bluuebunny/crossref_metadata_2025 huggingface dataset:
Qualitative evidence of crimes against humanity: the August 2017 attacks on the Rohingya in northern Rakhine State, Myanmar
Authors: Messner Nicole , Woods Andrea , Petty Agnes , Parmar Parveen K. , Leigh Jennifer , Thomas Ernest , Curry Douglass , Venters Homer , Gilbert Andra , Nelson Tamaryn , Lester Ed
Published: September 2019

Background

The Rohingya ethnic minority population in northern Rakhine state, Myanmar, have experienced some of the most protracted situations of persecution. Government-led clearance operations in August 2017 were one of many, but notably one of the most devastating, attacks on the population. The study aimed to conduct a multiphase mixed-methods assessment of the prevalence and contexts of violence and mortality across affected hamlets in northern Rakhine State during the August 2017 attacks. This publication describes qualitative accounts by Rohingya community leaders from affected hamlets, with a focus on the events and environment leading up to and surrounding the attacks.

Methods

Qualitative in-depth interviews were conducted with Rohingya community leaders representing 88 northern Rakhine state hamlets across three townships affected by the August 2017 attacks (Maungdaw, n = 34; Buthidaung, n = 42; Rathedaung, n = 12). Prior quantitative surveys conducted among representative hamlet leaders allowed for preliminary screening and identification of interview candidates: interviewees were then selected based on prior reports of 10 or more deaths among Rohingya hamlet community members, mass rape, and/or witness of mass graves in a hamlet or during displacement. Recorded interviews were transcribed, translated, and thematically coded.

Results

Rohingya leaders reported that community members were subjected to systematic civil oppression characterized by severe restrictions on travel, marriage, education, and legal rights, regular denial of citizenship rights, and unsubstantiated accusations of terrorist affiliations in the months prior to August 2017. During the attacks, Rohingya civilians (inclusive of women, men, children, and elderly) reportedly suffered severe, indiscriminate violence perpetrated by Myanmar security forces. Crimes against children and sexual violence were widespread. Bodies of missing civilians were discovered in mass graves and, in some cases, desecrated by armed groups. Myanmar Armed Forces (Tatmadaw), consisting of the Army, Navy, and Border Guard Police continued to pursue, assault, and obstruct civilians in flight to Bangladesh.

Conclusions

Qualitative findings corroborate previously published evidence of widespread and systematic violence by the Myanmar security forces against the Rohingya. The accounts describe intentional oppression of Rohingya civilians leading up to the August 2017 attacks and coordinated and targeted persecution of Rohingya by state forces spanning geographic distances, and ultimately provide supporting evidence for investigations of crimes against humanity and acts of genocide.
Determining post-treatment surveillance criteria for predicting the elimination of Schistosoma mansoni transmission
Authors: Toor Jaspreet , Truscott James E. , Werkman Marleen , Turner Hugo C. , Phillips Anna E. , King Charles H. , Medley Graham F. , Anderson Roy M.
Published: September 2019

Background

The World Health Organization (WHO) has set elimination (interruption of transmission) as an end goal for schistosomiasis. However, there is currently little guidance on the monitoring and evaluation strategy required once very low prevalence levels have been reached to determine whether elimination or resurgence of the disease will occur after stopping mass drug administration (MDA) treatment.

Methods

We employ a stochastic individual-based model of Schistosoma mansoni transmission and MDA impact to determine a prevalence threshold, i.e. prevalence of infection, which can be used to determine whether elimination or resurgence will occur after stopping treatment with a given probability. Simulations are run for treatment programmes with varying probabilities of achieving elimination and for settings where adults harbour low to high burdens of infection. Prevalence is measured based on using a single Kato-Katz on two samples per individual. We calculate positive predictive values (PPV) using PPV ≥ 0.9 as a reliable measure corresponding to ≥ 90% certainty of elimination. We analyse when post-treatment surveillance should be carried out to predict elimination. We also determine the number of individuals across a single community (of 500–1000 individuals) that should be sampled to predict elimination.

Results

We find that a prevalence threshold of 1% by single Kato-Katz on two samples per individual is optimal for predicting elimination at two years (or later) after the last round of MDA using a sample size of 200 individuals across the entire community (from all ages). This holds regardless of whether the adults have a low or high burden of infection relative to school-aged children.

Conclusions

Using a prevalence threshold of 0.5% is sufficient for surveillance six months after the last round of MDA. However, as such a low prevalence can be difficult to measure in the field using Kato-Katz, we recommend using 1% two years after the last round of MDA. Higher prevalence thresholds of 2% or 5% can be used but require waiting over four years for post-treatment surveillance. Although, for treatment programmes where elimination is highly likely, these higher thresholds could be used sooner. Additionally, switching to more sensitive diagnostic techniques, will allow for a higher prevalence threshold to be employed.
Human population movement can impede the elimination of soil-transmitted helminth transmission in regions with heterogeneity in mass drug administration coverage and transmission potential between villages: a metapopulation analysis
Authors: Vegvari Carolin , Truscott James E. , Kura Klodeta , Anderson Roy M.
Published: September 2019

Background

Soil-transmitted helminth (STH) infections affect predominantly socio-economically disadvantaged populations in sub-Saharan Africa, East Asia and the Americas. Previous mathematical modelling studies have evaluated optimal intervention strategies to break STH transmission in clusters of villages. These studies assumed that villages are closed independent units with no movement of people in or out of communities. Here we examine how human population movement, for example, of seasonal migrant labourers, affect the outcome of mass drug administration (MDA) programmes.

