bluuebunny/crossref_metadata_2025 huggingface dataset:
Scoring model for discriminating gastric cancer risk in patients with negative serum pepsinogen and anti‐Helicobacter pylori antibody results
Authors: Cho Jun‐Hyung , Jin So‐Young , Park Suyeon
Published: July 2021

Background

The ABC test measures serum pepsinogen and anti‐Helicobacter pylori IgG antibody levels to predict precancerous conditions in the stomach and gastric cancer. However, a limitation of this test is that the gastric cancer risk is not negligible in patients with a negative result.

Methods

Based on their ABC results, 1157 patients were classified into Groups A (n = 392), B (n = 479), C (n = 247), and D (n = 39). In Group A, 24.2% of patients had atrophic gastritis and/or intestinal metaplasia and had thus been incorrectly assigned to Group A. Patients in Group A were then assigned to derivation (n = 236) and validation (n = 156) cohorts by 3:2 random sampling. Logistic regression analyses were performed to identify the factors discriminating between a correct (true) and incorrect (false) Group A classification.

Results

A 4‐point discriminative model was constructed based on a high‐negative H. pylori IgG antibody titer and the patient's age (50–64 and ≥65 years). The areas under the receiver operating characteristic curve for the derivation and validation cohorts were 0.868 and 0.894, respectively. In the validation cohort, the addition of a discriminative model score ≥2 to the ABC method showed a similar accuracy for predicting gastric cancer risk compared with the ABC method alone (93.8% vs. 92.4%).

Conclusion

The 4‐point discriminative model may help identify patients with a normal serological test who are nonetheless at risk of developing gastric cancer.
Effectiveness of an integrated three‐mode bed exit alarm system in reducing inpatient falls within an acute care setting
Authors: Seow Jason Phil , Chua Tse Lert , Aloweni Fazila , Lim Shu Hui , Ang Shin Yuh
Published: July 2021

Aim

To examine the effectiveness of an integrated three‐mode bed exit alarm system in reducing inpatient falls within an acute care hospital setting in Singapore.

Method

A retrospective before‐and‐after study design was adopted.

Results

Our results revealed that the use of bed exit alarms are associated with a reduction in falls incidence.

Conclusion

Bed exit alarm systems are associated with reduced fall incidence. Nonetheless, for an institution to benefit from the technology, there will be a need to take into account the effects of “alarm fatigue”, ability of nurses to respond in time to alarms, and selection of right alarm mode/limits based on the patient's profile.
Serum neurofilament light chain and glial fibrillary acidic protein in AQP4‐IgG‐seropositive neuromyelitis optica spectrum disorders and multiple sclerosis: A cohort study
Authors: Liu Chunxin , Lu Yaxin , Wang Jingqi , Chang Yanyu , Wang Yuge , Chen Chen , Liu Zifeng , Kermode Allan G. , Zhang Yongbiao , Qiu Wei
Published: July 2021

We investigated the serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) levels in a cohort of Chinese patients with neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) in relation to clinical disease course and treatment. sNfL and sGFAP levels were determined by ultrasensitive single molecule array (Simoa) assay in patients with NMOSD (n = 102) and MS (n = 98) and healthy controls (HCs; n = 84). Notably, 13 patients with NMOSD and 27 patients with MS were enrolled in the 1‐year follow‐up cohort. Levels were compared with data such as clinical course, disease duration, Expanded Disability Status Scale (EDSS) score, and lesions on MRI. Higher levels of sNfL and sGFAP were found in subjects with NMOSD and MS than in HCs (sNfL, median 12.11, 17.5 vs. 8.88 pg/ml, p < .05; sGFAP, median 130.2, 160.4 vs. 80.01 pg/ml, p < .05). Moreover, sNfL levels were higher in the relapse phase of MS than in the relapse phase of NMOSD (30.02 vs. 14.57 pg/ml, p < .05); sGFAP levels were higher in the remission phase of MS than in the remission phase of NMOSD (159.8 vs. 124.5 pg/ml, p < .01). A higher sGFAP/sNfL quotient at relapse differentiated NMOSD from MS. Multivariate analyses indicated that sGFAP levels were associated with the EDSS score in NMOSD (p < .05). At the 1‐year follow‐up, sNfL and sGFAP levels were both decreased in NMOSD patients in remission, while only sNfL levels were decreased in MS patients in remission. sGFAP and sNfL are potential blood biomarkers for diagnosing and monitoring NMOSD and MS.

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Evolution of orbit size in toothed whales (Artiodactyla: Odontoceti)
Authors: Churchill Morgan , Baltz Colin
Published: July 2021

