bluuebunny/crossref_metadata_2025 huggingface dataset:
Biphasic squamoid alveolar renal carcinoma with positive CD57 expression: A clinicopathologic study of three cases
Authors: Zhou Luting , Xu Haimin , Zhou Yangfan , Zhou Jun , Zhang Peipei , Yang Xiaoqun , Wang Chaofu
Published: August 2019

Biphasic squamoid alveolar renal cell carcinoma (BSARCC) is a rare and recently characterized form of papillary renal cell carcinoma (PRCC). Herein, we describe three cases of BSARCC that were CD57+. Among a total of 90 cases of PRCC, three cases were found to be consistent with a diagnosis of BSARCC. In addition to reviewing these cases, we reviewed the relevant literature pertaining to this form of cancer and assessed the immunohistochemical staining for CD57 on the available tumor samples. The three BSARCC cases in the present study were composed of two primary populations of cells. Tumors stained positive for CK, PAX8, CK7, CK19, AMACR, EMA, and vimentin. Larger cells expressed detectable levels of cyclin D1, and expression of CD57 was limited to the larger cells. All three patients were alive and free of disease during the most recent follow‐up. Our results suggest that the CD57 positivity of at least a subset of cases should necessitate their differentiation from cases of metanephric adenoma.
Calcicole behaviour of Callisthene fasciculata Mart., an Al‐accumulating species from the Brazilian Cerrado
Authors: de Souza M. C. , Williams T. C. R. , Poschenrieder C. , Jansen S. , Pinheiro M. H. O. , Soares I. P. , Franco A. C.
Published: August 2019

Most aluminium (Al)‐accumulating species are found on soils with high Al saturation and low Ca availability (Ca poor). Callisthene fasciculata Mart. (Vochysiaceae), however, is an Al‐accumulating tree restricted to Ca‐rich soils with low Al saturation in the Brazilian Cerrado savanna. Here we tested its calcicole behaviour, and the possible role of organic acids in detoxification of Al during the early stages of plant development.

We assessed growth, dry mass, nutrients, Al and organic acids in seedlings grown for 50 days on two contrasting Cerrado soils; one with high Ca concentrations and low Al saturation and the other with low Ca availability and high Al saturation.

Relative to plants on Ca‐rich soil, plants on Ca‐poor soil had necrotic spots and bronzing of leaves. Roots and shoots contained reduced concentrations of P and Cu, but higher concentrations of Fe, Al and citrate. Despite lower concentrations in the soil, Ca and Mg increased in shoots. Shoot concentrations of oxalate were also higher.

We confirmed C. fasciculata as an Al‐accumulating species with calcicole behaviour. The increased concentrations of organic acids in plants with higher Al accumulation suggest that high availability of soluble Al does not prevent occurrence of this species on soils with high Al saturation. Instead, the absence of C. fasciculata from Ca‐poor soils is probably due to imbalances in tissue Fe, Cu and Zn imposed by this soil type.
Unitization modulates recognition of within‐domain and cross‐domain associations: Evidence from event‐related potentials
Authors: Li Bingcan , Han Meng , Guo Chunyan , Tibon Roni
Published: August 2019

Although it is often assumed that memory of episodic associations requires recollection, it has been suggested that, when stimuli are experienced as a unit, earlier memory processes might contribute to their subsequent associative recognition. We investigated the effects of associative relations and perceptual domain during episodic encoding on the ability to utilize early memory processes to retrieve associative information. During the study phase, participants encoded compound and noncompound words pairs, presented either to the same sensory modality (visual presentation) or to different sensory modalities (audiovisual presentation). At the test phase, they discriminated between old, rearranged, and new pairs while ERPs were recorded. In an early ERP component, differences related to associative memory emerged only for compounds, regardless of their encoding modality. These findings indicate that episodic retrieval of compound words can be supported by early‐onset recognition processes regardless of whether both words were presented to the same or different sensory modalities, and suggests that unitization can operate at an abstract level, across a broad range of materials.
Contrasting effects of heat shock during in vitro maturation on development of in vitro‐fertilized and parthenogenetic bovine embryos
Authors: Camargo Luiz Sergio Almeida , Costa Fernanda Queiros , Munk Michele , Wohlres‐Viana Sabine , Serapião Raquel Varela , Carvalho Bruno Campos , Campos Paulo Henrique , Vieira Alex Cabral , Nogueira Luiz Altamiro Garcia , Viana Joao Henrique Moreira
Published: August 2019

This study investigated the influence of heat shock during in vitro maturation on embryo development following in vitro fertilization (IVF) or parthenogenesis (Part). Immature bovine cumulus–oocyte complexes were exposed to heat shock (41.0°C) during the first 12 hr of in vitro maturation (IVM), followed by 12 hr at 38.5°C. Control group consisted of in vitro maturation for 24 hr at 38.5°C. Oocytes were in vitro‐fertilized or activated with ionomycin and cultured in vitro for 192 hr post‐in vitro insemination or parthenogenetic activation (hpia). There was an interaction (p < .01) between temperature of IVM and method of oocyte activation (IVF or Part) for cleavage at 48 hpia. Heat shock had a negative impact (p < .01) on cleavage of IVF embryos, whereas no (p > .05) effect was found in the Part embryos. Embryo development towards blastocyst stage at 168 and 192 hpia decreased in both IVF and Part embryos derived from heat‐shocked oocytes. Heat shock increased (p < .05) the apoptotic index in Part blastocysts, but no effect (p > .05) was found in IVF counterparts. Heat shock also down‐regulated the expression of AQP3 (p < .01) and up‐regulated the expression of HSP70.1 (p < .01) in Part blastocysts, whereas it down‐regulated the expression of ATP1A1 (p < .05) in IVF blastocysts. In conclusion, the effects of heat shock during IVM on early embryo cleavage and blastocyst apoptosis are influenced by the method of oocyte activation and expression of some genes can be disturbed in embryos derived from heat‐shocked oocytes.
Ecosystem engineering by a canopy‐forming kelp facilitates the recruitment of native oysters
Authors: Shelamoff Victor , Layton Cayne , Tatsumi Masayuki , Cameron Matthew J. , Wright Jeffrey T. , Johnson Craig R.
Published: August 2019

