bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of 2 Neonicotinoid Insecticides on Blood Cell Profiles and Corticosterone Concentrations of Wood Frogs (Lithobates sylvaticus)
Authors: Gavel Melody J. , Richardson Sarah D. , Dalton Rebecca L. , Soos Catherine , Ashby Brendan , McPhee Landon , Forbes Mark R. , Robinson Stacey A.
Published: March 2019

Neonicotinoids are widely used insecticides that are detectable in agricultural waterways. These insecticides are of concern due to their potential impacts on nontarget organisms. Pesticides can affect development of amphibians and suppress the immune system, which could impact disease susceptibility and tolerance. No previous studies on amphibians have examined the effects of these insecticides on differential blood cell proportions or concentrations of corticosterone (a general stress hormone). We investigated the effects of chronic exposure to 2 neonicotinoids, thiamethoxam and clothianidin, on immunometrics of wood frogs (Lithobates sylvaticus). Frogs were exposed to single, chronic treatments of 2.5 or 250 µg/L of clothianidin or thiamethoxam for 7 wk from Gosner stages 25 to 46. The juvenile frogs were then maintained for 3 wk post metamorphosis without exposure to neonicotinoids. We measured water-borne corticosterone twice: at 6 d and 8 wk after exposure in larval and juvenile frogs, respectively. We assessed differential blood cell profiles from juvenile frogs. Corticosterone was significantly lower in tadpoles exposed to 250 µg/L of thiamethoxam compared with other tadpole treatments, but no significant differences in corticosterone concentrations were found in treatments using juvenile frogs. Anemia was detected in all treatments compared with controls with the exception of tadpoles exposed to 2.5 µg/L of clothianidin. Neutrophil-to-leukocyte and neutrophil-to-lymphocyte ratios were elevated in frogs exposed to 250 µg/L of thiamethoxam. Collectively, these results indicate that chronic exposure to neonicotinoids has varied impacts on blood cell profiles and corticosterone concentrations of developing wood frogs, which are indicative of stress. Future studies should investigate whether exposure to neonicotinoids increases susceptibility to infection by parasites in both larval and adult wood frogs. Environ Toxicol Chem 2019;38:1273–1284. © 2019 Crown in the right of Canada. Published by Wiley Periodicals Inc. on behalf of SETAC.
Enhancing the security of a cloud‐based smart grid AMI network by leveraging on the features of quantum key distribution
Authors: Diovu R.C. , Agee J.T.
Published: March 2019

In the last decade, there have been many research proposals on the potentials of incorporating cloud computing technology to the electrical power grid as it evolves rapidly to the smart grid. The advanced metering infrastructure (AMI) is one domain of the smart grid that can be greatly impacted by cloud computing technology with regards to an improved capability for data storage and computations, which will be a serious burden to the AMI in an evolved smart grid environment. In our previous study, a cloud‐based OpenFlow firewall for the mitigation of distributed denial‐of‐service attacks in a smart grid AMI (SG AMI) was proposed. In that study, it was clearly demonstrated that cloud computing technology, in addition to improving the storage and computation capability of the AMI, can also be leveraged on to enhance the security of the SG AMI in an attack scenario. In this study, we propose a cloud‐based SG AMI system model utilizing quantum key distribution (QKD) cryptography for enhancing the security of a cloud‐based SG AMI. The proposed model has been designed to complement the security features of the previously designed OpenFlow firewall to guarantee not only the availability but also the confidentiality and integrity of data traversing the AMI network and beyond. The analysis on computation and communication costs shows that the protocols utilized in the proposed system model are lightweight protocols. In addition, results from the simulation of the QKD (BB84) protocol show that QKD can be leveraged on to provide information theoretic security for the cloud‐based SG AMI.
A rate‐maximizing spectrum sharing algorithm for cognitive radio networks with generic resource constraints
Authors: Halloush Rami , Halloush Mohammed , Almalkawi Islam , Musa Ahmed , Bany Salameh Haythem
Published: March 2019

Algorithms for spectrum sharing over resource‐limited cognitive radio networks are often designed to solve specific problems. This means that a certain algorithm deals specifically with a certain limited resource, and is not suitable for other resources. This limitation violates the software‐defined networking philosophy, where a scheme has to be reprogrammable to cope with different limited resources that can dynamically arise depending on network conditions. In this work, we investigate the problem of spectrum sharing in resource‐limited cognitive radio networks. Specifically, we introduce a novel spectrum sharing algorithm that is compatible with software‐defined networks, in the sense that it can be reprogrammed to support multiple constraints on resources of different types. A main feature of the proposed scheme is that computations could be distributed across multiple processing units to reduce computational complexity on each unit. In addition, the proposed algorithm is equipped with a fairness scheme. Simulation results demonstrate the efficacy of the proposed scheme.
Prevalence and severity of symptoms suggestive of gastroparesis in prodromal dementia with Lewy bodies
Authors: Durcan Rory , Donaghy Paul C. , Barnett Nicky A. , Olsen Kirsty , Yarnall Alison J. , Taylor John‐Paul , McKeith Ian , O'Brien John T. , Thomas Alan J.
Published: March 2019

Introduction

Lewy body disease is postulated, by the Braak model, to originate in the enteric nervous system, before spreading to the central nervous system. Therefore, a high prevalence of gastroparesis symptoms would be expected in prodromal dementia with Lewy bodies (DLB) and be highest in those with a dopaminergic deficit on imaging. The aim of this study was to explore whether gastroparesis symptoms are an early diagnostic marker of prodromal DLB and explore the relationship between symptoms and dopaminergic imaging findings on FP‐CIT SPECT.