For many marine tetrapods, vision is important for finding food and navigating underwater, and eye size has increased to improve the capture of light in dim ocean depths. Odontocete whales, in contrast, rely instead on echolocation for navigation and prey capture. We tested whether the evolution of echolocation has influenced the orbit size, a proxy for eye size, and examined how orbit size evolved over time. We also assessed variation in orbit size amongst whales and tested how body size, diving ability, sound production, foraging habitat, and prey capture strategy influenced the orbit size using phylogenetic independent contrasts and phylogenetic ANOVAs. Using measurements of orbit length and bizygomatic width, we calculated proportional orbit size for 70 extant and 29 extinct whale taxa, with an emphasis on Odontoceti. We then performed ancestral character state reconstruction on a time‐calibrated composite phylogeny. Our analysis revealed that there was no shift in proportional orbit size from archaeocetes through stem odontocetes, indicating that the evolution of echolocation did not influence the orbit size. Proportional orbit size increased in Ziphiidae, Phocoenidae, and Cephalorhynchus. Proportional orbit size decreased in Balaenidae, Physeteridae, Platanistidae, and Lipotidae. Body size, diving ability, foraging environment, and prey capture strategy had a significant influence on orbit size, but only without phylogenetic correction. An increase in orbit size is associated with deep diving behavior in beaked whales, while progenesis and retention of juvenile features into adulthood explain the pattern observed in Phocoenidae and Cephalorhynchus. Decrease in proportional orbit size is associated with adaptation toward murky freshwater environments in odontocetes and skim feeding in balaenids. Our study reveals that the evolution of echolocation had little effect on orbit size, which is variable in whales, and that adaptation for different feeding modes and habitat explains some of this variance.
Nurses´ and nurse managers´ perceptions of sustainable development in perioperative work: A qualitative study
Authors: Leppänen Taava , Kvist Tarja , McDermott‐Levy Ruth , Kankkunen Päivi
Published: July 2021

Aims and objectives

To describe how nurses and nurse managers consider sustainable development principles in their daily work, how well they recognise these principles and how these principles are considered in decision‐making in perioperative work.

Background

Sustainable development involves interpersonal social and cultural relations and long‐term economic and ecological thinking in societal decision‐making. These dimensions are well‐suited for a foundation of decision‐making in acute health care. No previous research has been performed on perioperative work from the sustainable development perspective.

Design

Qualitative descriptive design was used. Data were collected from perioperative nurses (n = 20) and nurse managers (n = 6) working in five surgical departments in a Finnish university hospital. Data were analysed by content analysis. The reporting follows qualitative research checklist (COREQ).

Results

The principles of sustainable development were poorly known among the participants. Nurse managers considered their opportunities to influence decision‐making were reduced by their limited economic knowledge. Resource use, individuality, and ecological viewpoints were emphasised in the decision‐making process in perioperative work.

Conclusions

Findings reveal that perioperative nurses and nurse managers are aware of economic and ecological sustainability, but they do not actively consider it as part of their work. Social and cultural sustainability must be developed further in decision‐making in perioperative work.

Relevance to clinical practice

Perioperative nurses and nurse managers consider that it is important to develop the principles of sustainable development in perioperative work. This research indicates that economic understanding is not guiding decision‐making, and there is a lack of knowledge about the benefits of ecological procedures. Social and cultural sustainability are not connected in perioperative work, although there is collaboration between the surgical team and the patient is essential. This study helps to organise operating room management effectively and diversely.
Successful salvage treatment with paclitaxel, ifosfamide, and cisplatin in a patient with methotrexate‐resistant gestational trophoblastic neoplasia who developed hypersensitivity reaction to etoposide
Authors: Yamaguchi Noriko , Hamada Yoshinobu , Inagaki Risa , Nemoto Kohei , Yoshitomi Hideyuki , Takakura Satoshi
Published: July 2021

We report a 34‐year‐old woman with recurrent gestational trophoblastic neoplasia (GTN) who showed hypersensitivity to etoposide. Computed tomography (CT) revealed a 32‐mm solid mass in the right lung and a 101‐mm cystic mass with solid components in the left side of the liver. The patient's serum human chorionic gonadotropin (HCG) level was 689 439 mIU/mL. After eight cycles of combined paclitaxel 175 mg/m2 on day 1, ifosfamide 1 g/m2 on days 2–5, and cisplatin 20 mg/m2 on days 2–5 (TIP) every 3 weeks, the serum HCG level decreased to 2.4 mIU/mL. CT scan revealed disappearance of the lung tumor and significant reduction in the solid components of the liver tumor. Then, left hemihepatectomy was performed. After 3 months, there was no evidence of the disease, and the serum HCG level normalized. Thus, TIP chemotherapy, followed by residual mass resection, might be effective for methotrexate‐resistant GTN.
The effect of CEO regulatory focus on changes to investments in R&D
Authors: Scoresby Richard B. , Withers Michael C. , Ireland R. Duane
Published: July 2021

Research and development (R&D) is a key contributor to organizations’ pursuit of innovation. In turn, CEOs can influence important decisions related to changes in R&D spending—the kind of spending with the potential to lead to innovation. We seek to understand the motivation and conditions under which CEOs may influence R&D spending changes. Drawing on regulatory focus theory, this study investigates how CEO motivation affects changes in firm R&D spending. We explore the effect of CEO promotion and prevention foci on yearly R&D increase. We use a panel dataset of 688 S&P 1500 firms to test our hypotheses. Our findings suggest a negative relationship between CEO prevention focus and R&D increase, while CEO promotion focus produces no meaningful effect. We further test CEO compensation as a moderating mechanism, testing both incentive and fixed CEO compensation. We find that incentive compensation negatively moderates the relationship between CEO promotion focus and R&D increase, and positively moderates the relationship between CEO prevention focus and R&D increase. Additionally, CEO fixed income negatively moderates the relationship between CEO prevention focus and R&D increase. Based on these results we discuss theoretical implications of our findings, including differing effects of CEO regulatory focus on firm risk‐taking behavior and how compensation packages may alter those effects. We further discuss the practical necessity for boards of directors to understand both the R&D goals of an organization and the individual motivational orientation of CEOs when crafting compensation packages.
Effect of total replacement of fish oil with tallow and emulsifier in diet on growth, feed utilization, and immunity of olive flounder (Paralichthys olivaceus)
Authors: Medagoda Nalin , Kim Min‐Gi , Gunathilaka Buddhi E. , Park Seung‐Hwan , Lee Kyeong‐Jun
Published: July 2021