Ecosystem engineers are species that influence the abiotic and biotic environment around them and may assist the restoration of associated species, including other habitat‐forming species. We deployed an array of 28 artificial reefs with transplanted Ecklonia radiata, the dominant canopy‐forming kelp species across southern Australia, to investigate how the patch size and density of E. radiata influenced the establishment of the associated communities of plants and animals. Many of the reefs were rapidly colonized by Ostrea angasi, a critically depleted reef‐forming oyster. Over the 24‐month deployment of the reefs, thick oyster mats formed across the entire surface of many of the reefs with estimated biomass densities exceeding 5 kg of live oysters/m2; however, oyster density was dependent on E. radiata patch size and density. Increasing patch size and the presence of kelp resulted in significantly higher densities of oysters 5 months after the reefs were deployed and at the end of the experiment, where oysters were approximately three times more numerous on reefs with kelp compared to those without kelp. E. radiata appeared to facilitate the establishment of O. angasi largely through its capacity to reduce benthic light and thus suppress competition from turfing algae. These results may inform the development of novel approaches to tackle recruitment bottlenecks affecting the restoration of O. angasi reefs.
Fetal surgery for open spina bifida
Authors: Sacco Adalina , Ushakov Fred , Thompson Dominic , Peebles Donald , Pandya Pranav , De Coppi Paolo , Wimalasundera Ruwan , Attilakos George , David Anna Louise , Deprest Jan
Published: August 2019

Key content

Spina bifida is a congenital neurological condition with lifelong physical and mental effects.

Open fetal repair of the spinal lesion has been shown to improve hindbrain herniation, ventriculoperitoneal shunting, independent mobility and bladder outcomes for the child and, despite an increased risk of prematurity, does not seem to increase the risk of neurodevelopmental impairment.

Open fetal surgery is associated with maternal morbidity.

Surgery at our institution is offered and performed according to internationally agreed criteria and protocols.

Further evidence regarding long‐term outcomes, fetoscopic repair and alternative techniques is awaited.

Learning objectives

To understand the clinical effects, potential prevention and prenatal diagnosis of spina bifida.

To understand the rationale and evidence supporting the benefits and risks of fetal repair of open spina bifida.

To understand the criteria defining those who are likely to benefit from fetal surgery.

Ethical issues

The concept of the fetus as a patient, and issues surrounding fetal death or the need for resuscitation during fetal surgery.

The associated maternal morbidity in a procedure performed solely for the benefit of the fetus/child.

The financial implications of new surgical treatments.
Perinatal iron deficiency combined with a high salt diet in adulthood causes sex‐dependent vascular dysfunction in rats
Authors: Woodman Andrew G. , Noble Ronan M. N. , Panahi Sareh , Gragasin Ferrante S. , Bourque Stephane L.
Published: August 2019

Key points

Perinatal iron deficiency causes changes in offspring mesenteric artery function in adulthood, particularly in males, which can be exacerbated by chronic intake of a high salt diet.

Perinatal iron deficient male offspring exhibit enhanced conversion of big endothelin‐1 to active endothelin‐1, coinciding with decreased nitric oxide levels.

Perinatal iron deficient male offspring have reduced nitric oxide‐mediated endothelial‐dependent vasodilatation coincident with increased vascular superoxide levels following consumption of a high salt diet.

Perinatal iron deficiency has no apparent effects on vascular function in female offspring, even when fed a high salt diet.

These results help us better understand underlying vascular mechanisms contributing to increased cardiovascular risk from perinatal stressors such as iron deficiency.

Pre‐ and immediate postnatal stressors, such as iron deficiency, can alter developmental trajectories and predispose offspring to long‐term cardiovascular dysfunction. Here, we investigated the impact of perinatal iron deficiency on vascular function in the adult offspring, and whether these long‐term effects were exacerbated by prolonged consumption of a high salt diet in adulthood. Female Sprague Dawley rats were fed either an iron‐restricted or ‐replete diet prior to and throughout pregnancy. Six weeks prior to experimentation at 6 months of age, adult offspring were fed either a normal or high salt diet. Mesenteric artery responses to vasodilators and vasoconstrictors were assessed ex vivo by wire myography. Male perinatal iron deficient offspring exhibited decreased reliance on nitric oxide with methacholine‐induced vasodilatation (interaction P = 0.03), coincident with increased superoxide levels when fed the high salt diet (P = 0.01). Male perinatal iron deficient offspring exhibit enhanced big endothelin‐1 conversion to active endothelin‐1 (P = 0.02) concomitant with decreased nitric oxide levels (P = 0.005). Female offspring vascular function was unaffected by perinatal iron deficiency, albeit the high salt diet was associated with impaired vasodilation and decreased nitric oxide production (P = 0.02), particularly in the perinatal iron deficient offspring. These findings implicate vascular dysfunction in the sex‐specific programming of cardiovascular dysfunction in the offspring by perinatal iron deficiency.
Fidelity of muscle fibre reinnervation modulates ageing muscle impact in elderly women
Authors: Sonjak Vita , Jacob Kathryn , Morais José A. , Rivera‐Zengotita Marie , Spendiff Sally , Spake Carole , Taivassalo Tanja , Chevalier Stéphanie , Hepple Russell T.
Published: August 2019