Methods

We recruited 75 patients over 60 with mild cognitive impairment (MCI), 48 with MCI with suspected Lewy body disease (MCI‐LB) and 27 with MCI with suspected Alzheimer's disease (MCI‐AD). All patients completed the Gastroparesis Cardinal Symptom Index (GSCI) questionnaire and also underwent FP‐CIT [123I‐N‐fluoropropyl‐2β‐carbomethoxy‐3β‐(4‐iodophenyl)] dopaminergic imaging.

Results

At least one symptom suggestive of gastroparesis was reported in 48% (n = 23) MCI‐LB vs 37% MCI‐AD (n = 10) (P = 0.36). Rates of definite symptoms of gastroparesis, as defined by a GCSI total score ≥ 1.90, were rare and rates in MCI‐LB were not different from MCI‐AD (6% vs 0%, p = 0.55). After adjusting for gender differences between groups, no difference in gastroparesis symptom prevalence (2.27 vs 0.81 P = 0.05) or severity score (0.62 vs 0.28, p = 0.28) was noted between normally and abnormally visually rated FP‐CIT SPECT scans.

Conclusion

The GCSI is not a useful tool for differentiating MCI‐LB from MCI‐AD. A low rate of definite gastroparesis was detected in prodromal DLB. No association was found between gastroparesis symptoms and FP‐CIT SPECT findings.
Predicting admission to long‐term care and mortality among community‐based, dependent older people in Ireland
Authors: Aspell Niamh , O'Sullivan Maria , O'Shea Eamon , Irving Kate , Duffy Chloe , Gorman Rebecca , Warters Austin
Published: March 2019

Objective

To identify factors that predict admission to long‐term care (LTC) and mortality among community‐based, dependent older people in Ireland, who were in receipt of formal home support.

Methods

An audit was conducted of all community‐dwelling older adults receiving government funded home support during 2017 in the Dublin North Central, Health Service Executive administrative area. Data were extracted from the Common Summary Assessment Report (CSAR), a mandatory form used in the provision of home support. Multiple logistic regression analysis was used to examine the factors associated with admission to LTC and mortality, with the results presented as odds ratios (OR) and 95% confidence intervals.

Results

The audit comprised 1597 community‐dwelling older adults with a mean age of 83.3 (SD: 7.2) years. The prevalence of transition to LTC and mortality was 8% and 9%, respectively, during the 12‐month period. Factors significantly associated with admission to LTC were “cognitive dysfunction” [OR 2.10 (1.41‐3.14), P < .001] and the intensity of home support [OR 1.05 (1.01‐1.06), P < .003], as measured by weekly formal care hours. Physical dependency and advanced age (aged 95 years +) were significantly associated with mortality in this population (P < .001).

Conclusion

“Cognitive dysfunction” and intensity of formal home support were associated with transition to LTC, while physical dependency and advanced age were associated with mortality. Investment in personalised, cognitive‐specific, services and supports are necessary to keep people with dementia and related cognitive impairments living at home for longer.
A comprehensive modelling framework to forecast the demand for all hospital services
Authors: Ordu Muhammed , Demir Eren , Tofallis Chris
Published: March 2019

Background

Because of increasing demand, hospitals in England are currently under intense pressure resulting in shortages of beds, nurses, clinicians, and equipment. To be able to effectively cope with this demand, the management needs to accurately find out how many patients are expected to use their services in the future. This applies not just to one service but for all hospital services.

Purpose

A forecasting modelling framework is developed for all hospital's acute services, including all specialties within outpatient and inpatient settings and the accident and emergency (A&E) department. The objective is to support the management to better deal with demand and plan ahead effectively.

Methodology/Approach

Having established a theoretical framework, we used the national episodes statistics dataset to systematically capture demand for all specialties. Three popular forecasting methodologies, namely, autoregressive integrated moving average (ARIMA), exponential smoothing, and multiple linear regression were used. A fourth technique known as the seasonal and trend decomposition using loess function (STLF) was applied for the first time within the context of health‐care forecasting.

Results

According to goodness of fit and forecast accuracy measures, 64 best forecasting models and periods (daily, weekly, or monthly forecasts) were selected out of 760 developed models; ie, demand was forecasted for 38 outpatient specialties (first referrals and follow‐ups), 25 inpatient specialties (elective and non‐elective admissions), and for A&E.

Conclusion

This study has confirmed that the best demand estimates arise from different forecasting methods and forecasting periods (ie, one size does not fit all). Despite the fact that the STLF method was applied for the first time, it outperformed traditional time series forecasting methods (ie, ARIMA and exponential smoothing) for a number of specialties.

Practise implications

Knowing the peaks and troughs of demand for an entire hospital will enable the management to (a) effectively plan ahead; (b) ensure necessary resources are in place (eg, beds and staff); (c) better manage budgets, ensuring enough cash is available; and (d) reduce risk.
Response of the Native Springtail Parisotoma insularis to Diesel Fuel–Contaminated Soils Under Field-Realistic Exposure Conditions at Subantarctic Macquarie Island
Authors: Mooney Thomas J , Wasley Jane , Raymond Ben , Andrew Nigel R , King Catherine K
Published: March 2019