Results

We used a stochastic individual-based metapopulation model to analyse the impact of human population movement at varying rates on STH elimination efforts. Specifically, we looked at seasonal clumped movement events of infected individuals into a village. We showed that even if on average 75% of the entire resident population within a village are treated, an annual rate of 2–3% of the population arriving from an untreated source village can reduce the probability of STH elimination to less than 50% in high-prevalence settings. If a village is infection-free, an annual movement rate of 2–3% from an infected source village imposes a risk of re-introduction of STH of 75% or higher, unless the prevalence in the source village is less than 20%. Even a single arrival of 2–3% of the population can impose a risk of re-introducing STH of 50% or greater depending on the prevalence in the source village. The risk of re-introduction also depends on both the age group of moving individuals and STH species, since the pattern of cross-sectional age-prevalence and age-intensity profiles of infection in the human host are species-specific.

Conclusions

Planning for STH elimination programmes should account for human mobility patterns in defined regions. We recommend that individuals arriving from areas with ongoing STH transmission should receive preventive chemotherapy for STHs. This can most easily be implemented if migration is seasonal and overlaps with treatment rounds, e.g. seasonal migrant labour. Moreover, transmission hotspots in or near treatment clusters should be eliminated, for example, by implementing appropriate water, sanitation and hygiene (WASH) measures and targeting treatment to individuals living in hotspots.
Mini-FLOTAC as an alternative, non-invasive diagnostic tool for Schistosoma mansoni and other trematode infections in wildlife reservoirs
Authors: Catalano Stefano , Symeou Amelia , Marsh Kirsty J. , Borlase Anna , Léger Elsa , Fall Cheikh B. , Sène Mariama , Diouf Nicolas D. , Ianniello Davide , Cringoli Giuseppe , Rinaldi Laura , Bâ Khalilou , Webster Joanne P.
Published: September 2019

Background

Schistosomiasis and food-borne trematodiases are not only of major public health concern, but can also have profound implications for livestock production and wildlife conservation. The zoonotic, multi-host nature of many digenean trematodes is a significant challenge for disease control programmes in endemic areas. However, our understanding of the epidemiological role that animal reservoirs, particularly wild hosts, may play in the transmission of zoonotic trematodiases suffers a dearth of information, with few, if any, standardised, reliable diagnostic tests available. We combined qualitative and quantitative data derived from post-mortem examinations, coprological analyses using the Mini-FLOTAC technique, and molecular tools to assess parasite community composition and the validity of non-invasive methods to detect trematode infections in 89 wild Hubert’s multimammate mice (Mastomys huberti) from northern Senegal.

Results

Parasites isolated at post-mortem examination were identified asPlagiorchissp.,Anchitremasp.,Echinostoma caproni,Schistosoma mansoni, and a hybrid betweenSchistosoma haematobiumandSchistosoma bovis. The reports ofE. caproniandAnchitremasp. represent the first molecularly confirmed identifications for these trematodes in definitive hosts of sub-Saharan Africa. Comparison of prevalence estimates derived from parasitological analysis at post-mortem examination and Mini-FLOTAC analysis showed non-significant differences indicating comparable results between the two techniques (P = 1.00 forS. mansoni;P = 0.85 forE. caproni;P = 0.83 forPlagiorchissp.). A Bayesian model, applied to estimate the sensitivities of the two tests for the diagnosis ofSchistosomainfections, indicated similar median posterior probabilities of 83.1% for Mini-FLOTAC technique and 82.9% for post-mortem examination (95% Bayesian credible intervals of 64.0–94.6% and 63.7–94.7%, respectively).

Conclusions

Our results showed that the Mini-FLOTAC could be applied as an alternative diagnostic technique for the detection of the zoonoticS. mansoniand other trematodes in rodent reservoirs. The implementation of non-invasive diagnostics in wildlife would offer numerous advantages over lethal sampling methodologies, with potential impact on control strategies of zoonotic helminthiases in endemic areas of sub-Saharan Africa and on fostering a framework of animal use reduction in scientific practice.
Lineage-specific rapid diagnostic tests can resolve Trypanosoma cruzi TcII/V/VI ecological and epidemiological associations in the Argentine Chaco
Authors: Murphy Niamh , Macchiaverna Natalia P. , Victoria Cardinal M. , Bhattacharyya Tapan , Mertens Pascal , Zeippen Nicolas , Gustin Yves , Gilleman Quentin , Gürtler Ricardo E. , Miles Michael A.
Published: September 2019

Background

Trypanosoma cruzi, the protozoan agent of Chagas disease, is comprised of at least 6 genetic lineages (TcI-TcVI). Their geographical distribution, clinical associations and reservoir hosts are not fully elucidated, as genotyping is hampered due to the difficulty in isolating representative populations of organisms. Lineage-specific serological techniques may address these issues.

