolavirusSDPsBioinformatics2019.

Supplementary information

Supplementary data are available at Bioinformatics online.
Non-steroidal anti-inflammatory drugs in chronic kidney disease: a systematic review of prescription practices and use in primary care
Authors: Lefebvre Claire , Hindié Jade , Zappitelli Michael , Platt Robert W , Filion Kristian B
Published: April 2019

Background

Chronic kidney disease (CKD) management focuses on limiting further renal injury, including avoiding nephrotoxic medications such as non-steroidal anti-inflammatory drugs (NSAIDs). We performed a systematic review to evaluate the prevalence of primary care NSAID prescribing in this population.

Methods

We systematically searched MEDLINE and Embase from inception to October 2017 for observational studies examining NSAID prescribing practices or use in CKD patients in a primary care setting. The methodological quality of included studies was assessed independently by two authors using a modified version of the Agency for Healthcare Research and Quality’s Methodological Evaluation of Observational Research checklist.

Results

Our search generated 8055 potentially relevant publications, 304 of which were retrieved for full-text review. A total of 14 studies from 13 publications met our inclusion criteria. There were eight cohort and three cross-sectional studies, two quality improvement intervention studies and one prospective survey, representing a total of 49 209 CKD patients. Cross-sectional point prevalence of NSAID use in CKD patients ranged from 8 to 21%. Annual period prevalence rates ranged from 3 to 33%. Meta-analysis was not performed due to important clinical heterogeneity across study populations.

Conclusions

Evidence suggests that NSAID prescriptions/use in primary care among patients with CKD is variable and relatively high. Future research should explore reasons for this to better focus knowledge translation interventions aimed at reducing NSAID use in this patient population.
Social media and orthodontic treatment from the patient’s perspective: a systematic review
Authors: Papadimitriou Aikaterini , Kakali Lydia , Pazera Pawel , Doulis Ioannis , Kloukos Dimitrios
Published: April 2019

Background

Social media are one of the most common and easily accessible ways of gaining information about orthodontic treatment.

Objective

The main objective of this study was to systematically search the literature and determine the various aspects of the interrelationship between social media and orthodontics from the patient’s perspective.

Search methods

Electronic database searches of published and unpublished literature were performed. The reference lists of all eligible articles were hand-searched for additional studies.

Selection criteria

Randomized clinical trials (RCTs), prospective, retrospective, and cross-sectional studies were included.

Data collection and analysis

Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate by the first two authors.

Results

One RCT, three retrospective, and four cross-sectional studies were deemed as eligible for inclusion in this review. The studies included patient’s statements in social media or results from questionnaires given to patients. The social media reported were with order of frequency: Twitter, YouTube, Facebook, Google+, Pinterest, and Instagram. The feelings the patients expressed seemed to be more positive than negative: enthusiasm, self-esteem and pleasure, excitement about the aesthetic result, excitement after braces removal but also antipathy, annoyances, reduced self-esteem, and impatience for removing mechanisms. In addition, one study referred to bullying through Twitter.

Limitations

The high amount of heterogeneity precluded a valid interpretation of the results through pooled estimates.

Conclusions and implications

This systematic review demonstrated that information about orthodontics, how the patient feels, and other psychosocial facets are spread through social media. It is intuitive that research relating to the effects and impact of orthodontic interventions should account not only for the physical impacts of treatment but also to encompass patient-centered outcomes.

Registration

The protocol of this study was not registered in publicly assessable database.

Conflicts of interest

None to declare.
Does Empathy Have a Cost? Older Adults and Social Partners Experiencing Problems
Authors: Huo Meng , Fuentecilla Jamie L , Birditt Kira S , Fingerman Karen L
Published: April 2019

Background and Objectives

Empathy underlies older adults’ awareness and responses to their social partners’ needs, but it is unclear whether such awareness is beneficial or harmful to older adults’ well-being. We examined whether older adults’ empathy was associated with having encounters with social partners incurring problems and their own well-being throughout the day.

Research Design and Methods

Participants were adults aged more than 65 years from the Daily Experiences and Well-being Study. These older adults (n = 313) rated empathy and indicated social partners’ problems (e.g., health, emotional, and financial problems) in a baseline interview. They also reported encounters with social partners and their mood every 3 hr over 5–6 days.

Results

Multiple regressions showed that more empathic older adults reported a greater proportion of social partners with major life problems than less empathic older adults. Older adults’ empathy was not associated with their contact or negative encounters with social partners experiencing problems. Multilevel models revealed that encounters with these social partners had negative consequences for older adults’ mood throughout the day; however, these consequences were reduced in more empathic older adults.

