bluuebunny/crossref_metadata_2025 huggingface dataset:
Probabilistic Assessment of the Failure Risk of the Europa Clipper Spacecraft due to Radiations
Authors: Ding Yiqing , Duggan Sean , Ferranti Matthew , Jagadpramana Michael , Rege Rushal , Zhovtobryukh Yuriy , Paté‐Cornell M.‐Elisabeth
Published: January 2020

The Europa mission approved in 2019 is still in the development phase. It is designed to conduct a detailed reconnaissance of that moon of Jupiter as it could possibly support life as we know it. This article is based on a top‐down approach (mission → system → subsystems → components) to model the probability of mission failure. The focus here is on the case where the (uncertain) radiation load exceeds the (uncertain) capacity of critical subsystems of the spacecraft. The model is an illustrative quantification of the uncertainties about (1) the complex external radiation environment in repeated exposures, (2) the effectiveness of the shielding in different zones of the spacecraft, and (3) the components’ capacities, by modeling all three as dynamic random variables. A simulation including a sensitivity analysis is used to obtain the failure probability of the whole mission in forty‐five revolutions around Jupiter. This article illustrates how probabilistic risk analysis based on engineering models, test results and expert opinions can be used in the early stages of the design of space missions when uncertainties are large. It also describes the optimization of the spacecraft design, taking into account the decisionmakers’ risk attitude and the mission resource constraints.
Description of two new HLA alleles: HLA‐DRB1*07:112 and HLA‐DQB1*02:169
Authors: Loginova Maria , Paramonov Igor
Published: January 2020

Two new HLA alleles were characterized in the population of the North Caucasus.
HIV-1 Vpu Downregulates Tim-3 from the Surface of Infected CD4
+
T Cells
Authors: Prévost Jérémie , Edgar Cassandra R. , Richard Jonathan , Trothen Steven M. , Jacob Rajesh Abraham , Mumby Mitchell J. , Pickering Suzanne , Dubé Mathieu , Kaufmann Daniel E. , Kirchhoff Frank , Neil Stuart J. D. , Finzi Andrés , Dikeakos Jimmy D.
Published: January 2020

HIV infection modulates the surface expression of Tim-3, but the molecular determinants remain poorly understood. Here, we show that HIV-1 Vpu downregulates Tim-3 from the surface of infected primary CD4
+
T cells through its transmembrane domain and alters its subcellular localization. Tim-3 blockade increases HIV-1 replication, suggesting a potential negative role of this protein in viral spread that is counteracted by Vpu.
Complete Genome Sequence of Lactococcus lactis subsp.
lactis
bv. diacetylactis SD96
Authors: Dorau Robin , Chen Jun , Jensen Peter Ruhdal , Solem Christian
Published: January 2020

The genome of
Lactococcus
lactis
subsp.
lactis
bv. diacetylactis SD96, a strain used for cheese production, is presented. SD96 is refractory to phage attack, which is a desired property for starter bacteria. Its 10 plasmids provide industrially important traits, such as lactose and citrate metabolism, proteolytic activity, and phage resistance.
Five Closed
Salmonella enterica
Genome Sequences from a 2017–2018 Multistrain, Multistate Kratom Outbreak
Authors: Rauch Hallie E. , Haendiges Julie , Balkey Maria , Hoffmann Maria
Published: January 2020

We report here the closed genomes of
Salmonella enterica
strains from the 2017–2018 multistrain, multistate kratom outbreak using single-molecule real-time DNA sequencing. Four of the genomes consist of one circular chromosome, and the fifth has a circular chromosome and a single plasmid.
Genome Sequences of 20 Bacteriophages Isolated on Gordonia terrae
Authors: Pope Welkin H. , Butela Kristen A. , Garlena Rebecca A. , Jacobs-Sera Deborah , Russell Daniel A. , Warner Marcie H. ,   University of Pittsburgh SEA-PHAGES, Hatfull Graham F.
Published: January 2020

We report here the sequences of 20 bacteriophages isolated on
Gordonia terrae
3612. These phages span considerable sequence diversity, represent 12 clusters and a singleton genome, and range in genome length from 16.2 kbp to 151.3 kbp. Phages Pupper and SCentae are the first reported
Myoviridae
phages of
Gordonia
spp.
Long term exposure to ambient fine particulate matter and incidence of stroke: prospective cohort study from the China-PAR project
Authors: Huang Keyong , Liang Fengchao , Yang Xueli , Liu Fangchao , Li Jianxin , Xiao Qingyang , Chen Jichun , Liu Xiaoqing , Cao Jie , Shen Chong , Yu Ling , Lu Fanghong , Wu Xianping , Zhao Liancheng , Wu Xigui , Li Ying , Hu Dongsheng , Huang Jianfeng , Liu Yang , Lu Xiangfeng , Gu Dongfeng
Published: January 2020

Objective

To study the effect of long term exposure to ambient fine particulate matter of diameter ≤2.5 μm (PM2.5) on the incidence of total, ischemic, and hemorrhagic stroke among Chinese adults.

Design

Population based prospective cohort study.

Setting

Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project carried out in 15 provinces across China.

Participants

117 575 Chinese men and women without stroke at baseline in the China-PAR project.

Main outcome measures

Incidence of total, ischemic, and hemorrhagic stroke.

