bluuebunny/crossref_metadata_2025 huggingface dataset:
Financing seasonal demand
Authors: Fairhurst Douglas (DJ)
Published: September 2019

This paper identifies seasonal firms and their peak seasons to provide empirical evidence of the approach these firms take to finance seasonal operations. The seasonal use of funds, which builds before seasonal revenue, is largely financed with transitory sources of credit, such as credit lines, trade credit, and commercial paper. Permanent financing is used only moderately to meet seasonal needs. However, both weak credit market conditions and firm‐level financial constraints limit the ability of seasonal firms to use debt as transitory financing. These frictions result in a partial shift to permanent financing but reduce the seasonal use of funds overall.
Electrofishing in streams of low water conductivity but high biodiversity value: Challenges, limits and perspectives
Authors: Pottier Gaetan , Beaumont William R. , Marchand Frédéric , Le Bail Pierre‐Yves , Azam Didier , Rives Jacques , Vigouroux Régis , Roussel Jean‐Marc
Published: September 2019

Electrofishing in streams of low water conductivity has technical limitations leading to the widespread use of poison fishing. In theory, provided a high enough voltage gradient can be created in water, electrofishing should be possible in all but the lowest of conductivities (<10 µS/cm). Using custom‐made equipment delivering up to 1,500 V DC, tests were carried out in French Guiana on 27 streams with water conductivity as low as 16 µS/cm. Approximately 5,800 fish of 93 species were captured, with an electrofishing mortality rate of 1.83%. Poison treatments were used within enclosed sections to assess how efficient multiple pass electrofishing removal is when assessing species richness and population number. The Chao II estimator on 2 electrofishing passes gave the best results for species richness, but rare species can elude electrofishing. Estimates of total fish abundance (i.e. all species pooled) were possible with the use of depletion models. Capture efficiencies by species were highly biased, however, and abundance could be underestimated for the most difficult species to catch. These results show that with the right equipment and settings, electrofishing can be an efficient alternative to poison fishing surveys in small tropical streams of low water conductivity but high biodiversity value.
Homogenization of freshwater lakes: Recent compositional shifts in fish communities are explained by gamefish movement and not climate change
Authors: Cazelles Kevin , Bartley Timothy , Guzzo Matthew M. , Brice Marie‐Hélène , MacDougall Andrew S. , Bennett Joseph R. , Esch Ellen H. , Kadoya Taku , Kelly Jocelyn , Matsuzaki Shin‐ichiro , Nilsson Karin A. , McCann Kevin S.
Published: September 2019

Globally, lake fish communities are being subjected to a range of scale‐dependent anthropogenic pressures, from climate change to eutrophication, and from overexploitation to species introductions. As a consequence, the composition of these communities is being reshuffled, in most cases leading to a surge in taxonomic similarity at the regional scale termed homogenization. The drivers of homogenization remain unclear, which may be a reflection of interactions between various environmental changes. In this study, we investigate two potential drivers of the recent changes in the composition of freshwater fish communities: recreational fishing and climate change. Our results, derived from 524 lakes of Ontario, Canada sampled in two periods (1965–1982 and 2008–2012), demonstrate that the main contributors to homogenization are the dispersal of gamefish species, most of which are large predators. Alternative explanations relating to lake habitat (e.g., area, phosphorus) or variations in climate have limited explanatory power. Our analysis suggests that human‐assisted migration is the primary driver of the observed compositional shifts, homogenizing freshwater fish community among Ontario lakes and generating food webs dominated by gamefish species.
On the uniform distribution and optimal consumption of stretch film used for wrapping cylindrical baled silage
Authors: Stankiewicz Anna
Published: September 2019

The main objective of this article was to mathematically formulate the problem of the uniform coverage of round baled silage, solve this problem and propose a design approach. A mathematical model which describes the distribution and consumption of stretch film used for bale wrapping is derived. The model aims at capturing more features of a realistic description of the wrapping process than existing mathematical models, so as to provide a deeper insight into the issues concerning bale coverage and film consumption. Bale and film dimensions, mechanical properties of the stretch film described by the Poisson ratio and unit deformation, the overlap between adjacent film strips and the pre‐assumed number of basic film layers are taken into account. It is proved that the complete set of the overlap ratios guaranteeing uniform film distribution is composed of irreducible fractions in which dividend is the divisor minus one. For the bale wrapping technique, only the first four equal to are significant. However, the essence of this study is the uniform film distribution, but optimization and robustness issues are also discussed. Simple mathematical rules are derived to calculate the optimal overlap ratios which minimize film usage. The parallelism between the uniform film distribution and minimal film usage is demonstrated, but it is also proved that these requirements are not equivalent. Robustness on the wrapping process disturbances is examined, and two algorithms for robustly optimal overlap ratio design are developed. The main developments are illustrated by examples, figures and supporting discussions.
Special issue introduction: maritime networks and transnational spaces
Authors: FEATHERSTONE DAVID
Published: September 2019