Key points

Susceptibility to age‐related muscle atrophy relates to the degree of muscle denervation and the capacity of successful reinnervation. However, the specific role of denervation as a determinant of the severity of muscle aging between populations with low versus high physical function has not been addressed.

We show that prefrail/frail elderly women exhibited marked features of muscle denervation, whereas world class octogenarian female master athletes showed attenuated indices of denervation and greater reinnervation capacity.

These findings suggest that the difference in age‐related muscle impact between low‐ and high‐functioning elderly women is the robustness of the response to denervation of myofibers.

Ageing muscle degeneration is a key contributor to physical frailty; however, the factors responsible for exacerbated vs. muted ageing muscle impact are largely unknown. Based upon evidence that susceptibility to neurogenic impact is an important determinant of the severity of ageing muscle degeneration, we aimed to determine the presence and extent of denervation in pre‐frail/frail elderly (FE, 77.9 ± 6.2 years) women compared to young physically inactive (YI, 24.0 ± 3.5 years) females, and contrast these findings to high‐functioning world class octogenarian female masters athletes (MA, 80.9 ± 6.6 years). Muscle biopsies from vastus lateralis muscle were obtained from all three groups to assess denervation‐related morphological and transcriptional markers. The FE group displayed marked grouping of slow fibres, accumulation of very small myofibres, a severe reduction in type IIa/I size ratio, highly variable inter‐subject accumulation of neural cell adhesion molecule (NCAM)‐positive myofibres, and an accumulation of pyknotic nuclei, indicative of recurring cycles of denervation/reinnervation and persistent denervation. The MA group exhibited a smaller decline in type IIa/I size ratio and fewer pyknotic nuclei, accompanied by a higher degree of type I fibre grouping and larger fibre group size, suggesting a greater reinnervation of denervated fibres. Consistent with this interpretation, MA had higher mRNA levels of the reinnervation‐promoting cytokine fibroblast growth factor binding protein 1 (FGFBP1) than FE. Our results indicate that the muscle of FE women has significant neurogenic atrophy, whereas MA muscle exhibit superior reinnervation capacity, suggesting that the difference in age‐related muscle impact between low‐ and high‐functioning elderly women is the robustness of the response to denervation of myofibres.
Attack of the Edible Robots
Authors: Sukel Kayt
Published: August 2019

Robots are designed to go where humans cannot, places that are too inaccessible or dangerous. The human gastrointestinal tract is one of them. The average GI tract packs 30 feet of twists and turns into a compact space, and it is filled with gastric juices, acids, and waste. Its size and complexity makes it difficult for physicians to image, much less diagnose many digestive diseases, ranging from ulcerative colitis to colorectal cancer. Edible robots may be the solution, and may one day help surgeons operate more precisely as well.
A Perspective on the Mechanics Issues in Soft Solid Electrolytes and the Development of Next-Generation Batteries
Authors: Ardebili Haleh
Published: August 2019

In this perspective, we provide a brief account of the key mechanics issues underpinning the development of soft solid electrolytes for next-generation batteries.
A Robotic Glenohumeral Simulator for Investigating Prosthetic Implant Subluxation
Authors: Mancuso Matteo , Arami Arash , Becce Fabio , Farron Alain , Terrier Alexandre , Aminian Kamiar
Published: August 2019

Total shoulder arthroplasty (TSA) is an effective treatment for glenohumeral (GH) osteoarthritis. However, it still suffers from a substantial rate of mechanical failure, which may be related to cyclic off-center loading of the humeral head on the glenoid. In this work, we present the design and evaluation of a GH joint robotic simulator developed to study GH translations. This five-degree-of-freedom robot was designed to replicate the rotations (±40 deg, accuracy 0.5 deg) and three-dimensional (3D) forces (up to 2 kN, with a 1% error settling time of 0.6 s) that the humeral implant exerts on the glenoid implant. We tested the performances of the simulator using force patterns measured in real patients. Moreover, we evaluated the effect of different orientations of the glenoid implant on joint stability. When simulating realistic dynamic forces and implant orientations, the simulator was able to reproduce stable behavior by measuring the translations of the humeral head of less than 24 mm with respect to the glenoid implant. Simulation with quasi-static forces showed dislocation in extreme ranges of implant orientation. The robotic GH simulator presented here was able to reproduce physiological GH forces and may therefore be used to further evaluate the effects of glenoid implant design and orientation on joint stability.
Correlations for Convection in Hydrodynamically Developing Laminar Duct Flow
Authors: Bennett T. D.
Published: August 2019