The supplementary effects of an emulsifier mixture (polyoxyethylene (20) sorbitan monolaurate and distilled monoglycerides) were investigated on feed utilization, growth performance, and immunity of olive flounder, Paralichthys olivaceus, replacing fish oil with beef tallow. A fish oil containing diet was considered as positive control (PC) and a diet containing beef tallow instead of fish oil was considered as negative control (TW). Two other diets (EM01 and EM02) were prepared by adding 0.01 and 0.02% of the emulsifier into the TW diet. After 8 weeks of a feeding trial, growth performance and feed utilization were significantly higher in fish fed EM01, EM02, or PC diets compared to those fed the TW diet. Dry matter digestibility was higher in EM01 and EM02 diets than the TW diet and comparable to PC diet. Lipid digestibility was significantly higher in PC diet compared to TW diet. Liver EPA and DHA levels were lower, and oleic acid level was higher in fish fed diets containing tallow compared to PC group. Significantly increased aspartate aminotransferase and triglyceride levels were observed in TW group. Dietary supplemented emulsifier restored the reduced performance of olive flounder fed diets containing tallow instead of fish oil. However, the optimum inclusion level of the emulsifier should be elucidated in future studies.
Growth, red blood cells, and gill alterations of red pacu (Piaractus brachypomus) fingerlings by chronic exposure to different total suspended solids in biofloc
Authors: Angeles‐Escobar Beatriz Elena , da Silva Suzianny Maria Bezerra Cabral , Severi William
Published: July 2021

Chronic exposure to high biofloc total suspended solids (TSS) could affect growth, red blood cells, and generate gill alterations in fish. Red pacu, Piaractus brachypomus, fry (2.7 ± 0.5 g weight) were exposed to different biofloc TSS concentrations with low (T1: 200–300), and medium (T2: 400–600 mg/L) levels and compared to a treatment control (TC) without solids during a 45‐day period in 50 L experimental units (in quadruplicate). Water quality, productive parameters, red blood cell values, and gill histopathological alteration index (HAI) were assessed. Red pacu reached higher final biomass (11.34 ± 0.73 kg/m3), better growth (DWG = 0.30 ± 0.03 g/day) and food conversion rate (1.05 ± 0.02) in TC than in biofloc treatments (p < .05). T2 had higher RBC count, and lower hemoglobin, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration (p < .05) than T1 and TC. The histological sections of TC gills showed monogenean parasites in low quantity; thus, the HAI value was similar among treatments and corresponded to low to medium gill damage. Growth, red blood cell values, and gill morphology of red pacu fingerlings were affected by moderate (400–600 mg/L) chronic exposure to TSS concentration in biofloc.
IIE irons: Origin, relationship to ordinary chondrites, and evidence for siderophile‐element fractionations caused by chondrule formation
Authors: Rubin Alan E.
Published: July 2021

IIE irons were derived from chondritic precursors that were the most reduced ordinary chondrites. The bulk chemical (e.g., Ir/Ni, Ir/Au, Au/Ni, Co/Ni) and bulk isotopic (i.e., Δ17O and δ74/70Ge) compositions of IIE irons lie along extensions of LL‐L‐H trends. Chondrule‐bearing silicate clasts in IIE irons have mineralogical and petrological characteristics that extend LL‐L‐H trends; these clasts have higher modal metallic Fe‐Ni and lower values for olivine Fa, low‐Ca‐pyroxene Fs, kamacite Co, and mean chondrule diameter. IIE irons are modeled as agglomerating before H‐L‐LL chondrites; they acquired more 26Al and reached the Fe,Ni‐FeS eutectic temperature (~940 °C). An FeS‐rich metallic melt separated from unmelted silicate and drained to the core, eventually generating a dynamo. Most IIE metal remained within the crust/mantle region alongside recrystallized chondritic clasts. Alkali‐rich IIE silicate inclusions formed from late‐stage impacts via preferential melting of plagioclase. Some separation of K from Na occurred during vapor transport. Because most type I chondrules formed before most type II chondrules, the (type I)/(type II) modal ratio decreased from IIE to H to L to LL during agglomeration. Earlier‐formed chondrules acquired higher abundances of refractory metal nuggets within CAI‐fragment precursors, accounting for systematic changes in bulk OC of refractory/common siderophile and refractory/volatile siderophile ratios (IIE>H>L>LL). Because more Au and Co than Ni were retained in silicates, loss of metal globules from spinning partly molten type I chondrules caused systematic whole‐rock decreases in Au/Ni and Co/Ni from IIE through LL. Expelled globules had different nebular aerodynamic properties than chondrules and drifted away (accounting, in part, for the metal/silicate fractionation).
Organic matter in carbonaceous chondrite lithologies of Almahata Sitta: Incorporation of previously unsampled carbonaceous chondrite lithologies into ureilitic regolith
Authors: Kebukawa Yoko , Zolensky Michael. E. , Goodrich Cyrena A. , Ito Motoo , Ogawa Nanako O. , Takano Yoshinori , Ohkouchi Naohiko , Kiryu Kento , Igisu Motoko , Shibuya Takazo , Marcus Matthew A. , Ohigashi Takuji , Martinez James , Kodama Yu , Shaddad Muawia H. , Jenniskens Peter
Published: July 2021