Results

The long term average PM2.5 level from 2000 to 2015 at participants’ residential addresses was 64.9 μg/m3, ranging from 31.2 μg/m3 to 97.0 μg/m3. During 900 214 person years of follow-up, 3540 cases of incident stroke were identified, of which 63.0% (n=2230) were ischemic and 27.5% (n=973) were hemorrhagic. Compared with the first quarter of exposure to PM2.5 (<54.5 μg/m3), participants in the highest quarter (>78.2 μg/m3) had an increased risk of incident stroke (hazard ratio 1.53, 95% confidence interval 1.34 to 1.74), ischemic stroke (1.82, 1.55 to 2.14), and hemorrhagic stroke (1.50, 1.16 to 1.93). For each increase of 10 μg/m3 in PM2.5 concentration, the increased risks of incident stroke, ischemic stroke, and hemorrhagic stroke were 13% (1.13, 1.09 to 1.17), 20% (1.20, 1.15 to 1.25), and 12% (1.12, 1.05 to 1.20), respectively. Almost linear exposure-response relations between long term exposure to PM2.5 and incident stroke, overall and by its subtypes, were observed.

Conclusions

This study provides evidence from China that long term exposure to ambient PM2.5 at relatively high concentrations is positively associated with incident stroke and its major subtypes. These findings are meaningful for both environmental and health policy development related to air pollution and stroke prevention, not only in China, but also in other low and middle income countries.
Bend it like Beckham or fix them like Florence—proportional representation of healthcare in New Year honours: an observational study
Authors: Emelifeonwu John A , Hazelwood James E , Nolan Oscar , Sharland Emma , O’Donald Anna , Peet Alison , Frazer Ricky
Published: January 2020

Objectives

To compare the proportional representation of healthcare workers in receipt of New Year honours (NYHs) with workers in other industries and to determine whether the NYH system has gender or geographical biases.

Design

Observational study of the UK honours system with a comparative analysis of proportional representation of the UK workforce and subgroup analyses of gender and geographical representations.

Participants

Recipients of NYHs from 2009 to 2018.

Main outcome measures

Absolute risk of receiving an NYH based on industry, gender, or region of the UK. Relative risk of receiving an NYH for services to healthcare compared with other industries.

Results

10 989 NYHs were bestowed from 2009 to 2018, 47% of which were awarded to women. 832 awards (7.6%) were for services to healthcare. People working in sport and in the arts and media were more likely to receive NYHs than those working in healthcare (relative risks of 22.01 (95% confidence interval 19.91 to 24.34) and 5.84 (5.31 to 6.44), respectively). There was no significant difference between the rate of receiving honours for healthcare and for science and technology (P=0.22). 34% (3741) of awards were issued to people living in London and in the southeast of England, and only 496 of 1447 (34%) higher order awards (knighthoods, damehoods, companions of honour, and commanders of the order of the British empire) were received by women.

Conclusions

In relation to the size of its workforce, a career in healthcare is not as “honourable” as careers in certain other industries. Geographical and gender biases might exist in the honours system.
Potential impacts of post-Brexit agricultural policy on fruit and vegetable intake and cardiovascular disease in England: a modelling study
Authors: Seferidi Paraskevi , Laverty Anthony A , Collins Brendan , Bandosz Piotr , Capewell Simon , O’Flaherty Martin , Millett Christopher , Pearson-Stuttard Jonathan
Published: January 2020

Background

Current proposals for post-Brexit agricultural policy do not explicitly incorporate public health goals. The revised agricultural policy may be an opportunity to improve population health by supporting domestic production and consumption of fruits and vegetables (F&V). This study aims to quantify the potential impacts of a post-Brexit agricultural policy that increases land allocated to F&V on cardiovascular disease (CVD) mortality and inequalities in England, between 2021 to 2030.

Methods

We used the previously validated IMPACT Food Policy model and probabilistic sensitivity analysis to translate changes in land allocated to F&V into changes in F&V intake and associated CVD deaths, stratified by age, sex and Index of Multiple Deprivation. The model combined data on F&V agriculture, waste, purchases and intake, CVD mortality projections and appropriate relative risks. We modelled two scenarios, assuming that land allocated to F&V would gradually increase to 10% and 20% of land suitable for F&V production.

Results

We found that increasing land use for F&V production to 10% and 20% of suitable land would increase fruit intake by approximately 3.7% (95% uncertainty interval: 1.6% to 8.6%) and 17.4% (9.1% to 36.9%), and vegetable intake by approximately 7.8% (4.2% to 13.7%) and 37% (24.3% to 55.7%), respectively, in 2030. This would prevent or postpone approximately 3890 (1950 to 7080) and 18 010 (9840 to 28 870) CVD deaths between 2021 and 2030, under the first and second scenario, respectively. Both scenarios would reduce inequalities, with 16% of prevented or postponed deaths occurring among the least deprived compared with 22% among the most deprived.

Conclusion

Post-Brexit agricultural policy presents an important opportunity to improve dietary intake and associated cardiovascular mortality by supporting domestic production of F&V as part of a comprehensive strategy that intervenes across the supply chain.
Cholinesterase alterations in delirium after cardiosurgery: a German monocentric prospective study
Authors: Adam Elisabeth Hannah , Haas Victoria , Lindau Simone , Zacharowski Kai , Scheller Bertram
Published: January 2020

Objectives

Postoperative delirium (POD) is a common complication after elective cardiac surgery. Recent evidence indicates that a disruption in the normal activity of the cholinergic system may be associated with delirium.

