bluuebunny/crossref_metadata_2025 huggingface dataset:
Transient left septal fascicular block and left anterior fascicular block as a consequence of proximal subocclusion of the left anterior descending coronary artery
Authors: Pérez‐Riera Andrés Ricardo , Barbosa‐Barros Raimundo , Daminello‐Raimundo Rodrigo , de Abreu Luiz Carlos , Nikus Kjell
Published: April 2018

The association of left anterior fascicular block (LAFB) with left septal fascicular block (LSFB) characterizes a left bifascicular block subtype rarely described in the literature, probably due to the fact that most researchers are not aware of the existence of the left septal fascicle. We describe a case with this transient intraventricular dromotropic disturbance due to left anterior descending coronary artery subocclusion.
Synoptic reporting of pituitary magnetic resonance imaging
Authors: Dhillon Rana S. , King James A. , Goldschlager Tony , Wang Yi Yuen
Published: April 2018

Background

Pituitary adenomas are common, often asymptomatic tumours that are diagnosed incidentally by magnetic resonance imaging (MRI) of the brain. There is considerable variation in the reporting of pituitary MRI, in part because there is no consensus as to what information should be included in such reports. Synoptic reporting consists of using structured checklists to standardize communication. It has been adopted in the surgical pathology literature and more recently in the breast imaging field. The purpose of this study was to assess what parameters of a pituitary MRI report were useful to surgeons and in doing so, to propose a synoptic reporting template.

Methods

We used the Delphi technique to obtain group consensus between three neuroradiologists, three otolaryngologists and three anterior skull base neurosurgeons across three tertiary Melbourne hospitals. Answers from the three speciality groups were then converted into numerical scores for analysis.

Results

There was statistically significant consensus between specialties over which characteristics were deemed most important. These were T1 pre‐ and post‐contrast sequences in the coronal and sagittal planes, the degree of displacement of the optic chiasm, invasion of the medial wall of the cavernous sinus, the size and pneumatization pattern of the sphenoid sinus and the differential diagnosis of aneurysm. There were also significant differences between groups.

Conclusions

There are similarities and differences between what radiologists, otolaryngologists and neurosurgeons deem as important features when reporting pituitary MRI. A synoptic reporting system template is proposed to improve consistency in pituitary imaging reports.
Best surgical technique and outcomes for large macular holes: retrospective multicentre study in Japan
Authors: Yamashita Toshifumi , Sakamoto Taiji , Terasaki Hiroto , Iwasaki Masanori , Ogushi Yoko , Okamoto Fumiki , Takeuchi Masaru , Yasukawa Tsutomu , Takamura Yoshihiro , Ogata Nahoko , Nakamura Yumiko ,   for the writing committee of Japan‐Clinical Retina Research Team (J‐CREST)
Published: April 2018

The purpose of this study was to compare the surgical outcomes of vitrectomy with conventional internal limiting membrane (C‐ILM) peeling to that with the inverted ILM (I‐ILM) flap technique for large macular holes (MHs). This was a retrospective chart review of consecutive cases with a large MH at nine hospitals in Japan. Among the 1342 eyes, 165 eyes of 165 cases met the inclusion criteria. The results for medium‐large MHs with a diameter 400–550 μm were compared to that of eyes with an extra‐large MH with a diameter >550 μm. In addition, the results of C‐ILM peeling were compared to that of the I‐ILM technique. In medium‐large MHs, the closure rate was 95.2% (59/62) by C‐ILM peeling and 100% (19/19) by the I‐ILM technique. In extra‐large MHs, the closure rate was 88.4% (38/43) by C‐ILM peeling and 100% (41/41) by I‐ILM. Although the difference between the two methods was not significant, the I‐ILM technique was successful in 100% of the cases. Multiple logistic regression analysis showed the best‐corrected visual acuity (BCVA) at 6 months was significantly associated with the preoperative BCVA, MH size, age and sex of the patient. Analyses of the eyes with extra‐large MHs show that the surgical success is high, and the I‐ILM technique is more effective for closure in eyes with extra‐large MHs.
Visualization of corneal vascularization in peripheral hypertrophic subepithelial corneal opacification with OCT angiography
Authors: Riedl Jana C. , Wasielica‐Poslednik Joanna , Weyer‐Elberich Veronika , Vossmerbaeumer Urs , Pfeiffer Norbert , Lisch Walter , Gericke Adrian
Published: April 2018

Purpose

The major goal of this study was to test the hypothesis that in patients with peripheral hypertrophic subepithelial corneal opacification (PHSCO), visualization of corneal vessels is better with optical coherence tomography angiography (OCTA) than with conventional slit lamp microphotography.

Methods

Patients with PHSCO were included in this prospective study. The corneal findings were photographed using a slit lamp camera (Haag Streit BM 900®) and visualized with anterior‐segment OCT (Optovue XR Avanti, Fremont, California, USA). Additionally, OCTA with the Angiovue Imaging™ System was performed in the area of PHSCO.

Results

Thirty‐four eyes of 19 patients (26% male and 74% female) with PHSCO were included in this study. In 21 eyes, vascularization in the area of PHSCO was visualized with the Angiovue‐OCT, whereas only 10 eyes presented vessels in slit lamp photographs.