A number of sites contaminated by petroleum hydrocarbons from past fuel spills are currently undergoing remediation on subantarctic Macquarie Island (under the jurisdiction of Tasmania, Australia). To assess the environmental risks these spills pose, and to establish remediation targets and guideline values, toxicity data for a range of native biota are required. The availability of data for local biota is limited, especially for soil invertebrates, which are critical to soil health. To examine the response of naturally occurring soil invertebrate communities to fuel contamination, intact soil cores from a range of soil types were collected along an organic carbon (OC) gradient. Organic carbon was factored into the toxicity assessment due to its toxicity-modifying potential. Soil cores were spiked with Special Antarctic Blend diesel, to mimic a fresh fuel spill at the soil surface. Springtails were the most abundant taxa, with the community heavily dominated by the native species Parisotoma insularis. This species was sensitive to fuel contamination (EC20 48 mg/kg, CI 5–188), irrespective of soil organic content. This study is the first to derive critical effect concentrations (CECs) for a subantarctic springtail species and provides important data that will be incorporated into future derivation of site-specific soil quality guideline values for fuels for Macquarie Island soils and the broader subantarctic region. Integr Environ Assess Manag 2019;15:565–574. © 2019 SETAC
The role of stakeholders on rejection of bankruptcy applications in the case of “poverty” of the estate: A Polish case study
Authors: Prusak Błażej , Morawska Sylwia , Kuczewska Joanna , Banasik Przemysław
Published: March 2019

The aim of this article is to supplement the Law and Economics area of science with regard to the scope of the ex ante effectiveness of bankruptcy law using the example of Poland. Bankruptcy law is effective in the ex ante stage when it eliminates from the market insolvent entrepreneurs who cannot even afford to cover the costs of bankruptcy proceedings. In these cases, the bankruptcy court should dismiss the petition for bankruptcy because of “poverty” of the insolvent estate. As a result, the insolvent debtor should be liquidated and deleted from the register of companies. This paper investigates entities whose bankruptcy petition has been rejected due to “poverty” of the insolvent estate. The study shows that, after the filing has been dismissed, the majority of these entities are not liquidated. To determine who is responsible for this state of affairs, the article identifies the stakeholders at the time that applications are filed for bankruptcy proceedings and also after the bankruptcy petition has been rejected. The article highlights stakeholders' diverging interests, strengths, and weaknesses to assess their potential impact on bankruptcy procedures that should be dismissed due to “poverty” of the insolvent estate.
Value of increased nuchal translucency in the era of noninvasive prenatal testing with cell‐free DNA
Authors: Holzer Iris , Husslein Peter W. , Bettelheim Dieter , Scheidl Julia , Kiss Herbert , Farr Alex
Published: March 2019

Objective

To assess the value of increased nuchal translucency (NT) at first‐trimester screening (FTS) despite the superiority of noninvasive prenatal testing with cell‐free DNA (cfDNA) for the detection of fetal aneuploidies.

Methods

Retrospective analysis of all FTS data from 2005 to 2015 in our department. Only cases with increased NT and euploid karyotype were considered eligible for inclusion. Abnormal findings, diagnostic work‐up, and perinatal outcomes were assessed.

Results

Of 18 084 FTS results, 460 (2.5%) showed increased fetal NT, of which 242 (52.6%) underwent invasive karyotyping and 179 (74.0%) had an aneuploidy. Of the remaining 63 cases, 61 (96.8%) showed an additional sonographic finding at FTS and25 (78.1%) had a major anomaly at the second trimester organ scan. The outcome was termination of pregnancy in 28 (44.4%) cases, fetal demise in 5 (7.9%), delivery of an infant with malformation in 21 (33.3%), and delivery of a healthy infant in 7 (11.1%) cases.

Conclusion

All cases with increased NT would have been detected by cfDNA or by a major sonographic anomaly not later than the second trimester. Routine use of cfDNA, a basic sonogram, and an organ scan could reduce unnecessary work‐up and anxiety.
d‐amino acid modification protects N‐Acetyl‐seryl‐aspartyl‐lysyl‐proline from physiological hydroxylation and increases its antifibrotic effects on hepatic fibrosis
Authors: Zhang Xutao , Zhou Jiming , Zhu Yichao , He Lei , Pang Zhijun , Wang Zhaowei , Xu Chuanyang , Zhang Cun , Hao Qiang , Li Weina , Zhang Wei , Zhang Yingqi , Li Meng
Published: March 2019

N‐Acetyl‐seryl‐aspartyl‐lysyl‐proline (Ac‐SDKP) is a critical negative regulator of fibrosis development in the liver. However, its extremely short half‐life in vivo greatly compromises its potential applications. Here, we report an Ac‐SDKP analog peptide with d‐amino acid replacement (Ac‐SDDKDP). The stability of Ac‐SDDKDP and its prevention of liver fibrosis were investigated in vitro and in vivo. The stabilities of Ac‐SDKP and Ac‐SDDKDP exposed to angiotensin‐1‐converting enzyme (ACE) and their half‐lives in rats and human sera were determined by high‐performance liquid chromatography. The inhibitory effects of Ac‐SDKP and Ac‐SDDKDP on the proliferation and activation of hepatic stellate cells (HSC‐T6) were evaluated using the Cell Counting Kit‐8, Western blotting, reverse transcription quantitative polymerase chain reaction, and immunofluorescence assays. Finally, the protective effects of Ac‐SDKP and Ac‐SDDKDP on carbon tetrachloride (CCl4)‐induced liver fibrosis in rats were compared. d‐Amino acid replacement significantly enhanced the stability of the peptide to ACE and prolonged the half‐life of Ac‐SDKP in rats and human sera. The Ac‐SDKP‐mediated inhibition of HSC‐T6 cell proliferation was well preserved, and Ac‐SDDKDP exerted inhibitory effects comparable to Ac‐SDKP on α‐smooth muscle actin (α‐SMA), collagen I and III expression, and phosphorylated‐Smad‐2 expression. After intraperitoneal (i.p.) administration, Ac‐SDDKDP exhibited significantly greater protection than Ac‐SDKP against CCl4‐induced liver fibrosis in rats. The serum alanine aminotransferase, aspartate aminotransferase, albumin, and total protein levels of the Ac‐SDDKDP‐treated rats were significantly lower than those of the Ac‐SDKP‐treated rats. α‐SMA, CD45, and collagen I and III expression, as well as Smad‐2 phosphorylation were significantly attenuated in the livers of the Ac‐SDDKDP‐treated rats compared to those of the Ac‐SDKP‐treated rats. Furthermore, we showed that the Ac‐SDDKDP concentration in the rat liver increased to a physiological level of 60 min after i.p. administration, although i.p. administration of Ac‐SDKP failed to enhance the peptide concentration in the rat liver. Our findings indicate that d‐amino acid replacement is a simple and effective method to enhance the stability of Ac‐SDKP. Ac‐SDDKDP represents potential application of Ac‐SDKP in fibrosis treatment and provides a new potential treatment strategy for liver fibrosis. © 2019 IUBMB Life, 71(9):1302–1312, 2019
Morphology of the mandibular gland of the ant Paraponera clavata (Hymenoptera: Paraponerinae)
Authors: Andrade Thito Thomston , Gonçalves Wagner Gonzaga , Serrão José Eduardo , Martins Luiza Carla Barbosa
Published: March 2019