Methods

Trypanosoma cruzi lineage-specific serological assays were performed on human, canine, feline and armadillo sera from the Gran Chaco in northern Argentina, a region of ongoing transmission. Synthetic peptides representing lineage-specific epitopes of the trypomastigote small surface antigen (TSSA) were used in ELISA, and the TcII/V/VI shared epitope peptide (TSSApep-II/V/VI) was used in the Chagas Sero K-SeT rapid diagnostic test (RDT).

Results

Chagas Sero K-SeT RDT, using Protein G to detect human and canine IgG, was at least as sensitive as TSSApep-II/V/VI ELISA using specific secondary antibodies. For sera from humans TSSApep-II/V/VI seroprevalence by Chagas Sero K-SeT was 273/393 (69.5%), for dogs 48/73 (65.8%) and for armadillos 1/7 (14.3%); by ELISA for cats 5/19 (26.3%). The seroprevalence for humans was similar to that for Bolivian patients, amongst whom we previously observed an association of TSSApep-II/V/VI seropositivity with severity of cardiomyopathy. In humans, prevalence of TSSApep-II/V/VI recognition was associated with locality, and with increasing and decreasing age within the Qom and Creole populations, respectively. For dogs TSSApep-II/V/VI recognition was associated with being born before community-wide insecticide spraying (P = 0.05) and with Qom household (P < 0.001).

Conclusions

We show here that Chagas Sero K-SeT RDT can replace ELISA for TSSApep-II/V/VI serology of humans and dogs; for humans there were statistically significant associations between a positive Chagas Sero K-SeT RDT and being resident in Area IV, and for dogs association with Qom household or with being born before the mass spraying campaign; we also show that with cats the TcII/V/VI epitope can be detected by ELISA. We assessed the lineage distribution in an unprecedented 83% of the human T. cruzi-seropositive population. These results form the basis for more detailed studies, enabling rapid in-the-field surveillance of the distribution and clustering of these lineages among humans and mammalian reservoirs of T. cruzi infection.
Mapping the baseline prevalence of lymphatic filariasis across Nigeria
Authors: Eneanya Obiora A. , Fronterre Claudio , Anagbogu Ifeoma , Okoronkwo Chukwu , Garske Tini , Cano Jorge , Donnelly Christl A.
Published: September 2019

Introduction

The baseline endemicity profile of lymphatic filariasis (LF) is a key benchmark for planning control programmes, monitoring their impact on transmission and assessing the feasibility of achieving elimination. Presented in this work is the modelled serological and parasitological prevalence of LF prior to the scale-up of mass drug administration (MDA) in Nigeria using a machine learning based approach.

Methods

LF prevalence data generated by the Nigeria Lymphatic Filariasis Control Programme during country-wide mapping surveys conducted between 2000 and 2013 were used to build the models. The dataset comprised of 1103 community-level surveys based on the detection of filarial antigenemia using rapid immunochromatographic card tests (ICT) and 184 prevalence surveys testing for the presence of microfilaria (Mf) in blood. Using a suite of climate and environmental continuous gridded variables and compiled site-level prevalence data, a quantile regression forest (QRF) model was fitted for both antigenemia and microfilaraemia LF prevalence. Model predictions were projected across a continuous 5 × 5 km gridded map of Nigeria. The number of individuals potentially infected by LF prior to MDA interventions was subsequently estimated.

Results

Maps presented predict a heterogeneous distribution of LF antigenemia and microfilaraemia in Nigeria. The North-Central, North-West, and South-East regions displayed the highest predicted LF seroprevalence, whereas predicted Mf prevalence was highest in the southern regions. Overall, 8.7 million and 3.3 million infections were predicted for ICT and Mf, respectively.

Conclusions

QRF is a machine learning-based algorithm capable of handling high-dimensional data and fitting complex relationships between response and predictor variables. Our models provide a benchmark through which the progress of ongoing LF control efforts can be monitored.
Heterogeneity in transmission parameters of hookworm infection within the baseline data from the TUMIKIA study in Kenya
Authors: Truscott James E. , Ower Alison K. , Werkman Marleen , Halliday Katherine , Oswald William E. , Gichuki Paul M. , Mcharo Carlos , Brooker Simon , Njenga Sammy M. , Mwandariwo Charles , Walson Judd L. , Pullan Rachel , Anderson Roy
Published: September 2019

Background

As many countries with endemic soil-transmitted helminth (STH) burdens achieve high coverage levels of mass drug administration (MDA) to treat school-aged and pre-school-aged children, understanding the detailed effects of MDA on the epidemiology of STH infections is desirable in formulating future policies for morbidity and/or transmission control. Prevalence and mean intensity of infection are characterized by heterogeneity across a region, leading to uncertainty in the impact of MDA strategies. In this paper, we analyze this heterogeneity in terms of factors that govern the transmission dynamics of the parasite in the host population.

Results

Using data from the TUMIKIA study in Kenya (cluster STH prevalence range at baseline: 0–63%), we estimated these parameters and their variability across 120 population clusters in the study region, using a simple parasite transmission model and Gibbs-sampling Monte Carlo Markov chain techniques. We observed great heterogeneity in R0 values, with estimates ranging from 1.23 to 3.27, while k-values (which vary inversely with the degree of parasite aggregation within the human host population) range from 0.007 to 0.29 in a positive association with increasing prevalence. The main finding of this study is the increasing trend for greater parasite aggregation as prevalence declines to low levels, reflected in the low values of the negative binomial parameter k in clusters with low hookworm prevalence. Localized climatic and socioeconomic factors are investigated as potential drivers of these observed epidemiological patterns.