Conclusion

Optical coherence tomography angiography allows better visualization of corneal neovascularization than slit lamp photography in patients with PHSCO. Corneal opacifications were found predominantly nasally, which was reflected by a local enlargement of corneal thickness.
Wilkie's syndrome in monozygotic twins treated by 3‐D laparoscopic duodenojejunostomy
Authors: Aneiros Castro Belén , Cano Novillo Indalecio , García Vázquez Araceli , Martín Alelu Rubén , Gómez Fraile Andrés
Published: April 2018

Superior mesenteric artery syndrome, also known as Wilkie's syndrome, is a rare cause of proximal duodenum obstruction in children. Here, we describe the first pediatric case of superior mesenteric artery syndrome in monozygotic twin brothers. Both patients underwent 3‐D laparoscopic duodenojejunostomy at the same age with an uneventful recovery.
Peripheral T cell lymphoma, not otherwise specified (PTCL‐NOS). A new prognostic model developed by the International T cell Project Network
Authors: Federico Massimo , Bellei Monica , Marcheselli Luigi , Schwartz Marc , Manni Martina , Tarantino Vittoria , Pileri Stefano , Ko Young‐Hyeh , Cabrera Maria E. , Horwitz Steven , Kim Won S. , Shustov Andrei , Foss Francine M. , Nagler Arnon , Carson Kenneth , Pinter‐Brown Lauren C. , Montoto Silvia , Spina Michele , Feldman Tatyana A. , Lechowicz Mary J. , Smith Sonali M. , Lansigan Frederick , Gabus Raul , Vose Julie M. , Advani Ranjana H. ,   the T cell Project Network
Published: April 2018

Different models to investigate the prognosis of peripheral T cell lymphoma not otherwise specified (PTCL‐NOS) have been developed by means of retrospective analyses. Here we report on a new model designed on data from the prospective T Cell Project. Twelve covariates collected by the T Cell Project were analysed and a new model (T cell score), based on four covariates (serum albumin, performance status, stage and absolute neutrophil count) that maintained their prognostic value in multiple Cox proportional hazards regression analysis was proposed. Among patients registered in the T Cell Project, 311 PTCL‐NOS were retained for study. At a median follow‐up of 46 months, the median overall survival (OS) and progression‐free survival (PFS) was 20 and 10 months, respectively. Three groups were identified at low risk (LR, 48 patients, 15%, score 0), intermediate risk (IR, 189 patients, 61%, score 1–2), and high risk (HiR, 74 patients, 24%, score 3–4), having a 3‐year OS of 76% [95% confidence interval 61–88], 43% [35–51], and 11% [4–21], respectively (P < 0·001). Comparing the performance of the T cell score on OS to that of each of the previously developed models, it emerged that the new score had the best discriminant power. The new T cell score, based on clinical variables, identifies a group with very unfavourable outcomes.
A comparison of mesoporous silica nanoparticles and mesoporous organosilica nanoparticles as drug vehicles for cancer therapy
Authors: Yue Juan , Luo Shi‐zhong , Lu Meng‐meng , Shao Dan , Wang Zheng , Dong Wen‐fei
Published: April 2018

Mesoporous silica nanoparticles (MSNs) are promising drug carriers for use in cancer treatment owing to their excellent biocompatibility and drug‐loading capacity. However, MSN's incomplete drug release and toxic bioaccumulation phenomena limit their clinical application. Recently, researchers have presented redox responsive mesoporous organosilica nanoparticles containing disulfide (S–S) bridges (ss‐MONs). These nanoparticles retained their ability to undergo structural degradation and increased their local release activity when exposed to reducing agents. Disulfide‐based mesoporous organosilica nanoparticles offer researchers a better option for loading chemotherapeutic drugs due to their effective biodegradability through the reduction of glutathione. Although the potential of ss‐MONs in cancer theranostics has been studied, few researchers have systematically compared ss‐MONs with MSNs with regard to endocytosis, drug release, cytotoxicity, and therapeutic effect. In this work, ss‐MONs and MSNs with equal morphology and size were designed and used to payload doxorubicin hydrochloride (DOX) for liver cancer chemotherapy. The ss‐MONs showed considerable degradability in the presence of glutathione and performed comparably to MSNs on biocompatibility measures, including cytotoxicity and endocytosis, as well as in drug‐loading capacity. Notably, DOX‐loaded ss‐MONs exhibited higher intracellular drug release in cancer cells and better anticancer effects in comparison with DOX‐loaded MSNs. Hence, the ss‐MONs may be more desirable carriers for a highly efficient and safe treatment of cancer.
Vedolizumab as a rescue therapy for patients with medically refractory Crohn's disease
Authors: Crowell K. T. , Tinsley A. , Williams E. D. , Coates M. D. , Bobb A. , Koltun W. A. , Messaris E.
Published: April 2018

Aim

Vedolizumab, a monoclonal antibody resulting in gut‐selective anti‐inflammatory activity, was approved by the US Food and Drug Administration in 2014 for use in patients with Crohn's disease (CD). The aim of this study was to investigate the efficacy of vedolizumab as a rescue therapy when other medical therapies have failed.

Method

A retrospective review was performed on consecutive patients with CD receiving vedolizumab at the Penn State Hershey IBD Center between May 2014 and March 2016. These patients were unresponsive or intolerant to tumour necrosis factor (TNF) antagonist therapy, and previously would have been candidates for surgery. Outcomes included surgical intervention, clinical response and endoscopic improvement.