Discussion and Implications

This study emphasizes the importance of empathy in late life and refines our understanding of older adults’ social lives and well-being. Findings carry implications for interventions that aim to protect older adults’ well-being when their close others incur crises.
The Real Cost: Alaska’s innovative media campaign to raise awareness about the direct and indirect costs of smoking to society
Authors: Pizacani Barbara , Rohde Kristen , Fenaughty Andrea , Tutiakoff Tiffany
Published: April 2019

Smoking incurs heavy financial costs for direct medical expenditures and lost productivity related to premature death. The Alaska Tobacco Prevention and Control Program designed a media campaign called ‘The Real Cost’ to raise awareness of the economic cost of smoking to all Alaskans, regardless of their smoking status. The campaign presented this information through television and radio ads between December 2012 and March 2013. The first ad, ‘Dream Scene’, focused on overall cost of smoking to Alaska. The second ad, ‘Oil Change’, focused on lost productivity. We conducted three cross-sectional telephone surveys, one prior to the campaign and one after each ad was run to assess changes in beliefs associated with the main campaign messages. At Survey 2, we observed increased adjusted odds of agreement with the main campaign message, ‘I am affected financially by other people’s smoking’ (adjusted odds ratio = 4.5, 95% confidence interval = 3.0–6.7). At Survey 3, we observed elevated adjusted odds of agreement for beliefs related to all campaign messages. This campaign was successful in raising knowledge and awareness of the cost of smoking on a societal level among adult, nonsmoking residents of Alaska.
Derived Categories of Families of Sextic del Pezzo Surfaces
Authors: Kuznetsov Alexander
Published: April 2019

We construct a natural semiorthogonal decomposition for the derived category of an arbitrary flat family of sextic del Pezzo surfaces with at worst du Val singularities. This decomposition has three components equivalent to twisted derived categories of finite flat schemes of degrees 1, 3, and 2 over the base of the family. We provide a modular interpretation for these schemes and compute them explicitly in a number of standard families. For two such families the computation is based on a symmetric version of homological projective duality for ${{\mathbb{P}}}^2 \times{{\mathbb{P}}}^2$ and ${{\mathbb{P}}}^1 \times{{\mathbb{P}}}^1 \times{{\mathbb{P}}}^1$, which we explain in an appendix.
An intuitionistic logic for preference relations
Authors: Maffezioli Paolo , Naibo Alberto
Published: April 2019

We investigate in intuitionistic first-order logic various principles of preference relations alternative to the standard ones based on the transitivity and completeness of weak preference. In particular, we suggest two ways in which completeness can be formulated while remaining faithful to the spirit of constructive reasoning, and we prove that the cotransitivity of the strict preference relation is a valid intuitionistic alternative to the transitivity of weak preference. Along the way, we also show that the acyclicity axiom is not finitely axiomatizable in first-order logic.
Ability of Two Commercially Available Host-Targeted Technologies to Reduce Abundance of Ixodes scapularis (Acari: Ixodidae) in a Residential Landscape
Authors: Jordan Robert A , Schulze Terry L
Published: April 2019

Host-targeted technologies provide an alternative to the use of conventional pesticide applications to reduce the abundance of Ixodes scapularis Say, the vector for an array of tick-associated human diseases. We compared the ability of Damminx Tick Tubes (Damminix) and SELECT Tick Control System (Select TCS) bait boxes to control host-seeking I. scapularis nymphs in a wooded residential environment. Small mammals accepted and used Select TCS bait boxes with greater frequency compared to Damminix tubes over the course of the 2-yr trial. Nymphal tick infestation prevalence and intensity on captured mice and chipmunks provided no conclusive evidence of a treatment effect during May–June of both years. However, both treatments had a measurable effect on larval tick burdens in July–August and the magnitude of the effect was greater at the Select TCS-treated area and reflected the fact that Select TCS effectively treated chipmunks, while Damminix did not. Deployment of Damminix resulted in 27.6 and 20.3% control of questing nymphs in treated areas at 1 yr and 2 yr postintervention, while Select TCS bait boxes provided 84.0 and 79.1% control, respectively. The economics of residential tick control using these products in wooded residential landscapes is discussed.
How Cognitive Frameworks Shape the American Approach to International Relations and Security Studies
Authors: Cheng Christine , Brettle Alison
Published: April 2019

