bluuebunny/crossref_metadata_2025 huggingface dataset:
Fatigue behaviour of dry or partially saturated hot mix asphalt (HMA)
Authors: Lamothe Sébastien , Perraton Daniel , Di Benedetto Hervé
Published: December 2019

This paper analyses the water, the degree of saturation, and the void content effects on the fatigue behaviour of hot mix asphalt (HMA) samples mixed in the laboratory. Some results on stiffness are also given. Fatigue characterization was carried out through a uniaxial tension‐compression (T‐C) test performed in a controlled‐strain mode, at 10°C and 10 Hz, on cylindrical samples. Our results show that the stiffness is not significantly affected by the water. This finding could be attributed to the short period of immersion of samples in water, low testing temperature, low void content of tested samples, and high viscosity of bitumen used. Furthermore, the fatigue resistance of HMA partially saturated with water (PSW) is lower than the one obtained for dry materials.
Metabolic measurements and parameter estimations for bioenergetics modelling of Pacific Chub Mackerel Scomber japonicus
Authors: Guo Chenying , Ito Shin‐ichi , Wegner Nicholas C. , Frank Laura N. , Dorval Emmanis , Dickson Kathryn A. , Klinger Dane H.
Published: December 2019

As a crucial step in developing a bioenergetics model for Pacific Chub Mackerel Scomber japonicus (hereafter chub mackerel), parameters related to metabolism, the largest dissipation term in bioenergetics modelling, were estimated. Swimming energetics and metabolic data for nine chub mackerel were collected at 14°C, a low temperature within the typical thermal range of this species, using variable‐speed swim‐tunnel respirometry. These new data were combined with previous speed‐dependent metabolic data at 18 and 24°C and single‐speed (1 fork length per second: FL/s) metabolic data at 15 and 20°C to estimate respiration parameters for model development. Based on the combined data, the optimal swimming speed (the swimming speed with the minimum cost of transport, Uopt) was 42.5 cm/s (1.5–3.0 FL/s or 2.1 ± 0.4 FL/s) and showed no significant dependence on temperature or fish size. The daily mass‐specific oxygen consumption rate (R, g O2 g fish−1 day−1) was expressed as a function of fish mass (W), temperature (T) and swimming speed (U): R = 0.0103W−0.490 e(0.0457T) e(0.0235U). Compared to other small pelagic fishes such as Pacific Herring Clupea harengus pallasii, Pacific Sardine Sardinops sagax and various anchovy species, chub mackerel respiration showed a lower dependence on fish mass, temperature and swimming speed, suggesting a greater swimming ability and lower sensitivity to environmental temperature variation.
Management strategies for forage rape (Brassica napus L. cv Goliath): Impact on dry‐matter yield, plant reserves, morphology and nutritive value
Authors: Islam M. R. , Garcia Sergio C , Horadagoda Ajantha , Kerrisk Kendra L. , Clark Cameron E. F.
Published: December 2019

Limited information is available on the grazing management principles of forage rape (Brassica napus L.), particularly in relation to grazing height and intensity and the impact of these on dry‐matter (DM) yield and nutritive value. A glasshouse study was undertaken to investigate the effect of three defoliation heights (plant height at harvest; DH: 40, 70 and 90 cm; L, M and H DH respectively) and three defoliation intensities (height at which plants were cut; DI: 5, 20 and 35 cm of residual height; H, M and L DI respectively) on forage rape (cv Goliath) yield and nutritive value at two harvests (harvest 1, H1 and harvest 2, H2), and the impact of nitrogen (N) and water soluble carbohydrate (WSC) reserves on regrowth. Increasing DH from L to H increased estimated total DM yield (H1 plus H2) from 0.5 to 4.6 t DM/ha but DI did not affect yield. Dry‐matter yield was optimized at 90 cm DH, but greater nutritive value was achieved by harvesting at lower levels of DH. Despite high in vitro DM digestibility (IVDMD; 852–889 g/kg), harvesting at 90 cm DH could not meet the protein requirement of lactating dairy cows and harvesting at lower levels risks nitrate poisoning. Our results indicate the optimum DH may be between 70 and 90 cm DH, and 20 and 35 cm DI, which requires further studies.
Diagnostic work up of patients with increased bleeding tendency
Authors: Zegers Suzanne A. M. , Smit Yolba , Saes Joline L. , van Duren Clint , Schuijt Tim J. , van Heerde Waander L. , Schols Saskia E. M.
Published: December 2019

Introduction

The diagnostic trajectory of patients with increased bleeding tendency can be very costly and time‐consuming. In addition, previous studies have shown that half of these patients remain without final diagnosis despite all efforts.

Aim

This study aimed to improve insight into the current diagnostic process of these patients.

Methods

A total of 117 adult patients, referred to an academic hospital because of being suspected to have an increased bleeding tendency, were included. Different parameters were compared between patients receiving final diagnosis, patients without final diagnosis but a high Tosetto bleeding assessment tool (BAT) score (classified as bleeding of unknown cause, or BUC) and a control group consisting of patients without final diagnosis and a low BAT score.