The Almahata Sitta (AhS) meteorite is a unique polymict ureilite. Recently, carbonaceous chondritic lithologies were identified in AhS. Organic matter (OM) is ubiquitously found in primitive carbonaceous chondrites. The molecular and isotopic characteristics of this OM reflect its origin and parent body processes, and are particularly sensitive to heating. The C1 lithologies AhS 671 and AhS 91A were investigated, focusing mainly on the OM. We found that the OM in these lithologies is unique and contains primitive isotopic signatures, but experienced slight heating possibly by short‐term heating event(s). These characteristics support the idea that one or more carbonaceous chondritic bodies were incorporated into the ureilitic parent body. The uniqueness of the OM in the AhS samples implies that there were large variations in primitive carbonaceous chondritic materials in the solar system other than known primitive carbonaceous chondrite groups such as CI, CM, and CR chondrites.
Retail Distribution Strategy with Outlet Stores
Authors: Bai Jiaru , Gurnani Haresh , Yin Shuya
Published: July 2021

Traditionally, outlet stores were situated away from main stores in order to provide older, less desirable products at discounted prices. More recently, some firms have featured an outlet‐within‐a‐store concept and offer consumers the experience of outlet shopping at the same location. With interest in examining the effect of location differentiation and uncertain outlet store's product fit on a firm's distribution strategy, we model a firm with an existing main store and study its motivation on whether to open an outlet store, and where to locate it. The analysis leads to a number of key observations. First, if the firm decides to open an outlet store, it may be co‐located with the main store or at a remote location, depending on the combined role of customer dispersion, outlet store's product fit, customer travel sensitivity, and fixed costs. Second, there exists a substitution effect between location and quality (and price) differentiation. We show that customer dispersion always encourages the firm to offer outlet stores so as to achieve better market coverage. While a higher probability of product fit at the outlet store makes its more attractive (e.g., it makes customers at one location more willing to travel to the outlet store at another location), interestingly, it has a non‐monotone effect on its location. Also, in contrast to intuition, higher customer travel sensitivity may even lead to locating the outlet store away from the city center depending on the level of customer dispersion. We also study three extensions. First, the results of our base model are shown to be robust if product quality at the outlet store can positively influence the outlet product's fit probability. Second, heterogeneous consumer travel sensitivity makes it easier for the firm to segment consumers and hence can increase profits even when travel sensitivity is high. Finally, we consider a continuum of possible outlet store locations, and demonstrate the robustness of the base model results.
Is Your Retailer a Friend or Foe: When Should the Manufacturer Allow Its Retailer to Refurbish?
Authors: Timoumi Ahmed , Singh Narendra , Kumar Subodha
Published: July 2021

Refurbishing of used products is increasingly being recognized as a value recovery strategy in sustainable operations. Hence, manufacturers, retailers, as well as third‐party firms, engage in refurbishing. Manufacturers, to some extent, can deter other players from refurbishing through various means such as product design, intellectual property, and restricting access to spare parts and diagnostic tools. While previous research has extensively examined the question of whether a manufacturer should allow an independent third‐party player to refurbish used products, the question of whether a manufacturer should allow his retailer to refurbish them, to our knowledge, remains unanswered. In this study, we examine whether a manufacturer should refurbish used products himself or allow his retailer to refurbish them. We compare two closed‐loop supply chain structures: Model‐M, where the manufacturer refurbishes used products; and Model‐R, where the retailer refurbishes. In a two‐period setting, new products are sold in both periods and some of the first‐period products are refurbishable in the second period. We show that when either (i) the refurbishability of used products is low and the attractiveness of refurbishing (value of the refurbished product as compared to the refurbishing cost) is either moderate or sufficiently high, or (ii) the refurbishability is high and the attractiveness of refurbishing is moderate, the manufacturer, despite forgoing profits and facing competition from refurbished products, is better off with letting the retailer refurbish used products (Model‐R) than with refurbishing them himself (Model‐M). Identifying a novel mechanism through which the manufacturer benefits in Model‐R is our key theoretical contribution to the closed‐loop supply chain literature. Moreover, we provide some useful and interesting insights to policymakers related to customer welfare and the environment. We also analyze the performances of these models (Model‐M and Model‐R) in terms of supply chain efficiency. In addition, we discuss how some of our key results change if a third‐party refurbisher coexists with the manufacturer and the retailer. Our results not only support some of the current policies and practices but also shed some light on their limitations and suggest some avenues for improvement.
Cross‐instrument feasibility, validity, and reproducibility of wireless heart rate monitors: Novel opportunities for extended daily life monitoring
Authors: Kunkels Yoram K. , van Roon Arie M. , Wichers Marieke , Riese Harriëtte
Published: July 2021