A generalized correlation for combined entry convection in ducts of arbitrary cross section has been developed. The correlation is constructed for the average Nusselt number using knowledge of fully developed transport constants. The general correlation reproduces the first principle solutions for the well-established round and parallel plate duct geometries to within ±5% for both constant temperature and constant heat flux wall conditions when Pr ≥ 0.7. A survey of the literature demonstrates that the new generalized correlation performs as well or better than existing correlations, which are expressed for specific geometries and wall conditions. The new correlation is generally in good agreement with the first principle solutions of less common duct geometries so long as the duct has a convective surface equal to the wetted perimeter. The new correlation is not recommended for ducts having small aspect ratios that pinch the flow when convection is prescribed by the H2 constant heat flux wall condition.
Numerical Analysis of Thermofluid Performance of Fin-and-Tube Heat Transfer Surface Using Rectangular Winglets
Authors: Sarangi Shailesh Kumar , Mishra Dipti Prasad , Mishra Praveen
Published: August 2019

This paper numerically investigates the heat transfer enhancement using rectangular winglet pairs in a fin-and-tube type heat transfer surface having five inline rows of tubes. The influence of number of winglets, attack angles of the winglets, and their location has been analyzed under laminar flow conditions with Reynolds number ranging 400–1500. To account for the combined effect of heat transfer enhancement and pressure drop penalty, an enhancement factor is also discussed by changing the winglet pair's number and location. The numerical results show that pressure drop can be reduced significantly by placing the winglet more toward the exit of the flow channel. Streamwise distance and spanwise distance of the winglet pairs have been investigated for maximum enhancement factor. The numerically obtained results show that the winglets number and their placement at different locations have a major influence on enhancement factor. The results show that both the heat transfer and the pressure drop increase with an increase in attack angle of the winglets and best angle for the highest enhancement factor has been found out. Correlations have been developed for streamwise distance, spanwise distance, and angle of attack for different range of Reynolds numbers.
Spatial Grammar-Based Recurrent Neural Network for Design Form and Behavior Optimization
Authors: Stump Gary M. , Miller Simon W. , Yukish Michael A. , Simpson Timothy W. , Tucker Conrad
Published: August 2019

A novel method has been developed to optimize both the form and behavior of complex systems. The method uses spatial grammars embodied in character-recurrent neural networks (char-RNNs) to define the system including actuator numbers and degrees of freedom, reinforcement learning to optimize actuator behavior, and physics-based simulation systems to determine performance and provide (re)training data for the char-RNN. Compared to parametric design optimization with fixed numbers of inputs, using grammars and char-RNNs allows for a more complex, combinatorial infinite design space. In the proposed method, the char-RNN is first trained to learn a spatial grammar that defines the assembly layout, component geometries, material properties, and arbitrary numbers and degrees of freedom of actuators. Next, generated designs are evaluated using a physics-based environment, with an inner optimization loop using reinforcement learning to determine the best control policy for the actuators. The resulting design is thus optimized for both form and behavior, generated by a char-RNN embodying a high-performing grammar. Two evaluative case studies are presented using the design of the modular sailing craft. The first case study optimizes the design without actuated surfaces, allowing the char-RNN to understand the semantics of high-performing designs. The second case study extends the first by incorporating controllable actuators requiring an inner loop behavioral optimization. The implications of the results are discussed along with the ongoing and future work.
Multi-Fidelity Physics-Constrained Neural Network and Its Application in Materials Modeling
Authors: Liu Dehao , Wang Yan
Published: August 2019

Training machine learning tools such as neural networks require the availability of sizable data, which can be difficult for engineering and scientific applications where experiments or simulations are expensive. In this work, a novel multi-fidelity physics-constrained neural network is proposed to reduce the required amount of training data, where physical knowledge is applied to constrain neural networks, and multi-fidelity networks are constructed to improve training efficiency. A low-cost low-fidelity physics-constrained neural network is used as the baseline model, whereas a limited amount of data from a high-fidelity physics-constrained neural network is used to train a second neural network to predict the difference between the two models. The proposed framework is demonstrated with two-dimensional heat transfer, phase transition, and dendritic growth problems, which are fundamental in materials modeling. Physics is described by partial differential equations. With the same set of training data, the prediction error of physics-constrained neural network can be one order of magnitude lower than that of the classical artificial neural network without physical constraints. The accuracy of the prediction is comparable to those from direct numerical solutions of equations.
Performance Simulation to Understand the Effects of Multifluid Scaling of Gas Turbine Components for Generation IV Nuclear Power Plants
Authors: Osigwe Emmanuel O. , Gad-Briggs Arnold , Nikolaidis Theoklis , Pilidis Pericles , Sampath Suresh
Published: August 2019

A significant hurdle in the development of performance simulation tools to analyze and evaluate nuclear power plants (NPP) is finding data relating to component performance maps. As a result, engineers often rely on an estimation approach using various scaling techniques. The purpose of this study is to determine the component characteristics of a closed-cycle gas turbine NPP using the existing component maps with the corresponding design data. The design data are applied for different working fluids using a multifluid scaling approach to adapt data from one component map into another. The multifluid scaling technique described herein was developed as an in-house computer simulation tool. This approach makes it easy to theoretically scale the existing maps using similar or different working fluids without carrying out a full experimental test or repeating the whole design and development process. The results of selected case studies show a reasonable agreement with the available data. The analyses intend to aid the development of cycles for Generation IV NPPs specifically gas-cooled fast reactors (GFRs) and very high-temperature reactors (VHTRs).
Study on Calculation Difference of the SCWR Core Steady-State Analysis Code
Authors: Wang Lianjie , Yao Lei , Yang Ping , Lu Di , Zhao Wenbo
Published: August 2019