Results

The BAT score was significantly higher in patients in the BUC group as compared to patients reaching final diagnosis (8.1 vs 4.9). Interestingly, the two subcategories most prevalently increased were surgery and post‐partum haemorrhage‐associated bleeding (surgery: 2.1 vs 1.1; post‐partum haemorrhage: 0.7 vs 0.0). Laboratory screening results were more often abnormal in patients reaching final diagnosis compared to patients remaining without diagnosis and a high BAT score (n = 32 (78%) vs n = 14 (46%), 95% CI 1.5‐12), especially concerning the PFA (=27 (66%) vs n = 10 (33%), 95% CI 1.4‐10) and von Willebrand factor activity levels (n = 11 (27%) vs n = 1 (3%), 95% CI 1.3‐91).

Conclusion

Isolated high bleeding score on surgical or post‐partum bleeding correlates with a lower chance of receiving final diagnosis. Withholding extensive haemostatic testing should be considered. Better screening and confirmative haemostatic assays are still needed.
Landscape‐level environmental stressors contributing to the decline of Poweshiek skipperling (Oarisma poweshiek)
Authors: Belitz Michael W. , Monfils Michael J. , Cuthrell David L. , Monfils Anna K.
Published: December 2019

1. The Poweshiek skipperling [Oarisma poweshiek (Parker, 1870; Lepidoptera: Hesperiidae)] is a federally endangered butterfly that was historically common in prairies of the upper Midwestern United States and Southern Manitoba, Canada. Rapid declines over the last 20 years have reduced the population numbers to four verified extant sites. The causes of Poweshiek skipperling decline are unknown. 2. We aggregated all known Poweshiek skipperling occurrence records to examine the spatiotemporal patterns of Poweshiek skipperling decline. Ecological niche models were developed for five time frames (1985, 1990, 1995, 2000 and 2005) and three spatial extents (eastern occupied range, western occupied range and total occupied range). We used a backward elimination method to investigate the effects of climate and land use on the ecological niche of Poweshiek skipperling. 3. Predictors of occurrence changed over time and across the geographical extent of Poweshiek skipperling. Land use covariates were retained in east models. In the west and total extent, climate variables contributed the most to model predictive power for the 1985, 1990 and 1995 models; land use variables contributed the most to model predictive power in the 2000 and 2005 models. 4. During the rapid decline in Poweshiek skipperling population numbers occurring at the turn of the century, probability of Poweshiek skipperling presence was being driven by proportion of natural land cover and distance to nearest grassland/wetland. Our results suggest that these land use variables are important landscape‐level variables to consider when developing risk assessments of extant populations and potential reintroduction sites.
Bioactive assessment of bioactive glass nanostructures synthesized using synthetic and natural silica resources
Authors: Durgalakshmi Dhinasekaran , Ajay Rakkesh Rajendran , Subramanian Balakumar
Published: December 2019

The sol‐gel route of synthesizing bioactive glasses of composition 45S5 has shown higher compatibility than the melt casting method. In bioactive glass synthesis, a major silica source is derived from the synthetic tetraethyl orthosilicate precursor. This work demonstrates the sol–gel‐derived bioactive glass prepared from rice husk and TEOS as silica sources. In this study, the effect of crystallization with respect to the silica source in bioactive glass composition was investigated to gain further understanding on the processes involved in the fabrication of bioglass. The in vitro biodegradation and apatite formation of the bioactive glass in simulated body fluid was investigated by spectroscopic and morphological studies. Both the bioactive glasses show a change in morphology toward nanostructured apatite formation after in vitro immersion studies. Further, the hemocompatibility of bioactive glass prepared using rice husk is similar to bioactive glass prepared from organic silica sources. This promises the possibility of synthesizing low cost and biocompatible bioactive glass 45S5 system for tissue engineering applications.
A conjoint analysis of the communication preferences of registered nurses towards mechanically ventilated patients
Authors: Bayog Kriessa Mae S. , Bello Danielle Marie C. , Benabaye Jeph Marl P. , Benegas Thea Mae E. , Benito Alexandra Loise M. , Berioso Marlowe A. , Parial Laurence Lloyd B. , Macindo John Rey B.
Published: December 2019

Background

The nurse‐patient communication is a dyadic process involving the transmission and recognition of information and feelings. However, communication difficulty is a common phenomenon among mechanically ventilated patients which causes distress among patients and may compromise the quality of patient care that nurses provide.

Aim

To explicate the communication preferences of registered nurses towards mechanically ventilated patients.

Design

Cross‐sectional, choice‐based conjoint analysis

Methods

From August to November 2017, 201 purposively selected registered nurses with prior experience in caring for mechanically ventilated patients were surveyed and ranked 12 choice bundles with four selected attributes of the communication process.

Results

Family participation was the most important attribute (40.40%) while communication initiator was the least important attribute (15.44%). Registered nurses prefer to communicate with mechanically ventilated patients if family members are involved (utility = 1.03), if conventional communication equipment are used (utility = 0.24), if open‐ended questions are asked (utility = 0.13), and if nurses are the communication initiator (utility = 0.22).

Conclusion

The model of communication preferences highlights the importance of involving the family in the communication process and can inform family‐centered policies for mechanically ventilated patients. Unit policies on the use of conventional communication equipment should be considered to maximize the nurse‐patient communication and potentially improve patient care.
A National Study of End‐of‐Life Care among Older Veterans with Hearing and Vision Loss
Authors: Carpenter Joan G. , Ersek Mary , Nelson Francis , Kinder Daniel , Wachterman Melissa , Smith Dawn , Murray Andrew , Garrido Melissa M.
Published: December 2019

OBJECTIVES

Hearing and visual sensory loss is prevalent among older adults and may impact the quality of healthcare they receive. Few studies have examined sensory loss and end‐of‐life (EOL) care quality. Our aim was to describe hearing and vision loss and their associations with the quality of EOL care and family perception of care in the last 30 days of life among a national sample of veteran decedents.