This article introduces the key contributions of the special issue on ‘Maritime networks and transnational spaces’. It draws attention to three key thematics that the papers develop. These are a set of engagements between law, space and maritime networks; a set of questions around maritime spaces, subaltern histories and transnational networks and finally a set of concerns around the forms of ‘geopolitical literacy’ articulated by maritime actors (Troutman 2005). Through drawing together these interlocking problematics the articles contribute to a broad agenda highlighting the productive intersection of work on maritime networks and transnational spaces. The introduction sets out some of the ways in which engagements with maritime contexts and scholarship can offer new perspectives on the transnational spatialities of politics, resistance and regulation.
The frequency of circulating integrin α4β7+ cells correlates with protection against Helicobacter pylori infection in immunized mice
Authors: Akter Sarmin , Jeverstam Frida , Lundgren Anna , Magnusson Maria K. , Walduck Anna , Qadri Firdausi , Bhuiyan Taufiqur Rahman , Raghavan Sukanya
Published: September 2019

Background

Chronic Helicobacter pylori infection is the cause of peptic ulcers in a subpopulation of individuals and a risk factor for the development of gastric cancer. A vaccine against H pylori infection can prevent the acquisition of the infection and protect against reinfections. Clinical trials to date evaluating the efficacy of H pylori vaccines in human challenge models have shown moderate to poor protection with difficulties in predicting efficacy. Thus, while further studies are needed to design an effective vaccine, we also need to find relevant correlates for vaccine efficacy.

Objective

To find immune correlates to vaccine efficacy, the frequencies of neutrophils, eosinophils and inflammatory monocytes and CD4+ T‐cell memory and mucosa homing integrin α4β7+ cells were assessed by flow cytometry in the blood of mice after vaccination.

Materials and Methods

H pylori antigens and cholera toxin or the multiple mutant CT (mmCT) were administered via the sublingual (SL) and intragastric route (IG). The vaccinated mice were infected with H pylori strain SS1 bacteria, and colonization in the stomach and immune responses were evaluated.

Results

The H pylori vaccine was effective in reducing bacterial load in the stomach of mice and enhancing immune responses compared to unvaccinated infection controls. In the blood of mice after SL or IG route of vaccination, we observed changes in frequencies of innate and adaptive immune cell subsets compared to infection controls. Remarkably, the frequency of circulating mucosal homing α4β7+CD4+ T cells after vaccination correlated with low bacterial load in the stomach of individual mice irrespective of the immunization route.

Conclusions

Our study shows that the innate and adaptive immune cell subsets can be measured in the blood after vaccination and that increased frequency of α4β7+CD4+ in the blood after immunization could be used as a predictive marker for the efficacy of vaccine against H pylori infection.
Twice‐a‐day PPI, tetracycline, metronidazole quadruple therapy with Pylera® or Lactobacillus reuteri for treatment naïve or for retreatment of Helicobacter pylori. Two randomized pilot studies
Authors: Dore Maria Pina , Bibbò Stefano , Loria Mariafrancesca , Salis Roberta , Manca Alessandra , Pes Giovanni Mario , Graham David Yates
Published: September 2019

Background

Bismuth is no longer available in Europe except as part of combination therapy. Lactobacillus reuteri has also been used as an adjuvant for Helicobacter pylori therapy. We aimed to investigate the efficacy of a b.i.d. quadruple therapy containing Pylera® or L reuteri for H pylori infection.

Materials and Methods

We performed two open‐label randomized pilot studies. Adult patients positive for H pylori were randomly assigned to b.i.d therapy with quadruple therapy containing bismuth (2 capsules of Pylera® plus 250 mg each of tetracycline and metronidazole for a total of 500 mg of each), or the same dose of antibiotics plus 2 × 108 CFU L reuteri DSM 17 938 plus 2 × 108 CFU L reuteri ATCC PTA 6475 (Gastrus®) once daily and pantoprazole 20 mg b.i.d. Regimens were given with meals for 10 days. Cure was defined by negative 13C‐UBT or stool antigen test.

Results

A total of 99 subjects (29% men) were enrolled; 92 completed the study. In the Pylera® group, H pylori infection was cured in 95.7%; 95% CI = 85%‐99% (44/46) PP and 88%; 95% CI = 75%‐95% (44/50) ITT vs. 84.8%; 95% CI = 71%‐95% (39/46) PP and 79.6%; 95% CI = 65%‐89% (39/49) ITT in the Gastrus® group, respectively. Cure rates in naїve patients were 100%; 95% CI = 85%‐100% (25/25) PP with Pylera®, and 89.7%; 95% CI = 72%‐97% (26/29) with Gastrus®. Compliance was excellent and side effects mild with both regimens.

Conclusions

B.i.d. bismuth quadruple therapy was highly effective for H pylori eradication in treatment of naïve patients in Sardinia. Replacement of bismuth with Gastrus® might be considered when bismuth is contraindicated or unavailable.
Development of magnesium‐aluminum‐silicate glass‐ceramics nucleated with Nb2O5
Authors: Benitez Tobias , Veber Alexander , Pagnan Furlan Kaline , Barros Rebouças Lara , de Ligny Dominique , Hotza Dachamir , Novaes de Oliveira Antonio Pedro , Travitzky Nahum
Published: September 2019

The influence of nucleating agents and heat‐treatments on magnesium‐aluminum‐silicate (MAS) glass‐ceramics was studied. MAS precursor glasses were melted in oxidant (air) and reducing atmospheres. Nb2O5, MoO3and TiO2+ZrO2were added as nucleating agents at the same molar proportion (1.0%). MAS glass‐ceramics nucleated with Nb2O5are strike face candidates for security windows when relevant outputs are taken into account, such as transparency, crack resistance, hardness and feasibility. Nb2O5‐doped MAS can achieve up to 20% crystalline volume fraction, while keeping the visible transparency close to 70%. Knoop hardness was raised up to 7.4 GPa in comparison to precursor glass (6.2 GPa), considering the indentation size effect. The crack resistance reached 4 N.
Social protection systems and the future of work: Ensuring social security for digital platform workers
Authors: Behrendt Christina , Nguyen Quynh Anh , Rani Uma
Published: September 2019