Wired ambulatory monitoring of the electrocardiogram (ECG) is an established method used by researchers and clinicians. Recently, a new generation of wireless, compact, and relatively inexpensive heart rate monitors have become available. However, before these monitors can be used in scientific research and clinical practice, their feasibility, validity, and reproducibility characteristics have to be investigated. Therefore, we tested how two wireless heart rate monitors (i.e., the Ithlete photoplethysmography (PPG) finger sensor and the Cortrium C3 ECG monitor perform against an established wired reference method (the VU‐AMS ambulatory ECG monitor). Monitors were tested on cross‐instrument and test‐retest reproducibility in a controlled laboratory setting, while feasibility was evaluated in protocolled ambulatory settings at home. We found that the Cortrium and the Ithlete monitors showed acceptable agreement with the VU‐AMS reference in laboratory setting. In ambulatory settings, assessments were feasible with both wireless devices although more valid data were obtained with the Cortrium than with the Ithlete. We conclude that both monitors have their merits under controlled laboratory settings where motion artefacts are minimized and stationarity of the ECG signal is optimized by design. These findings are promising for long‐term ambulatory ECG measurements, although more research is needed to test whether the wireless devices’ feasibility, validity, and reproducibility characteristics also hold in unprotocolled daily life settings with natural variations in posture and activities.
Evidence for the association between physiological and emotional states in adolescents and young adults without psychopathology under ecologically valid conditions
Authors: Zenker Monique , Venz John , Koenig Julian , Voss Catharina , Beesdo‐Baum Katja , Pieper Lars
Published: July 2021

Well‐powered studies on the physiological concomitants underlying affect and its regulation during emerging adulthood are warranted to provide novel insight into mental health. The association between autonomic nervous system activity and emotional states occurring under natural conditions in daily life was investigated in individuals (N = 549, age 14–21, females 45.6%) without any lifetime mental disorder from an epidemiological cohort study in Germany. Using ecological momentary assessment, mood and optimism/pessimism were assessed over 4 days simultaneously with continuous heart rate monitoring. Lower vagal activity was found in mood states accompanied by high arousal (wakefulness, mania) and greater vagal activity in mood states with low arousal (calmness, pessimism). Findings illustrate important associations between autonomic nervous system activity and mood in youth under ecologically valid conditions. Vagal activity presents a prominent pathway by which mood may influence physiological function or vice versa. In contrast to commonly performed laboratory assessments, the ambulatory assessment in participants' daily life allows an application of the results to the field.
Reducing the Number of Experiments Required for Modelling the Hydrocracking Process with Kriging Through Bayesian Transfer Learning
Authors: Iapteff Loïc , Jacques Julien , Rolland Matthieu , Celse Benoit
Published: July 2021

The objective is to improve the learning of a regression model of the hydrocracking process using a reduced number of observations. When a new catalyst is used for the hydrocracking process, a new model must be fitted. Generating new data is expensive and therefore it is advantageous to limit the amount of new data generation. Our idea is to use a second data set of measurements made on a process using an old catalyst. This second data set is large enough to fit performing models for the old catalyst. In this work, we use the knowledge from this old catalyst to learn a model on the new catalyst. This task is a transfer learning task. We show that the results are greatly improved with a Bayesian approach to transfer linear model and kriging model.
Globalization, Productivity Performance, and the Transformation of the Production Process*
Authors: Baldwin John , Yan Beiling
Published: July 2021

In this paper, we examine whether a firm's decision to export and its subsequent performance are related to its prior global connections. By tracking Canadian manufacturing firms over an eight‐year period between 2002 and 2010, we find that firms with prior global connections (such as importing) are more likely to subsequently become exporters. Productivity and skill intensity grow faster in this group in the short and longer run than those with no global connections. The growth advantage is affected by movements in the exchange rate. In general, growth rates in productivity and investments in physical, human, and intangible innovation R&D are greater for firms with more international connections.
Two cases of acute lymphoid leukemia patients with loss of heterozygosity in HLA region before transplantation
Authors: Huang Wenqiu , Xue Song , Zhang Yongping , Liu Fuhong , Wang Jingbo
Published: July 2021

Leukemia is a complex disease in which mutations and other genomic and epigenomic abnormalities play a role in both its initiation and progression. Acute lymphoid leukemia (ALL) patients with loss of heterozygosity (LOH) in the HLA region before transplantation have been described rarely. In this report, we described two ALL cases with LOH encompassing the HLA, wholly or partly. HLA molecular typing was performed on peripheral blood (PB) and somatic cell. Simultaneously, we performed whole‐exome sequencing. Typing results on PB samples collected during blast crisis demonstrated complete or partial homozygosity at the ‐A, ‐B, ‐C, ‐DR, and ‐DQ loci. Two somatic samples demonstrated heterozygosity at all loci. LOH at the HLA gene locus may significantly influence the donor search, resulting in misidentification of homozygous donors. We recommend confirming the patients' HLA typing with hematological malignancies when homozygosity is detected at any locus by using somatic samples or alternatively from PB when remission is achieved.
Cytomegalovirus‐associated pseudomembranous colitis in a kidney transplant recipient
Authors: Chua Yi Yi , Ho Quan Yao , Ngo Nye Thane , Krishnamoorthy Thinesh Lee , Thangaraju Sobhana , Kee Terence , Wong Hei Man
Published: July 2021

Pseudomembranous colitis (PMC) is classically associated with Clostridium difficile infection. We report a rare case of cytomegalovirus (CMV)‐associated PMC in a 52‐year‐old female patient who had undergone kidney transplantation more than 20 years ago and was on low dose prednisolone and ciclosporin. She presented with an acute history of fever, lethargy, vomiting and diarrhoea on admission. Computed tomography of the abdomen showed extensive colitis, and colonoscopy revealed extensive pseudomembrane formation. Multiple tests for Clostridium difficile and other common microbiological causes of colitis were negative. CMV DNAemia and colonic biopsies confirmed the diagnosis of CMV colitis. The patient responded to prompt CMV treatment, as demonstrated by clinical, endoscopic, and histological response. While CMV is a common pathogen in the solid organ transplant population that is familiar to most transplant physicians, it may present atypically as PMC. Here, we review the literature on CMV‐associated PMC and its relevance to solid organ transplant recipients. To our knowledge, this is the first reported case of CMV‐associated PMC in a kidney transplant recipient.
Commitment behaviour in the World Trade Organization's Trade Facilitation Agreement
Authors: Hillberry Russell , Zurita Carlos
Published: July 2021