Design

Prospective observational study.

Setting

Single-centre at a European academic hospital.

Primary and secondary outcome measures

In our study the enzyme activities of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) were determined preoperatively as well as on the first and second postoperative day. The confusion assessment method for the intensive care unit was used to screen patients for the presence of POD.

Results

A total of 114 patients were included in the study. POD was associated with a decrease in BChE activity on postoperative day 1 (p=0.03). In addition, patients who developed POD, had significantly lower preoperative AChE activity than patients without POD (p<0.01). Multivariate analysis identified a preoperatively decreased AChE activity (OR 3.1; 95% CI 1.14 to 8.46), anticholinergic treatment (OR 5.09; 95% CI 1.51 to 17.23), elevated European System for Cardiac Operative Risk Evaluation (OR 3.68; 95% CI 1.04 to 12.99) and age (OR 3.02; 95% CI 1.06 to 8.62) to be independently associated with the development of POD.

Conclusions

We conclude that a reduction in the acetylcholine hydrolysing enzyme activity in patients undergoing cardiac surgery may correlate with the development of POD.
Development of a Cannabis Assessment Tool (CAT-1) to measure current and lifetime marijuana use among older Veterans
Authors: Keyhani Salomeh , Abraham Ann , Cohen Beth , Vali Marzieh , Yoo Sodahm Robin , Dollinger Camille , Steigerwald Stacey
Published: January 2020

Objective

To develop a tool to assess current (past 30 days) and lifetime marijuana use in older Veterans.

Setting

US Veteran’s Affairs Healthcare System.

Participants

704 older Veterans were screened, 339 completed the initial survey, 100 completed the follow-up.

Primary outcome measure

Pearson’s correlation coefficient to assess strength of association between initial and follow-up survey on measures of current and lifetime marijuana use.

Results

Both a ‘gram-month’ measure of marijuana smoked in the past 30 days (r=0.83) and a frequency-based measure assessing total number of times smoked in the past 30 days were reliable (r=0.89). Both a simple categorical measure of lifetime use (agreement=85%) and a continuous measure of lifetime use (r=0.82) were reliable.

Conclusions

The Cannabis Assessment Tool offers a reliable assessment of past 30 days and lifetime assessments of smoking cannabis in older adults.
What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care
Authors: Isbell Linda M , Boudreaux Edwin D , Chimowitz Hannah , Liu Guanyu , Cyr Emma , Kimball Ezekiel
Published: January 2020

Background

Despite calls to study how healthcare providers’ emotions may impact patient safety, little research has addressed this topic. The current study aimed to develop a comprehensive understanding of emergency department (ED) providers’ emotional experiences, including what triggers their emotions, the perceived effects of emotions on clinical decision making and patient care, and strategies providers use to manage their emotions to reduce patient safety risks.

Methods

Employing grounded theory, we conducted 86 semi-structured qualitative interviews with experienced ED providers (45 physicians and 41 nurses) from four academic medical centres and four community hospitals in the Northeastern USA. Constant comparative analysis was used to develop a grounded model of provider emotions and patient safety in the ED.

Results

ED providers reported experiencing a wide range of emotions in response to patient, hospital, and system-level factors. Patients triggered both positive and negative emotions; hospital and system-level factors largely triggered negative emotions. Providers expressed awareness of possible adverse effects of negative emotions on clinical decision making, highlighting concerns about patient safety. Providers described strategies they employ to regulate their emotions, including emotional suppression, distraction, and cognitive reappraisal. Many providers believed that these strategies effectively guarded against the risk of emotions negatively influencing their clinical decision making.

Conclusion

The role of emotions in patient safety is in its early stages and many opportunities exist for researchers, educators, and clinicians to further address this important issue. Our findings highlight the need for future work to (1) determine whether providers’ emotion regulation strategies are effective at mitigating patient safety risk, (2) incorporate emotional intelligence training into healthcare education, and (3) shift the cultural norms in medicine to support meaningful discourse around emotions.
Young women’s fertility knowledge: partial knowledge and implications for contraceptive risk-taking
Authors: Newton Victoria Louise , Dickson Jane , Hoggart Lesley
Published: January 2020

Background

There is a lack of research on young women’s fertility knowledge and awareness. This has implications for contraceptive risk-taking, including the use of emergency hormonal contraception (EHC). By drawing on two research studies, this article shows how greater fertility knowledge could benefit young women in terms of pregnancy prevention.

Methods

We draw on two qualitative research studies (‘fertility study’ and ‘abortion study’) resulting in a composite sample of 46 interviews with women aged 16–24 years. Focused secondary analysis was undertaken looking specifically at fertility knowledge in relation to contraceptive behaviour.

Findings

A lack of accurate knowledge about the menstrual cycle was evident in two ways. Young women drew conclusions about their invulnerability to pregnancy if previous unprotected sexual intercourse (UPSI) had not resulted in pregnancy. Additionally, although participants were aware of EHC, there was no awareness of when it might fail other than after a certain time limit.

Conclusions

Young women would benefit from a more nuanced understanding of fertility. Episodes of UPSI that do not result in pregnancy can encourage a belief that ‘it won’t happen to me’, and this has implications for taking chances with contraception. Partial knowledge about the effectiveness of EHC may also lead to unintended pregnancy. Calculating the number of hours following UPSI generates overreliance on what is only one of the factors determining the effectiveness of EHC. Information regarding the link between EHC and failure rates near the day of ovulation needs to be more widely publicised.
Significant variation in the management of cull sows before transport for slaughter: results from a survey of Danish pig farmers
Authors: Herskin Mette S , Aaslyng Margit D , Anneberg Inger , Thomsen Peter T , Gould Louisa M , Thodberg Karen
Published: January 2020

Background

Approximately 50% of sows are slaughtered each year, but management of cull sows is not well described.