Digitalization is transforming societies and economies worldwide at an unprecedented scale and pace. In the wake of automation and digitalization, new forms of employment have been emerging in various occupations and sectors, such as the digital platform economy. The emergence of new forms of employment, such as work on digital platforms, requires that existing social protection systems adapt to the specific situation and needs of such workers, as to realize the human right to social security for all. Current social protection coverage for workers on digital crowdwork platforms reveals significant gaps in social security coverage. Where such coverage exists, it is often provided through the workers’ previous or additional jobs, or indirectly through their spouses or other family members. This raises questions about digital platforms free riding on the traditional economy with regard to the financing of social security. How can social protection systems adapt to changing forms of work to ensure full and effective coverage for workers in all forms of employment, including those in “new” forms of employment? How can workers in all types of employment, including those on digital platforms, be protected in an adequate and comprehensive way, combining contributory and non‐contributory mechanisms and based on equitable and sustainable financing mechanisms, so as to ensure adequate social protection to all?
The regulatory challenge of occupational safety and health in the online platform economy
Authors: Garben Sacha
Published: September 2019

The online platform economy raises a range of intricate legal questions connected to labour law and social security protection. In particular, the atypical forms of labour relationships used by many online platforms (e.g. multilateral, hyper‐temporary, off‐site, autonomous), often contractually defined as independent contracting, have challenged the application of labour and occupational health and safety law in many countries across the world, as the application of these norms tends to be dependent on the existence of an “employment relationship”. These developments are compounding the general increase in atypical employment, especially as a result of the 2007–08 financial and economic crisis. It has mostly fallen to courts to resolve the disputes between online platforms and their online platform workers, but some European Union (EU) Member States (such as France) have taken specific legal measures in response to these difficulties. Also, the EU‐level as such is becoming increasingly involved, with the Court of Justice’s ruling in the case of Uber providing some guidance on the “employment question”, and a pending legislative initiative on a Directive for Transparent and Predictable Working Conditions which may provide minimum labour protection for online platform workers in the EU. This article analyzes the problem of labour law in the online platform economy and surveys the various responses by courts and policy‐makers across the EU, which may furthermore set the tone for developments outside the EU in this area.
Ten‐year trends in catheter ablation for ventricular tachycardia vs other interventional procedures in Australia
Authors: Anderson Robert D. , Lee Geoffrey , Prabhu Mukund , Patrick Cameron J. , Trivic Ivana , Campbell Timothy , Chow Clara K. , Kalman Jonathan M. , Kumar Saurabh
Published: September 2019

Aims

Major technological and procedural advancements have reinvigorated catheter ablation as adjunctive therapy for drug‐refractory ventricular tachycardia (VT). We examined temporal trends in VT ablations as compared to other interventional cardiovascular procedures namely, percutaneous coronary intervention (PCI) and atrial fibrillation (AF) ablation in Australia.

Methods and Results

A retrospective review of procedural numbers for VT ablations, AF ablations, and PCI was performed from 2008/09‐2016/17 the Australian Institute of Health, Welfare and Aging (AIHW), and Medicare Australia (MA) databases. Linear regression models were fitted to compare the trends in population‐adjusted procedural numbers over the 10‐year period. Data from the AIHW and MA sources respectively showed that (a) PCI had a 1.3% (AIHW data P = .15) and 1.8% (MA data P < .001) population‐adjusted increment per year, (b) AF ablations had a 12.7% (P < .001) and 11.7% (P < .001) per year population‐adjusted increment, and (c) VT ablations showed an 18% (P < .001) and 12.7% (P < .001) per year population‐adjusted increment. Growth of PCI was increasing at a lower rate than AF ablations (P < .001 for both AIHW and MA sources). Growth of VT ablation was significantly higher than AF ablations and PCI (AIHW: 18% vs 12.7% [P = .004] and 1.3% per year [P < .001]).

Conclusion

Catheter‐based VT ablation has increased significantly in Australia over the last decade, consistent with worldwide trends, and now surpassing all ablation procedures, including AF ablation and PCI for CAD. This data highlight the provision of additional resources to match the increasing demand for VT ablation procedures in Australia.
Persistent atrial fibrillation; It is time to regroup
Authors: Keramati Ali R. , Calkins Hugh
Published: September 2019

Pulmonary vein isolation (PVI) is the only proven ablation strategy for paroxysmal and persistent atrial fibrillation (AF). However, when AF recurs despite durable PVI in a subgroup of patients with persistent AF, there is no scientifically proven ablation strategy to pursue. Here, we summarized how we approach persistent AF at Johns Hopkins Hospital.
A texting‐based blood pressure surveillance intervention
Authors: Zahr Roula S. , Anthony Chris A. , Polgreen Philip M. , Simmering Jacob E. , Goerdt Christopher J. , Hoth Angela B. , Miller Michelle L. , Suneja Manish , Segre Alberto M. , Carter Barry L. , Cavanaugh Joseph E. , Polgreen Linnea A.
Published: September 2019