The ant Paraponera clavata (Fabricius, 1775) is the only extant species of Paraponerinae and is widely distributed in Brazilian forests. Aspects of its biology are documented extensively in the literature; however, knowledge of P. clavata internal morphology, specifically of exocrine glands, is restricted to the venom apparatus. The objective of this study was to describe the mandibular gland morphology of P. clavata workers. The mandibular gland is composed of a reservoir connected to a cluster of Type III secretory cells with cytoplasm rich in mitochondria and lipid droplets, similar to that of other ants. Notably, the glandular secretion is rich in protein and has a solid aspect. This is the first morphological description of the mandibular gland of P. clavata.

Research Highlights

This study presents the morphological description of the mandibular gland of Paraponera clavata (Hymenoptera: Paraponerinae). Singular characteristics of the gland are described: the glandular secretion is rich in protein and has a solid aspect.
Improved biosafety of a lentiviral vector by reducing cellular gene activation
Authors: Song Li , He Jiaping , Gao Yue , Fang Yudan , Zhang Liping , Wang Juan , Sun Fengqiang , Zhang Fan , Zeng Yitao , Zeng Fanyi , Zhang Jingzhi
Published: March 2019

Background

Lentiviral vectors (LVs) have enhancer activity and/or transcriptional read‐through (EATRT) properties that can lead to the activation of adjacent genes. Consequently, patients may be at increased risk for adverse effects if such vectors are used clinically.

Methods

In the present study, we assessed the abilities of different “pro‐LV”‐like constructs with respect to decreasing its EATRT, including the “pro‐LV” vector bearing a chimeric ΔLTR of the human foamy virus R‐U5 region replaced by that of an LV (HF).

Results

By analyzing the EATRT of “pro‐LV” constructs transfected in 293T cells, we observed that the inclusion of the first 400 bp of the chicken β‐globin locus HS4 insulator core sequence oriented in the reverse direction (C–) combined with two copies of the simian virus 40 upstream‐sequence element (U) at the ΔU3 of ΔLTR region of “pro‐LV” tended to shield the adjacent genomic sequences, such that the EATRT rate was lower than when either of the C– or U was included in the “pro‐LV”. Moreover, upon transduction, the pro‐HF appears to reduce the EATRT rate in the chromosomes of 293T (by 80%) and human peripheral blood mononuclear cells (PBMCs) (by 75%) compared to when pro‐LV C–U was included (with a 60% and 89% reduction in 293T and PBMCs, respectively). The HF construct had a significant reduction of viral biological titer compared tiowhen the pro‐LV C–U was used in 293T cells.

Conclusions

The results of the present study provide an important basis for the clinical applicability of LVs in gene and cell therapy.
Dempster's descendants—The core of the development of mass spectrometry
Authors: Nier Keith A.
Published: March 2019

The work of Arthur Dempster generally has been considered significant but of less importance in the growth of mass spectrometry than that of Francis Aston, and as essentially limited to the pre‐WW II era. The development of mass spectrometry, however, as distinct from nuclear science, was shaped far more by Dempster than by Aston. This influence is seen in several aspects of instrument design and practice, and it has continued into the 21st century.
Modeling, simulation, and fabrication of electron optic system for application on 105 GHz high‐power gyrotron
Authors: Guo Guo , Niu Xinjian , Liu Yinghui , Wang Hui , Liu Jianwei , Wei Yanyu
Published: March 2019

This paper introduces the modeling, simulation, and fabrication of the electron optic system (EOS) for high‐power 105 GHz gyrotron, which includes single anode magnetron injection electron gun, magnetic system, and the collector. Based on the specific research project and the theory of electron optics, the structure with detailed parameters is modeled and simulated by using two different electromagnetic analysis softwares. The simulation results show that the electron beam velocity ratio is around 1.3, and the electron landing regions from the two softwares are almost agreed with each other. At last, the components of the EOS are fabricated for the next assembling step.
Children's Creative Intentions: Where do the Ideas for their Drawings Come from?
Authors: Rose Sarah E. , Jolley Richard P.
Published: March 2019