We use a new database of commitments made during the process of ratifying the Trade Facilitation Agreement (TFA) to study variation in countries’ commitment behaviour. The TFA is a novel World Trade Organization agreement because it allows developing countries to select commitments from a menu of best practices in trade facilitation, rather than to consent, or not, to a comprehensive package of negotiated commitments. The operation of this á la carte approach to concluding trade agreements is worthy of study in its own right, but the commitment data also offer a high‐level description of progress in an international effort to improve border management procedures around the globe. Our study uses data on TFA commitments to describe progress across subcomponents of the agreement. A regression model shows that the number of Type A trade facilitation commitments that a country made in the TFA ratification process depends on its level of development, population size, ability to control corruption and foreign aid received to support trade facilitation. We use multidimensional scaling techniques to study differences in the content of national commitment bundles. This approach demonstrates that variation in the content of countries’ commitments is closely tied to the number of commitments made.
Trypanosoma cruzi infection in triatomines (Hemiptera: Reduviidae) from rural areas of the state of Pará, Brazil
Authors: Barros Flávia de Nazaré Leite , Vieira Juliana dos Santos Cruz , Sampaio Júnior Francisco Dantas , Lima Jaqueline dos Santos , Nobre Adriana Vasconcelos , Barrozo Pedro Henrique Marques , Paiva Jessica Rodrigues de , Cavalcante Gustavo Góes , Scofield Alessandra
Published: July 2021

The present study aimed to identify the triatomine species and evaluate Trypanosoma cruzi infection in insects captured in endemic areas of Pará State, Brazil. Triatomines were captured in nine rural communities in the municipality of São Domingos do Capim in August, September and December 2014 using active searches and Malaise and Noireau traps. Additionally, from 2014 to 2018, residents and community health agents submitted captured triatomines to the study team. The analysis of T. cruzi infection in the insects was performed by direct parasitological examination and nested‐PCR. A total of 225 triatomines were captured and identified: Rhodnius robustus (n = 111), Rhodnius pictipes (n = 54), Panstrongylus geniculatus (n = 44), Eratyrus mucronatus (n = 11), Panstrongylus lignarius (n = 4), and Panstrongylus rufotuberculatus (n = 1). Direct parasitological examination was performed in 27 living triatomines R. robustus (n = 14), P. geniculatus (n = 7) and R. pictipes (n = 6) and metacyclic trypomastigote forms similar to those of T. cruzi were observed in 66.6% (18/27) samples. Of 174 samples analysed by nested‐PCR, 81.6% were positive for T. cruzi DNA: R. robustus (84.7%; 72/85), R. pictipes (84.1%; 37/44), P. geniculatus (69.4%; 25/36), P. lignarius (100%; 4/4), E. mucronatus (75%; 3/4) and P. rufotuberculatus (100%; 1/1). R. robustus, R. pictipes and P. geniculatus were the main vectors of T. cruzi in the studied areas; however, the detection of infections in P. lignarius, E. mucronatus and P. rufotuberculatus indicated that these species can also act as potential vectors of T. cruzi in the study areas.
Operando study of the preferential growth of SiO2 during the dry thermal oxidation of Si0.60Ge0.40(001) by ambient pressure x-ray photoelectron spectroscopy
Authors: Lorona Shane P. , Trey Diulus J. , Bergevin Jo E. , Addou Rafik , Herman Gregory S.
Published: July 2021

Controlling the grown oxide composition, the oxide/semiconductor interface properties, and the semiconductor surface composition is of interest for SiGe devices. We have used ambient-pressure x-ray photoelectron spectroscopy (AP-XPS) to study the initial stages of dry thermal oxidation of an epitaxial Si0.60Ge0.40(001) film on Si(001). Si 2p and Ge 3d chemical-state resolved AP-XPS was performed at 300 °C and O2 pressures (PO2) of 10−4, 10−2, and 1 mbar during oxide growth. The National Institute of Standards simulated electron spectra for surface analysis (SESSA) was used to analyze both the oxide composition and the thickness versus time for each pressure. At all three PO2, the SESSA analysis indicated that oxidation proceeds via three oxide growth rate regimes: an initial rapid regime, an intermediate transitionary regime, and finally a quasisaturation slow regime. The Si and Ge oxidation rates were found to be pressure dependent during the rapid regime with both rates decreasing monotonically with decreasing pressure. Results indicated that Ge was much more sensitive to changes in PO2 compared to Si. As a result, a decrease in PO2 resulted in significant suppression of GeO2 formation compared to SiO2. Using SESSA, we were able to quantify the grown oxide composition and the thickness, both of which were strongly dependent on O2 pressure. The Ge composition, in Si1−xGexO2, was found to decrease monotonically with decreasing PO2.
Electric-to-acoustic pickup processing for string instruments: An experimental study of the guitar with a hexaphonic pickup
Authors: Rau Mark , Abel Jonathan S. , James Doug , Smith Julius O.
Published: July 2021