DESIGN

Retrospective medical record review and Bereaved Family Survey (BFS).

SETTING

Veterans Affairs (VA) Medical Centers (N = 145).

PARTICIPANTS

Medical record review of all veterans who died in an inpatient VA Medical Center between October 2012 and September 2017 (N = 96 424). Survey results included 42 428 individuals.

MEASUREMENTS

Three indicators of high‐quality EOL care were measured: palliative consultation in the last 90 days of life, death in a non‐acute setting, and contact with a chaplain. The BFS reflects a global evaluation of quality of EOL care; pain and posttraumatic stress disorder management; and three subscales characterizing perceptions regarding communication, emotional and spiritual support, and information about death benefits in the last month of life.

RESULTS

In adjusted models, EOL care quality indicators and BFS outcomes for veterans with hearing loss were similar to those for veterans without hearing loss; however, we noted slightly lower scores for pain management and less satisfaction with communication. Veterans with vision loss were less likely to have received a palliative care consult or contact with a chaplain than those without vision loss. Although BFS respondents for veterans with vision loss were less likely than respondents for veterans without vision loss to report excellent overall care and satisfaction with emotional support, other outcomes did not differ.

CONCLUSION

In general, the VA is meeting the EOL care needs of veterans with hearing and vision loss through palliative care practices. J Am Geriatr Soc 68:817–825, 2020
Validity of Cognitive Assessment Tools for Older Adult Hispanics: A Systematic Review
Authors: Arévalo Sandra P. , Kress Jennifer , Rodriguez Francisca S.
Published: December 2019

OBJECTIVES

A higher prevalence and incidence of dementia is found in Hispanic/Latino older adults. Therefore, valid instruments are necessary to assess cognitive functioning in this population group. Our aim was to review existing articles that have examined and reported on the validity of cognitive assessment tools in Hispanic/Latino population groups in the United States.

DESIGN

Systematic literature review according to the Preferred Reporting Items for Systematic Reviews and Meta‐analysis.

MEASUREMENTS

We systematically searched in the PubMed and Web of Science databases and assessed the quality of the search results using the Standards for the Reporting of Diagnostic Accuracy Studies. We included evidence from within the United States as well as from Spanish‐speaking countries of origin (Mexico, Central and South America, and the Caribbean).

RESULTS

The literature search revealed 27 studies with adequate quality that investigated 13 instruments. The Mini‐Mental Status Examination (MMSE) was the most frequently investigated instrument in Hispanic/Latino groups in the United States with high sensitivity for dementia but also with significant differences for ethnicity and education. The Addenbrooke Cognitive Examination‐Revised, Montreal Cognitive Assessment, 10/66 short diagnostic schedule, clock‐drawing test, Phototest, Eurotest, and Executive Battery 25 had good diagnostic performance in Spanish‐speaking countries. The naming test and verbal fluency tests have a higher risk of misclassifying US Hispanics/Latinos who have dementia.

CONCLUSION

Evidence on validity suggests that the MMSE may be an appropriate cognitive assessment tool for Hispanics. More research is needed to confirm the validity of cognitive tools to assess Hispanic/Latino groups for Alzheimer's disease and other related dementias in the United States to reduce current trends of culturally biased under‐ or overdiagnosis of cognitive impairments. J Am Geriatr Soc 68:882–888, 2020
Spatial dynamics of the insulin receptor in living neurons
Authors: Gralle Matthias , Labrecque Simon , Salesse Charleen , De Koninck Paul
Published: December 2019

Insulin signaling through the insulin receptor has long been studied in classic target organs, such as adipose tissue and skeletal muscle, where one of its effects is to increase glucose uptake. Insulin and insulin receptor are present in many areas of the brain, but the functions of brain insulin signaling outside feeding circuits are not well defined. It has been proposed that hippocampal insulin signaling is important for memory, that brain insulin signaling is deficient in Alzheimer's disease, and that intranasal insulin treatment improves cognition, but the mechanisms remain unclear and do not seem to involve increased glucose uptake by neurons. The molecular behavior of the insulin receptor itself is not well known in living neurons; therefore, we investigated the spatial dynamics of the insulin receptor on somatodendritic membranes of live rat hippocampal neurons in culture. Using single‐molecule tracking of quantum dot‐tagged insulin receptors and single‐particle tracking photoactivation localization microscopy, we show that the insulin receptor is distributed over both dendritic shafts and spines. Using colocalization with synaptic markers, we also show that in contrast to the glutamate receptor subunit glutamate receptor subunit A1, the dynamics of the insulin receptor are not affected by association with excitatory synapses; however, the insulin receptor is immobilized by components of inhibitory synapses. The mobility of the insulin receptor is reduced both by low concentrations of the pro‐inflammatory cytokine tumor necrosis factor α and by cholesterol depletion, suggesting an association with sphingolipid‐rich membrane domains. On the other hand, the insulin receptor dynamics in hippocampal neurons are not affected by increased excitatory signaling. Finally, using real‐time single‐event quantification, we find evidence of strong insulin receptor exocytosis on dendritic shafts. Our results suggest an association of the neuronal insulin receptor with specific elements of the dendritic shaft, rather than excitatory synapses.