Methods

We aimed to describe how cull sows are sent to slaughter using a questionnaire survey emailed to 885 Danish pig farmers, including questions about the use of pick‐up facilities (either a designated pen used for reasons of biosecurity and practicality, in a special part of the barn, where pigs are kept in the last hours before being loaded onto a commercial truck, or a stationary vehicle kept outside the buildings and used for the same purpose) and evaluation of fitness for transport.

Results

A total of 360 farmers answered all questions, constituting a homogeneous group of middle‐aged, experienced males. The management of the sows seemed rather variable, for example regarding choice of pick‐up facility, its available resources, actions taken when sows were not fit for transport and sow conditions leading to doubt about fitness for transport. Special condition transport was only reported rarely, and rejection of sows due to lack of fitness for transport, by drivers or veterinarians at the slaughterhouse, was only rarely experienced.

Conclusion

These findings may be used for formulation of hypotheses for future studies in this area characterised by welfare challenges, potentially leading to science‐based recommendations relevant for animal welfare, productivity and biosecurity.
Insight into centrifuge modelling errors in predicting embedment depths of dynamically installed anchors
Authors: Yi Jiang Tao , Cao Ming Yang , Liu Yong , Zhang Lei
Published: January 2020

In centrifuge modelling of dynamic events, a common practice is to preserve the inertial effect. This will lead to a loss of similitude in the strain rate between model and prototype. For centrifuge tests of dynamic installation of anchors, such strain rate dissimilarity may give rise to significant discrepancy in the anchor embedment depth between the model and the prototype, i.e., modelling error. Large-deformation finite element analyses that simulate both the model and the prototype were undertaken in this study to provide insight into this phenomenon. The calculation results revealed that the centrifuge model tends to underpredict the anchor embedment depth of the prototype. A parametric study of the influence of anchor geometry and weight, soil strength and stiffness, strain softening and rate parameters, and centrifuge acceleration level was subsequently conducted. It was found that such underprediction depends heavily upon the strain rate parameter. Based on analyses results, practical advices were given for centrifuge modellers to minimize the modelling error. The results presented and advices given in this study may facilitate the design of centrifuge model tests especially when the anchor embedment depth is an essential detail to be replicated in these tests.
Response amplification of back-rotated piles
Authors: Guo Wei Dong
Published: January 2020

Piles are largely back-rotated in sliding slope or subjected to lateral spreading. This paper reveals for the first time that response of these piles (e.g., displacement, rotation, bending moment, and shear force) is amplified against forward rotating piles. In particular, magnification is detrimental, once normalized rotational stiffness (NRS) of the piles is around a singularity value (i.e., normalized singularity stiffness, NSS). New expressions are developed to gain the NSS value, the magnification degree, and the sliding depth to incur the singularity. The NRS is assessed using 1g model tests. The solutions are adopted to capture the response of the model piles, to detect new failure mechanism of Showa Bridge, and to check the safety of Christchurch bridges. The main conclusions are as follows: (i) piles are prone to response amplification, when subjected to lateral spreading or in sliding slopes. (ii) The NRS is only slightly affected by soil movement profiles and sliding depths. (iii) Showa Bridge collapsed from displacement amplification of back-rotated piles. Finally, (iv) the roller connections between girder and piers, and an integral abutment and piers are proved to be effective to curb the amplification. The amplified response needs to be assessed in practice to lessen failure of back-rotated piles.
Computational and experimental studies on third-order optical nonlinearities of novel D-π-A-π-A type chalcone derivatives: (1E,4E)-1-(4-substituted)-5-phenylpenta-1,4-dien-3-one
Authors: Lu Heng , Gu Bing , Cui Yiping , He Jun , Vijaya Kumari , Ravindra H. J. , Usha H.
Published: January 2020

We report the theoretical and experimental investigations of structure–property relationships for [Formula: see text] at the wavelength of 800[Formula: see text]nm in three D-[Formula: see text]-A-[Formula: see text]-A type chalcone derivatives. Theoretically, the second hyperpolarizability [Formula: see text] at the wavelength of 800[Formula: see text]nm is numerically computed from the combination of density functional theory and semi-empirical method. Experimentally, we synthesize these three chalcone derivatives and investigate their nonlinear optical (NLO) properties using the femtosecond-pulsed [Formula: see text]-scan measurements at 800[Formula: see text]nm. It is shown that the dependence of the measured [Formula: see text] on the molecular structure has a trend, consistent with that of computational [Formula: see text]. These results indicate that the enhancement of the NLO response can be realized by design of the electron donating strength in the D-[Formula: see text]-A-[Formula: see text]-A type molecule.
Identifiability of parametric random matrix models
Authors: Hayase Tomohiro
Published: January 2020