Results

A total of 48 patients with medically refractory CD receiving vedolizumab were included. The median length of follow‐up was 69 weeks (range 15–113 weeks). A majority (81%) of patients previously failed at least two TNF antagonists, and 77% had prior surgery for CD. Surgical intervention was required in 21 (44%) patients and 13 (27%) patients required intra‐abdominal operations. At the conclusion of the study, 23 (48%) patients reported continued improvement of symptoms, and 22 of 37 (59%) patients undergoing endoscopy showed improvement. Patients with the inflammatory CD phenotype were more likely to improve clinically and avoid surgery.

Conclusion

Vedolizumab alone or in combination with immunomodulators or steroids may be used as a rescue therapy in patients with medically refractory CD and may decrease the rate of surgical intervention. Patients with the inflammatory CD phenotype had the best clinical response and decreased need for surgery, suggesting that vedolizumab is most effective in the inflammatory phenotype.
Metastatic melanoma with balloon/histiocytoid cytomorphology after treatment with immunotherapy: A histologic mimic and diagnostic pitfall
Authors: Farah Maya , Nagarajan Priyadharsini , Torres‐Cabala Carlos A. , Curry Jonathan L. , Amaria Rodabe N. , Wargo Jennifer , Tawbi Hussein , Ivan Doina , Prieto Victor G. , Tetzlaff Michael T. , Aung Phyu P.
Published: April 2018

Epithelioid cells with foamy cytoplasm (histiocytoid features) are typical histopathologic findings among benign and malignant histiocytic neoplasms such as xanthoma and atypical fibroxanthoma. However, these changes are unusual in melanoma, which is typically composed of nested and variably pigmented atypical epithelioid cells. Here, we report a patient with metastatic melanoma in lymph nodes presenting with prominent balloon cell/histiocytoid features expressing melanocytic markers, after treatment with nivolumab. This report suggests that the spectrum of neoplasms with histiocytoid features should be expanded to include melanoma, a pattern that, to the best of our knowledge, is uncommon, especially in the setting of post‐neoadjuvant therapy.
ALL‐PAY AUCTIONS WITH A BUY‐PRICE OPTION
Authors: Xu Minbo , Li Sanxi , Yan Jianye
Published: April 2018

This paper studies all‐pay auctions in which there is a buy‐price option for bidders to guarantee purchases at a seller‐specified price. We analyze symmetric increasing bidding equilibria in the first‐ and second‐price all‐pay auctions with the buy‐price option. While the optimal buy‐price in the second price is higher than are those in the first‐price all‐pay auction, both formats maintain the same expected profit. With an endogenous entry process, all‐pay auctions with the buy‐price can attract more consumers and ultimately reach a higher expected profit than does the uniform posted‐price selling mechanism. (JELD44, L11, L81)
Natural mortality augments population fluctuations of forage fish
Authors: Jacobsen Nis S , Essington Timothy E
Published: April 2018

Forage fish are a vital part of marine ecosystems, partly by supporting some of the largest fisheries worldwide, but also due to their role in food webs as prey for larger fish and other predators. One of the unresolved questions about forage fish dynamics is the causes of their significant temporal fluctuations. These fluctuations are often attributed to changes in environmental conditions, but direct correlations have proven hard to find. Here, we show how time‐varying predation mortality additionally plays a substantial role in forage fish population fluctuations. By analysing 10 stocks that have estimates of natural mortality changes through time, we find that natural mortality on average increases as population biomass declines towards a trough, and to a lesser degree decreases, when their biomass is growing towards a peak. While depensatory mortality was dominant on average in biomass dynamics leading up to peaks or troughs, some of the stocks exhibited compensatory mortality emphasizing variation between stocks. Furthermore, we show that the magnitude of natural mortality and productivity is generally higher than fishing mortality. The results underscore the importance of top‐down control on the dynamics of forage fish. We conclude that a holistic ecosystem analysis is required for a better ecological understanding of forage fish dynamics.
Interleukin‐33 contributes to ILC2 activation and early inflammation‐associated lung injury during abdominal sepsis
Authors: Xu Hui , Xu Jing , Xu Li , Jin Shuqing , Turnquist Heth R , Hoffman Rosemary , Loughran Patricia , Billiar Timothy R , Deng Meihong
Published: April 2018

Sepsis is defined as infection with organ dysfunction due to a dysregulated immune response. The lung is one of the most vulnerable organs at the onset of sepsis. Interleukin (IL)‐33 can be released by injured epithelial and endothelial cells in the lung and regulate immune activation and infiltration. Therefore, we postulated that IL‐33 would contribute to the immune response in the lung during sepsis. Using the cecal ligation and puncture (CLP) sepsis model, we show here that IL‐33 contributes significantly to both sepsis‐induced inflammation in the lung and systemic inflammatory response in the early phase of sepsis. Despite the higher intra‐peritoneal bacterial burden, the absence of IL‐33 resulted in less infiltration of neutrophils and monocytes into the lungs in association with lower circulating, lung and liver cytokine levels as well as reduced lung injury at 6 h after sepsis. IL‐33 was required for the upregulation of IL‐5 in type 2 Innate Lymphoid Cells (ILC2), while IL‐5 neutralization suppressed neutrophil and monocyte infiltration in the lungs during CLP sepsis. This reduction in leukocyte infiltration in IL‐33‐deficient mice was reversed by administration of recombinant IL‐5. These results indicate that IL‐33 plays a major role in the local inflammatory changes in the lung, in part, by regulating IL‐5 and this axis contributes to lung injury early after the onset of sepsis.
Synthetic CpG oligonucleotides induce a genetic profile ameliorating murine myocardial I/R injury
Authors: Hilbert Tobias , Markowski Paul , Frede Stilla , Boehm Olaf , Knuefermann Pascal , Baumgarten Georg , Hoeft Andreas , Klaschik Sven
Published: April 2018