The process of drawing is a creative endeavor, often beginning with ideas of what to draw. This exploratory study aimed to explore these creative intentions of pupils from mainstream schools (tending to focus on observational, imaginative, and expressive drawing), and from Steiner schools (tending to focus on imagination and expression). Fifty‐seven children (age 6–16 years) drew a single drawing at the request of the researcher. Before and after drawing, children completed a semi‐structured interview about the content of their drawing. This interview was first analyzed qualitatively using thematic analysis to describe where children got the ideas for their drawings from. Four key themes were identified: (a) content from immediate surroundings, (b) content from memory, (c) representational content with element of imagination added, and (d) intention to express a mood or message. Content analysis was then used to quantify the interview responses and compare them between the school types. This indicated no difference in the frequency that mainstream and Steiner pupils referred to ideas based on real‐world referents or imagination. However, Steiner pupils talked more about expressive ideas. The results suggest that children use a wide range of sources when generating ideas of what to draw, including their educational experiences.
Utilization of Intensive Care Unit Nutrition Consultation Is Associated With Reduced Mortality
Authors: Tignanelli Christopher J. , Sheetz Kyle H. , Petersen Ashley , Park Pauline K. , Napolitano Lena M. , Cooke Colin R. , Cherry‐Bukowiec Jill R.
Published: March 2019

Background

The aim of this project was to investigate the prevalence of nutrition consultation (NC) in U.S. intensive care units (ICUs) and to examine its association with patient outcomes.

Methods

Data from the Healthcare Cost and Utilization Project's state inpatient databases was utilized from 2010 – 2014. A multilevel logistic regression model was used to evaluate the relationship between NC and clinical outcomes.

Results

Institutional ICU NC rates varied significantly (mean: 14%, range: 0.1%–73%). Significant variation among underlying disease processes was identified, with burn patients having the highest consult rate (P < 0.001, mean: 6%, range: 2%–25%). ICU patients who received NC had significantly lower in‐hospital mortality (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.48–0.74, P < 0.001), as did the subset with malnutrition (OR 0.72, 95% CI 0.53–0.99, P = 0.047) and the subset with concomitant physical therapy consultation (OR 0.53, 95% CI 0.38–0.74, P < 0.001). NC was associated with significantly lower rates of intubation, pulmonary failure, pneumonia, and gastrointestinal bleeding (P < 0.05). Furthermore, patients who received NC were more likely to receive enteral or parenteral nutrition (ENPN) (OR 1.8, 95% CI 1.4–2.3, P < 0.001). Patients who received follow‐up NC were even more likely to receive ENPN (OR 3.0, 95% CI 2.1–4.2, P < 0.001).

Conclusions

Rates of NC were low in critically ill patients. This study suggests that increased utilization of NC in critically ill patients may be associated with improved clinical outcomes.
Environmental changes in the north‐east Sunda region over the last 40 000 years
Authors: Luo Chuanxiu , Haberle Simon , Zheng Zhuo , Xiang Rong , Chen Chixin , Lin Gang , Sazal Kumar
Published: March 2019

Pollen and spores from 110 samples from sediment core NS07‐25 from the Nansha Trough in the South China Sea (SCS) were analysed with a particular focus on reconstructing vegetation and climate change and identifying the sources of palynomorphs on the Sunda Shelf during the Last Glacial Maximum (LGM). Palynomorph sources were identified using the Near Analysis function in ArcGIS with 62 data points of the pollen in surface sediment samples from the southern SCS. The results showed that during the LGM, pollen and spores came from the exposed Sundaland, whereas before and after the LGM, pollen and spores came from Borneo. Changes in vegetation and climate were inferred from pollen percentages, concentrations and influx and indicated that during the LGM, ferns, lowland rainforests, upper montane rainforests and lower montane forests were present on the north‐east part of the exposed Sunda Shelf but not over the entire Sunda Shelf. Climate during the LGM was cooler than it is today, but humidity was not substantially lower. During the LGM, grasses and shrubs did not cover the southern continental shelf of the SCS, possibly because they were located in the Intertropical Convergence Zone.
Measuring the health utility of chronic eustachian tube dysfunction
Authors: Teklu Meron , Kulich Marta , Micco Alan G. , Brindisi Kristin , Ferski Andrew , Niekamp Katherine , Price Caroline P.E. , Tan Bruce K.
Published: March 2019

Objective

To assess the health utility of chronic Eustachian tube dysfunction (ETD).

Methods

This is a prospective study of 53 patients with chronic ETD recruited from a tertiary clinic from April 2017 to July 2018. The 7‐Item Eustachian Tube Dysfunction Questionnaire (ETDQ‐7) was administered, and health utility was evaluated using the EuroQol‐5 Dimensions‐3 Level Instrument (EQ‐5D‐3L), the visual analogue scale (VAS), time tradeoff (TTO), and standard gamble (SG). Participants were grouped into medical or procedural management groups. One‐week follow‐up included repeated health utility measures and ETDQ‐7.

Results

Fifty‐three patients were included in the final analysis. Of those, 34 were managed medically, and 19 received myringotomies ± PE tubes. The mean baseline ETDQ‐7 was 4.26 ± 1.31; whereas health utility measures were different depending on the method utilized: EQ‐5D‐3L 0.90 ± 0.11; VAS 0.76 ± 0.21; TTO 0.85 ± 0.23; and SG 0.94 ± 0.11 (P < .001). There was a significant change in ETDQ‐7 (P = .001) and TTO (P = .011) scores posttreatment. On the ETDQ‐7, question 2 (pain in the ears) was significantly associated with VAS (P = .032), and question 4 (ear symptoms during a cold or sinusitis) was significantly associated with TTO (P = .006).

Conclusion

Chronic ETD has a significant burden on quality of life, with a health utility similar to gastroesophageal reflux disease and moderate asthma. Although treatment‐related changes are measurable using disease‐specific quality‐of‐life measures, only TTO was significantly changed after treatment. Health utility seemed to depend on the method of measurement but provided a benchmark for evaluating cost‐effectiveness of innovations to manage ETD.