Conclusions

Our results show that lower prevalence is associated with higher degrees of aggregation and hence prevalence alone is not a good indicator of transmission intensity. As a consequence, approaches to MDA and monitoring and evaluation of community infection status may need to be adapted as transmission elimination is aimed for by targeted treatment approaches.
Estimating helminth burdens using sibship reconstruction
Authors: Neves M. Inês , Webster Joanne P. , Walker Martin
Published: September 2019

Background

Sibship reconstruction is a form of parentage analysis that can be used to identify the number of helminth parental genotypes infecting individual hosts using genetic data on only their offspring. This has the potential to be used for estimating individual worm burdens when adult parasites are otherwise inaccessible, the case for many of the most globally important human helminthiases and neglected tropical diseases. Yet methods of inferring worm burdens from sibship reconstruction data on numbers of unique parental genotypes are lacking, limiting the method’s scope of application.

Results

We developed a novel statistical method for estimating female worm burdens from data on the number of unique female parental genotypes derived from sibship reconstruction. We illustrate the approach using genotypic data onSchistosoma mansoni(miracidial) offspring collected from schoolchildren in Tanzania. We show how the bias and precision of worm burden estimates critically depends on the number of sampled offspring and we discuss strategies for obtaining sufficient sample sizes and for incorporating judiciously formulated prior information to improve the accuracy of estimates.

Conclusions

This work provides a novel approach for estimating individual-level worm burdens using genetic data on helminth offspring. This represents a step towards a wider scope of application of parentage analysis techniques. We discuss how the method could be used to assist in the interpretation of monitoring and evaluation data collected during mass drug administration programmes targeting human helminthiases and to help resolve outstanding questions on key population biological processes that govern the transmission dynamics of these neglected tropical diseases.
Pooling as a strategy for the timely diagnosis of soil-transmitted helminths in stool: value and reproducibility
Authors: Papaiakovou Marina , Wright James , Pilotte Nils , Chooneea Darren , Schär Fabian , Truscott James E. , Dunn Julia C. , Gardiner Iain , Walson Judd L. , Williams Steven A. , Littlewood D. Timothy J.
Published: September 2019

Background

The strategy of pooling stool specimens has been extensively used in the field of parasitology in order to facilitate the screening of large numbers of samples whilst minimizing the prohibitive cost of single sample analysis. The aim of this study was to develop a standardized reproducible pooling protocol for stool samples, validated between two different laboratories, without jeopardizing the sensitivity of the quantitative polymerase chain reaction (qPCR) assays employed for the detection of soil-transmitted helminths (STHs). Two distinct experimental phases were recruited. First, the sensitivity and specificity of the established protocol was assessed by real-time PCR for each one of the STHs. Secondly, agreement and reproducibility of the protocol between the two different laboratories were tested. The need for multiple stool sampling to avoid false negative results was also assessed. Finally, a cost exercise was conducted which included labour cost in low- and high-wage settings, consumable cost, prevalence of a single STH species, and a simple distribution pattern of the positive samples in pools to estimate time and money savings suggested by the strategy.

Results

The sensitivity of the pooling method was variable among the STH species but consistent between the two laboratories. Estimates of specificity indicate a ‘pooling approach’ can yield a low frequency of ‘missed’ infections. There were no significant differences regarding the execution of the protocol and the subsequent STH detection between the two laboratories, which suggests in most cases the protocol is reproducible by adequately trained staff. Finally, given the high degree of agreement, there appears to be little or no need for multiple sampling of either individuals or pools.

Conclusions

Our results suggest that the pooling protocol developed herein is a robust and efficient strategy for the detection of STHs in ‘pools-of-five’. There is notable complexity of the pool preparation to ensure even distribution of helminth DNA throughout. Therefore, at a given setting, cost of labour among other logistical and epidemiological factors, is the more concerning and determining factor when choosing pooling strategies, rather than losing sensitivity and/or specificity of the molecular assay or the method.
Impact of urate-lowering drugs on the progression and recovery from chronic kidney disease among gout patients
Authors: Chung Ting-Ting , Yu Kuang-Hui , Kuo Chang-Fu , Luo Shue-Fen , Chiou Meng-Jiun , Lan Wen-Ching , Chen Jung-Sheng , Tseng Wen-Yi , Hsieh Ao-Ho , Wang Lian-Chin
Published: September 2019

Background

This study investigates the association between exposure to urate-lowering drugs (ULDs) and progression and recovery from chronic kidney disease (CKD).

Methods

We identified 5860 incident gout patients at Chang Gung Memorial Hospital from 2012 to 2015. Propensity score (PS)-weighted Cox proportional hazards model was used to estimate hazard ratios (HRs) for CKD progression and improvement. A separate analysis was conducted to assess the HR for CKD progression and CKD recovery among those with worsening CKD.