A signal processing method to impart the response of an acoustic string instrument to an electric instrument that includes frequency-dependent string decay alterations is proposed. This type of processing is relevant when trying to make a less resonant instrument, such as an electric guitar, sound similar to a more resonant instrument, such as acoustic guitar. Unlike previous methods which typically only perform equalization, our method includes detailed physics-based string damping changes by using a time-varying filter which adds frequency-dependent exponential damping. Efficient digital filters are fit to bridge admittance measurements of an acoustic instrument and used to create equalization filters as well as damping correction filters. The damping correction filters are designed to work in real-time as they are triggered by onset and pitch detection of the signal measured through an under-saddle pickup to determine the intensity of the damping. A test case is presented in which an electric guitar is processed to model a measured acoustic guitar.
Thixotropy of cellulose nanocrystal suspensions
Authors: Fazilati Mina , Ingelsten Simon , Wojno Sylwia , Nypelö Tiina , Kádár Roland
Published: July 2021

The thixotropy of cellulose nanocrystal (CNC) water suspensions is intrinsically dependent on the hierarchical structure of the suspension. The diverse hierarchies that comprise individual CNC nanoparticles and mesophase liquid crystalline domains, chiral nematic and nematic structures, contribute selectively to the rheological material response. Here, we combine rheology with polarized light imaging (PLI) to elucidate the thixotropic behavior of CNCs suspended in water. The simultaneous monitoring of PLI and rheological tests enables the observation of mesogens and their orientation dynamics. Creep, dynamic time sweep, ramped hysteresis loop, and thixotropic recovery tests combined with PLI aim to differentiate the contribution of the different hierarchical levels of CNC suspensions to their thixotropy. The range of concentrations investigated comprised biphasic (4 and 5 wt. %) and liquid crystalline phase suspensions (6, 7, and 8 wt. %). The CNC suspensions exhibited complex thixotropy behavior, such as viscosity bifurcations in creep tests and overshoot in ramped hysteresis loop tests. The restructuring and destructuring appeared to correspond to different levels of their hierarchical structure, depending mainly on the phase, in agreement with previous studies. Restructuring was attributed to re-organizations of an individual CNC, e.g., in the isotropic fraction of biphasic suspensions and at the mesogen interfaces in liquid crystalline phase suspensions. However, by increasing liquid crystalline fraction in the biphasic concentrations, restructuring could also involve mesogens, as indicated in the creep tests. For flow conditions above the yield stress, as evidenced by the ramped hysteresis and thixotropy recovery tests, destructuring was dominated by orientation in the flow direction, a process that is readily observable in the form of PLI “Maltese-cross” patterns. Finally, we show that a simple thixotropy model, while unable to capture the finer details of the suspension’s thixotropic behavior, could be employed to predict general features thereof.
Population Pharmacokinetic Modeling and Dosing Simulations of Tobramycin in Pediatric Patients with Cystic Fibrosis
Authors: Praet Antonin , Bourguignon Laurent , Vetele Florence , Breant Valentine , Genestet Charlotte , Dumitrescu Oana , Doleans-Jordheim Anne , Reix Philippe , Goutelle Sylvain
Published: July 2021

Initial dosing and dose adjustment of intravenous tobramycin in children with cystic fibrosis (CF) is challenging. The objectives of this study were to develop nonparametric population pharmacokinetic (PK) models of tobramycin in children with CF to be used for dosage design and model-guided therapeutic drug monitoring.
Triazole-Resistant Aspergillus fumigatus in an Israeli Patient with Chronic Cavitary Pulmonary Aspergillosis Due to a Novel E306K Substitution in Hmg1
Authors: Handelman Mariana , Morogovsky Alma , Liu Wei , Ben-Ami Ronen , Osherov Nir
Published: July 2021

Triazole resistance in the pathogenic mold
Aspergillus fumigatus
has increased worldwide, posing a growing therapeutic challenge. Recently, mutations in the 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase gene (
hmg1
) have been associated with triazole resistance. Here, we describe a novel E306K triazole resistance-conferring mutation in the HMG-CoA reductase gene from an Israeli patient with chronic cavitary pulmonary aspergillosis (CCPA).
Chlamydia
Spreads to the Large Intestine Lumen via Multiple Pathways
Authors: Zhou Zengzi , Tian Qi , Wang Luying , Xue Min , Xu Dabao , Zhong Guangming
Published: July 2021

Chlamydia
in the genital tract is known to spread via the blood circulation system to the large intestine lumen to achieve long-lasting colonization. However, the precise pathways by which genital
Chlamydia
accesses the large intestine lumen remain unclear.
Bacterial Cytological Profiling Identifies Rhodanine-Containing PAINS Analogs as Specific Inhibitors of
Escherichia coli
Thymidylate Kinase
In Vivo
Authors: Montaño Elizabeth T. , Nideffer Jason F. , Sugie Joseph , Enustun Eray , Shapiro Adam B. , Tsunemoto Hannah , Derman Alan I. , Pogliano Kit , Pogliano Joe
Published: July 2021

We demonstrate that bacterial cytological profiling is a powerful tool for directing antibiotic discovery efforts because it can be used to determine the specificity of an antibiotic’s
in vivo
mechanism of action. By assaying analogs of PAINS, molecules that are notoriously intractable and nonspecific, we (surprisingly) identify molecules with specific activity against
E. coli
thymidylate kinase.
Great auricular nerve schwannoma: a rare presentation and literature review
Authors: Oh Soo , Abou-Foul Ahmad , Patel Sanjay , Wilson Paul
Published: July 2021