Level of Evidence

2 Laryngoscope, 130:E39–E44, 2020
A roadmap for implementation of patient‐centered digital outcome measures in Parkinson's disease obtained using mobile health technologies
Authors: Espay Alberto J. , Hausdorff Jeffrey M. , Sánchez‐Ferro Álvaro , Klucken Jochen , Merola Aristide , Bonato Paolo , Paul Serene S. , Horak Fay B. , Vizcarra Joaquin A. , Mestre Tiago A. , Reilmann Ralf , Nieuwboer Alice , Dorsey E. Ray , Rochester Lynn , Bloem Bastiaan R. , Maetzler Walter ,   on behalf of the Movement Disorder Society Task Force on Technology
Published: March 2019

Obtaining reliable longitudinal information about everyday functioning from individuals with Parkinson's disease (PD) in natural environments is critical for clinical care and research. Despite advances in mobile health technologies, the implementation of digital outcome measures is hindered by a lack of consensus on the type and scope of measures, the most appropriate approach for data capture (eg, in clinic or at home), and the extraction of timely information that meets the needs of patients, clinicians, caregivers, and health care regulators. The Movement Disorder Society Task Force on Technology proposes the following objectives to facilitate the adoption of mobile health technologies: (1) identification of patient‐centered and clinically relevant digital outcomes; (2) selection criteria for device combinations that offer an acceptable benefit‐to‐burden ratio to patients and that deliver reliable, clinically relevant insights; (3) development of an accessible, scalable, and secure platform for data integration and data analytics; and (4) agreement on a pathway for approval by regulators, adoption into e‐health systems and implementation by health care organizations. We have developed a tentative roadmap that addresses these needs by providing the following deliverables: (1) results and interpretation of an online survey to define patient‐relevant endpoints, (2) agreement on the selection criteria for use of device combinations, (3) an example of an open‐source platform for integrating mobile health technology output, and (4) recommendations for assessing readiness for deployment of promising devices and algorithms suitable for regulatory approval. This concrete implementation guidance, harmonizing the collaborative endeavor among stakeholders, can improve assessments of individuals with PD, tailor symptomatic therapy, and enhance health care outcomes. © 2019 International Parkinson and Movement Disorder Society
Calcaneal reconstruction after total calcanectomy with iliac crest free flap
Authors: Innocenti Marco , Lucattelli Elena , Daolio Primo Andrea , Bastoni Stefano , Marini Eleonora , Scoccianti Guido , Menichini Giulio
Published: March 2019

Introduction

Calcaneal tumors being a rare occurrence, surgical options and outcomes are not well‐known. Extensive defects following wide resection, especially in weight‐bearing areas, still remain a challenge and different reconstructive techniques have been proposed. The aim of this report was to analyze the clinical and functional long‐term outcomes of heel reconstruction using an iliac crest free flap.

Patients and methods

Four patients who underwent calcaneal reconstruction between 1999 and 2012 were included. Two were females and mean age was 27 years, ranging 18–42 years. Each patient underwent total calcanectomy, for two osteoblastomas, one osteosarcoma, and one Ewing's sarcoma. An iliac crest flap was harvested and shaped to fit the residual space. After the articular cartilage at recipient site was debrided, the flap was fixed to the talus and the cuboid.

Results

The average size of the flaps was 2 x 7 x 5 cm. Postoperatively wound dehiscence, screw breaking, and graft fracture healed conservatively. All the arthrodesis healed successfully and no donor site complication occurred. At an average follow‐up of 13 years (range 6–19 years) any patient claimed pain, evident limp or limitation of daily activities. Computerized pedobarographic examination and gait analysis revealed a satisfactory result and an acceptable weight‐bearing area in the reconstructed limb in each patient.

Conclusions

Calcaneal reconstruction with iliac crest free flap is likely to provide good chances of a long‐lasting result, especially in young patients. Particularly, it provides the possibility to adequately shape the graft to fit the bone loss while using the crest as the weight‐bearing surface.
Efficient energy‐preserving scheme of the three‐coupled nonlinear Schrödinger equation
Authors: Kong Linghua , Wei Ping , Hong Yuqi , Zhang Peng , Wang Ping
Published: March 2019

An energy‐preserving scheme is proposed for the three‐coupled nonlinear Schrödinger (T‐CNLS) equation. The T‐CNLS equation is rewritten into the classical Hamiltonian form. Then the spatial variable is discretized by using high‐order compact method to convert it into a finite‐dimensional Hamiltonian system. Next, a second‐order averaged vector field (AVF) method is employed in time which results in an energy‐preserving scheme. Some theoretical results such as convergence are investigated. In addition, it provides some numerical examples to illustrate the robustness and reliability of the theoretical results. It also explores the role of the parameters in the model and initial condition on the wave propagation.
Sensitization of Human Liver Cells Toward Fas‐Mediated Apoptosis by the Metabolically Activated Pyrrolizidine Alkaloid Lasiocarpine
Authors: Ebmeyer Johanna , Franz Luise , Lim Ramonique , Niemann Birgit , Glatt Hansruedi , Braeuning Albert , Lampen Alfonso , Hessel‐Pras Stefanie
Published: March 2019

Scope

Pyrrolizidine alkaloids (PAs) are common phytotoxins. Intoxication can lead to liver damage. Previous studies showed PA‐induced apoptosis in liver cells. However, the exact role of the extrinsic apoptotic pathway has not been investigated yet. This study aims to analyze whether the PA representative lasiocarpine sensitizes human liver cells toward extrinsic Fas‐mediated apoptosis.