Results

The incidence of CKD progression among allopurinol, febuxostat and uricosuric agent users were 1.98, 1.88 and 1.64 per 1000 person-days. Compared with allopurinol users, the PS-weighted HR (95% confidence intervals [CIs]) was 1.77 (0.85–1.76) for febuxostat users and 1.37 (0.71–1.37) for uricosuric agent users for CKD progression and 1.43 (1.26–1.62) for febuxostat users and 1.00 (0.88–1.14) for uricosuric agent users for CKD improvement. Compared to allopurinol users, the HRs for CKD progression were 1.14 (0.80–1.66) for febuxostat users and 0.92 (0.67–1.31) for uricosuric agent users. Among 741 patients who had CKD progression, the incidence of CKD recovery was 1.33, 6.21 and 3.53 per 1000 person-days for allopurinol, febuxostat and uricosuric agent users. The HRs (95% CIs) for recovery in febuxostat and uricosuric agent users were 2.17 (1.40–3.47) and 1.80 (1.20–2.83) compared to allopurinol users.

Conclusions

CKD progression and recovery are common in gout patients using ULDs. Febuxostat and benzbromarone were associated with a similar risk of CKD progression with allopurinol, which has a poorer recovery compared with other ULDs.
Routine lung ultrasound to detect postoperative pulmonary complications following major abdominal surgery: a prospective observational feasibility study
Authors: Touw H. R. , Schuitemaker A. E. , Daams F. , van der Peet D. L. , Bronkhorst E. M. , Schober P. , Boer C. , Tuinman P. R.
Published: September 2019

Background

Postoperative pulmonary complications after major abdominal surgery are associated with adverse outcome. The diagnostic accuracy of chest X-rays (CXR) to detect pulmonary disorders is limited. Alternatively, lung ultrasound (LUS) is an established evidence-based point-of-care diagnostic modality which outperforms CXR in critical care. However, its feasibility and diagnostic ability for postoperative pulmonary complications following abdominal surgery are unknown. In this prospective observational feasibility study, we included consecutive patients undergoing major abdominal surgery with an intermediate or high risk developing postoperative pulmonary complications according to the Assess Respiratory risk In Surgical patients in CATalonia (ARISCAT) score. LUS was routinely performed on postoperative days 0–3 by a researcher blinded for CXR or other clinical findings. Then, reports were drawn up for LUS concerning feasibility and detection rates of postoperative pulmonary complications. CXRs were performed on demand according to daily clinical practice. Subsequently, we compared LUS and CXR findings.

Results

A total of 98 consecutive patients with an ARISCAT score of 41 (34–49) were included in the study. LUS was feasible in all patients. In 94 (95%) patients, LUS detected one or more postoperative pulmonary complications during the first four postoperative days. On day 0, LUS detected 31 out of 43 patients (72.1%) with one or more postoperative pulmonary complications, compared to 13 out of 36 patients (36.1%) with 1 or more postoperative pulmonary complications detected with CXR RR 2.0 (95 CI [1.24–3.20]) (p = 0.004). The number of discordant observations between both modalities was high for atelectasis 23 (43%) and pleural effusion 29 (54%), but not for pneumothorax, respiratory infection and pulmonary edema 8 (15%), 3 (5%), and 5 (9%), respectively.

Conclusions

This study shows that LUS is highly feasible and frequently detects postoperative pulmonary complications after major abdominal surgery. Discordant observations in atelectasis and pleural effusions for LUS and CXR can be explained by a superior diagnostic ability of LUS in detecting these conditions. The effects of LUS as primary imaging modality on patient outcome should be evaluated in future studies.
A pilot prospective study of sleep patterns and DNA methylation-characterized epigenetic aging in young adults
Authors: Carskadon Mary A. , Chappell Kenneth R. , Barker David H. , Hart Anne C. , Dwyer Kayla , Gredvig-Ardito Caroline , Starr Caitlyn , McGeary John E.
Published: September 2019

Objective

Molecular markers in DNA methylation at a subset of CpG sites are affected by the environment and contribute to biological (epigenetic) age. We hypothesized that shorter sleep duration and possibly irregular sleep would be associated with accelerated epigenetic aging. We examined epigenetic vs. chronological age in 12 young women selected as shorter or longer sleepers studied prospectively across the first 9 weeks of college using a daily online sleep log. Genomic DNA was isolated from two blood samples spanning the interval, and DNA methylation levels were determined and used to measure epigenetic age.

Results

Epigenetic vs. chronological age differences averaged 2.07 at Time 1 and 1.21 at Time 2. Sleep duration was computed as average daily total sleep time and sleep regularity was indexed using the Sleep Regularity Index. Participants with longer and more regular sleep showed reduced age difference: mean = − 2.48 [95% CI − 6.11; 1.15]; those with shorter and more irregular sleep showed an increased age difference: 3.03 [0.02; 6.03]; and those with either shorter or more irregular sleep averaged no significant change: − 0.49 [− 3.55; 2.56]. These pilot data suggest that short and irregular sleep, even in a young healthy sample, may be associated with accelerated epigenetic aging.
Successful balloon valvuloplasty of a subpulmonic membrane associated with cor triatriatum dexter: a case report
Authors: Haboub Meryem , Drighil Abdenasser
Published: September 2019

Background

Subpulmonic membrane as a cause of right ventricular outflow tract obstruction in patients with concordant ventriculoarterial connection and intact ventricular septum is considered to be rare. Association with cor triatriatum dexter and success of subpulmonic balloon valvuloplasty have never been reported, at least to the best of our knowledge.