Why do American perspectives of international relations (IR) continue to hold sway over an increasingly diverse discipline? What actually constitutes “Americanness” in IR? Who is considered “American” in IR? These are the central questions we explore in this essay. Drawing on cognitive and behavioral insights from social psychology, we argue that there is a distinct “American approach” to international relations and security studies and that this approach is a product of Western cognitive frames. We identify three factors that represent the American approach's hyper-Westernized framing: individualism, equality, and a preference for causal rather than contextual analysis, and a preference for egalitarianism. We argue that these are reinforced by two social identity processes—academic identity and national identity. The consequences of “being American” in IR and security studies suggest not only problems of attention and accuracy, but an inherent failure to appreciate that Western—and particularly, American—ways of seeing and valuing the world are not universal.
Effect of Clinically Uninfected Orthopedic Implants and Pacemakers/AICDs in Low-Risk Staphylococcus aureus Bloodstream Infection on Crude Mortality Rate: A Post Hoc Analysis of a Large Cohort Study
Authors: Kaasch Achim J , Kern Winfried V , Joost Insa , Hellmich Martin , Seifert Harald , Rieg Siegbert
Published: April 2019

Background

The standard treatment duration in low-risk Staphylococcus aureus bloodstream (SAB) is 14 days. However, it is unclear whether an extended course of antimicrobial therapy is necessary in patients with clinically uninfected prosthetic joints/osteosyntheses or pacemakers/automated implanted cardioverter-defibrillators (AICDs). Thus, we compared the duration of antimicrobial therapy and outcomes in patients with and those without clinically uninfected foreign bodies.

Methods

We conducted a post hoc analysis of data from the prospective Invasive Staphylococcus aureus Infection Cohort (INSTINCT) study. Adult low-risk patients who survived ≥4 days were assessed for duration of treatment, SAB-related events (attributable death, relapse, or new deep-seated infection), and survival.

Results

Of the 1288 patients enrolled, 292 satisfied criteria for low-risk SAB. Forty-three patients (15%) had a clinically uninfected pacemaker/AICD or orthopedic implant. Patients with foreign bodies were significantly older (mean age, 72 vs 62 years for those without; P < .001; P = .9) and had a higher Charlson score (median, 3 vs 2; P = .06). The total duration of antimicrobial therapy (median, 18 vs 17 days, respectively; P = .7), all-cause mortality rate (16% vs 14%; P = .7), and prevalence of SAB-related events within 90 days were similar (2% vs 2%) in the 2 groups. At 1-year follow-up, SAB-related events were more frequent in patients with foreign bodies (7% vs 4% in those without; P = .4) (hazard ratio, 1.41; 95% confidence interval, .35–5.69; in a multivariable Cox model), but this difference was not statistically significant.

Conclusions

Low-risk patients with clinically uninfected foreign bodies received a similar duration of antimicrobial therapy without a significant impact on mortality rate. The observed higher hazard ratio of SAB-related events within 1 year necessitates additional studies before recommendations concerning treatment duration in this patient subgroup can be adapted or modified.
A Decade On: Systematic Review of ClinicalTrials.gov Infectious Disease Trials, 2007–2017
Authors: Jaffe Ian S , Chiswell Karen , Tsalik Ephraim L
Published: April 2019

Background

Registration of interventional trials of Food and Drug Administration–regulated drug and biological products and devices became a legal requirement in 2007; the vast majority of these trials are registered in ClinicalTrials.gov. An analysis of ClinicalTrials.gov offers an opportunity to define the clinical research landscape; here we analyze 10 years of infectious disease (ID) clinical trial research.

Methods

Beginning with 166 415 interventional trials registered in ClinicalTrials.gov from 2007–2017, ID trials were selected by study conditions and interventions. Relevance to ID was confirmed through manual review, resulting in 13 707 ID trials and 152 708 non-ID trials.

Results

ID-related trials represented 6.9%–9.9% of all trials with no significant trend over time. ID trials tended to be more focused on treatment and prevention, with a focus on testing drugs, biologics, and vaccines. ID trials tended to be large, randomized, and nonblinded with a greater degree of international enrollment. Industry was the primary funding source for 45.2% of ID trials. Compared with the global burden of disease, human immunodeficiency virus/AIDS and hepatitis C trials were overrepresented, and lower respiratory tract infection trials were underrepresented. Hepatitis C trials fluctuated, keeping with a wave of new drug development. Influenza vaccine trials peaked during the 2009 H1N1 swine influenza outbreak.