The authors examined whether using home BP measurements collected via a custom‐built bi‐directional‐texting platform incorporated into patients’ electronic medical records would lead to treatment calibration and improved BP management. Patients were randomized to either the intervention group and collected home measurements based on reminders and reported via bi‐directional texting, or to the control group, with home BP measurement reporting via standard practice (eg, phone, electronic medical record portal) and instructed to return 7 morning and 7 evening BP measurements. Outcomes included number of BP measurements submitted, the number of medication changes, reduction in BP, and BP control. 72% of the intervention group submitted at least 14 readings, compared with 45% of the control group. BP control improved in both groups. However, the authors found no statistically significant difference in BP or the number of BP‐medication changes at 1, 3, or 6 months compared with the control group.
Letter to editor in response to the article ‘Position statement: LEPROSY: diagnosis, treatment and follow‐up’
Authors: Subhadarshani S. , Mishra H.S.
Published: September 2019

Linked article: B. Naafs et al. J Eur Acad Dermatol Venereol 2020; 34: e73–e74. https://doi.org/10.1111/jdv.15947.
An agency model of consent and the standards of disclosure in health care: Knowing‐how to reach respectful shared decisions among real persons
Authors: Azevedo Marco Antonio , Dall'Agnol Darlei
Published: September 2019

Objective

In this article, we evaluate and compare the frailties of two different standards of disclosure of information regarding the risks of medical procedures applied in recent judicial decisions in the United Kingdom. As an alternative, we present the tenets and philosophical grounds of an agency model of consent and a person‐based standard of disclosure.

Methods

Critical philosophical analysis of the background assumptions of two standards of disclosure and their relative “tests of negligence” applied in recent legal judgements in the United Kingdom.

Results

Both standards, the “Professional Practice Standard” (the traditional standard employed in Sidaway versus Board of Governors of the Bethlem Royal Hospital, 1985) and the allegedly new “Reasonable Person Standard” (mentioned in Montgomery versus Lanarkshire Health Board, 2015), can lead to malpractice if the medical‐patient relationship is not guided by attitudes of respectful care. The traditional standard is disrespectful as it does not take patients as full agents, presupposing that the patient's right is only a negative right to refuse what was deliberated only by the practitioner. The “new” standard can be disrespectful if the practitioner, concerned only with what a hypothetical reasonable individual would take as relevant for choosing between alternatives of treatment, does not know how to respect their real patient in a genuine shared decision‐making process.

Conclusion

We conclude that in order to know how to obtain valid informed consent, doctors need to engage in real conversations with their patients, revealing as much information as they, taken as real persons, need to be part of a genuine shared and respectful decision‐making process.
Effect of particle size on compositional, structural, rheological, and thermal properties of shallot flour as a source of thickening agent
Authors: Khushbu S. , Sunil Chikkaballpur Krishnappa , Chidanand Duggonahalli Veeresh , Jaganmohan Rangarajan
Published: September 2019

Influence of three particle size (<180, 180, and 250
μm) of shallot flour on compositional, structural, rheological, and thermal properties were studied. Carbohydrate, starch, fiber, amylose, amylopectin, color, and other functional properties showed the indirect effect with an increase in particle size and were found to be higher in lowest particle size, whereas, protein, bulk, true density were lower and ash, fat, moisture, aw, was unaffected by particle size. Rheological properties at concentration (0.5, 1.0, 1.5, and 2.0% [w/w]), temperature (20, 30, 40, 60, and 80°C) and pH (4, 7, and 10) revealed Non‐Newtonian, shear thinning behavior of all samples with flow behavior index (n) <1 and coefficient of determination (R2) >0.90, using power law model. Examined pasting property showed higher viscosity values, holding strength and lower peak time and temperature for sample with lower particle size. Thermal parameters (T
o, T
p, and T
c) and change of enthalpy (
ΔH) values increased with increase in particle size.

Practical application

A comprehensive study of rheological, thermal, and structural properties concludes application of shallot flour as a thickener in various food products. The particle size of shallot flour (<180
μm) was found to be most suitable for their application as a thickener, evident from proximate, physiochemical, functional, rheological, pasting, and thermal parameters. SEM results also reveal the application of shallot flour (<180
μm) as a thickener. Shallot flour can not only improve the texture of the food products as natural thickener but can also enhance the flavor profile.
Onychomycosis: Correlation between the dermoscopic patterns and fungal culture
Authors: Abdallah Naglaa A. , Said Marwa , Mahmoud Mohamed Taha , Omar Maha A.
Published: September 2019

Background

Onychomycosis is a dermatophyte fungal infection of the nail plate, bed, and the matrix, leading to the gradual damage which often considered a cosmetic problem. Several presentations of onychomycosis: distolateral subungual (DLSOM), superficial white, proximal subungual, endonyx, and total dystrophic (TDOM). Although the diagnosis relies on mycological results, there are three specific dermoscopic findings for onychomycosis: a jagged edge of the onycholytic area, with spikes directed to the proximal fold, white‐yellow longitudinal striae in the onycholytic nail plate, and colored parallel bands.

Aims

The objective of this diagnostic cross‐sectional study was to evaluate the diagnostic accuracy of dermoscopy as a low‐cost tool compared with fungal culture in patients with onychomycosis.