image
Diurnal regulation of the function of the rat brain glutamate dehydrogenase by acetylation and its dependence on thiamine administration
Authors: Aleshin Vasily A. , Mkrtchyan Garik V. , Kaehne Thilo , Graf Anastasia V. , Maslova Maria V. , Bunik Victoria I.
Published: December 2019

Glutamate dehydrogenase (GDH) is essential for the brain function and highly regulated, according to its role in metabolism of the major excitatory neurotransmitter glutamate. Here we show a diurnal pattern of the GDH acetylation in rat brain, associated with specific regulation of GDH function. Mornings the acetylation levels of K84 (near the ADP site), K187 (near the active site), and K503 (GTP‐binding) are highly correlated. Evenings the acetylation levels of K187 and K503 decrease, and the correlations disappear. These daily variations in the acetylation adjust the GDH responses to the enzyme regulators. The adjustment is changed when the acetylation of K187 and K503 shows no diurnal variations, as in the rats after a high dose of thiamine. The regulation of GDH function by acetylation is confirmed in a model system, where incubation of the rat brain GDH with acetyl‐CoA changes the enzyme responses to GTP and ADP, decreasing the activity at subsaturating concentrations of substrates. Thus, the GDH acetylation may support cerebral homeostasis, stabilizing the enzyme function during diurnal oscillations of the brain metabolome. Daytime and thiamine interact upon the (de)acetylation of GDH in vitro. Evenings the acetylation of GDH from control animals increases both IC50GTP and EC50ADP. Mornings the acetylation of GDH from thiamine‐treated animals increases the enzyme IC50GTP. Molecular mechanisms of the GDH regulation by acetylation of specific residues are proposed. For the first time, diurnal and thiamine‐dependent changes in the allosteric regulation of the brain GDH due to the enzyme acetylation are shown.

image
Quantitative analysis of exercise among pregnant women with impaired glucose tolerance using pedometer data: An observational study
Authors: Ueno Mariko , Takagi Koichiro , Tachibana Yasunari , Morita Yoshihiro , Nagano Hiroaki , Muraoka Mitsue , Yanagisawa Keiko
Published: December 2019

Aims

The aim of our study was to examine the feasibility of the use of a pedometer to quantify the amount of exercise and the relationship between the amount of exercise and carbohydrate metabolism in pregnant women with impaired glucose tolerance.

Methods

Seven pregnant women with impaired glucose tolerance (gestational diabetes: three, overt diabetes in pregnancy: one, pregestational diabetes type 2: three) were provided with pedometers. The relationship between pedometer data with blood glucose levels, maternal body weight, amount of insulin administered, blood hemoglobin A1c (HbA1c) levels, blood glycoalbumin levels and infant birth weight was investigated.

Results

When the 24‐h‐based data were examined, there was no correlation between the number of steps walked and blood glucose level immediately after walking, nor the average number of steps per day and the fasting blood glucose level in the next day. However, 4‐week‐based data showed that there was a negative correlation between the number of steps per day and the change in HbA1c level. Moreover, there was a negative correlation between the average number of steps per day and change in the maternal body weight. A 1‐week‐based data from five participants who were being administered insulin indicated that there was a negative correlation between the average number of steps per day and the total amount of insulin administered per day.

Conclusion

Active application of pedometers is suggested to be feasible to improve metabolic control in pregnant women with glucose intolerance through the quantification of their exercise.
Dynamic injunctions against Internet intermediaries: An overview of emerging trends in India and Singapore
Authors: Dixit Pratik P.
Published: December 2019

The courts generally resort to website blocking injunctions to protect the rights of the content creators from digital piracy. However, merely disabling access to infringing websites does not necessarily ensure protection of copyright as there are dynamic ways of accessing an online location. The courts, therefore, have sought to develop new mechanisms to counter the menace of digital piracy. Recently, the Delhi High Court granted India's first dynamic injunction against Internet intermediaries to combat digital piracy in cinematographic works. A dynamic injunction would allow a plaintiff to extend the main injunction order against mirror websites providing access to the flagrantly infringing online locations that were the subject of the main injunction. This note primarily aims to analyse the concept of dynamic injunctions. The author examines and compares the Indian position to that in Singapore to highlight the different trends that have emerged with respect to dynamic injunction. The principal conclusion is that, despite the near similarities of the dynamic injunctions issued by the courts in the two countries, the dynamic injunction issued by the Indian court seeks to effectively protect the rights of the website operators as it affords constant judicial supervision.
Bicameralism and Minority‐Party Influence on Legislative Development: Evidence from House Standing Committee Votes
Authors: Ryan Josh M.
Published: December 2019

The ability of the minority party to influence legislation in Congress is debated. Most bills are passed with large bipartisan majorities, yet the House, where most legislation is developed, is seen as a majority‐party‐dominated institution. I develop a theory of House minority‐party influence at the committee markup stage as a result of the Senate’s institutional rules. An original data set of congressional committee votes shows that minority‐party support in House committees predicts House and Senate passage. During unified party control of the chambers, an increase in Senate majority‐party seats results in lower minority‐party support for the legislation in the House committee, while during divided party control of Congress, the House majority passes more extreme bills as the chambers polarize. Even in the majority‐party‐dominated House, the minority’s preferences are incorporated into legislation, and the Senate’s institutional rules moderate bills to a significant degree.
Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction
Authors: Batra Suruchi , Rahman Sheikh , Rana Md Sohel , Matta Sravan , Darbari Anil
Published: December 2019

Background

Pediatric intestinal pseudo‐obstruction is a rare disorder affecting gastrointestinal motility leading to chronic symptoms and hospitalizations. There is limited understanding of the epidemiology and healthcare burden.