We investigate parameter identifiability of spectral distributions of random matrices. In particular, we treat compound Wishart type and signal-plus-noise type. We show that each model is identifiable up to some kind of rotation of parameter space. Our method is based on free probability theory.
Comparison of the Effects of Sufentanil and Fentanyl in Intravenous Patient-Controlled Analgesia after Pediatric Moyamoya Surgery: A Retrospective Study
Authors: Lim Leerang , Jang Young-Eun , Kim Eun-Hee , Lee Ji-Hyun , Kim Jin-Tae , Kim Hee-Soo
Published: January 2020

Introduction: Intravenous patient-controlled analgesia (PCA) has been one of the most popular modalities for postoperative pain management in orthopedic surgery, plastic surgery, or neurosurgery in children. Objective: We compared the effects of fentanyl and sufentanil used in intravenous PCA on postoperative pain management and opioid-related side effects in pediatric moyamoya disease. Methods: This retrospective study included 97 pediatric patients who underwent surgery for moyamoya disease. Preoperative and perioperative parameters were assessed. The PCA regimen was as follows: fentanyl group (0.2 μg/kg/mL, 1 mL of loading volume, 0.1 μg/kg/h of basal infusion, a bolus of 0.2 μg/kg on demand, “lock-out” interval of 15 min); sufen­tanil group (0.04 μg/kg/mL, 1 mL of loading volume, 0.02 μg/kg/h of basal infusion, a bolus of 0.04 μg/kg on demand, 15 min lock-out), 10 μg/kg (up to 300 μg) of ramosetron for prophylaxis of postoperative nausea and vomiting with the same loading dose in both groups. Peripheral nerve blocks were performed. Pain was assessed by numeric rating scale or revised Faces Pain Scale. Side effects were reviewed. Results: The two groups showed similar pain scores and incidence of nausea or vomiting during the first 48 h postoperatively. Additional analgesics were more frequent in the fentanyl group, and PCA was discontinued more frequently in the sufentanil group. Conclusions: Postoperatively, sufen­tanil in PCA provided more analgesia than fentanyl with less additional analgesics in moyamoya disease. However, PCA with sufentanil was more frequently discontinued due to nausea or vomiting compared to fentanyl-based PCA.
Blue-Light Fundus Autofluorescence Imaging following Ruthenium-106 Brachytherapy for Choroidal Melanoma
Authors: Bindewald-Wittich Almut , Swenshon Tomasz , Carasco Eva , Dreyhaupt Jens , Willerding Gregor D.
Published: January 2020

Purpose: To describe changes in blue-light fundus autofluorescence (FAF) and corresponding alterations in optical coherence tomography (OCT) within the irradiation field after ruthenium-106 brachytherapy (RBT) for choroidal melanoma. Methods: Consecutive patients with choroidal melanoma were included in a retrospective case series. Patients were treated with RBT at a single institution. As part of their routine examination patients underwent multimodal imaging including ultrasonography, fundus photography, OCT, and FAF imaging (excitation = 488 nm). FAF images were analysed for changes within the irradiation field. Results: 31 patients (mean age 65.7 years) were treated with RBT for unilateral choroidal melanoma. Mean tumour height before therapy was 2.7 mm (SD 1.0). Mean follow-up time was 23.3 months (SD 13.3). Main FAF characteristics attributable to RBT emerged as increased FAF with speckled decreased FAF (FAF mottling) within the irradiation field and a rim of increased FAF at its border. OCT scans demonstrated loss of the ellipsoid zone and the external limiting membrane, thinning of the neurosensory retina, and alterations of the retinal pigment epithelium like clumping, migration, and atrophy. Conclusions: FAF changes in the irradiation field after RBT of choroidal melanomas follow a characteristic pattern that correlates with distinct OCT alterations. FAF and OCT imaging give additional information to monitor effects of RBT and, therefore, complement multimodal imaging techniques after plaque therapy.
Improving Engagement of Mild to Moderate Dementia Alzheimer’s Disease Patients Using Evidence-Based Visual Cognitive Stimulation Exercises
Authors: Tato-Colín Silvia , Hurtado-Aznar Luis Alberto , García-Rodríguez Isaías , Benavides-Cuéllar Carmen , Sánchez-Valdeón Leticia
Published: January 2020

Introduction: Different studies have proven the effectiveness of cognitive stimulation (CS) for people with mild to moderate dementia, but further research is needed to gain insight into how CS interventions should be designed and developed. Objectives: The objective of this study was to gather and analyze data about the development of a series of CS sessions with Alzheimer’s disease (AD) patients, to gain insight into how different individuals engage to different CS activities. Methods: 24 AD patients with mild to moderate dementia (GDS = 4 and 5) participated in the study. Twelve different sessions were held with a different stimulation exercise each. Information about the achievement and engagement for each of the exercises were recorded for each patient. Results: A significant correlation was found between the global engagement and the GDS level, and between engagement and gender (and also with educational level) for one of the exercises. These results may be useful for designing CS sessions depending on the composition of the group. For example, five exercises got very different engagement results when comparing patients with GDS = 4 and GDS = 5; if the session group consists of patients with both GDS levels, these kinds of exercises should be avoided to gain homogeneity in the engagement and prevent discouragement. Conclusions: The type and characteristics of CS exercises have an impact on the engagement level of AD patients with mild to moderate dementia. Further studies are necessary to better understand which characteristics of the exercises affect the engagement of the patient according to their particularities. This kind of study may help the design of CS sessions and improve the results obtained.
An Evaluation of Regulatory Regimes of Medical Cannabis: What Lessons Can Be Learned for the UK?
Authors: Schlag Anne Katrin
Published: January 2020