We previously demonstrated that pre‐conditioning with CpG oligonucleotide (ODN) 1668 induces quick up‐regulation of gene expression 3 hours post‐murine myocardial ischaemia/reperfusion (I/R) injury, terminating inflammatory processes that sustain I/R injury. Now, performing comprehensive microarray and biocomputational analyses, we sought to further enlighten the “black box” beyond these first 3 hours. C57BL/6 mice were pretreated with either CpG 1668 or with control ODN 1612, respectively. Sixteen hours later, myocardial ischaemia was induced for 1 hour in a closed‐chest model, followed by reperfusion for 24 hours. RNA was extracted from hearts, and labelled cDNA was hybridized to gene microarrays. Data analysis was performed with BRB ArrayTools and Ingenuity Pathway Analysis. Functional groups mediating restoration of cellular integrity were among the top up‐regulated categories. Genes known to influence cardiomyocyte survival were strongly induced 24 hours post‐I/R. In contrast, proinflammatory pathways were down‐regulated. Interleukin‐10, an upstream regulator, suppressed specifically selected proinflammatory target genes at 24 hours compared to 3 hours post‐I/R. The IL1 complex is supposed to be one regulator of a network increasing cardiovascular angiogenesis. The up‐regulation of numerous protective pathways and the suppression of proinflammatory activity are supposed to be the genetic correlate of the cardioprotective effects of CpG 1668 pre‐conditioning.
Constraints on the evolution of phenotypic plasticity in the clonal plant Hydrocotyle vulgaris
Authors: Wang Mo‐Zhu , Bu Xiang‐Qi , Li Lin , Dong Bi‐Cheng , Li Hong‐Li , Yu Fei‐Hai
Published: April 2018

The evolution of phenotypic plasticity of plant traits may be constrained by costs and limits. However, the precise constraints are still unclear for many traits under different ecological contexts. In a glasshouse experiment, we grew ramets of 12 genotypes of a clonal plant Hydrocotyle vulgaris under the control (full light and no flood), shade and flood conditions and tested the potential costs and limits of plasticity in 13 morphological and physiological traits in response to light availability and flood variation. In particular, we used multiple regression and correlation analyses to evaluate potential plasticity costs, developmental instability costs and developmental range limits of each trait. We detected significant costs of plasticity in specific petiole length and specific leaf area in response to shade under the full light condition and developmental range limits in specific internode length and intercellular CO2 concentration in response to light availability variation. However, we did not observe significant costs or limits of plasticity in any of the 13 traits in response to flood variation. Our results suggest that the evolution of phenotypic plasticity in plant traits can be constrained by costs and limits, but such constraints may be infrequent and differ under different environmental contexts.
Gallstone disease and increased risk of mortality: Two large prospective studies in US men and women
Authors: Zheng Yan , Xu Min , Heianza Yoriko , Ma Wenjie , Wang Tiange , Sun Dianjianyi , Albert Christine M , Hu Frank B , Rexrode Kathryn M , Manson JoAnn E , Qi Lu
Published: April 2018

Background and Aim

Gallstone disease has been related to a higher prevalence and incidence of chronic conditions, such as dyslipidemia, obesity, and cardiovascular disease (CVD). However, limited data are available regarding whether gallstone disease is related to mortality.

Methods

We examined the relationship of a history of gallstone disease and risk of death, using Cox proportional hazards regression analysis, among 86 030 women from the Nurses' Health Study and 43 949 men from the Health Professionals Follow‐up Study.

Results

During the up‐to 32 years of follow‐up, 34 011 all‐cause deaths were confirmed, of which 8138 were CVD deaths and 12 173 were cancer deaths. For the participants with a history of gallstone disease compared with those without, the hazard ratio of total mortality was 1.16 (95% confidence interval 1.13, 1.20), of CVD mortality 1.11 (1.05, 1.17), of cancer mortality 1.15 (1.09, 1.20), and of other mortality 1.19 (1.14, 1.25) from a pooled‐analysis of women and men (all P < 0.001). The multi‐adjusted associations between gallstone disease and total mortality persisted among women and men, and among participants with various risk profiles including the different status of body mass index, hormone therapy use, diabetes, hypertension, and hypercholesterolemia (all P for interaction ≥ 0.09).

Conclusion

These data suggest that gallstone disease is associated with a higher risk of total mortality and disease‐specific mortality, including CVD and cancer mortality, independent of various traditional risk factors.
Validation of Caregiver‐Centered Delirium Detection Tools: A Systematic Review
Authors: Rosgen Brianna , Krewulak Karla , Demiantschuk Danielle , Ely E. Wesley , Davidson Judy E. , Stelfox Henry T. , Fiest Kirsten M.
Published: April 2018

Objectives

To summarize the validity of caregiver‐centered delirium detection tools in hospitalized adults and assess associated patient and caregiver outcomes.

Design

Systematic review.

Setting

We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus from inception to May 15, 2017.

Participants

Hospitalized adults.

Intervention

Caregiver‐centered delirium detection tools.

Measurements

We drafted a protocol from the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Two reviewers independently completed abstract and full‐text review, data extraction, and quality assessment. We summarized findings using descriptive statistics including mean, median, standard deviation, range, frequencies (percentages), and Cohen's kappa. Studies that reported on the validity of caregiver‐centered delirium detection tools or associated patient and caregiver outcomes and were cohort or cross‐sectional in design were included.