The three-dimensional code system supercritical water-cooled reactor (SCWR) coupled neutronics/thermal-hydraulics analysis (SNTA) code is developed for SCWR core steady-state analysis by coupling neutronics/thermal-hydraulics (N/T). This paper studies the calculation difference between the SNTA code and the standard reactor analysis code (SRAC). By using the impacts exclusive method, it is confirmed that the calculation difference between these two codes is caused by different feedback of the cross section. The cross section data and the energy group structure of the SRAC code differ from the SNTA code, and the density coefficient of reactivity calculated by the SRAC code is higher, which means the feedback of the density and power distribution is bigger and the axial power distribution varies rapidly. The SNTA code with finer energy group structure is suitable for the performance analysis of SCWR core which has strong N/T coupling characteristics.
Formation of Local, Transient “Acid Spikes” in the Fast Neutron Radiolysis of Supercritical Water at 400 °C: A Potential Source of Corrosion in Supercritical Water-Cooled Reactors?
Authors: Patwary Md Mohsin , Sanguanmith Sunuchakan , Meesungnoen Jintana , Jay-Gerin Jean-Paul
Published: August 2019

The use of supercritical water (SCW) in GEN IV reactors is a logical approach to the ongoing development of nuclear energy. A proper understanding of the radiation chemistry and reactivities of transients in a reactor core under SCW conditions is required to achieve optimal water chemistry control and safety. A Monte Carlo simulation study of the radiolysis of SCW at 400 °C by incident 2 MeV monoenergetic neutrons (taken as representative of a fast neutron flux in a reactor) was carried out as a function of water density between ∼150 and 600 kg/m3. The in situ formation of H3O+ by the generated recoil protons was shown to render the “native” track regions temporarily very acidic (pH ∼ 1). This acidity, though local and transitory (“acid spikes”), raises the question whether it may promote a corrosive environment under proposed SCW-cooled reactor operating conditions that would lead to progressive degradation of reactor components.
Acoustic characteristics of Arabic pharyngealized obstruents in children with cochlear implants
Authors: Khwaileh Fadwa A. , Flipsen Peter , Hammouri Hanan M. , Alzoubi Firas Q.
Published: August 2019

Speech production of children with cochlear implants (CIs) is generally characterized by low intelligibility and reduced phoneme accuracy. However, limited research investigated their speech production using acoustic measures. The current study examined voice onset time (VOT) for pharyngealized plosives [t,d], and spectral moments and noise duration for pharyngealized fricatives [s,ð] produced by Arabic speaking children with CIs. Productions from children with CIs were compared with both chronological age-matched and hearing experience-matched normal hearing children. Results showed that children with CIs exhibited difficulty producing distinct VOTs between plosives and produced different spectral patterns of both fricatives relative to both comparison groups; however, they were able to produce an acoustic distinction between both fricatives. Children with CIs produced the fricatives with lower spectral mean and higher skewness and kurtosis. The sources for inter-group differences in the acoustic measures appeared to be due in part to limitations in the quality of auditory input provided by CIs as well as reduced motor experience in speech production. Results suggest that VOT and spectral moments are sensitive to changes in perceived sound quality. Spectral moments analysis appears to give details on subtle aspects of fricative production at the phonetic level beyond that available using perceptual judgments.
The Association of Sport and Exercise Activities With Cardiovascular Disease Risk: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Porter Anna K. , Schilsky Samantha , Evenson Kelly R. , Florido Roberta , Palta Priya , Holliday Katelyn M. , Folsom Aaron R.
Published: August 2019

Background: This study assessed the independent associations between participation in self-reported sport and exercise activities and incident cardiovascular disease (CVD). Methods: Data were from 13,204 participants in the Atherosclerosis Risk in Communities Study cohort (1987–2015). Baseline sport and exercise activities were assessed via the modified Baecke questionnaire. Incident CVD included coronary heart disease, heart failure, or stroke. Multivariable-adjusted Cox proportional hazard models assessed the association of participation in specific sport and exercise activities at enrollment with risk of CVD. Results: During a median follow-up time of 25.2 years, 30% of the analytic sample (n = 3966) was diagnosed with incident CVD. In fully adjusted models, participation in racquet sports (hazard ratio [HR] 0.75; 95% confidence interval [CI], 0.61–0.93), aerobics (HR 0.75; 95% CI, 0.63–0.88), running (HR 0.68; 95% CI, 0.54–0.85), and walking (HR 0.89; 95% CI, 0.83–0.95) was significantly associated with a lower risk of CVD. There were no significant associations for bicycling, softball/baseball, gymnastics, swimming, basketball, calisthenics exercises, golfing with cart, golfing with walking, bowling, or weight training. Conclusions: Participation in specific sport and exercises may substantially reduce the risk for CVD.
Laboratory mice born to wild mice have natural microbiota and model human immune responses
Authors: Rosshart Stephan P. , Herz Jasmin , Vassallo Brian G. , Hunter Ashli , Wall Morgan K. , Badger Jonathan H. , McCulloch John A. , Anastasakis Dimitrios G. , Sarshad Aishe A. , Leonardi Irina , Collins Nicholas , Blatter Joshua A. , Han Seong-Ji , Tamoutounour Samira , Potapova Svetlana , Foster St. Claire Mark B. , Yuan Wuxing , Sen Shurjo K. , Dreier Matthew S. , Hild Benedikt , Hafner Markus , Wang David , Iliev Iliyan D. , Belkaid Yasmine , Trinchieri Giorgio , Rehermann Barbara
Published: August 2019