Case presentation

A 3-year-old Moroccan boy was referred to our tertiary care hospital with complaints of dyspnea on moderate exertion. A physical examination revealed parasternal lift, systolic thrill, and a 4/6 ejection systolic murmur, best heard over the left second intercostal space. His oxygen saturation was 99% on room air. Two-dimensional echocardiography showed a discrete circumferential membrane just below the pulmonic valve and a right atrial membrane. Continuous wave Doppler interrogation showed peak systolic pressure gradient of 85 mmHg across the subpulmonic membrane and no significant gradient across the right atrial membrane. Balloon dilation of the subpulmonic membrane was performed and the pressure gradient came down to 50 mmHg. During follow-up, he reported marked improvement in terms of exercise tolerance. Transthoracic echocardiography showed residual pressure gradient of approximately 40 mmHg across the membrane. Surgery resection of the two membranes was programmed, but he died after an extracardiac disease (appendicular peritonitis).

Conclusions

Subpulmonic membrane as an isolated cause of right ventricular outflow tract obstruction is rare. Its association with cor triatriatum dexter is even less common. The result of percutaneous balloon valvuloplasty of subpulmonic membrane is an interesting alternative while waiting for surgery. Surgery is currently the preferred modality of treatment with the resection of both right atrial and subpulmonic membranes.
Peripheral and placental immune responses in sheep after experimental infection with Toxoplasma gondii at the three terms of gestation
Authors: Castaño Pablo , Fernández Miguel , Regidor-Cerrillo Javier , Fuertes Miguel , Horcajo Pilar , Ferre Ignacio , Ferreras M. Carmen , Ortega-Mora Luis Miguel , Pérez Valentín , Benavides Julio
Published: September 2019

Although it is known that gestation could influence the clinical course of ovine toxoplasmosis, the precise effect of the term of gestation when sheep are infected are yet mostly unknown. The aim of this study was to evaluate the peripheral and placental immune responses developed in pregnant sheep after experimental infection with Toxoplasma gondii at different times of gestation. Thirty-six pregnant sheep were allocated in different groups, orally inoculated with sporulated oocysts of T. gondii at early, mid and late gestation and culled within 30 days post-infection. The peripheral humoral and cytokine responses were evaluated, as well as the transcription of cytokines at the placenta. Serological analysis revealed that, regardless the term of gestation when infected, specific IgG against T. gondii were detected from day 8 post-infection and there was an early peripheral release of IFN-γ at the first week post-infection followed by a short peak of IL10 and TNF-α at the second week post-infection. There were no significant differences in this response between infected groups. At the placenta, a similar increase in transcription of IFN-γ, and TNF-α was found at the three terms of gestation, while IL-4 increased mainly at the first and second terms and IL-10 transcription was higher at the last term. While these findings show that both Th1 and Th2 cytokines play a key role in the pathogenesis of ovine toxoplasmosis and that placental and peripheral immune responses do not closely correlate, there seems to be no clear modulation of these responses along the gestation.
Optimal Mixture Design of Low-CO2 High-Volume Slag Concrete Considering Climate Change and CO2 Uptake
Authors: Lee Han-Seung , Lim Seung-Min , Wang Xiao-Yong
Published: September 2019

High-volume slag (HVS) can reduce the CO2 emissions of concrete, but increase the carbonation depth of concrete. In particular, because of the effects of climate change, carbonation will accelerate. However, the uptake of CO2 as a result of carbonation can mitigate the harm of CO2 emissions. This study proposes an optimal mixture design method of low-CO2 HVS concrete considering climate change, carbonation, and CO2 uptake. Firstly, net CO2 emissions are calculated by subtracting the CO2 emitted by the material from the uptake of CO2 by carbonation. The strength and depth of carbonation are evaluated by a comprehensive model based on hydration. Secondly, a genetic algorithm (GA) is used to find the optimal mixture. The objective function of the GA is net CO2 emissions. The constraints of the GA include the strength, carbonation, workability, and range of concrete components. Thirdly, the results show that carbonation durability is a control factor of the mixture design of low-strength HVS concrete, while strength is a control factor of the mixture design of high-strength HVS concrete. After considering climate change, the threshold of strength control increases. With the increase of strength, the net CO2 emissions increase, while the CO2 uptake ratio decreases.
Effect of different dietary protein levels and amino acids supplementation patterns on growth performance, carcass characteristics and nitrogen excretion in growing-finishing pigs
Authors: Zhao Yumei , Tian Gang , Chen Daiwen , Zheng Ping , Yu Jie , He Jun , Mao Xiangbing , Huang Zhiqing , Luo Yuheng , Luo Junqiu , Yu Bing
Published: September 2019

Background

This study was conducted to determine the effects of different dietary protein levels and amino acids supplementation patterns in low protein diets on the growth performance, carcass characteristics and nitrogen excretion in growing-finishing pigs.