Methods and results

HepG2 cells with limited xenobiotic metabolic activity are used to analyze metabolism‐dependent effects. External in vitro metabolism is simulated using rat or human liver enzymes. Additionally, metabolically competent HepaRG cells are used to confirm the observed effects in a human liver cell system with internal xenobiotic metabolism. Metabolized lasiocarpine decreases cell viability and induces Fas receptor gene expression in both cell lines. Increased Fas receptor protein expression on the cell surface is demonstrated by flow cytometry. The addition of a Fas ligand–simulating antibody induces apoptosis. Induction of extrinsic Fas‐mediated apoptosis is verified by Western blotting for cleaved caspase 8, the initiator caspase of extrinsic apoptosis. All effects are dependent on lasiocarpine metabolism.

Conclusion

The results demonstrate that metabolically metabolized lasiocarpine sensitizes human liver cells toward Fas‐mediated apoptosis. They broaden our knowledge on the hepatotoxic molecular mechanisms of PA as widely distributed food contaminants.
Nurses’ experiences of health concerns, teamwork, leadership and knowledge transfer during an Ebola outbreak in West Africa
Authors: Holmgren Jessica , Paillard‐Borg Stéphanie , Saaristo Panu , von Strauss Eva
Published: March 2019

Aim

To describe nurses’ experiences of health concerns, teamwork, leadership and management and knowledge transfer during an Ebola outbreak in West Africa.

Design

The study has a qualitative descriptive design.

Methods

The 44 nurses who had worked in an Ebola Treatment Centre in Kenema in 2014 and 2015 were invited by email to respond to a questionnaire. The qualitative, open‐ended answers were analysed using a thematic analysis. Data have been coded systematically, with the identification of semantic patterns presented in four themes.

Results

The themes are as follows: personal health management—a way to feel safe and secure for delegates and affiliates; pre‐deployment training—crucial for a joint value base and future collaboration; the importance of a professional democratic approach and being a good role model; and the value of timely in‐depth knowledge transfer of experienced former delegates.
Safety and Effectiveness of Longer‐Term Phentermine Use: Clinical Outcomes from an Electronic Health Record Cohort
Authors: Lewis Kristina H. , Fischer Heidi , Ard Jamy , Barton Lee , Bessesen Daniel H. , Daley Matthew F. , Desai Jay , Fitzpatrick Stephanie L. , Horberg Michael , Koebnick Corinna , Oshiro Caryn , Yamamoto Ayae , Young Deborah R. , Arterburn David E.
Published: March 2019

Objective

The aim of this work was to study weight loss and risk of cardiovascular disease (CVD) or death associated with longer‐term phentermine use.

Methods

Using electronic health record data, 13,972 adults were identified with a first phentermine fill in 2010 to 2015, creating exposure categories according to a patient’s duration of use (referent: ≤ 3 months). Multivariable linear models were used to compare percent weight loss across categories at 6, 12, and 24 months, and Cox proportional hazards models were used to compare risk of composite CVD or death, up to 3 years after starting phentermine.

Results

The cohort was 84% female and 45% white, with a mean (SD) baseline age 43.5 (10.7) years and BMI of 37.8 (7.2) kg/m2. In multivariable models, longer‐term users of phentermine experienced more weight loss; patients using continuously for > 12 months lost 7.4% more than the referent group at 24 months (P < 0.001). The composite CVD or death outcome was rare (0.3%, 41 events), with no significant difference in hazard ratios between groups.

Conclusions

Greater weight loss without increased risk of incident CVD or death was observed in patients using phentermine monotherapy for longer than 3 months. Despite the limitations of the observational design, this study supports the effectiveness and safety of longer‐term phentermine use for low‐risk individuals.
Capped antithrombin III dosing is cost effective in the management of asparaginase‐associated thrombosis
Authors: Young Jennifer , Sawyer Jaclyn , Jenkins Meredith , O'Brien Maureen , Luchtman‐Jones Lori , Breese Erin H.
Published: March 2019

Asparaginase therapy induces a transient antithrombin III (ATIII) deficiency, which contributes to the risk of asparaginase‐induced thrombosis. At Cincinnati Children's Hospital Medical Center, management of asparaginase‐induced thrombosis includes ATIII supplementation during therapeutic anticoagulation with enoxaparin. Due to the expense associated with ATIII, a capped dosing approach for ATIII was evaluated in this population. Peak ATIII levels were obtained following capped doses to evaluate response. In this pilot evaluation, 11 patients received a total of 138 capped doses for a total cost savings of $803 782. This pilot evaluation represents the first reported analysis of capped ATIII dosing in oncology patients.
A novel SAMD9 variant identified in patient with MIRAGE syndrome: Further defining syndromic phenotype and review of previous cases
Authors: Perisa Michael P. , Rose Melissa J. , Varga Elizabeth , Kamboj Manmohan K. , Spencer John D. , Bajwa Rajinder P.S.
Published: March 2019

We present here a case of MIRAGE syndrome due to novel variant (c.2318T>C) in the sterile α motif domain‐containing protein 9 (SAMD9) gene. Previous reports have described the clinical phenotype, which includes myelodysplasia, recurrent infections, restriction of growth and development, adrenal insufficiency, genitourinary abnormalities, and enteropathies, often resulting in fatality within the first few years of life. This report illustrates the variability in phenotype by describing an 11‐year‐old male, diagnosed with MIRAGE at age 9 years when his novel variant was identified through whole exome sequencing. A brief review of previously published cases of MIRAGE syndrome and the genotypic and phenotypic spectrum are presented.
Implications of hepatic dysfunction in Kawasaki disease: Time‐related changes in aspartate aminotransferase, alanine aminotransferase, total bilirubin, and C‐reactive protein levels
Authors: Tomita Yasuhiko , Fukaya Takashi , Yamaura Yasuko , Tsujiguchi Rie , Muratani Haruko , Shimaya Maki
Published: March 2019

Importance

The cause of the hepatic dysfunction that commonly accompanies Kawasaki disease (KD) remains unclear.