Patients/Methods

This study was carried out on 40 patients with a clinical diagnosis of onychomycosis collected from dermatology outpatient clinic of Alzahraa University Hospital after approval from the research ethics committee of Al‐Azhar University. For each patient, dermoscopic imaging of nail was done. And nail scrapings, culture on sabouraud's dextrose agar medium, and dermatophyte test agar medium. Informed written consent was taken from all patients, and the data collected from dermoscopic and laboratory results were statistically evaluated.

Results

Concerning the dermoscopic features, longitudinal white striae, jagged proximal edge with spikes, were the most commonly detected in DLSOM and TDOM. Linear edge was exclusive to traumatic onycholysis. Laboratory results: Aspergillus species was the most common detected fungus (45%) followed by Candida (32.5%).

Conclusion

Dermoscopy could facilitate the diagnosis of onychomycosis and differentiate it from mycologically negative onycholysis.
Alter circulating cell‐free DNA variables in plasma of ovarian cancer patients
Authors: Yu Zhou , Qin Shanshan , Wang Haidong
Published: September 2019

Aim

Liquid biopsy shows great potential in the fields of early diagnosis and prognosis in cancer. Ovarian cancer (OC) is the seventh most common cancer and the eighth most common cause of death from cancer in women. The early diagnosis of OC is vital for subsequent treatment and outcome. Here we investigated two markers: cell‐free DNA concentration (cfDNA conc) and cell‐free DNA integrity (cfDI) between OC patients and healthy controls.

Methods

Age‐matched OC patients and healthy controls were enrolled in this study. In total, there are 20 patients and 20 healthy controls. cfDNA conc and cfDI were calculated by arthrobacter luteus (ALU) gene using quantitative real‐time polymerase chain reaction (PCR).

Results

An increased cfDNA conc in OC patients compared to healthy controls was observed (mean cfDNA conc for OC patients: 1.98 ng/μL, for healthy control: 0.51 ng/μL, P = 0.02). For cfDI, the median value of OC patients is 0.49 while the median value of healthy control is 0.61 (P = 0.038). The diagnostic value of area under the curve was 0.86 for cfDNA conc and 0.72 for cfDI. When cfDNA conc and cfDI were combined, the diagnostic value was 0.90 which indicates a good diagnostic marker.

Conclusion

As few reports of cfDNA conc and cfDI differences between OC patients and healthy controls reported, our study shows increased cfDNA concentrations and decreased cfDI in OC patients compared to healthy controls. We also propose that cfDNA biomarkers can be potential diagnostic markers in ovarian cancer.
Long‐term oncological outcomes of minimally invasive radical hysterectomy for early‐stage cervical cancer: A retrospective, single‐institutional study in the wake of the LACC trial
Authors: Kanno Kiyoshi , Andou Masaaki , Yanai Shiori , Toeda Mitsuru , Nimura Ryo , Ichikawa Fuyuki , Teishikata Yasuhiro , Shirane Terumi , Sakate Shintaro , Kihira Tomohisa , Hamasaki Yoichiro , Sawada Mari , Shirane Akira , Ota Yoshiaki
Published: September 2019

Aim

The objective of this study was to investigate the long‐term oncological outcomes of minimally invasive radical hysterectomy (MIRH) for the treatment of early‐stage cervical cancer retrospectively in the wake of the laparoscopic approach to cervical cancer (LACC) trial.

Methods

A total of 109 patients with stage IA1 with lymphovascular space involvement, IA2, and IB1 cervical cancers were included in this study. The surgical and oncological outcomes were retrospectively evaluated. All patients underwent type C MIRH with a no‐touch isolation technique for cervical tumor.

Results

The median number of resected pelvic lymph nodes was 36 (range, 14–94), and 10 patients (9.2%) had positive nodes. One patient (0.9%) had positive surgical margins. Forty‐six patients (42%) underwent adjuvant therapy. The median follow‐up time was 73 months (range, 30–146 months). Five patients (4.6%) developed recurrent disease, and 3 patients (2.8%) died of cervical cancer. The 5‐year disease‐free survival and overall survival rates were 96.3% and 97.2%, respectively. A comparison between patients with tumor diameter ≤ 2 cm (n = 59) and those with tumor diameter > 2 cm (n = 50) did not identify any significant differences, with 5‐year disease‐free survival 96.6% versus 94.0% and 5‐year overall survival 98.3% versus 96.0%, respectively.

Conclusion

In this retrospective study, MIRH with a no‐touch isolation technique for stage IA to IB1 cervical cancer was a safe approach in terms of oncological outcomes. However, every surgeon who treats early‐stage cervical cancer should inform each patient of the results of the LACC trial because it has an exceedingly high impact.
Minimally invasive mitral valve surgery is associated with a low rate of complications
Authors: Kastengren M. , Svenarud P. , Ahlsson A. , Dalén M.
Published: September 2019

Minimally invasive mitral valve surgery is generally performed through a right minithoracotomy, in contrast to the traditional full median sternotomy approach. Minimally invasive mitral valve surgery is performed with increasing frequency, and by reducing surgical trauma, several observational studies suggest potential benefits with decreased bleeding and postoperative pain, reduced incidence of sternal wound infections, reduced length of hospital stay and shortened recovery period after surgery. In this review, we present an overview of mitral valve surgery, summarize the available evidence regarding the minimally invasive approach and report our experiences from introducing a minimally invasive mitral valve surgery programme at the Karolinska University Hospital in Stockholm, Sweden.
Point‐of‐care HCV RNA testing in the setting of DAA therapy: HCV‐FiS (HEpatitis C Virus Fingerstick Study)
Authors: Calvaruso Vincenza , Bronte Fabrizio , Ferraro Donatella , Reina Giada , Conte Elisabetta , Rini Francesca , Magro Bianca , Petta Salvatore , Di Marco Vito , Craxì Antonio
Published: September 2019