Conclusions

This study presents the most comprehensive characterization of ID clinical trials over the past decade. These results help define how clinical research aligns with clinical need. Temporal trends reflect changes in disease epidemiology and the impact of scientific discovery and market forces. Periodic review of ID clinical trials can help identify gaps and serve as a mechanism to realign resources.
Chekhov’s corner: Using Dreamland: The True Tale of America’s Opiate Epidemic in the public health classroom
Authors: Basch Corey H , Wagner Victoria H
Published: April 2019

Background

Narratives can provide an interesting approach to health communication, incorporating anecdotes, imagery, and details that resonate with readers. Given this context, the purpose of this study was to explore the use of Dreamland: The True Tale of America’s Opiate Epidemic to define and demonstrate an understanding of Ethos, Pathos and Logos.

Methods

This qualitative, cross-sectional education research was based on the use of Dreamland: The True Tale of America's Opiate Epidemic by Sam Quinones in an undergraduate elective. The elective course focused on using popular literature to promote a better understanding of health concepts. The assignment focused on the applicability of models of persuasion (Ethos, Pathos, and Logos) used in this book. Responses (n = 18) were compiled and reviewed following the basic premise of the Grounded Theory approach. This allowed for the identification and development of overarching themes in a way that gives a sense of how students applied this reading to the aforementioned directed question regarding models of persuasion.

Results

In establishing Ethos, the author’s background as a journalist and the detailed interviews with credible sources were two major themes. Student quotations demonstrate that Pathos in this book was exemplified by presenting many different aspects of a complicated epidemic, rife with possibilities for evoking emotion. Illustrative quotations indicate that students are critically analyzing the text.

Conclusion

Narratives can serve as a vehicle that influences people’s understandings and beliefs, potentially promoting change in behavior or attitudes. They can enhance public health education and learning in an enriching and cross-disciplinary way.
TEMPORAL CHANGES IN RADIOCESIUM DEPOSITION ON THE FUKUSHIMA FLOODPLAIN
Authors: Nakanishi T , Sato S , Matsumoto T
Published: April 2019

There has been significant concern about increases in the exposure dose in living areas due to the accumulation of radiocesium discharged from contaminated mountainous forests in Fukushima. In this study, we investigated the history of radiocesium deposition on several floodplains in Fukushima following the nuclear power plant accident. Radiocesium concentrations in river suspended particles and the air dose rates on the floodplains were observed continuously. The annual sediment accumulation on the floodplains was 5.5–200 kg m−2, and the observed radiocesium concentration decreased with the decrease in the radiocesium concentration of suspended particles. The air dose rates on the floodplains were gradually decreasing with time. In 2015, with heavy flood discharge, a sediment accumulation of 180–200 kg m−2 and a sharp decrease in the air dose rate were observed at the Takase River, which does not have a reservoir. Conversely, the sediment accumulation at the Ukedo River was significantly reduced due to deposition in an upstream reservoir.
The HosA Histone Deacetylase Regulates Aflatoxin Biosynthesis Through Direct Regulation of Aflatoxin Cluster Genes
Authors: Lan Huahui , Wu Lianghuan , Sun Ruilin , Keller Nancy P. , Yang Kunlong , Ye Liuqing , He Shuibin , Zhang Feng , Wang Shihua
Published: April 2019

Histone deacetylases (HDACs) always function as corepressors and sometimes as coactivators in the regulation of fungal development and secondary metabolite production. However, the mechanism through which HDACs play positive roles in secondary metabolite production is still unknown. Here, classical HDAC enzymes were identified and analyzed in Aspergillus flavus, a fungus that produces one of the most carcinogenic secondary metabolites, aflatoxin B1 (AFB1). Characterization of the HDACs revealed that a class I family HDAC, HosA, played crucial roles in growth, reproduction, the oxidative stress response, AFB1 biosynthesis, and pathogenicity. To a lesser extent, a class II family HDAC, HdaA, was also involved in sclerotia formation and AFB1 biosynthesis. An in vitro analysis of HosA revealed that its HDAC activity was considerably diminished at nanomolar concentrations of trichostatin A. Notably, chromatin immunoprecipitation experiments indicated that HosA bound directly to AFB1 biosynthesis cluster genes to regulate their expression. Finally, we found that a transcriptional regulator, SinA, interacts with HosA to regulate fungal development and AFB1 biosynthesis. Overall, our results reveal a novel mechanism by which classical HDACs mediate the induction of secondary metabolite genes in fungi.
Digalactosyldiacylglycerol Synthase Gene MtDGD1 Plays an Essential Role in Nodule Development and Nitrogen Fixation
Authors: Si Zaiyong , Yang Qianqian , Liang Rongrong , Chen Ling , Chen Dasong , Li Youguo
Published: April 2019

