bluuebunny/crossref_metadata_2025 huggingface dataset:
Medieval and Renaissance Rome: Mending the divide
Authors: Palmer James A.
Published: September 2017

Historians of late medieval and renaissance Italy have long seen the fourteenth century as a dramatic period of upheaval and transformation. Yet despite the fact that Rome has long fascinated scholars, the city's fourteenth‐century history is often given short shrift. Only the dazzling figure of Cola di Rienzo consistently draws scholarly attention, resulting in his somewhat exaggerated role in Roman political history. With important exceptions, Anglophone scholars primarily interested in the Italian Renaissance have traditionally begun their histories in the mid‐fifteenth century with the result that fourteenth‐century Rome is largely passed over. The Avignon Papacy, 1309–1377, is seen as a period of abandonment and ruin. The situation is different among scholars, mostly Continental, whose study of fourteenth‐century Rome's social and economic history has been appearing over the last few decades. This historiography, which has largely operated discretely from the Anglophone tradition, has conclusively demonstrated that late medieval Rome must be considered alongside Italy's city communes. This has transformative implications for Roman historiography. Recent work on Rome's earlier medieval history, as well as on the history and character of the Italian communes, suggests that now more than ever there is much to be gained by bringing these discrete strands of scholarship on late medieval Rome to bear on one another.
Role of robot‐assisted radical prostatectomy in locally advanced prostate cancer
Authors: Saika Takashi , Miura Noriyoshi , Fukumoto Tetsuya , Yanagihara Yutaka , Miyauchi Yuki , Kikugawa Tadahiko
Published: September 2017

Locally advanced prostate cancer is regarded as a very high‐risk disease with a poor prognosis. Although there is no definitive consensus on the definition of locally advanced prostate cancer, radical prostatectomy for locally advanced prostate cancer as a primary treatment or part of a multimodal therapy has been reported. Robot‐assisted radical prostatectomy is currently carried out even in high‐risk prostate cancer because it provides optimal outcomes. However, limited studies have assessed the role of robot‐assisted radical prostatectomy in patients with locally advanced prostate cancer. Herein, we summarize and review the current knowledge in terms of the definition and surgical indications of locally advanced prostate cancer, and the surgical procedure and perisurgical/oncological outcomes of robot‐assisted radical prostatectomy and extended pelvic lymphadenectomy for locally advanced prostate cancer.
Surgical treatment of peri‐implantitis: 3‐year results from a randomized controlled clinical trial
Authors: Carcuac Olivier , Derks Jan , Abrahamsson Ingemar , Wennström Jan L. , Petzold Max , Berglundh Tord
Published: September 2017

Objectives

This study reports on the 3‐year follow‐up of patients enrolled in a randomized controlled clinical trial on surgical treatment of advanced peri‐implantitis.

Material and Methods

A total of 100 patients with advanced peri‐implantitis were randomly assigned to one of four treatment groups. Surgical therapy aiming at pocket elimination was performed and, in three test groups, supplemented by either systemic antibiotics, use of an antiseptic agent for implant surface decontamination or both. Outcomes were evaluated after 1 and 3 years by means of clinical and radiological examinations. Differences between groups were explored by regression analysis.

Results

Clinical examinations at 3 years after treatment revealed (i) improved peri‐implant soft tissue health with a mean reduction in probing depth of 2.7 mm and a reduction in bleeding/suppuration on probing of 40% and (ii) stable peri‐implant marginal bone levels (mean bone loss during follow‐up: 0.04 mm). Implant surface characteristics had a significant impact on 3‐year outcomes, in favour of implants with non‐modified surfaces. Benefits of systemic antibiotics were limited to implants with modified surfaces and to the first year of follow‐up.

Conclusion

It is suggested that surgical treatment of peri‐implantitis is effective and that outcomes of therapy are affected by implant surface characteristics. Potential benefits of systemic antibiotics are not sustained over 3 years.
Covered duodenal self‐expandable metal stents prolong biliary stent patency in double stenting: The largest series of bilioduodenal obstruction
Authors: Hori Yasuki , Naitoh Itaru , Hayashi Kazuki , Kondo Hiromu , Yoshida Michihiro , Shimizu Shuya , Hirano Atsuyuki , Okumura Fumihiro , Ando Tomoaki , Jinno Naruomi , Takada Hiroki , Togawa Shozo , Joh Takashi
Published: September 2017

Background and Aim

Endoscopic biliary and duodenal stenting (DS; double stenting) is widely accepted as a palliation therapy for malignant bilioduodenal obstruction. The aim of the current study was to investigate the patency and adverse events of duodenal and biliary stents in patients with DS.