Born to be a wildling

Inbred laboratory mouse strains are used extensively in basic and translational immunology research. However, the commensal and pathogenic repertoire of resident microbes encountered in the wild is not replicated in a lab setting. This can substantially distort how the immune system develops and functions, leading to false assumptions of how our own “wild” immune system works. Rosshart
et al.
circumvented this dilemma by implanting lab-strain embryos into wild mice (see the Perspective by Nobs and Elinav). The resultant “wildlings” had a systemic immune phenotype and a bacterial, viral, and fungal microbiome much closer to those of their wild counterparts. In two preclinical experiments, where lab mice had previously failed to predict the human response to drug treatments, wildlings accurately phenocopied patient outcomes.

Science
, this issue p.
eaaw4361
; see also p.
444
Stabilizing halide perovskite surfaces for solar cell operation with wide-bandgap lead oxysalts
Authors: Yang Shuang , Chen Shangshang , Mosconi Edoardo , Fang Yanjun , Xiao Xun , Wang Congcong , Zhou Yu , Yu Zhenhua , Zhao Jingjing , Gao Yongli , De Angelis Filippo , Huang Jinsong
Published: August 2019

Stability through oxysalts

The stability of organic-inorganic perovskite solar cells is limited by degradation from oxygen and water. Yang
et al.
show that in situ reaction of perovskites with sulfate or phosphate ions can create thin, strongly bonded lead oxysalt layers that protect defect sites. This layer also boosts charge carrier lifetimes that lead to a power conversion efficiency of more than 20%. Encapsulated devices maintained about 97% of this efficiency with simulated solar irradiation for nearly 2 months at a realistic operation temperature of 65°C.

Science
, this issue p.
473
The world mosquitoes built
The Mosquito: A Human History of Our Deadliest Predator
Timothy C. Winegard
Dutton, 2019. 496 pp.
Authors: Hemingway Janet
Published: August 2019

A new tome traces the outsized effects the tiny insect has had on human history
Embryonic self-fracking
Authors: Arroyo Marino , Trepat Xavier
Published: August 2019

Mammalian embryos use controlled hydraulic fracturing to sculpt their shape
Optical modulation goes deep in the brain
Authors: Chen Shuo
Published: August 2019

Nanoparticle-mediated optogenetics enables minimally invasive deep brain modulation
Nongenetic neural control with light
Authors: Tian Bozhi
Published: August 2019

Light-activated neuromodulation inspired by semiconductor energy sciences
Whole-Genome-Based Public Health Surveillance of Less Common Shiga Toxin-Producing Escherichia coli Serovars and Untypeable Strains Identifies Four Novel O Genotypes
Authors: Lang Christina , Hiller Miriam , Konrad Regina , Fruth Angelika , Flieger Antje
Published: August 2019

Shiga toxin-producing
Escherichia coli
(STEC) and the STEC subgroup enterohemorrhagic
E. coli
cause intestinal infections with symptoms ranging from watery diarrhea to hemolytic-uremic syndrome (HUS). A key tool for the epidemiological differentiation of STEC is serotyping. The serotype in combination with the main virulence determinants gives important insight into the virulence potential of a strain.
Behavioural outcome in twin–twin transfusion syndrome survivors treated with laser surgery
Authors: Brandsma Fieke L , Spruijt Marjolijn S , Rijken Monique , Tan Ratna N G B , Oepkes Dick , Lopriore Enrico , van Klink Jeanine M M
Published: August 2019

Objective

Evaluate the incidence of and risk factors for behavioural problems in twin–twin transfusion syndrome (TTTS) survivors treated with fetoscopic laser coagulation.

Design

Observational cohort study.

Setting

National referral center for fetal therapy, Leiden University Medical Center, The Netherlands.

Patients

Behavioural outcome was assessed in 417 TTTS survivors, at the age of 2 years.

Interventions

Parents completed the Child Behavior Checklist for their twins. Antenatal, neonatal and follow-up data including Bayley III and a neurological exam were recorded from the medical database.

Main outcome measures

The incidence of and risk factors for behavioural problems.

Results

332 twin pregnancies (664 fetuses) were treated with fetoscopic laser for TTTS between 2008 and 2015. For 517 children eligible for follow-up, 417 (81%) Child Behavior Checklist questionnaires were completed. The study group was born at a mean gestational age of 32.8 weeks±3.2. Total behavioural problems within the borderline to clinical range were reported in 8% (95% CI 5.9 to 11.2) of survivors, compared with 10% in the general Dutch population (p=0.12). No difference between donors and recipients was detected (p=0.84). Internalising and externalising problems were reported in 9.4% (95% CI 6.9 to 12.6) and 11.5% (95% CI 8.8 to 15.0), respectively. Severe neurodevelopmental impairment was more frequent in the children with behavioural problems. High maternal educational level was associated with lower behavioural problem scores.