Little is known about the genes participating in digalactosyldiacylglycerol (DGDG) synthesis during nodule symbiosis. Here, we identified full-length MtDGD1, a synthase of DGDG, and characterized its effect on symbiotic nitrogen fixation in Medicago truncatula. Immunofluorescence and immunoelectron microscopy showed that MtDGD1 was located on the symbiosome membranes in the infected cells. β-Glucuronidase histochemical staining revealed that MtDGD1 was highly expressed in the infection zone of young nodules as well as in the whole mature nodules. Compared with the control, MtDGD1-RNA interference transgenic plants exhibited significant decreases in nodule number, symbiotic nitrogen fixation activity, and DGDG abundance in the nodules, as well as abnormal nodule and symbiosome development. Overexpression of MtDGD1 resulted in enhancement of nodule number and nitrogen fixation activity. In response to phosphorus starvation, the MtDGD1 expression level was substantially upregulated and the abundance of nonphospholipid DGDG was significantly increased in the roots and nodules, accompanied by corresponding decreases in the abundance of phospholipids such as phosphatidylcholine, phosphatidylethanolamine, and phosphatidylinositol. Overall, our results indicate that DGD1 contributes to effective nodule organogenesis and nitrogen fixation by affecting the synthesis and content of DGDG during symbiosis.
Molecular Typing of ‘Candidatus Phytoplasma solani’ in Iranian Vineyards
Authors: Jamshidi Elham , Murolo Sergio , Ravari Sareh Baghaee , Salehi Mohammad , Romanazzi Gianfranco
Published: April 2019

Grapevine (Vitis vinifera L.) is one of the most important horticultural crops in Iran, with >200,000 ha of cultivated area. Recently, outbreaks of the grapevine yellows Bois noir that is associated with phytoplasma strains related to ‘Candidatus Phytoplasma solani’ were recorded in several Iranian regions. This has resulted in severe economic losses. We carried out a survey in 2015, followed by collection of leaf samples from symptomatic grapevines and weeds. Because no information is available on the molecular epidemiology of ‘Ca. P. solani’ in Iran, multiple gene analyses were carried out here according to molecular characterization of the tuf and vmp1 genes. From the molecular characterization, all of the samples (i.e., grapevines, weeds) were infected with tuf b type. Detailed molecular characterization of the vmp1 gene (i.e., PCR–restriction fragment length polymorphism, sequence analysis) defined five molecular types: V1, V4, V10, V15, and V20. The abundance of Convolvulus arvensis in vineyards and detection of the same ‘Ca. P. solani’ molecular types in grapevines and weeds suggest that C. arvensis has a major role in Bois noir epidemiology of Iranian vineyards. Therefore, control strategies should be developed to manage these host plants to reduce inoculum sources of the phytoplasma in vineyards.
A-101 The human leukemia virus-HTLV-1—persistence and pathogenesis
Authors: Bangham Charles
Published: April 2019

The human leukemia virus HTLV-1 persists lifelong in infected people. Although the virus elicits a strong chronically activated T cell immune response to the major viral proteins Gag, Pol, Env and Tax, the genes encoding these proteins are usually silent in circulating lymphocytes. In contrast, there is a weak T cell response to the viral protein HBZ, which appears to be persistently expressed at a low level. There is recent evidence that the plus strand of the HTLV-1 provirus, which encodes the immunodominant T cell antigens, is expressed in intermittent bursts, whereas the minus strand (encoding hbzis almost constantly expressed, in all cells, at a low level. We are now investigating how HTLV-1 regulates this selective expression of the proviral plus- and minus-strands. I shall present evidence from single molecule RNA-FISH, chromosome conformation capture, small-molecule inhibitors, and transcription analysis (RNA-Seq; qRT-PCR) that specific epigenetic and metabolic factors regulate this strand-specific proviral expression. The results offer an explanation of long-standing paradoxes and unexplained observations in the biology of this pathogenic retrovirus.
A-105 Role of fibroblasts in HTLV-1-mediated lymphomagenesis
Authors: Chieco-Bianchi Luigi , Vicario Mattia , Mattiolo Adriana , Montini Barbara , Piano Maria Assunta , Calabrò Maria Luisa
Published: April 2019