Results

We reviewed 6,056 titles and abstracts, included 6 articles, and identified 6 caregiver‐centered tools. All tools were designed to be administered in several minutes or less and had 11 items or fewer. Three tools were caregiver administered (completed independently by caregivers): Family Confusion Assessment Method (FAM‐CAM), Informant Assessment of Geriatric Delirium (I‐AGeD), and Sour Seven. Three tools were caregiver informed (administered by a healthcare professional using caregiver input): Single Question in Delirium (SQiD), Single Screening Question Delirium (SSQ–Delirium), and Stressful Caregiving Response to Experiences of Dying. Caregiver‐administered tools had better psychometric properties (FAM‐CAM sensitivity 75%, 95% confidence interval (CI)=35–95%, specificity 91%, 95% CI=74–97%; Sour Seven positive predictive value 89.5%, negative predictive value 90%) than caregiver‐informed tools (SQiD: sensitivity 80%, 95% CI=28.4–99.5%; specificity 71%, 95% CI=41.9–91.6%; SSQ‐Delirium sensitivity 79.6%, specificity 56.1%).

Conclusion

Delirium detection is essential for appropriate delirium management. Caregiver‐centered delirium detection tools show promise in improving delirium detection and associated patient and caregiver outcomes. Comparative studies using larger sample sizes and multiple centers are required to determine validity and reliability characteristics.
Evolution of metamorphic fluid recorded in granulite facies metacarbonate rocks from the middle segment of the Mogok metamorphic belt in central Myanmar
Authors: Ye Kyaw Thu  , Enami M.
Published: April 2018

The Mogok metamorphic belt of Palaeogene age, which records subduction‐ and collision‐related events between the Indian and Eurasian plates, lies along the western margin of the Shan plateau in central Myanmar and continues northwards to the eastern Himalayan syntaxis. Reaction textures of clinohumite‐ and scapolite‐bearing assemblages in Mogok granulite facies metacarbonate rocks provide insights into the drastic change in fluid composition during exhumation of the collision zone. Characteristic high‐grade assemblages of marble and calcsilicate rock are clinohumite+forsterite+spinel+phlogopite+pargasite/edenite+calcite+dolomite, and scapolite+diopside+anorthite+quartz+calcite respectively. Calculated petrogenetic grids in CaO–MgO–Al2O3–SiO2–H2O–CO2 and subsets of this system were employed to deduce the pressure–temperature–fluid evolution of the clinohumite‐ and scapolite‐bearing assemblages. These assemblages suggest higher temperature (>780–810°C) and [=CO2/(CO2+H2O) >0.17–0.60] values in the metamorphic fluid for the peak granulite facies stage, assuming a pressure of 0.8 GPa. Calcite grains commonly show exsolution textures with dolomite particles, and their reintegrated compositions yield temperatures of 720–880°C. Retrograde reactions are mainly characterized by a reaction zone consisting of a dolomite layer and a symplectitic aggregate of tremolite and dolomite grown between clinohumite and calcite in marble, and a replacement texture of scapolite by clinozoisite in calcsilicate rock. These textures indicate that the retrograde reactions developed under lower temperature (<620°C) and (<0.08–0.16) conditions, assuming a pressure of 0.5 GPa. The metacarbonate rocks share metamorphic temperatures similar to the Mogok paragneiss at the peak granulite facies stage. The values of the metacarbonate rock at peak metamorphic stage are, however, distinctly higher than those previously deduced from carbonate mineral‐free paragneiss. Primary clinohumite, phlogopite and pargasite/edenite in marble have F‐rich compositions, and scapolite in calcsilicate rock contains Cl, suggesting a contrast in the halogen compositions of the metamorphic fluids between these two lithologies. The metamorphic fluid compositions were probably buffered within each lithology, and the effective migration of metamorphic fluid, which would have extensively changed the fluid compositions, did not occur during the prograde granulite facies stage throughout the Mogok metamorphic belt. The lower conditions of the Mogok metacarbonate rocks during the retrograde stage distinctly contrast with higher conditions recorded in metacarbonate rocks from other metamorphic belts of granulite facies. The characteristic low conditions were probably due to far‐ranging infiltration of H2O‐dominant fluid throughout the middle segment of the Mogok metamorphic belt under low‐amphibolite facies conditions during the exhumation and hydration stage.
Incidence of and risk factors for severe maternal complications associated with hypertensive disorders after 36 weeks’ gestation in uncomplicated twin pregnancies: A prospective cohort study
Authors: Yamamoto Ryo , Ishii Keisuke , Muto Haruka , Ota Shiyo , Kawaguchi Haruna , Hayashi Shusaku , Mitsuda Nobuaki
Published: April 2018

Aim

To elucidate the incidence of and risk factors for severe hypertensive disorders (HD) and related maternal complications in uncomplicated twin pregnancies that reached 36 weeks’ gestation.

Methods

We conducted a prospective cohort study of twin pregnancies delivered after 36 weeks’ gestation. Cases of twin–twin transfusion syndrome, twin anemia–polycythemia sequence, malformed fetuses, monoamniotic twins, selective reduction, fetal therapy and HD or fetal death before 35 weeks’ gestation were excluded. The study's primary outcome was the incidence of severe maternal complications, including severe HD, eclampsia, placental abruption, HELLP (hemolysis, elevated liver enzyme and low platelet) syndrome, pulmonary edema and cerebrovascular disease. Perinatal factors associated with the primary outcome were identified using a multivariate logistic regression model.