Methods

We analyzed data from Kids' Inpatient Database from 2016, which includes inpatient discharge records from US hospitals. ICD‐10 codes were used to identify patients 0‐18 years with pediatric intestinal pseudo‐obstruction and comorbid conditions. Multivariable logistic regression and Wilcoxon rank‐sum test were used.

Results

In 2016, there were 1671 inpatient discharges from US hospitals for patients 0‐18 years of age with this diagnosis. The incidence of inpatient admission was 29/100 000 patients. After controlling for age, race, income status, and insurance, males vs females (adjusted odds ratio, aOR: 1.10; 95% CI: 0.94‐1.28; P = .241) and caucasians vs other races (aOR: 1.55; 95% CI: 1.27‐1.88; P < .001) were more likely to be admitted. Inpatient admissions incurred significant healthcare burden; median (inter quartile range IQR) cost of hospitalization of US$ 52 079 (US$ 23 530‐120 961) and a median (IQR) length of stay of 6 days (3‐14 days). Gastrostomy (32%) and ileostomy (12.6%) status appeared to incur lower healthcare burden. Parenteral nutrition, malnutrition, and central line/bloodstream infections resulted in higher healthcare burden.

Conclusions

Pediatric intestinal pseudo‐obstruction is a rare diagnosis with a high incidence of inpatient admissions and healthcare burden. An aggressive multidisciplinary management is crucial in reducing inpatient admissions in this cohort.
Orofacial manifestations and dental management of systemic lupus erythematosus: A review
Authors: Benli Merve , Batool Fareeha , Stutz Céline , Petit Catherine , Jung Sophie , Huck Olivier
Published: December 2019

Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease with numerous clinical manifestations. There is no consensus about the ideal oral management for this group of patients to date. This review aimed to describe the broad spectrum of orofacial and clinical manifestations and their therapeutic approaches. Studies concerning orofacial manifestations of SLE and dental treatment modalities were selected by a literature search (1978–2019) using Google Scholar, PubMed/MEDLINE electronic databases. The initial search strategy provided a total of 129 articles, and of these, 30 were included for qualitative synthesis. The reviewed studies revealed that SLE patients are more at risk of compromised oral and dental health exhibiting increased risk of periodontal diseases and temporomandibular joint disorders. The use of systemic drugs especially immunosuppressive and anticoagulants in SLE patients may also influence their oral management. Results emphasize the need to carry out, at an early stage of the disease, an appropriate oral management of these patients to improve oral health‐related quality of life and to prevent the need of more invasive therapeutics. A multidisciplinary approach is needed for dental and medical management of such patients.
Laryngeal reflex responses in pediatric anesthesia
Authors: Erb Thomas O. , Trachsel Daniel , von Ungern‐Sternberg Britta S.
Published: December 2019

Laryngeal and respiratory reflexes are vitally important defense mechanisms against foreign body aspiration, safeguarding airway patency, and ventilation. These highly preserved automatisms easily overrule external influences like willpower or (anesthetic) medication. Prevention and anticipation are, therefore, the essential strategies to avoid adverse events and damage, and treatment is most effective in the early stage of the reflex response. The physiology and pathophysiology of the various defensive reflexes as well as a comprehensive anesthetic approach to prevention and treatment are outlined in this review.
Differentiation of simple renal parenchymal cyst and calyceal diverticulum
Authors: Sahin Hilal , Sarioglu Fatma Ceren , Alaygut Demet , Akdogan Asli Irmak , Pekcevik Yeliz
Published: December 2019

Background

Calyceal diverticulum is the cystic eventration of the upper urinary tract within the renal parenchyma, which gives the first impression of a simple renal cyst and therefore can easily be misdiagnosed. We conducted a study to assess the role of static‐fluid magnetic resonance (MR) urography in the differentiation of renal parenchymal cysts and calyceal diverticulum in comparison with focused renal ultrasonography (US).

Methods

Focused renal US, static‐fluid, and excretory MR urography studies of 45 children who were admitted to our pediatric nephrology department with a diagnosis of renal cyst were reviewed retrospectively. Excretory MR urography was accepted as gold standard for the diagnosis of calyceal diverticulum. Sensitivity and specificity of focused renal US and static fluid MR urography in the diagnosis of renal calyceal diverticulum were assessed. Interobserver agreement between three radiologists in the diagnosis of calyceal diverticulum on MRI was also evaluated.

Results

The study included 29 patients (13 boys and 16 girls) aged between 6–18 years (mean 11.5 ± 4.1). Five calyceal diverticula and 24 solitary renal parenchymal cysts were diagnosed. The sensitivity and the specificity of focused renal US were 40% and 100% in the diagnosis of calyceal diverticulum. The sensitivity and the specificity of static‐fluid MR urography were 100% and 91.6%, respectively. The degree of interobserver agreement was excellent for the diagnosis of diverticulum for static‐fluid MR urography (κ = 0.86, 95% CI: 0.71–1.00).