Forty-two barrows (25.00 ± 0.39 kg) were randomly assigned to 7 diets. Diet 1: the high crude protein diet with balanced for 10 essential amino acids (EAAs). Diet 2: the medium crude protein diet with 2% (approx) decreased protein level of Diet 1 and balanced 10 EAAs. Diet 3: the low crude protein diet with 4% decreased protein level of Diet 1 and balanced 10 EAAs. The protein levels of Diet 4, 5, 6 and 7 were the same as that of Diet 3. Diet 4 was only balanced for lysine (Lys), methionine (Met), threonine (Thr) and tryptophan (Trp); Diet 5 and 6 were further supplemented with extra isoleucine (Ile) or valine (Val), respectively; Diet 7 was further supplemented with extra Ile + Val.

Results

Over the 112 days trial, the reduction of dietary protein by 2% or 4% with balanced10 EAAs significantly decreased nitrogen excretion (P <  0.05), but had no effects on growth performance and carcass characteristics (P > 0.05). In low protein diet, Val supplementation significantly increased body weight gain at 25–50 kg phase (P <  0.05), while Ile supplementation at 75–100 kg phase and 100–125 kg phase significantly reduced the ratio of feed to gain (P <  0.05). No effect of different dietary protein levels and amino acids supplementation patterns in low protein diets on carcass characteristics was observed (P > 0.05). The total N excretion of pigs supplemented with only Lys, Met, Thr and Trp was numerically higher than that of pigs fed with extra Ile, or Val, or Ile + Val diets.

Conclusion

In low protein diet, Val is more required than Ile in the early growing phage (25–50 kg), while Ile becomes more required in the late growing and finishing phage (75–125 kg).
Silver staining (Campbell-Switzer) of neuronal α-synuclein assemblies induced by multiple system atrophy and Parkinson’s disease brain extracts in transgenic mice
Authors: Lavenir Isabelle , Passarella Daniela , Masuda-Suzukake Masami , Curry Annabelle , Holton Janice L. , Ghetti Bernardino , Goedert Michel
Published: September 2019

Synucleinopathies [Parkinson’s disease (PD), dementia with Lewy bodies (DLB) and multiple system atrophy (MSA)] share filamentous α-synuclein assemblies in nerve cells and glial cells. We compared the abilities of brain extracts from MSA and PD patients to induce neuronal α-synuclein assembly and neurodegeneration following intracerebral injection in heterozygous mice transgenic for human mutant A53T α-synuclein. MSA extracts were more potent than PD extracts in inducing α-synuclein assembly and in causing neurodegeneration. MSA assemblies were Campbell-Switzer- and Gallyas-silver-positive, whereas PD assemblies were only Campbell-Switzer-positive, in confirmation of previous findings. However, induced α-synuclein inclusions were invariably Campbell-Switzer-positive and Gallyas-negative, irrespective of whether MSA or PD brain extracts were injected. The α-synuclein inclusions of non-injected homozygous mice transgenic for A53T α-synuclein were also Campbell-Switzer-positive and Gallyas-negative. These findings demonstrate that transgene expression and its intracellular environment dominated over the silver staining properties of the conformers of assembled α-synuclein.
Fading into the background: the dark space surrounding Vermeer’s Girl with a Pearl Earring
Authors: Vandivere Abbie , van Loon Annelies , Callewaert Tom , Haswell Ralph , Proaño Gaibor Art Ness , van Keulen Henk , Leonhardt Emilien , Dik Joris
Published: September 2019

The background of Vermeer’s Girl with a Pearl Earring (c. 1665, Mauritshuis) has, until recently, been interpreted as a flat dark space. The painting was examined in 2018 as part of the research project The Girl in the Spotlight using a combination of micro- and macro-scale analytical techniques. The stratigraphy of the background was determined from samples mounted as cross-sections, and its material composition was analysed using electron microscopy and chromatographic techniques. The underlayer contains mainly charcoal black, and the glaze contains two organic colourants—indigo and weld—and a copper drier. Deterioration of the glaze has made features in the background difficult to discern with the naked eye. Complementary imaging techniques were able to visualise Vermeer’s signature, and the suggestion of folded fabric (possibly a curtain) on the right side of the painting. The distribution of the layer(s) in the background were imaged using: infrared reflectography (900–1100 nm), multi-scale optical coherence tomography scanning, macroscopic X-ray fluorescence and 3D digital microscopy. Vermeer applied the black underlayer vigorously with overlapping brushstrokes that varied in thickness. When he applied the glaze on top, it levelled out to make a smooth flat surface. The visual effect of the background contrasts the figure of the Girl and projects her forward in space, closer to the viewer.
White light emitting diode based on purely organic fluorescent to modern thermally activated delayed fluorescence (TADF) and perovskite materials
Authors: Das Dipjyoti , Gopikrishna Peddaboodi , Barman Debasish , Yathirajula Ramesh Babu , Iyer Parameswar Krishnan
Published: September 2019