Only a low percentage (2%–5%) of HTLV-1-infected people develop ATLL after a very prolonged latency (2–6 decades). Besides Tax and HBZ viral products, responsible for immortalization of CD4+ T lymphocytes, and genetic and epigenetic cell abnormalities, host factors most likely contribute to the induction of the overt clinical disease. On the basis of previous in vitro studies done by other groups, we conducted in vivo experiments to investigate the role of fibroblasts, one of the major components of microenvironment, in HTLV-1-induced tumorigenesis. Primary human foreskin fibroblasts (HFF) xenotransplanted together with in vitro HTLV-1-immortalized C91/PL cells into immunodeficient Balb/c Rag2−/−ɣc−/− mice were found to significantly trigger the oncogenic potential of C91/PL cells. Cell lines established from lymphomatous masses and subsequent in vitro/in vivo passages acquired the stable property to induce aggressive T-cell lymphoma without the need of HFF support. Tumorigenic cell lines, among which C91/III cells, derived from C91/PL cells, showed no significant variation in the expression of the HTLV-1 gag, env and tax/rex mRNAs compared to C91/PL cells; in contrast, all the viral transcripts coding for the accessory proteins revealed a significant increase in C91/III cells. Moreover, these cells released higher amounts of several factors, suggesting the amplification of soluble autocrine and paracrine signals. HFF-co-cultured C91/PL cells acquired several characteristics of C91/III cells, including a more aggressive in vivo behavior. Conversely, viral transcription profile of co-cultured cells was not significantly different from that of C91/PL cells, indicating that changes in viral gene expression observed in C91/III cells were likely not responsible for the higher lymphomagenic capacity of the C91/PL-derived cell lines. These findings suggest that the crosstalk with fibroblasts may boost the tumorigenic properties of HTLV-1-immortalized T-cells through activation of autocrine and paracrine pro-lymphomagenic, stimulatory loops. These results provide new insight into ATLL pathogenic mechanisms and new potential targets for ATLL prevention.
B-101 Placental exosomes in maternal-placental-fetal communication and viral resistance
Authors: Ouyang Yingshi , Li Hui , Krawczynski Kamil , Mouillet Jean-Francois , Coyne Carolyn , Sorkin Alexander , Sadovsky Yoel
Published: April 2019

The placenta plays a critical role in regulating maternal-fetal gas exchange, supply of nutrients to the fetus and removal of waste, production of hormones, and immunological defense, including resistance to diverse pathogens. While many of these functions are controlled by hormones, growth factors and other signaling molecules, the recent discovery of placental small RNAs and their release to the plasma within extracellular vesicles provides a new dimension to our investigation into paracrine and distant signaling networks that constitute maternal-fetal crosstalk. In this context, we found that primary human trophoblasts are resistant to infection by diverse types of DNA and RNA viruses, and that this resistance can be partly conferred to non-trophoblastic cells by transferring placenta- and primate-specific miRNAs, expressed from the chromosome 19 miRNA cluster (C19MC). Furthermore, we found that all trophoblastic EVs contain C19MC miRNAs, and that trophoblastic exosomes execute an antiviral effect when applied to non-placental cells. To pursue the patterns of miRNA transport in vivo among the maternal, placental and fetal compartments, we created a humanized mouse model that stably expresses the human C19MC miRNA cluster. We detected the trafficking of placental miRNAs among the maternal and fetal compartments. Our current work centers on the mechanisms of uptake of trophoblastic exosomes by non-trophoblastic cells, and the proteins that are essential for that process. Together, our findings establish previously unrecognized mechanisms of exosome-based maternal-fetal crosstalk. These pathways have functional implications for defense against viral pathogens and possibly have other homeostatic functions during pregnancy.
B-103 Not all soluble cytokines are soluble: cytokines in extracellulr vesiclesmediate cell-cell communications
Authors: Margolis Leonid
Published: April 2019

To maintain complex multicellular systems, cells need to communicate with each other. At least 2 systems of such communication are known: Cytokines, classical soluble factors, and recently discovered extracellular vesicles (EVs). We found that these 2 systems are not strictly separated since many cytokines in vitro, ex vivo, and in vivo are released in EV-associated forms. EVs carry cytokines both on their surface and in encapsulated forms; the latter are not detectable by standard cytokine assays. Cytokines associated with EVs may target vesicles to particular cells and upon contact with them are capable of eliciting biological effects. Association of cytokines with EVs is not a property of a particular cytokine but rather of a biological system and is changed upon system activation. Moreover, the pattern of such association is altered in different pathologies. Deciphering the regulatory mechanisms of EV-cytokine association in health and disease may lead to new therapeutic strategies.