Conclusion

Parents of twins treated with fetoscopic laser therapy for TTTS do not report more behavioural problems compared with general population norms. More behavioural problems are reported in children with severe neurodevelopmental impairment.
Cortical blindness due to cerebral infarct in advanced pancreatic cancer
Authors: Nimesh Nivedita , Verma Sanjeev Kumar , Gupta Sanjiv Kumar
Published: August 2019

A 65-year-old man, a known case of advanced pancreatic cancer on cisplatin and gemcitabine-based chemotherapy, presented with sudden bilateral painless loss of vision with altered sensorium. Clinical examination showed a normal pupillary light reaction, normal anterior segment and normal fundus. MRI brain showed bilateral parieto-occipital infarct. This report highlights the incidence of cortical blindness due to thromboembolism at the cerebral level in pancreatic cancer. Cerebral ischaemic events occur at an advanced stage of pancreatic cancer already diagnosed at stroke onset and portend a poor prognosis. Anticoagulation therapy, especially low molecular weight heparin, remains the best strategy to prevent recurrences.
Thrombocytopaenia and thyroiditis: coincidence?
Authors: Fonseca Sara , Lacerda Catarina , Ganhão Ines , Castro Sofia
Published: August 2019

Thrombocytopaenia can be associated with an autoimmune mechanism. Immune thrombocytopaenia can be associated with thyroid autoimmune disease. The authors present a case of a teenager with a history of thrombocytopaenia who complained of tiredness. Laboratory investigation showed thyroid autoantibodies. The co-existence of thrombocytopaenia and thyroiditis lead to further investigation and antibodies against platelet glycoprotein IIbIIIa were found. This case illustrates the association of the overlap aspects between thyroid and platelet autoimmunity.
Team illness prevention strategy (TIPS) is associated with a 59% reduction in acute illness during the Super Rugby tournament: a control–intervention study over 7 seasons involving 126 850 player days
Authors: Schwellnus Martin , Janse van Rensburg Charl , Bayne Helen , Derman Wayne , Readhead Clint , Collins Rob , Kourie Alan , Suter Jason , Strauss Org , Sewry Nicola , Jordaan Esme
Published: August 2019

Objectives

To determine whether a team illness prevention strategy (TIPS) would reduce the incidence of acute illness during the Super Rugby tournament.

Methods

We studied 1340 male professional rugby union player seasons from six South African teams that participated in the Super Rugby tournament (2010–2016). Medical staff recorded all illnesses daily (126 850 player days) in a 3-year control (C: 2010–2012; 47 553 player days) and a 4-year intervention (I: 2013–2016; 79 297 player days) period. A five-element TIPS was implemented in the I period, following agreement by consensus. Incidence rate (IR: per 1000 player days; 95% CI) of all acute illnesses, illness by main organ system, infectious illness and illness burden (days lost due to illness per 1000 player days) were compared between C and I period.

Results

The IR of acute illness was significantly lower in the I (5.5: 4.7 to 6.4) versus the C period (13.2: 9.7 to 18.0) (p<0.001). The IR of respiratory (C=8.6: 6.3 to 11.7; I=3.8: 3.3 to 4.3) (p<0.0001), digestive (C=2.5: 1.8 to 3.6; I=1.1: 0.8 to 1.4) (p<0.001), skin and subcutaneous tissue illness (C=0.7: 0.4 to 1.4; I=0.3: 0.2 to 0.5) (p=0.0238), all infections (C=8.4: 5.9 to 11.9; I=4.3: 3.7 to 4.9) (p<0.001) and illness burden (C=9.2: 6.8 to 12.5; I=5.7: 4.1 to 7.8) (p=0.0314) were significantly lower in the I versus the C period.

Conclusion

A TIPS during the Super Rugby tournament was associated with a lower incidence of all acute illnesses (59%), infectious illness (49%) and illness burden (39%). Our findings may have important clinical implications for other travelling team sport settings.
Cardiorespiratory fitness, different measures of adiposity, and serum vitamin D levels in African-American adults
Authors: Farrell Stephen William , DeFina Laura , Willis Benjamin , Barlow Carolyn E , Pavlovic Andjelka , Leonard David , Haskell William
Published: August 2019

We examined the associations among cardiorespiratory fitness (CRF), adiposity, and serum 25-hydroxyvitamin D [25(OH)D) levels in African-American (AA) adults. 468 AA patients from the Cooper Clinic in Dallas, TX were examined between 2007 and 2018. Measures included body mass index (BMI), waist circumference (WC), percent body fat (%fat) via skinfolds, CRF via a maximal treadmill test, and 25(OH)D. Participants were classified by CRF based on age and sex, as well as by clinical categories of adiposity exposures and 25(OH)D. We examined trends of 25(OH)D across CRF and adiposity categories. We calculated OR with 95% CIs for 25(OH)D deficiency across categories of CRF and adiposity measures. We observed a significant positive trend for CRF (p=0.01) and a significant inverse trend for BMI (p=0.005) across ordered 25(OH)D categories. Adjusted mean 25(OH)D levels were higher across ordered CRF categories (p=0.03), and lower across ordered categories of BMI (p=0.02), WC (p=0.03) and %fat (p=0.04). When grouped into categories of fit and unfit (upper 80% and lower 20% of the CRF distribution, respectively), OR for vitamin D deficiency was significantly lower in fit compared with unfit men and women (OR=0.55, 95% CI: 0.35–0.87, p=0.01). Compared with normal weight BMI (referent), ORs for 25(OH)D deficiency were significantly higher for BMI-obese subjects (OR=1.70, 95% CI: 1.00–2.87, p=0.04). 25(OH)D levels are positively associated with CRF and negatively associated with different measures of adiposity in AA men and women. Because of the study design, causal inferences cannot be made and future prospective studies are needed.
Elevated serum complement levels and higher gene copy number of complementC4Bare associated with hypertension and effective response to statin therapy in childhood-onset systemic lupus erythematosus (SLE)
Authors: Mulvihill Evan , Ardoin Stacy , Thompson Susan D , Zhou Bi , Yu Gakit Richard , King Emily , Singer Nora , Levy D M , Brunner Hermine , Wu Yee Ling , Nagaraja Haikady N , Schanberg Laura Eve , Yu Chack-Yung
Published: August 2019