Conclusions

Static‐fluid MR urography can be successfully used in children for the differentiation of renal parenchymal cyst and calyceal diverticulum due to its high sensitivity and specificity, without exposing children to ionizing radiation or intravenous contrast agents.
Respiratory illness and acute flaccid myelitis in the Tokai district in 2018
Authors: Okumura Akihisa , Numoto Shingo , Iwayama Hideyuki , Kurahashi Hirokazu , Natsume Jun , Saitoh Shinji , Yoshikawa Tetsushi , Fukao Toshiyuki , Hirayama Masahiro , Takahashi Yoshiyuki
Published: December 2019

Background

An outbreak of acute flaccid myelitis was chronologically correlated with an outbreak of severe respiratory illness in Japan in 2015. We hypothesized that increases in children hospitalized with severe respiratory illnesses might also be associated with increase in acute flaccid myelitis in autumn 2018.

Methods

We explored the temporal correlations between respiratory illness outbreaks and acute flaccid myelitis during autumn season between 2016 and 2018 using questionnaire surveys. One questionnaire explored the monthly numbers of children with acute flaccid myelitis, Guillain–Barré syndrome, and other acute flaccid paralyses. The other questionnaire explored the monthly numbers of children hospitalized with respiratory illnesses associated with wheezing. A correlation between the monthly numbers of children with acute flaccid myelitis and those with respiratory illness was analyzed using the Pearson correlation test.

Results

Although the number of patients hospitalized with respiratory illness did not correlate with the number of those admitted with myelitis, increases in children aged 7–12 and 13–19 years requiring intensive care unit admission correlated temporally with an outbreak of acute flaccid myelitis.

Conclusions

An increase in intensive care unit admissions to treat respiratory disease occurred in association with a cluster of acute flaccid myelitis. An increase in the number of intensive care unit admissions due to respiratory illness may be a clue to expect the occurrence of acute flaccid myelitis.
Nosocomial Acinetobacter baumannii infection in children in adult versus pediatric intensive care units
Authors: Kim Beomjoon , Kim Kyunghoon , Yoon Jong‐seo
Published: December 2019

Background

We hypothesized that children treated in adult intensive care units (ICUs) might be at increased risk of hospital‐acquired infection. We therefore compared the incidence of Acinetobacter baumannii infection in children treated in pediatric ICUs (PICUs) and in those treated in adult ICUs.

Methods

Patients aged <18 years admitted to PICUs or adult ICUs between March 2009 and June 2017 were enrolled. We retrospectively investigated A. baumannii isolates and calculated the A. baumannii incidence during ICU admission. Cox regression was used to identify possible risk factors for A. baumannii infection.

Results

Eight hundred and thirty ICU cases were included; 508 were treated in PICUs (“PICU group”) and 322 in adult ICUs (“adult‐ICU group”). Acinetobacter baumannii was isolated 19 (3.7%) and 23 (7.1%) times in the PICU and adult‐ICU groups, respectively. Incidence densities for A. baumannii acquisition in PICU and adult‐ICU groups were 1.63 and 5.62 per 1,000 ICU days, respectively. In the Cox regression model, the hazard ratio for A. baumannii acquisition associated with treatment in PICUs was 0.33 (95% confidence interval: 0.17–0.61; P = 0.001). In multivariate analysis after adjusting for age and sex, treatment in PICU remained significantly associated with a reduced risk of A. baumannii infection (hazard ratio: 0.40; 95%; confidence interval: 0.20–0.76).

Conclusions

Pediatric patients treated in a PICU had a lower rate and incidence density of A. baumannii nosocomial infection than those treated in adult ICUs, suggesting that PICUs provide better infection control for children than adult ICUs.
Nationwide epidemiological survey of holoprosencephaly in Japan
Authors: Abe Yuichi , Araki Ryuichiro , Sobajima Hisanori , Tamura Masanori , Kunikata Tetsuya , Ohtake Akira , Yamanouchi Hideo
Published: December 2019

Background

Holoprosencephaly (HPE) is a congenital malformation with an estimated prevalence of 0.10–6.06 per 10 000 births but with no nationwide data specific to Japan.

Methods

This nationwide retrospective questionnaire survey was conducted from 2011 to 2013. All 467 training hospitals for perinatal and neonatal care certified by the Japan Society of Perinatal and Neonatal Medicine were contacted. The birth prevalence rate (BPR) was assessed from the primary survey and clinical characteristics from the secondary survey.

Results

We received valid responses from 253 hospitals in the primary survey (54.6%). Of 390 342 live births, 60 were diagnosed with HPE (23 males and 37 females), resulting in an actual BPR of 1.54 per 10 000 live births. The point estimate for HPE cases was 100 (95% confidence interval [CI]: 80.7–120), and the estimated BPR of HPE was calculated to be 0.32 per 10 000 live births (95% CI: 0.26–0.38) based on 3 117 853 live births according to Japanese national statistics during the study period. In the secondary survey, we obtained data for 49 cases (19 males and 30 females). Of these, 20 were alobar (40.8%), 20 were semilobar (40.8%), five were lobar (10.4%), and four were of unknown type. Genetic examination was performed in 37 of the 49 HPE patients and revealed that chromosomes 13, 18, and 7 were affected in eight, six, and four patients, respectively.