Results

In 330 enrolled women, the number of cases with the primary outcome was 28 (8.5%; 95% confidence interval 5.9–12.0), including 25 cases of severe HD and each one case of placental abruption, HELLP syndrome and eclampsia. The rate of severe maternal complications significantly increased with gestational age, demonstrating 1.2% at 36 weeks, 3.9% at 37 weeks and 6.4% at 38 weeks. Only gestational proteinuria was identified as the independent risk factor for severe maternal complications (adjusted odds ratio 17.1 [95% confidence interval 6.71–45.4]).

Conclusion

Severe maternal HD and related complications increased from late preterm to early term; particularly, patients with gestational proteinuria were at high risk.
Cervical intradural extramedullary lipoma: A rare differential diagnosis of nontraumatic limping in an adult patient
Authors: Carrasco Sira , Camacho Ana , Franco Andrés , Burriel Laura , Hernández Amalia
Published: April 2018

Intradural lipomas behave similarly to any other spinal cord tumor. They are very rare, accounting for less than 1% of all spinal cord tumors, and mainly affect pediatric and occasionally young adult patients. Back pain, weakness (paraparesis or quadriparesis), sensory alterations, and incontinence are the most common manifestations. We present the case of a 47‐year‐old patient who attended our department due to a 3‐year history of nontraumatic limping secondary to a cervical intradural extramedullary lipoma. The lipoma was partially resected and symptoms progressed satisfactorily.
Will China build a green Belt and Road in the Arctic?
Authors: Liu Nengye
Published: April 2018

This article aims to shed light on two questions: what are the implications of China's Belt and Road Initiative (BRI) for Arctic governance? And what are the environmental implications of the BRI for the Arctic? The article first discusses the interaction between China's BRI and Arctic policy, examining the vision that China would like to use the BRI to shape Arctic governance. The article focuses on the environmental components of the BRI. It explores whether China's current regulatory regimes are sufficient to help ensure a green Belt and Road in the Arctic.
Dengue Fever and Aedes aegypti in indigenous Brazilians: seroprevalence, risk factors, knowledge and practices
Authors: Sacramento Rafael Henrique Machado , de Carvalho Araújo Fernanda Montenegro , Lima Danielle Malta , Alencar Carlos Carlos Henrique , Martins Victor Emanuel Pessoa , Araújo Lucas Venâncio , de Oliveira Tais Castelo , de Góes Cavalcanti Luciano Pamplona
Published: April 2018

Objective

Dengue remains an important public health problem in Brazil. We estimated the associated factors of dengue seroprevalence among native Indians of the Tremembé ethnic and their knowledge about the aspects related to the presence of mosquitoes of the genus Aedes.

Methods

An analytical cross‐sectional study and a prospective environmental study to monitor the trapping of mosquito eggs monthly were performed. The serological portion of the study involved indigenous people living in the village of Tapera in northeastern Brazil. Ovitraps were monitored for 12 months.

Results

Two hundred and ninety of 350 indigenous people (82.9%) participated in the study, with an average age of 30.2 years. The seroprevalence was 22.1% and positivity increased with age, with rates of 4.2% in children under 15 years of age, 26.8% in 15 to 59‐year‐olds and 42.3% in those older than 59 (CI: 2.25–15.96; P < 0.001). A higher incidence of moving to the city and the presence of underlying diseases were associated with the occurrence of dengue (P < 0.001). Four serotypes were detected, with the highest prevalence of DENV‐1 (77.8%), followed by DENV‐2 (70.4%), DENV‐3 (14.8%) and DENV‐4 (11.1%). Eggs were collected in all months of the year and in the traps located in the vicinities of the domiciles (57%).

Conclusions

We present the first seroepidemiological survey of dengue conducted among indigenous populations in Brazil. This lack of studies is likely due to the great bureaucratic challenge of working with indigenous populations, which may lead to greater negligence in the health of these populations.
Algebraic Convexity Conditions for Gotoh's Nonquadratic Yield Function
Authors: Tong Wei
Published: April 2018

A necessary and sufficient condition in terms of explicit algebraic inequalities on its five on-axis material constants and a similarly formulated sufficient condition on its entire set of nine material constants are given for the first time to guarantee a calibrated Gotoh's fourth-order yield function to be convex. When considering the Gotoh's yield function to model a sheet metal with planar isotropy, a single algebraic inequality has also been obtained on the admissible upper and lower bound values of the ratio of uniaxial tensile yield stress over equal-biaxial tensile yield stress at a given plastic thinning ratio. The convexity domain of yield stress ratio and plastic thinning ratio defined by these two bounds may be used to quickly assess the applicability of Gotoh's yield function for a particular sheet metal. The algebraic convexity conditions presented in this study for Gotoh's nonquadratic yield function complement the convexity certification based on a fully numerical minimization algorithm and should facilitate its wider acceptance in modeling sheet metal anisotropic plasticity.
Nonlinear Stability Analysis of Sandwich Wide Panels—Part II: Postbuckling Response
Authors: Yuan Zhangxian , Kardomateas George A.
Published: April 2018