Head and neck schwannomas are a rare form of tumour arising from the nerve sheath. They are often slow growing and asymptomatic, posing a diagnostic challenge for clinicians. The great auricular nerve (GAN) provides cutaneous innervation to the lower pinna, ear lobule and the inferior periauricular area. Hence, surgical management of GAN schwannomas can have sensory and functional dysfunction postoperatively, necessitating good counselling and communication with the patient. We present the first documented case of GAN schwannoma in the West, with literature review and considerations for surgical management.
Fibrillin-1gene mutations in a Chinese cohort with congenital ectopia lentis: spectrum and genotype–phenotype analysis
Authors: Chen Zexu , Chen Tianhui , Zhang Min , Chen Jiahui , Deng Michael , Zheng Jialei , Lan Li-Na , Jiang Yongxiang
Published: July 2021

Aims

To identify the mutation spectrum and genotype–phenotype correlations offibrillin-1(FBN1) mutations in a Chinese cohort with congenital ectopia lentis (EL).

Methods

Patients clinically suspected of congenital zonulopathy were screened using panel-based next-generation sequencing followed by multiplex ligation-dependent probe amplification. All the probands were subjected to thorough ocular examinations. Molecular and clinical data were integrated in pursuit of genotype–phenotype correlation.

Results

A total of 131 probands ofFBN1mutations from unrelated families were recruited. Around 65% of the probands were children younger than 9 years old. Overall, 110 distinctFBN1mutations were identified, including 39 novel ones. The most at-risk regions were exons 13, 2, 6, 15, 24 and 33 in descending order of mutation frequency. The most prevalent mutation was c.184C>T (seven, 5.34%) in the coding sequence and c.5788+5G>A (three, 2.29%) in introns. Missense mutations were the most frequent type (103, 78.63%); half of which were distributed in the N-terminal regions (53, 51.46%). The majority of missense mutations were detected in one of the calcium-binding epidermal growth factor-like domains (62, 60.19%), and 39 (62.90%) of them were substitutions of conserved cysteine residues. Microspherophakia (MSP) was found in 15 patients (11.45%). Mutations in the middle region (exons 22–42), especially exon 26, had higher risks of combined MSP (OR, 5.51 (95% CI 1.364 to 22.274), p=0.017).

Conclusions

This study extended the knowledge of theFBN1mutation spectrum and provided novel insights into its clinical correlation regarding EL and MSP in the Chinese population.
MRI signs helpful in the differentiation of patients with anterior ischaemic optic neuropathy and optic neuritis
Authors: Petroulia Valentina Daphne , Brügger Dominik , Hoepner Robert , Vicini Rino , Winklehner Anna , Abegg Mathias , Wagner Franca
Published: July 2021

Background/Aims

The aim of this study was to identify specific MRI characteristics of anterior ischaemic optic neuropathy (AION) and optic neuritis (ON) that would aid in the differentiation between these two diagnoses.

Methods

We retrospectively analysed a consecutive case series including all patients with an MRI study of brain and orbit and the clinical diagnosis of either ON or AION. We examined the scans for restricted diffusion of the optic nerve, optic sheath diameter, enhancement and location of enhancement of the optic nerve and distribution of the white matter lesions.

Results

Fifty patients met the inclusion criteria. We found an accuracy of 0.98 for the discrimination between AION and ON based solely on parameters extracted from MRI data. Dominance analysis to determine the most influential parameters showed that the enhancement pattern of the optic nerve and distribution of the white matter lesions had the biggest impact on the classification and led to a discrimination accuracy of 0.9 when used alone.

Conclusion

In patients with an inconclusive clinical diagnosis, optic nerve enhancement pattern and distribution of white matter lesions can aid in the diagnosis and differentiation between AION and ON. Diffusion-weighted imaging did not add significant information to the diagnosis or help to differentiate between the two conditions.
Living with Psychosis without Mental Health Services: A Narrative Interview Study
Authors: McGranahan Rose , Jakaite Zivile , Edwards Alice , Rennick-Egglestone Stefan , Slade Mike , Priebe Stefan
Published: July 2021

Objectives

Little research has looked at how people who do not use mental health services experience psychosis. Thus, the present study aimed to explore the experiences and views of people with psychosis who have neither sought nor received support from mental health services for at least 5 years.

Design

A narrative interview study. Thematic analysis was used to analyse the data.

Setting

England.

Participants

Twenty-eight participants with self-defined psychotic experiences were asked to provide a free narrative about their experiences.

Results

Five themes were identified: (1) Perceiving psychosis as positive; (2) Making sense of psychotic experiences as a more active psychological process to find explanations and meaning; (3) Finding sources of strength, mainly in relationships and the environment, but outside of services; (4) Negative past experiences of mental health services, leading to disengagement and (5) Positive past experiences with individual clinicians, as an appreciation of individuals despite negative views of services as a whole.

Conclusions

Perceiving psychosis as something positive, a process of making sense of psychotic experiences and the ability to find external sources of strength all underpin—in addition to negative experiences with services—a choice to live with psychosis outside of services. Future research may explore to what extent these perceptions, psychological processes and abilities can be facilitated and strengthened, in order to support those people with psychosis who do not seek treatment and possibly also some of those who are in treatment.