Conclusions

This is the most extensive survey on holoprosencephaly to date in Japan. The estimated BPR was consistent with that reported in previous research.
Preparing for the 2019‐2020 influenza season
Authors: de St. Maurice Annabelle , Halasa Natasha
Published: December 2019

Although the 2017‐2018 influenza season had very high rates of influenza‐associated illness, the 2018‐2019 influenza season was comparable to previous seasons. Influenza A was the most commonly identified type worldwide, although variations in influenza A subtype prevalence existed. Influenza vaccination remains the single most effective way to prevent influenza‐associated illness. A novel influenza antiviral, baloxavir, has demonstrated promising results; however, concerns about development of resistance exist.
Species specificity preliminary evaluation of an IL‐4‐based test for the differential diagnosis of human echinococcosis
Authors: Petrone Linda , Albrich Werner C. , Tamarozzi Francesca , Frischknecht Manuel , Gomez‐Morales Maria Angeles , Teggi Antonella , Hoffmann Matthias , Goletti Delia
Published: December 2019

The diagnosis of cystic echinococcosis (CE) is based on imaging, while serology is a complementary test of particular use when imaging is inconclusive. Serology has several limitations. Among them, false‐positive results are often obtained in subjects with alveolar echinococcosis (AE), rendering difficult the differential diagnosis. We set up an immune assay based on IL‐4‐specific production after stimulating whole blood with an antigen B (AgB)‐enriched fraction from E granulosus that associates with CE and CE cysts in active stage. We aimed to evaluate potential cross‐reactivity of this test using samples from patients with AE. Twelve patients with AE were recruited; IL‐4 levels ranged from 0 to 0.07 pg/mL. Based on the previously identified cut‐off of 0.39 pg/mL using samples from patients with CE, none of samples from AE patients scored positive. In contrast, almost 80% of samples from AE patients scored positive in serology tests based on different E granulosus‐derived antigenic preparations. Our preliminary data show that this experimental whole‐blood assay has no cross‐reactivity in our cohort of patients with AE, in turn indicating a high specificity of the assay for CE diagnosis. This result supports further work towards the development of improved diagnostic tests for CE.
Bidirectional colonization and biofilm formation by Erwinia psidii in eucalypt plants
Authors: Caires N. P. , Guimarães L. M. S. , Hermenegildo P. S. , Rodrigues F. A. , Badel J. L. , Alfenas A. C.
Published: December 2019

Dieback and wilt caused by Erwinia psidii is an emerging disease that has been causing considerable damage in eucalypt plantations. Because it is a recently emerged disease, several aspects of the bacterial interaction with its host still remain to be elucidated. In this work, we studied the E. psidii colonization and biofilm formation in eucalypt tissues by specific detection using PCR and scanning electron microscopy (SEM). The results indicate that the bacterium is able to translocate in stem tissue mainly acropetally, although movement in the basipetal direction was also observed to a lesser extent, always through the xylem. No colonization of phloem tissues was observed. In addition to colonizing the xylem, E. psidii colonized the parenchymatous tissue. The bacterium formed cell aggregates enveloped by fibrillar material that evolved into complex, well‐structured biofilms in stem and leaf tissues. In contrast, no biofilm formation was observed on abiotic surfaces. These observations suggest that biofilm formation plays an important role in the elicitation of dieback and wilt symptoms caused by E. psidii on eucalypt plants. This study not only shows ultrastructural aspects of the E. psidii communities but also tissue damage in eucalypt plants that was associated with the presence of bacterial aggregates and formation of tyloses.
Reducing caesarean delivery: An economic evaluation of routine induction of labour at 39 weeks in low‐risk nulliparous women
Authors: Callander Emily J. , Creedy Debra K. , Gamble Jenny , Fox Haylee , Toohill Jocelyn , Sneddon Anne , Ellwood David
Published: December 2019

Background

Clinical interventions known to reduce the risk of caesarean delivery include routine induction of labour at 39 weeks, caseload midwifery and chart audit, but they have not been compared for cost‐effectiveness.

Objective

To assesses the cost‐effectiveness of three different interventions known to reduce caesarean delivery rates compared to standard care; and conduct a budget impact analysis.

Methods

A Markov microsimulation model was constructed to compare the costs and outcomes produced by the different interventions. Costs included all costs to the health system, and outcomes were quality‐adjusted life years (QALY) gained. A budget impact analysis was undertaken using this model to quantify the costs (in Australian dollars) over three years for government health system funders.

Results

All interventions, plus standard care, produced similar health outcomes (mean of 1.84 QALYs gained over 105 weeks). Caseload midwifery was the lowest cost option at $15 587 (95% confidence interval [CI] 15 269, 15 905), followed by routine induction of labour ($16 257, 95% CI 15 989, 16 536), and chart audit ($16 325, 95% CI 15 979, 16 671). All produced lower costs on average than standard care ($16 905, 95% CI 16 551, 17 259). Caseload midwifery would produce the greatest savings of $172.6 million over three years if implemented for all low‐risk nulliparous women in Australia.