The nonlinear post-buckling response of sandwich panels based on the extended high-order sandwich panel theory (EHSAPT) is presented. The model includes the transverse compressibility, the axial rigidity, and the shear effect of the core. Both faces and core are considered undergoing large displacements with moderate rotations. Based on the nonlinear weak form governing equations, the post-buckling response is obtained by the arc-length continuation method together with the branch switching technique. Also, the post-buckling response with imperfections is studied. The numerical examples discuss the post-buckling response corresponding to global buckling and wrinkling. It is found that due to the interaction between faces and core, localized effects may be easily initiated by imperfections after the sandwich structure has buckled globally. Furthermore, this could destabilize the post-buckling response. The post-buckling response verifies the critical load and buckling mode given by the buckling analysis in part I. The axial rigidity of the core, although it is very small compared to that of the faces, has a significant effect on the post-buckling response.
Anisotropic Mechanics of Cellular Substrate Under Finite Deformation
Authors: Zhu Feng , Xiao Hanbin , Xue Yeguang , Feng Xue , Huang Yonggang , Ma Yinji
Published: April 2018

The use of cellular substrates for stretchable electronics minimizes not only disruptions to the natural diffusive or convective flow of bio-fluids, but also the constraints on the natural motion of the skin. The existing analytic constitutive models for the equivalent medium of the cellular substrate under finite stretching are only applicable for stretching along the cell walls. This paper aims at establishing an analytic constitutive model for the anisotropic equivalent medium of the cellular substrate under finite stretching along any direction. The model gives the nonlinear stress–strain curves of the cellular substrate that agree very well with the finite element analysis (FEA) without any parameter fitting. For the applied strain <10%, the stress–strain curves are the same for different directions of stretching, but their differences become significant as the applied strain increases, displaying the deformation-induced anisotropy. Comparison of the results for linear and nonlinear elastic cell walls clearly suggests that the nonlinear stress–strain curves of the cellular substrate mainly result from the finite rotation of cell walls.
Reversible and irreversible heat engine and refrigerator cycles
Authors: Leff Harvey S.
Published: April 2018

Although no reversible thermodynamic cycles exist in nature, nearly all cycles covered in textbooks are reversible. This is a review, clarification, and extension of results and concepts for quasistatic, reversible and irreversible processes and cycles, intended primarily for teachers and students. Distinctions between the latter process types are explained, with emphasis on clockwise (CW) and counterclockwise (CCW) cycles. Specific examples of each are examined, including Carnot, Kelvin and Stirling cycles. For the Stirling cycle, potentially useful task-specific efficiency measures are proposed and illustrated. Whether a cycle behaves as a traditional refrigerator or heat engine can depend on whether it is reversible or irreversible. Reversible and irreversible-quasistatic CW cycles both satisfy Carnot's inequality for thermal efficiency, η≤ηCarnot. Irreversible CCW cycles with two reservoirs satisfy the coefficient of performance inequality K≤KCarnot. However, an arbitrary reversible cycle satisfies K≥KCarnot when compared with a reversible Carnot cycle operating between its maximum and minimum temperatures, a potentially counterintuitive result.
Exploring extra dimensions with scalar fields
Authors: Brown Katherine , Mathur Harsh , Verostek Mike
Published: April 2018

This paper provides a pedagogical introduction to the physics of extra dimensions by examining the behavior of scalar fields in three landmark models: the ADD, Randall-Sundrum, and DGP spacetimes. Results of this analysis provide qualitative insights into the corresponding behavior of gravitational fields and elementary particles in each of these models. In these “brane world” models, the familiar four dimensional spacetime of everyday experience is called the brane and is a slice through a higher dimensional spacetime called the bulk. The particles and fields of the standard model are assumed to be confined to the brane, while gravitational fields are assumed to propagate in the bulk. For all three spacetimes, we calculate the spectrum of propagating scalar wave modes and the scalar field produced by a static point source located on the brane. For the ADD and Randall-Sundrum models, at large distances, the field looks like that of a point source in four spacetime dimensions, but at short distances, it crosses over to a form appropriate to the higher dimensional spacetime. For the DGP model, the field has the higher dimensional form at long distances rather than short. The behavior of these scalar fields, derived using only undergraduate level mathematics, closely mirror the results that one would obtain by performing the far more difficult task of analyzing the behavior of gravitational fields in these spacetimes.
Gamma ray spectroscopy with Arduino UNO
Authors: Lavelle C. M.
Published: April 2018

We review a simple gamma ray spectrometer constructed on a solderless breadboard. The spectrometer's detector consists of a CsI(Tl) scintillator and silicon photomultiplier (SiPM) and its readout is facilitated by an Arduino UNO. The system is low cost and utilizes a minimum of components while still achieving satisfactory charge linearity and noise levels. This instrument can be used in instructional laboratories to introduce both radiation detection and analog signal processing concepts. We also expect it will be of interest to those seeking to introduce gamma spectroscopy to the expanding ecosystem of Arduino hardware.
Amplitude modulation detection with a short-duration carrier: Effects of a precursor and hearing loss
Authors: Jennings Skyler G. , Chen Jessica , Fultz Sara E. , Ahlstrom Jayne B. , Dubno Judy R.
Published: April 2018