HCV‐RNA assessment during therapy with Direct‐Acting Antiviral (DAA) regimens still relies on assays requiring blood collection and transport to a specialised laboratory, which may compromise linkage to care. GeneXpert‐HCV Viral Load (GXHVL) (Cepheid) is a plasma‐based assay used at point of care (POC) with a sensitivity of ≤10 IU/mL, and, results available within 2 hours. Fifty‐nine consecutive HCV‐patients ready for DAAs treatment were enrolled. HCV‐RNA was simultaneously tested using Roche TaqMan RT‐PCR (venous blood sample) and GXHVL (capillary blood collected by fingerstick), at baseline (BL), week 4 (W4) of therapy, end of therapy (EOT) and week 12 of follow‐up (W12FU). Both assays demonstrated undetectable HCV‐RNA in all patients at EOT and identified the single case of HCV‐relapse at W12FU. GXHVL used as a point‐of‐care assay in the outpatient setting provides results fully comparable to the laboratory‐based test. Its excellent performance and ease of use suggest its adoption in non‐specialist settings where simplicity of care is paramount to implement HCV eradication campaigns.
Targeted transposition with Tn7 elements: safe sites, mobile plasmids, CRISPR/Cas and beyond
Authors: Peters Joseph E.
Published: September 2019

Transposon Tn7 is notable for the control it exercises over where transposition events are directed. One Tn7 integration pathways recognizes a highly conserved attachment (att) site in the chromosome, while a second pathway specifically recognizes mobile plasmids that facilitate transfer of the element to new hosts. In this review, I discuss newly discovered families of Tn7‐like elements with different targeting pathways. Perhaps the most exciting examples are multiple instances where Tn7‐like elements have repurposed CRISPR/Cas systems. In these cases, the CRISPR/Cas systems have lost their canonical defensive function to destroy incoming mobile elements; instead, the systems have been naturally adapted to use guide RNAs to specifically direct transposition into these mobile elements. The new families of Tn7‐like elements also include a variety of novel att sites in bacterial chromosomes where genome islands can form. Interesting families have also been revealed where proteins described in the prototypic Tn7 element are fused or otherwise repurposed for the new dual activities. This expanded understanding of Tn7‐like elements broadens our view of how genetic systems are repurposed and provides potentially exciting new tools for genome modification and genomics. Future opportunities and challenges to understanding the impact of the new families of Tn7‐like elements are discussed.
Different DNA methylation profile is demonstrated in paracoccidioidomycosis patients without oral lesions
Authors: Singi Paola , Rocha Raissa P. , de Carli Marina L. , Hanemann João Adolfo C. , Pereira Alessandro A. C. , Coelho Luiz Felipe L. , Malaquias Luiz Cosme C.
Published: September 2019

Background

Paracoccidioidomycosis (PCM) is a neglected fungal infection with a high impact on the quality of life of the affected patients. The disease presents primary pulmonary involvement and systemic dissemination may occur. About 50% of the cases show oral involvement, and the factors that lead to this manifestation are not clear.

Objectives

The aim of this study was to evaluate the DNA methylation profile in PCM patients with oral lesions.

Material and Methods

Genomic DNA was extracted from whole blood of eighteen PCM patients, being ten with oral lesions and eight with no oral lesion. Analysis of methylation profile was performed using the technique of methylation‐sensitive arbitrarily primed PCR (MS‐AP‐PCR). The sequences of recombinant plasmids obtained were evaluated according to parameters that define a CpG island, as well as their relative position in the known human genome genes and/or CpG islands.

Results

After DNA amplification, three different expressed bands were observed between the two groups, being found in the samples of patients with no oral manifestations. The cloned fragment in the plasmid showed similarity with a DNA sequence present in chromosome 20, next to the YTHDF1 gene. Other bands showed homology with intronic region in the genes RBPMS2 and DPH6 and no CpG island was identified.

Conclusions

DNA methylation was found in PCM patients with no oral lesion affecting the YTHDF1 gene. Further studies are necessary to elucidate to role of YTHDF1 gene in the oral PCM manifestations.
The beliefs of non‐psychiatric doctors about the causes, treatments, and prognosis of schizophrenia
Authors: Magliano Lorenza , Citarelli Giulia , Read John
Published: September 2019

Objectives

To examine the causal beliefs about schizophrenia of non‐psychiatric doctors and whether differential belief in biogenetic vs. psychosocial causes influences doctors’ views about treatments and prognosis.

Design and methods

Three hundred and five non‐psychiatric doctors working in outpatient community centres completed the ‘Opinions on mental disorders Questionnaire’ after reading a clinical description of people with schizophrenia.