White organic/polymer light emitting diode (WOLED/WPLED) processed from solution has attracted significant research interest in recent years due to their low device production cost, device flexibility, easy fabrication over large area including roll to roll and ability to print in various designs and shapes providing enormous design possibilities. Although WOLEDs fabricated using solution process lack their thermally evaporated counterparts in terms of device efficiency, remarkable progress has been made in this regard in recent years by utilizing new materials and device structures. In the present review, we have summarized and extrapolated an excellent association of old and modern concept of cost-effective materials and device structure for realization of white light. In particular, this article demonstrated and focused on design, and development of novel synthesis strategy, mechanistic insights and device engineering for solution process low cost WOLEDs device. Herein, an overview of the prevailing routes towards white light emitting devices (WLEDs) and corresponding materials used, including polymer based WLED, small molecules emitters based thermally activated delayed fluorescence (TADF), perovskite light-emitting diodes (PeLEDs) and hybrid materials based LEDs, color down-converting coatings with corresponding best efficiencies ever realized. We presume that this exhaustive review on WLEDs will offer a broad overview of the latest developments on white SSL and stonework the approach en route for innovations in the immediate future.
Sinus bone graft and simultaneous vertical ridge augmentation: case series study
Authors: Kang Dong-Woo , Yun Pil-Young , Choi Yong-Hoon , Kim Young-Kyun
Published: September 2019

Background

This study aims to examine the outcome of simultaneous maxillary sinus lifting, bone grafting, and vertical ridge augmentation through retrospective studies.

Methods

From 2005 to 2010, patients with exhibited severe alveolar bone loss received simultaneous sinus lifting, bone grafting, and vertical ridge augmentations were selected. Fifteen patients who visited in Seoul National University Bundang Hospital were analyzed according to clinical records and radiography. Postoperative complications; success and survival rate of implants; complications of prosthesis; implant stability quotient (ISQ); vertical resorption of grafted bone after 1, 2, and 3 years after surgery; and final observation and marginal bone loss were evaluated.

Results

The average age of the patients was 54.2 years. Among the 33 implants, six failed to survive and succeed, resulting in an 81.8% survival rate and an 81.8% success rate. Postoperative complications were characterized by eight cases of ecchymosis, four cases of exposure of the titanium mesh or membrane, three cases of peri-implantitis, three cases of hematoma, two cases of sinusitis, two cases of fixture fracture, one case of bleeding, one case of numbness, one case of trismus, and one case of fixture loss. Prosthetic complications involved two instances of screw loosening, one case of abutment fracture, and one case of food impaction. Resorption of grafted bone material was 0.23 mm after 1 year, 0.47 mm after 2 years, 0.41 mm after 3 years, and 0.37 mm at the final observation. Loss of marginal bone was 0.12 mm after 1 year, and 0.20 mm at final observation.

Conclusions

When sinus lifting, bone grafting, and vertical ridge augmentation were performed simultaneously, postoperative complications increased, and survival rates were lower. For positive long-term prognosis, it is recommended that a sufficient recovery period be needed before implant placement to ensure good bone formation, and implant placement be delayed.
Understanding acute burn injury as a chronic disease
Authors: Barrett Lucy W. , Fear Vanessa S. , Waithman Jason C. , Wood Fiona M. , Fear Mark W.
Published: September 2019

While treatment for burn injury has improved significantly over the past few decades, reducing mortality and improving patient outcomes, recent evidence has revealed that burn injury is associated with a number of secondary pathologies, many of which arise long after the initial injury has healed. Population studies have linked burn injury with increased risk of cancer, cardiovascular disease, nervous system disorders, diabetes, musculoskeletal disorders, gastrointestinal disease, infections, anxiety and depression. The wide range of secondary pathologies indicates that burn can cause sustained disruption of homeostasis, presenting new challenges for post-burn care. Understanding burn injury as a chronic disease will improve patient care, providing evidence for better long-term support and monitoring of patients. Through focused research into the mechanisms underpinning long-term dysfunction, a better understanding of burn injury pathology may help with the development of preventative treatments to improve long-term health outcomes. The review will outline evidence of long-term health effects, possible mechanisms linking burn injury to long-term health and current research into burns as a chronic disease.
Impact of peer review on discussion of study limitations and strength of claims in randomized trial reports: a before and after study
Authors: Keserlioglu Kerem , Kilicoglu Halil , ter Riet Gerben
Published: September 2019

Background

In their research reports, scientists are expected to discuss limitations that their studies have. Previous research showed that often, such discussion is absent. Also, many journals emphasize the importance of avoiding overstatement of claims. We wanted to see to what extent editorial handling and peer review affects self-acknowledgment of limitations and hedging of claims.

Methods

Using software that automatically detects limitation-acknowledging sentences and calculates the level of hedging in sentences, we compared the submitted manuscripts and their ultimate publications of all randomized trials published in 2015 in 27 BioMed Central (BMC) journals and BMJ Open. We used mixed linear and logistic regression models, accounting for clustering of manuscript-publication pairs within journals, to quantify before-after changes in the mean numbers of limitation-acknowledging sentences, in the probability that a manuscript with zero self-acknowledged limitations ended up as a publication with at least one and in hedging scores.

Results

Four hundred forty-six manuscript-publication pairs were analyzed. The median number of manuscripts per journal was 10.5 (interquartile range 6–18). The average number of distinct limitation sentences increased by 1.39 (95% CI 1.09–1.76), from 2.48 in manuscripts to 3.87 in publications. Two hundred two manuscripts (45.3%) did not mention any limitations. Sixty-three (31%, 95% CI 25–38) of these mentioned at least one after peer review. Changes in mean hedging scores were negligible.

Conclusions

Our findings support the idea that editorial handling and peer review lead to more self-acknowledgment of study limitations, but not to changes in linguistic nuance.