Conclusions

Caseload midwifery presents the best value for reducing caesarean delivery rates of the options considered. Routine induction of labour at 39 weeks and chart audit would also reduce costs compared to standard care.
Rhodesian Ridgebacks have an increased risk to develop benign prostatic hyperplasia
Authors: Werhahn Beining Franziska , Urhausen Carola , Wolf Karola , Schmicke Marion , Rohn Karl , Schuler Gerhard , Günzel‐Apel Anne‐Rose
Published: December 2019

Benign prostatic hyperplasia (BPH) is an age‐dependent primarily non‐inflammatory enlargement of the accessory gland in the intact dog. The aim of the present study was to control a previously raised suspicion of a breed‐related higher incidence of BPH in dogs of the Rhodesian Ridgeback breed. For this, 18 Labrador Retrievers/LR and 20 Rhodesian Ridgebacks/RR were assigned to the age groups 18–24 months (n = 12), 25–48 months (n = 13) and 49–72 months (n = 13). Prostate gland status was determined by rectal palpation, B‐mode ultrasound, calculation of the prostate gland volume and semen analysis regarding haemospermia and was classified according to blood plasma concentrations of canine prostate‐specific arginine esterase (CPSE) (normal ≤ 60 ng/ml, increased ≥ 61 ng/ml; Pinheiro et al., 2017). Concentrations of testosterone, 5α‐dihydrotestosterone and estradiol were analysed in peripheral blood serum or plasma for detecting breed‐specific conditions regarding the endocrine metabolism. Prostatic volume was significantly larger in RR irrespective of the CPSE status. In RR, BPH occurred more frequently and started at an earlier age compared with the LR. Breed‐related specificities in steroid metabolism in the RR were indicated by correlations of 5α‐dihydrotestosterone and estradiol with age and of testosterone with prostate gland volume. Although the incidence of sonographic signs of BPH and haemospermia did not fit with normal and increased CPSE concentrations, a breed‐specific higher incidence of BPH in the RR breed could be clearly verified.
The scarring effects of youth joblessness in Sri Lanka
Authors: Kuchibhotla Murali , Orazem Peter F. , Ravi Sanjana
Published: December 2019

Retrospective data on labor market spells for successive cohorts of youth in the school‐to‐work transition in Sri Lanka are used to examine whether early spells of joblessness lead to subsequent difficulty in finding or keeping a job. A balancing score approach is used to generate pairs of youth in the school‐to‐work transition who have similar expected levels of joblessness but who differ in realized levels of joblessness. Assuming that youth are not able to perfectly control whether they are employed or not employed, we argue that marginal differences in joblessness among otherwise observationally equivalent youth can be viewed similarly to a regression discontinuity in experienced joblessness. We find evidence of scarring in that spending the first year after leaving school without a job or training increases subsequent share of time spent jobless by 23–31 percentage points and lowers subsequent wages by 5.5%–7.5%.
Development and analysis of a malaria transmission mathematical model with seasonal mosquito life‐history traits
Authors: Djidjou‐Demasse Ramsés , Abiodun Gbenga J. , Adeola Abiodun M. , Botai Joel O.
Published: December 2019

In this paper, we develop and analyze a malaria model with seasonality of mosquito life‐history traits: periodic‐mosquitoes per capita birth rate, ‐mosquitoes death rate, ‐probability of mosquito to human disease transmission, ‐probability of human to mosquito disease transmission, and ‐mosquitoes biting rate. All these parameters are assumed to be time dependent leading to a nonautonomous differential equation system. We provide a global analysis of the model depending on two threshold parameters and (with ). When , then the disease‐free stationary state is locally asymptotically stable. In the presence of the human disease‐induced mortality, the global stability of the disease‐free stationary state is guarantied when . On the contrary, if , the disease persists in the host population in the long term and the model admits at least one positive periodic solution. Moreover, by a numerical simulation, we show that a sub‐critical (backward) bifurcation is possible at . Finally, the simulation results are in accordance with the seasonal variation of the reported cases of a malaria‐epidemic region in Mpumalanga province in South Africa.
The HLA‐DRB1*04:68 allele recognized in a Taiwanese individual
Authors: Yang Kuo‐Liang , Lin Py‐Yu
Published: December 2019

Nucleotide substitution in codon 37 of HLA‐DRB1*04:04:01 results in a new allele, HLA‐DRB1*04:68.
Mapping the Socio-Economic Indicators of Greece from the Implementation of the Monetary Policy and the Tax Administration
Authors: Liargovas Panagiotis , Anastasiou Athanasios , Komninos Dimitrios , Dermatis Zacharias
Published: December 2019

The economic crisis that led to a decline in private consumption in the period 2009-2016 is the main factor that has accelerated developments in the country's business map, in the sense that in many cases of business development in Greece there are structural weaknesses revealed by the crisis. This confirms that the country's economic crisis cannot be an alibi for the many problems of the Greek economy.The impact of the economic crisis differs not only between countries where low- and middle-income countries are more affected by developed countries but also within countries. The dramatic decline in wages and pensions has led to a decline in the purchasing power of citizens. The debt crisis, the weakening of demand in the context of addressing the competitiveness of the Greek economy and the significant structural interventions in the labor market, affected supply and demand in the labor market and its participants.The purpose of this paper is to present the social and economic indicators of our country by implementing the policy of the memorandums and the Tax Administration. In particular, a mapping exercise is being undertaken in the period 2009-2016:• The number of starts, change of tax office and business holidays• The business map of our country• Unemployment rates as they have been in our country• The degree of contribution of austerity programs and memorandum policies to addressing unemployment.• The areas and categories of occupations where the highest unemployment rates have occurred.• The role of Tax Administration in addressing these problems.