Results

The factors most frequently reported as causes of schizophrenia were heredity (65.2%) and use of street drugs (54.1%). Seventy‐five per cent of participants endorsed both one or more biological causal factors and one or more psychosocial causal factors. Of the 264 participants who expressed their opinion about the most important cause of schizophrenia, 53.8% indicated a biogenetic cause. Fifty‐two per cent of respondents thought it ‘completely true’ that drugs are useful in schizophrenia, and 33.9% thought it ‘completely true’ that people with schizophrenia must take drugs all their life. Participants stating that the most important cause was biogenetic more frequently recommended a psychiatrist and less frequently a psychologist. Compared to doctors who indicated a psychosocial cause as the most important one, those who indicated a biogenetic cause were more sceptical about recovery, more confident in the usefulness of drugs, and more convinced of the need of lifelong pharmacological treatments in schizophrenia.

Conclusions

These findings suggest the need to provide some doctors with training on the multiple, interacting causes of schizophrenia and the efficacy of the broad range of available treatments. The education of health professionals regarding stigma and its effects on clinical practice is also needed.

Practitioner points

Viewing schizophrenia as mainly due to a biological cause is associated with greater confidence in the usefulness of drugs, higher belief in the need for lifelong pharmacological treatments, and greater prognostic pessimism.

Belief in a biologically oriented model of schizophrenia may lead doctors to underestimate the value of psychologists.

Prognostic pessimism among doctors may negatively influence clinical decisions, the information doctors provide to their clients, and clients’ own beliefs about their chances of recovery.

Belief in the need for lifelong pharmacological treatments in schizophrenia may lead doctors to resist drug withdrawal in case of severe side effects.
Foreign entrants and domestic entrepreneurship: Evidence from Vietnam
Authors: Yang Chih‐Hai
Published: September 2019

This paper examines the impacts of foreign entrants and international trade on potential entrants in Vietnam. Based on a discrete entry model, estimates show that foreign direct investment (FDI) stimulates more domestic entrants in the short run, while the aggregate effect of FDI varies across FDI types. Horizontal FDI tends to have no impact on local start‐ups while vertical FDI is found to have a positive impact on the inflow of domestic entry for only the backward linkage and not for the forward linkage. Moreover, industries with more exports accommodate more domestic entrants, whereas imports tend to deter domestic start‐ups.
Characterization of the first HLA‐B*15:31 variant, B*15:31:01:02, found in a Brazilian individual
Authors: Vianna Romulo , Secco Danielle , Santos Angela , Porto Luís Cristóvão
Published: September 2019

Characterization of the first HLA‐B*15:31 variant, called HLA‐B*15:31:01:02.
Personal Identity and Trivial Survival
Authors: Sauchelli Andrea
Published: September 2019

Your replica is created on Mars and you, on Earth, are destroyed. Parfit claims that your replica may still have what prudentially matters for you – provided that you are psychologically connected and continuous with your replica. If someone accidently destroys the tapes containing your psychological profile used in the production of your replica and this same action fortuitously produces a functionally equivalent tape, Ehring claims that Parfit should maintain that the resulting new individual may still have what matters. Nihilism about what matters follows, or so Ehring claims. I argue that Ehring is wrong and that the difference between the two ways of creating a replica is not trivial – there is no trivial survival.
Gastrointestinal pathogen colonization and the microbiome in asymptomatic kidney transplant recipients
Authors: Westblade Lars F. , Satlin Michael J. , Albakry Shady , Botticelli Brittany , Robertson Amy , Alston Tricia , Magruder Matthew , Zhang Lisa T. , Edusei Emmanuel , Chan Kevin , Lubetzky Michelle , Dadhania Darshana M. , Pamer Eric G. , Suthanthiran Manikkam , Lee John R.
Published: September 2019

Background

In kidney transplant recipients, gastrointestinal (GI) pathogens in feces are only evaluated during diarrheal episodes. Little is known about the prevalence of GI pathogens in asymptomatic individuals in this population.

Methods

We recruited 142 kidney transplant recipients who provided a non‐diarrheal fecal sample within the first 10 days after transplantation. The specimens were evaluated for GI pathogens using the BioFire® FilmArray® GI Panel (BioFire Diagnostics, LLC), which tests for 22 pathogens. The fecal microbiome was also characterized using 16S rRNA gene sequencing of the V4‐V5 hypervariable region. We evaluated whether detection of Clostridioides difficile and other GI pathogens was associated with post‐transplant diarrhea within the first 3 months after transplantation.

Results

Among the 142 subjects, a potential pathogen was detected in 43 (30%) using the GI Panel. The most common organisms detected were C difficile (n = 24, 17%), enteropathogenic Escherichia coli (n = 8, 6%), and norovirus (n = 5, 4%). Detection of a pathogen on the GI panel or detection of C difficile alone was not associated with future post‐transplant diarrhea (P > .05). The estimated number of gut bacterial species was significantly lower in subjects colonized with C difficile than those not colonized with a GI pathogen (P = .01).

Conclusion

Colonization with GI pathogens, particularly C difficile, is common at the time of kidney transplantation but does not predict subsequent diarrhea. Detection of C difficile carriage was associated with decreased microbial diversity and may be a biomarker of gut dysbiosis.
A new reliable test for crossmatching: microplate hydrogel immunoassay technology
Authors: Chen Y. , Wang M. , Ding S. , Duan S. , Wei S. , Li Y. , Wang H.
Published: September 2019

Objectives

To provide a novel assay to detect incomplete antibodies in the crossmatching test.

Background

There is a requirement in China that both major and minor crossmatch tests are required. Among all methods of crossmatching, the tube anti‐human globulin test requires tedious washing steps and is time‐consuming, whereas the microcolumn gel immunoassay anti‐human globulin test is susceptible to sample quality.