This paper evaluates current regulatory regimes of medical cannabis using peer-reviewed and grey literature as well as personal communications. Despite the legalization of medical cannabis in the UK in November 2018, patients still lack access to the medicine, with fewer than 10 NHS prescriptions having been written to date. We look at six countries that have been at the forefront of prescribing medical cannabis, including case studies of the three largest medical cannabis markets in the EU: Germany, Italy, and the Netherlands. Canada, Israel and Australia add global examples. These countries have a more successful history of prescribing medical cannabis than the UK. Their legislations are outlined and numbers of medical cannabis prescriptions are provided to give an indication of how successful their regulatory regime has been in providing patient access. Evaluating countries’ medical cannabis regulations allows us to offer implications for lessons to be learned for the development of a successful medical cannabis regime in the UK.
Stiff Person Syndrome and Acetylcholine Receptor Ganglionic Neuronal Antibodies
Authors: Lester Jacobo , Cojab Jimmy , Klériga Enrique
Published: January 2020

The association between stiff person syndrome and paraneoplastic syndromes has been described, linking intracellular or extracellular antibodies. We describe the case of a 64-year-old woman with stiff person syndrome and positivity for acetylcholine receptor ganglionic neuronal antibodies, which can also be seen in muscular hyperexcitability conditions, as well as other paraneoplastic syndromes. The relevance of this report is the possible direct elevation of this antibody due to a direct immunological cause. Acetylcholine receptor ganglionic neuronal antibodies have been reported with autoimmune autonomic neuropathy and paraneoplastic syndromes linked to lung cancer and myastheniform syndromes, as well as in some muscular hyperexcitability states, but not in stiff person syndrome.
Trauma Severity in Early Childhood Correlates with Stress and Satiety Hormone Levels in a Pilot Cohort Receiving Diamorphine Maintenance Treatment
Authors: Groh Adrian , Rhein Mathias , Roy Mandy , Gessner Christine , Lichtinghagen Ralf , Heberlein Annemarie , Hillemacher Thomas , Bleich Stefan , Walter Marc , Frieling Helge
Published: January 2020

Aims: Childhood trauma is of importance for the manifestation of substance-related disorders and maintenance of hypothalamic-pituitary-adrenal (HPA)-axis disorders. Since stress plays a crucial role in opioid compliance and craving, we investigated the immediate effects of diacetylmorphine application on the HPA axis. In particular, adrenocorticotropic hormone (ACTH) and cortisol secretion, as well as satiety regulating proopiomelanocortin peptides α-melanocyte-stimulating hormone (MSH) and β-endorphin (END) in a cohort of opioid-dependent patients in diamorphine maintenance treatment concerning the clinical severity of their childhood trauma. Methods: We compared the serum levels of ACTH, cortisol, MSH, and END in 15 opioid-dependent patients. All participants received treatment with diamorphine and were observed at 5 timepoints before and after injection. We split the cohort into 2 subgroups concerning childhood trauma measured by the Childhood Trauma Questionnaire. Results: Splitting in 2 subgroups for mild (5) and severe trauma (10), we found that while both groups show a significant reduction of ACTH and cortisol levels over time, slopes display different progressions over time for cortisol (F[1.6] = 9.38, p = 0.02), while remaining identical for ACTH (F[1.6] = 1.69, p = 0.24). Also, levels of both MSH and END were significantly lower in severely traumatized patients. Conclusions: For the first time, we present a detailed representation of stress- and addiction-related proteins for the first 5 h after diamorphine application, demonstrating the interrelationship between stress hormones and childhood trauma as well as its potential effects on the progression of addictions such as opioid dependence.
Mortality of Patients on Maintenance Hemodialysis Submitted to Coronary Artery Bypass Surgery
Authors: da Silva Sirlei C. , Gaiotto Fábio , Hajjar Ludhmila A. , Consolim-Colombo Fernanda M. , Yu Luís , Moysés Rosa M.A. , Elias Rosilene M.
Published: January 2020

Background: Patients with chronic kidney disease (CKD) are less likely to be submitted to coronary artery bypass grafting (CABG) then clinical medical treatment based on the potential high risk of mortality. However, whether patients on maintenance dialysis who underwent an elective CABG experience high hospital- and long-term mortality is still debatable. Methods: This is a prospective observational study that evaluated patients who underwent elective CABG. Three groups were compared: reference (n = 167, estimated glomerular filtration rate [eGFR] ≥60 mL/min/1.73 m2), CKD3–4 (n = 84, eGFR 15–59 mL/min/1.73 m2), and maintenance hemodialysis (n = 31). Demographic, clinical, biochemical, fluid balance data, and Sequential Organ Failure Assessment (SOFA) scores were assessed daily for the same observer from day 1 (surgery) to hospital discharge. Results: The main outcomes were in-hospital and 1-year mortality. Patients aged 63 ± 10, 63 ± 8, and 65 ± 6 years old, in reference, CKD3–4, and dialysis groups, respectively (p = 0.605). Patients from the reference group had a lower prevalence of diabetes (p = 0.010) and hypertension (p = 0.021). SOFA scores were higher in CKD3–4 and dialysis groups (p = 0.001), though this difference disappeared without the renal component (p = 0.326). In-hospital mortality (n = 17) was similar across groups (p = 0.955). There was no difference in 1-year mortality among groups even after adjustments for age, diabetes, intraoperative blood loss, and time on ventilation. Conclusions: CABG short-term mortality seems not to be greater among selected patients on maintenance dialysis. A multidisciplinary team has been helping cardiologists and cardiac surgeons in the decision-making process regarding the best approach in coronary artery disease, and CABG should be considered a worthy therapeutic option.
Adrenal Tumors: Are Gender Aspects Relevant?
Authors: Alesina Pier Francesco , Walz Martin K.
Published: January 2020