This study tests the hypothesis that amplitude modulation (AM) detection will be better under conditions where basilar membrane (BM) response growth is expected to be linear rather than compressive. This hypothesis was tested by (1) comparing AM detection for a tonal carrier as a function of carrier level for subjects with and without cochlear hearing impairment (HI), and by (2) comparing AM detection for carriers presented with and without an ipsilateral notched-noise precursor, under the assumption that the precursor linearizes BM responses. Average AM detection thresholds were approximately 5 dB better for subjects with HI than for subjects with normal hearing (NH) at moderate-level carriers. Average AM detection for low-to-moderate level carriers was approximately 2 dB better with the precursor than without the precursor for subjects with NH, whereas precursor effects were absent or smaller for subjects with HI. Although effect sizes were small and individual differences were noted, group differences are consistent with better AM detection for conditions where BM responses are less compressive due to cochlear hearing loss or due to a reduction in cochlear gain. These findings suggest the auditory system may quickly adjust to the local soundscape to increase effective AM depth and improve signal-to-noise ratios.
Pathogenic Nocardia cyriacigeorgica and Nocardia nova Evolve To Resist Trimethoprim-Sulfamethoxazole by both Expected and Unexpected Pathways
Authors: Mehta H. , Weng J. , Prater A. , Elworth R. A. L. , Han X. , Shamoo Y.
Published: April 2018

Nocardia
spp. are Gram-positive opportunistic pathogens that affect largely immunocompromised patients, leading to serious pulmonary or systemic infections. Combination therapy using the folate biosynthesis pathway inhibitors trimethoprim (TMP) and sulfamethoxazole (SMX) is commonly used as an antimicrobial therapy. Not surprisingly, as antibiotic therapies for nocardiosis can extend for many months, resistance to TMP-SMX has emerged. Using experimental evolution, we surveyed the genetic basis of adaptation to TMP-SMX across 8 strains of
Nocardia nova
and 2 strains of
Nocardia cyriacigeorgica
. By employing both continuous experimental evolution to provide longitudinal information on the order of changes and characterization of resistant endpoint isolates, we observe changes that are consistent with modifications of two enzymes of the folate biosynthesis pathway: dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) (FolP), with the mutations often being clustered near the active site of the enzymes. While changes to DHFR and DHPS might be expected, we also noted that mutations in a previously undescribed homolog of DHPS (DHPS2 or FolP2) that was annotated as being “nonfunctional” were also sufficient to generate TMP-SMX resistance, which serves as a cautionary tale for the use of automated annotation by investigators and for the future discovery of drugs against this genus. Additionally,
folP2
overlapped glucosyl-3-phosphoglycerate synthase. Remarkably, an adaptive frameshift mutation within the overlapping region resulted in a new in-frame fusion to the downstream gene to produce a potentially new bifunctional enzyme. How a single potentially bifunctional DHPS2 enzyme might confer resistance is unclear. However, it highlights the unexpected ways in which adaptive evolution finds novel solutions for selection.
Pneumococcal haemolytic uraemic syndrome in the postvaccine era
Authors: Lawrence Jolie , Gwee Amanda , Quinlan Catherine
Published: April 2018

Objective

Pneumococcal infection is a leading cause of haemolytic uraemic syndrome (HUS) and is potentially vaccine preventable. Published data suggest high mortality and poor renal outcomes. The introduction of the 7-valent pneumococcal conjugate vaccine (PCV) has seen the emergence of disease caused by non-vaccine strains, particularly 19A. We sought to describe serotype prevalence and outcomes, particularly after the introduction of the 13-valent PCV.

Design and setting

We performed a retrospective chart review, using hospital medical records to identify cases of HUS in a tertiary paediatric hospital in Australia over a 20-year period (January 1997–December 2016). Associated pneumococcal infection was identified, and serotype data were categorised according to vaccine era: prevaccine (January 1997–December 2004), PCV7 (January 2005–June 2011) and PCV13 (July 2011–December 2016).

Results

We identified 66 cases of HUS. Pneumococcal infection was proven in 11 cases, representing 4% (1/26) of cases prior to the introduction of PCV7, 20% (3/15) in the PCV7 era and 28% (7/25) in the PCV13 era. Subtype 19A was the most prevalent pneumococcal serotype (6/11). All four patients who received PCV7 were infected with a non-vaccine serotype. Four of the five patients who received PCV13 were classed as vaccine failures. Median follow-up was 14 (range 1–108) months. Chronic kidney disease was the most common complication (4/7). We observed no mortality, neurological sequelae or progression to end-stage kidney disease.

Conclusions

Serotype 19A is most commonly associated with pneumococcal HUS, despite the introduction of the 13-valent vaccine. Chronic kidney disease is a significant complication of pneumococcal HUS.
From microscopic to macroscopic sports injuries. Applying the complex dynamic systems approach to sports medicine: a narrative review
Authors: Pol Rafel , Hristovski Robert , Medina Daniel , Balague Natalia
Published: April 2018

A better understanding of how sports injuries occur in order to improve their prevention is needed for medical, economic, scientific and sports success reasons. This narrative review aims to explain the mechanisms that underlie the occurrence of sports injuries, and an innovative approach for their prevention on the basis of complex dynamic systems approach. First, we explain the multilevel organisation of living systems and how function of the musculoskeletal system may be impaired. Second, we use both, a constraints approach and a connectivity hypothesis to explain why and how the susceptibility to sports injuries may suddenly increase. Constraints acting at multiple levels and timescales replace the static and linear concept of risk factors, and the connectivity hypothesis brings an understanding of how the accumulation of microinjuries creates a macroscopic non-linear effect, that is, how a common motor action may trigger a severe injury. Finally, a recap of practical examples and challenges for the future illustrates how the complex dynamic systems standpoint, changing the way of thinking about sports injuries, offers innovative ideas for improving sports injury prevention.