Objective

Systemic lupus erythematosus (SLE) features high frequency of cardiovascular disease (CVD) and fluctuating complement levels. The clinical trial Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) aimed to evaluate whether atorvastatin treatment reduced the progression of atherosclerosis in 221 patients with childhood-onset SLE (cSLE), using carotid intima media thickness (CIMT) as surrogates. We leveraged APPLE biorepository and trial data to investigate the relationship betweencomplementand CVD in cSLE.

Methods

Gene copy numbers (GCNs) for totalC4,C4AandC4Bwere measured by TaqMan-based real-time PCR and Southern blotting, and analysed with laboratory and clinical parameters through Student’s t-test and χ2analyses. Effects of totalC4,C4AandC4BGCNs on the response to placebo or atorvastatin treatment and progression of CIMT were examined by regression analyses.

Results

At baseline, C4 protein levels strongly correlated with GCNs of totalC4(p=1.8×10−6). Each copy ofC4gene increased mean serum C4 by 3.28 mg/dL. Compared with those without hypertension (N=142), individuals with hypertension demonstrated significantly elevated serum levels for C4 and C3 at baseline and serially (C4: P=5.0×10−25; C3: P=5.84×10−20). Individuals with ≥2C4Bgenes had 2.5 times the odds of having hypertension (p=0.016) and higher diastolic blood pressure (p=0.015) compared with those withC4Bdeficiency. At the study end, subjects with ≥2C4Band atorvastatin treatment had significantly slower increase in CIMT compared with those treated with placebo (p=0.018).

Conclusions

cSLE with hypertension had elevated serum levels of C4 and C3 and higher GCN ofC4B; cSLE with ≥2C4Bgenes would benefit from statins therapy to prevent atherosclerosis.
Heightened malpractice risk for hospitalist physicians in the USA: what to know and what to do
Authors: Paterick Zachary R , Paterick Timothy Edward
Published: August 2019

Hospitalists, nurse practitioners, physician assistants and institutions are all at risk for the potential professional liability issues. The unique relationship between healthcare providers and their sponsoring institution generates complex and evolving legal issues for all participants. The law has played a great role integrating quality care and patient safety with physicians, while providing an avenue for relief when a medical error occurs. The intersection of law and medicine, while allowing for optimal patient care, exposes participating medical providers and the sponsoring institutions to specific professional liability issues. This article addresses the heightened medical practice risk that hospitalist physicians’ encounter in today’s practice of hospital medicine.
Transarticular hinged external skeletal fixation for revision surgery of stifle subluxation associated with multiple ligament injuries in a cat
Authors: Elliott Ross Christopher
Published: August 2019

Stifle subluxation with multiple ligamentous injuries are a rare but catastrophic injury seen most commonly in cats in the veterinary literature. There is often damage to both cruciate ligaments, the medial and lateral collateral ligaments and the menisci. The long‐term prognosis for this injury is guarded due to the development of marked osteoarthritis after the injury. This paper describes the use of a commercially available range of motion hinge used as a secondary stabilisation for a failed primary anatomical stabilisation. None of the primary implants were removed or augmented at the time of revision surgery. A transarticular fixator was placed and increasing range of motion was allowed by adjusting the hinge at varying intervals over 8 weeks. This allowed fibrous tissue to stabilise the stifle while preventing articular cartilage degeneration. From this case report, transarticular hinge fixation can be considered a method of stabilisation in patients with stifle subluxation.
Misery of insufficient treatment guidelines in post‐traumatic epilepsy
Authors: Riese Franziska , Meyerhoff Nina , Nessler Jasmin , Tipold Andrea
Published: August 2019

Two dogs were presented after traumatic brain injury (TBI): a Jack Russell Terrier (JRT) kicked by a horse and a Magyar Vizsla (MV) hit by train. Both dogs developed seizures immediately after trauma and were treated successfully with antiepileptic drugs (AEDs) for 1 month (JRT) with imepitoin and for half a year (MV) with phenobarbital. After discontinuing the antiepileptic therapy, both dogs developed seizures again resulting in death of the JRT in status epilepticus. The MV was treated again with AEDs and continued to have cluster seizures every 2 weeks. In conclusion, it can be recommended to treat dogs with immediate seizures continuously after TBI with AEDs, if no life‐threatening adverse events occur.
A fully nonlinear equation in relativistic Teichmüller theory
Authors: Tam Luen-Fai , Wan Tom Yau-Heng
Published: August 2019

We obtain some basic estimates for a Monge–Ampère type equation introduced by Moncrief in the study of the Relativistic Teichmüller Theory. We then give another proof of the parametrization of the Teichmüller space obtained by Moncrief. Our approach provides yet another proof of the classical Teichmüller theorem that the Teichmüller space of a compact oriented surface of genus [Formula: see text] is diffeomorphic to the disk of dimension [Formula: see text]. We also give another proof of properness of a certain energy function on the Teichmüller space.