The distribution of malignant tumors is strongly related to gender due to sex-related organ and tissue differentiation. Neoplasias of the adrenal glands are relatively common and typically benign. Mainly based on our recently published contributions, we analyzed the influence of gender on type of tumors, complexity of surgery, and long-term outcome. Cortisol-secreting adrenal tumors are more often diagnosed in female patients, while the incidence of Conn’s syndrome and pheochromocytoma is similar between male and female patients. Adrenalectomy is more difficult in male patients because of longer operating time and higher blood loss. The probability of cure in male patients with Conn’s syndrome is significantly lower. Gender does not influence long-term results in adrenal hypercortisolism and pheochromocytomas.
Epicardial Connections Involving Pulmonary Veins
Authors: Barrio-Lopez Maria Teresa , Sanchez-Quintana Damian , Garcia-Martinez Joaquin , Betancur Andres , Castellanos Eduardo , Arceluz Martín , Ortiz Mercedes , Nevado-Medina Jorge , Garcia Fermin , Almendral Jesús
Published: January 2020

Background:

The presence of epicardial connections (ECs) between pulmonary veins (PVs) and other anatomic structures may hinder PV isolation. In this study, we analyzed their prevalence, location, associated factors, and clinical implications.

Methods:

Five hundred thirty-four consecutive patients with atrial fibrillation undergoing radiofrequency ablation were included. We considered that an EC was present if: (1) the first pass around the PV antrum did not produce PV isolation and (2) subsequent atrial activation during PV pacing showed that the earliest site was located away from the ablation line and later activation sites were observed near the ablation line. Clinical and electrophysiological variables were collected from all patients. Patients were followed during 12.9±9.4 months, and any documented atrial tachyarrhythmia after the 3-month blanking period was classified as a recurrence.

Results:

Out of the 534 patients included, 72 (13.5%) were found to have 81 ECs. There was a significant association between the presence of ECs and structural heart disease (15.3% in patients without ECs versus 36.5% in patient with ECs;
P
<0.001) and patent foramen ovale (4.6% versus 13.5%;
P
=0.002). The presence of a left common trunk was significantly associated with the absence of ECs (29.6% in patients without ECs versus 16.2% in patients with ECs;
P
=0.014). Patients with ECs had lower acute success in PV isolation compared with patients without ECs (99.1% versus 86.1%;
P
<0.001). After adjusting for age, sex, type of atrial fibrillation, left atrium area, hypertension, structural heart disease, presence of left common trunk, patent foramen ovale, and time for atrial fibrillation diagnosis to the ablation, we found a significantly higher risk of atrial tachyarrhythmia recurrences in patients with ECs compared with patients without ECs (hazard ratio, 1.7 [95% CI, 1.1–2.9];
P
=0.04).

Conclusions:

ECs between PVs and other adjacent structures are frequent in patient with atrial fibrillation (prevalence: 13.5%). Structural heart disease and a patent foramen ovale are strongly associated with the presence of ECs. ECs reduce the acute and chronic success of PV isolation.
Brain connectivity during Alzheimer’s disease progression and its
cognitive impact in a transgenic rat model
Authors: Muñoz-Moreno Emma , Tudela Raúl , López-Gil Xavier , Soria Guadalupe
Published: January 2020

The research of Alzheimer’s disease (AD) in its early stages and its progression till symptomatic onset is essential to understand the pathology and investigate new treatments. Animal models provide a helpful approach to this research, since they allow for controlled follow-up during the disease evolution. In this work, transgenic TgF344-AD rats were longitudinally evaluated starting at 6 months of age. Every 3 months, cognitive abilities were assessed by a memory-related task and magnetic resonance imaging (MRI) was acquired. Structural and functional brain networks were estimated and characterized by graph metrics to identify differences between the groups in connectivity, its evolution with age, and its influence on cognition. Structural networks of transgenic animals were altered since the earliest stage. Likewise, aging significantly affected network metrics in TgF344-AD, but not in the control group. In addition, while the structural brain network influenced cognitive outcome in transgenic animals, functional network impacted how control subjects performed. TgF344-AD brain network alterations were present from very early stages, difficult to identify in clinical research. Likewise, the characterization of aging in these animals, involving structural network reorganization and its effects on cognition, opens a window to evaluate new treatments for the disease.
Peliosanthes crassicoronata (Asparagaceae), a new species from southern Vietnam

Authors: NGUYEN KHANG SINH , AVERYANOV LEONID V. , TANAKA NORIYUKI , QUANG BUI HONG , HAI DO VAN , BINH TRAN DUC , QAO QI
Published: January 2020

Peliosanthes crassicoronata is described and illustrated as a new species from southern Vietnam. It somewhat resembles P. macrostegia in having drooping bowl-shaped purplish flowers, but is readily distinguishable by the larger leaves with more numerous longitudinal veins, internally thickly ribbed staminal corona, and pistil with a hexagonal ovary and an indistinct style. The phylogenetic relationship of the new species was inferred from an analysis of chloroplast and nuclear DNA sequences.
Studies on the genus Capparis L. (Capparaceae) in Lao PDR. IV: A new species from the Khammouan Province