Objective

We tried to clarify the cause of the hepatic dysfunction.

Methods

A total of 381 consecutive patients with acute KD, who had undergone inpatient treatment with intravenous immunoglobulin until the 7th day of illness, were divided into a group of 199 patients with an alanine aminotransferase (ALT) level ≥ 40 IU/L on admission (group I), a group of 52 patients with an ALT level ≥ 40 IU/L at some point after admission (group II), and a group of 130 patients with ALT levels consistently < 40 IU/L throughout hospitalization (group III). Aspartate aminotransferase (AST), ALT, total bilirubin (T‐Bil), and C‐reactive protein (CRP) levels were analyzed over time, and time‐courses were compared.

Results

In the initial stage of illness, in group I, AST, ALT, T‐Bil peaked on days 1–3, and AST tended to improve significantly on the 4th day (P < 0.001). T‐Bil improved on day 5 (P < 0.01), and ALT improved significantly on day 6 (P < 0.001). CRP increased every day up to day 6 (P < 0.001). In group II, AST and ALT increased after admission, and thereafter CRP increased, then decreased. The frequency of use of aspirin and aspirin doses did not differ significantly in the three groups.

Interpretation

Recovery from liver dysfunction occurred in the initial stage of illness in group I—within the period of CRP exacerbation, which is an indicator of systemic inflammation.
Modulation of Autonomic Function by Physical Exercise in Patients with Fibromyalgia Syndrome: A Systematic Review
Authors: Andrade Alexandro , Vilarino Guilherme Torres , Serafim Thiago Teixeira , Pereira Júnior Altair Argentino , de Souza Cícero Augusto , Sieczkowska Sofia Mendes
Published: March 2019

Objective

To evaluate the effects of physical exercise on autonomic dysfunction in patients with fibromyalgia syndrome (FM).

Literature Survey and Methodology

A systematic review of experimental studies published until December 2017 that analyzed the effect of physical exercise on autonomic dysfunction in patients with FM was performed using the PubMed, Pedro, Scopus, ScienceDirect, and Web of Science databases.

Synthesis

A total of 1105 articles were identified, 12 of which were included in the final analysis. The most analyzed exercise modalities were aerobic and resistance exercises. Overall, the studies demonstrated that aerobic exercise performed twice a week with moderate to high intensity was effective in reducing autonomic dysfunction by increasing heart rate variability. Resistance training was associated with reduced symptoms of anxiety and depression as well as increased muscle strength; however, it did not reduce autonomic dysfunction in these patients in the short or long term.

Conclusions

Preliminary evidence suggests that aerobic exercise reduces autonomic dysfunction in patients with FM, whereas resistance training reduces psychological symptoms such as anxiety and depression.

Level of Evidence

I
Water structure and mobility in acrylamide copolymer glycohydrogels with galactose and siloxane pendant groups
Authors: Fogel April L. , Ravichandran Ashwin , Mani Sriramvignesh , Upadhyay Bishal , Khare Rajesh , Morgan Sarah E.
Published: March 2019

Glycohydrogels containing 2′‐acrylamidoethyl‐β‐d‐galactopyranoside and varying levels of N,N′ methylene bisacrylamide and 3‐acrylamidopropyltris(trimethylsiloxy)silane were synthesized to determine the effects of crosslinker and amphipathic balance on equilibrium water content (EWC), bound water population, and hydrogen bonding dynamics at the water–polymer interface. Analogous dimethylacrylamide hydrogels were synthesized for comparison with a system containing lower hydrogen bonding propensity. An approach combining experiment (proton nuclear magnetic resonance, thermogravimetric analysis, differential scanning calorimetry, and dynamic vapor sorption analysis) and molecular dynamics simulations was employed to examine the relationship between bulk hydrogel properties, molecular water mobility, and hydrogen bonding characteristics. It was found that copolymer composition (hydrophobic content) and crosslink concentration in high water content glycohydrogels affect EWC, and by extension, structural water population. The organization of water at the polymer interface is greatly impacted by the surrounding environment, where hindered molecular water mobility promotes water–polymer binding and decreases water–water clustering. © 2019 Wiley Periodicals, Inc. J. Polym. Sci., Part B: Polym. Phys. 2019, 57, 584–597
Explosive Emulsion Characterisation using Nuclear Magnetic Resonance
Authors: Hayward Nathan E. , Ling Nicholas N. A. , Johns Michael L.
Published: March 2019

Explosive emulsions are frequently employed in mining operations as they offer a comparatively robust, safe and effective product. These are typically formulated as concentrated ammonium nitrate solutions dispersed in an oil phase in the form of a highly concentrated water‐in‐oil emulsion. Being highly concentrated, determining the droplet size distribution (which is critical to assessing long‐term emulsion stability and explosive effectiveness) of these emulsions is challenging. Here we demonstrate that this is readily achieved using bench‐top Nuclear Magnetic resonance (NMR) Pulsed Field Gradient (PFG) techniques. The initial mean droplet size is shown to decrease with an increase in the concentration of ammonium nitrate or emulsifier or when inert salt was added to the composition, it was found to increase as the concentration of the aqueous (oxidiser) phase was increased. The emulsion droplet size distributions were observed to remain constant for a 3‐month period over the composition range explored.