Methods

The process of the microplate hydrogel immunoassay anti‐human globulin test involves the use of our patented hydrogel chromatography medium and U‐bottom microplates pre‐coated with goat anti‐human globulin (AHG). A mixture of red blood cells (RBCs) and serum is centrifuged through the hydrogel under precise conditions. In incompatible reactions, the sensitised RBCs are captured by the pre‐coated AHG and form a layer over the bottom of the well, whereas in compatible reactions, the unbound RBCs form a button at the bottom of the well. The sensitivity of this new approach and the performance when testing old specimens were evaluated.

Results

This approach was more convenient and slightly more sensitive than the tube anti‐human globulin test and was superior to the microcolumn gel immunoassay when testing old specimens.

Conclusion

In general, this assay is suitable for the routine clinical use of crossmatching to detect incomplete antibodies.
Acute hemolytic transfusion reaction associated with anti‐Mta: case report and review of the literature
Authors: Claes Vincent , Peyrard Thierry , Deleers Marie , El Kenz Hanane
Published: September 2019

BACKGROUND

Mta (MNS14) is a low‐prevalence antigen of the MNS system. A few cases of hemolytic disease of the fetus and newborn caused by anti‐Mta have been reported in the literature, but up to now this antibody has never been associated with a hemolytic transfusion reaction (HTR).

CASE REPORT

A 38‐year‐old male with sickle cell disease undergoing exchange transfusion presented with shivering, nausea, dyspnea, and pain in the lower limbs. Biologic parameters showed increased hemolysis. The administered red blood cell (RBC) units had been issued by electronic crossmatch due to a negative antibody screening test. In the posttransfusion investigations, crossmatch of the transfused RBC units with the patient's serum showed incompatibility of one unit. The presence of an antibody against a low‐prevalence antigen was suspected and further serologic testing was performed for identification.

RESULTS

Anti‐Mta was identified in the patient's serum. The RBCs of the incompatible unit implicated in the HTR were Mt(a+). An eluate of a posttransfusion blood sample of the patient was nonreactive with the incompatible RBCs, and the direct antiglobulin test was negative.

CONCLUSION

To our knowledge, this is the first case report of an HTR associated with anti‐Mta.
Antitumour effects of Liporaxel (oral paclitaxel) for canine melanoma in a mouse xenograft model
Authors: Yang Ji‐In , Jin Bohwan , Kim Su‐Yeon , Li Qiang , Nam Aryung , Ryu Min‐Ok , Lee Won Woo , Son Min‐Hee , Park Hye‐Jin , Song Woo‐Jin , Youn Hwa‐Young
Published: September 2019

Paclitaxel, a member of the taxane family, exhibits antitumour effects by targeting the microtubules in cancer cells. Recently, oral paclitaxel has been developed to overcome the side effects of intravenous paclitaxel administration in human patients. The objective of this study was to investigate the antitumour effects of oral paclitaxel in vitro and in vivo. Three weeks after inoculation, oral paclitaxel (25 and 50 mg/kg) or saline was administered every week for three consecutive weeks. To explore the underlying mechanism, tumour angiogenesis was examined by immunohistochemistry with an anti‐CD31 antibody. Tumour cell apoptosis was detected by Terminal deoxynucleotidyl transferase dUTP Nick‐End Labeling assay, and cell cycle arrest was confirmed by western blot analysis. Oral paclitaxel treatment of canine melanoma cells exerted mediated antiproliferative effects and mediated cell cycle arrest in vitro. In animal experiments, after oral paclitaxel administration, the average tumour size decreased to approximately 30% of that in the control. Histologically, oral paclitaxel showed anti‐angiogenic effects and induced the apoptosis in tumour tissues. Oral paclitaxel also downregulated the intratumoural expression of cyclin D1 and inhibited cell proliferation. The study findings support potential application of oral paclitaxel as a novel chemotherapeutic strategy to treat canine melanoma. This is the first study to investigate the potential of oral paclitaxel as a therapeutic drug against canine tumours.
Integration of 21st Century Learning Skills (4C Elements) in Interventions to Improve English Writing Skill Among 3K Class Students
Authors: Yu Tan Xin , Wan Mohammad Wan Muna Ruzanna
Published: September 2019

21st Century Learning is a student-centered learning process that has been introduced in Malaysia since 2014. This study aims to integrate the 4C elements, which are collaboration, communication, creativity, and critical thinking in the interventions to improve English writing skill among 3K class students. Also, the study was conducted to determine how peer guidance can help 3K class students, who were weak in writing, to improve their English writing skills. The action research was carried out based on Kurt Lewin's Model. The research instruments involved were pre-test, post-test, and semi-structured interview. A total of 32 students sat for both pre-test and post-test before and after the interventions. A semi-structured interview consisting of five questions was conducted after the student completed the post-test. Descriptive statistics involving mean and percentage scores were used to analyze pre-test and post-test findings, while the interview findings were summarized. The results showed that there was an improvement in their English writing skills, where the mean score for the pre-test was 19.34, while the mean score for post-test was 22.66. The findings indicate that weaker students agreed that guidance of students who possess better writing skills helped them improve their English writing skills. The results of the pre-test and post-test showed that the intervention conducted has successfully helped 3K class students to improve their English writing skills.