Authors: FICI SILVIO , SOUVANNAKHOUMMANE KEOOUDONE , LANORSAVANH SOULIVANH , LAMXAY VICHITH
Published: January 2020

A new species of Capparis, C. florida, is described and illustrated from the Hin Nam No National Protected Area, Khammouan Province in central Lao PDR. The new species, collected in forest habitats of the Khammouan karst, belongs to sect. Monostichocalyx. It is an erect shrub characterized by the widely ovate or elliptical leaf-blade, by the flowers serial in supra-axillary rows, and by the slender ovary with evident style. Its affinities with related taxa, such as the widespread C. micracantha, are discussed and its conservation status assessed.
4. The Impact of Digital Resources
Authors: Warwick Claire , Bailey-Ross Claire
Published: January 2020

Warwick and Bailey-Ross begin the chapter with a tone of scepticism, examining why there is a bias among students, university managers funding councils, and policy makers alike towards digital resources. In this chapter, they examine what impact digital resources might have, upon whom, in what way and how it might be measured. Beginning by detailing the history of impact-assessment within the GLAM sector and analysing the weaknesses in current evaluation models, they critique Sara Selwood and Simon Tanner’s models of impact assessment before arguing that it is oversimplifying to draw a distinction between research-based digital resources created by academics and the digitisation of collections and resources by GLAM institutions. The authors revisit the case studies assessed by the UK’s Research Excellence Framework, highlighting how the text-mining methods used have limitations. They conclude that even though digital humanities can have an impact on numerous sectors, the impact itself is not easy to measure— one of the main issues being the question of continued funding for digital resources post-publication, which must be considered by.
7. The Evaluation and Peer Review of Digital Scholarship in the Humanities
Authors: Nyhan Julianne
Published: January 2020

In this chapter, Nyhan explores the history of evaluative assessment methods for digital scholarship in the humanities. Starting from the origin of humanities computing in 1949, Nyhan surveys recorded conversations of the humanities computing community concerning peer review and evaluation, adopting a broad definition of digital scholarship as including not only digital or digitally-derived scholarship but also scholarship that has been published digitally. Her findings highlight an overall mixed experience of, and attitude towards, peer review and formal evaluation. Not only was the use of computer for research as well as publishing work on a digital platform considered problematic before the 1990s, there were also concerns about the implementation of peer review and how it could be organised. Nyhan views the eventual consensus that emerged on the importance of formal evaluation as having been accelerated by the gradual acceptance of digital publication, digital humanities and institutionalisation itself. Nyhan concludes that the inauspicious reception digital scholarship has received is linked to the ambivalence towards the evaluation of digital scholarship; she suggests that our approaches towards the latter can reveal the evolving disciplinary identity of the digital humanities.
9. Springing the Floor for a Different Kind of Dance
Authors: Edmond Jennifer , Tasovac Toma , Fischer Frank , Romary Laurent
Published: January 2020

Edmond, Fischer, Romary, and Tasovac begin this chapter by exploring what infrastructure means in different contexts before going on to consider ‘digital infrastructure’ as not only a tool that needs to be built but also understood. They examine practices and theories in an attempt to define infrastructure for the arts and humanities in the digital age: firstly, considering infrastructure as knowledge spaces; secondly, considering why the arts and humanities need research infrastructure and; thirdly, establishing why a community approach should be adopted and what baseline requirements should be met. They focus on the case study of DARIA ERIC and its dual hierarchical and marketplace structure to optimise knowledge sharing and in-flow from within its community. They argue that infrastructures today not only represent a different model for supporting knowledge creation but are also developing new models for creating knowledge. They conclude that DARIAH ERIC harnesses the best of two communities — research infrastructures as originally conceived of in the sciences, as well as the arts and humanities research base.
Thunderstorm Trends over Africa
Authors: Harel Maayan , Price Colin
Published: January 2020

Thunderstorms inflict death and damage worldwide due to lightning, heavy rains, hail, and strong winds. While the effect of global warming on future thunderstorm activity is still debatable, this work investigates how thunderstorm activity over Africa may have changed over the last 70 years. Thunderstorm data were obtained from the World Wide Lightning Location Network (WWLLN) and processed to produce thunderstorm clusters. The number and area of clusters in one year (2013) were compared with several climate parameters tied to thunderstorm development, taken from the NCEP–NCAR Reanalysis-1 product (NCEP). The two parameters that correlated best with thunderstorm number were lifted index and specific humidity, with correlations of −0.795 and 0.779, respectively. These parameters were used to construct an empirical model that predicts the number and area of thunderstorm clusters over Africa on a particular day, month, or year. The empirical model was run from 1948 to 2016, providing a reconstruction of long-term thunderstorm activity over Africa. The time series was compared to temperature data from NCEP, and showed that the number of clusters increased with rising surface temperature on annual and decadal time scales, particularly since the mid-1990s. On an annual time scale, the number and area of thunderstorm clusters exhibited a highly sensitive relationship with surface temperature, with a ~40% increase in the number of thunderstorm clusters for every 1-K rise in temperature over Africa. The correlation coefficients with surface temperature were 0.745 and 0.743 for cluster number and area, respectively, indicating that surface temperature explains ~55% of the variability in interannual thunderstorm clusters over the past 70 years.