Methods

Patients who underwent DS from April 2004 to March 2017 were analyzed retrospectively with regard to clinical outcomes and predictive factors of recurrent biliary and duodenal obstruction (recurrent biliary obstruction [RBO] and recurrent duodenal obstruction [RDO]).

Results

A total of 109 consecutive patients was enrolled. Technical success of DS was achieved in 108 patients (99.1%). Symptoms due to biliary and duodenal obstruction were improved in 89 patients (81.7%). RBO occurred in 25 patients (22.9%) and RDO in 13 (11.9%). The median times to RBO and RDO from DS were 87 and 76 days, respectively. Placement of a duodenal uncovered self‐expandable metal stent (U‐SEMS) was significantly associated with RBO in the multivariable analysis (P = 0.007). Time to RBO was significantly longer in the duodenal covered self‐expandable metal stent group than in the U‐SEMS group (P = 0.003). No predictive factors of RDO were detected, and duodenal stent type was not associated with the time to RDO (P = 0.724).

Conclusions

Double stenting was safe and effective for malignant bilioduodenal obstruction. Duodenal U‐SEMS is a risk factor for RBO. The covered self‐expandable metal stent is the preferred type of duodenal SEMS in patients with DS (Clinical trial registration number: UMIN000027606).
Binswanger's disease: biomarkers in the inflammatory form of vascular cognitive impairment and dementia
Authors: Rosenberg Gary A.
Published: September 2017

Vascular cognitive impairment and dementia (VCID) is a major public health concern because of the increased incidence of vascular disease in the aging population and the impact of vascular disease on Alzheimer's disease. VCID is a heterogeneous group of diseases for which there are no proven treatments. Biomarkers can be used to select more homogeneous populations. Small vessel disease is the most prevalent form of VCID and is the optimal form for treatment trials because there is a progressive course with characteristic pathological changes. Subcortical ischemic vascular disease of the Binswanger type (SIVD‐BD) has a characteristic set of features that can be used both to identify patients and to follow treatment. SIVD‐BD patients have clinical, neuropsychological, cerebrospinal fluid (CSF) and imaging features that can be used as biomarkers. No one feature is diagnostic, but a multimodal approach defines the SIVD‐BD spectrum disorder. The most important features are large white matter lesions with axonal damage, blood–brain barrier disruption as shown by magnetic resonance imaging and CSF, and neuropsychological evidence of executive dysfunction. We have used these features to create a Binswanger Disease Scale and a probability of SIVD‐BD, using a machine‐learning algorithm. The patients discussed in this review are derived from published studies. Biomarkers not only aid in early diagnosis before the disease process has progressed too far for treatment, but also can indicate response to treatment. Refining the use of biomarkers will allow dementia treatment to enter the era of precision medicine.

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This article is part of the Special Issue “Vascular Dementia”.
Antifungal and Mechanical Properties of Tissue Conditioner Containing Plant‐Derived Component: An In Vitro Study
Authors: Naito Yoshihito , Yumoto Hiromichi , Kumar HS Kiran , Matsuo Takashi , Hirota Katsuhiko , Miyake Yoichiro , Nagao Kan , Tomotake Yoritoki , Jimbo Ryo , Ichikawa Tetsuo
Published: September 2017

Purpose

To evaluate the antifungal activity and mechanical properties of a novel antifungal tissue conditioner containing Juncus powder.

Materials and Methods

Juncus powder was mixed with GC tissue conditioner at concentrations of 2.5%, 5.0%, and 10.0% by mass. The cylindrical specimens of Juncus‐mixed tissue conditioner (dimensions: 10 mm in diameter and 2 and 6 mm in height for antimicrobial and mechanical tests, respectively) were prepared. The specimens placed on the bottom of the 24‐well tissue culture plate were cultured with Candida albicans CAD1 for 2 and 4 days. The proliferation of the C. albicans in the wells was determined by measuring the optical density of fungal culture, and the surface of the specimens were also observed by scanning electron microscopy (SEM). To assess the mechanical properties of the specimens, the fluidity and hardness of Juncus‐mixed tissue conditioner were measured using the methods certified according to ISO 10139‐1.

Results

Juncus‐mixed tissue conditioner significantly exhibited growth inhibitory effect in a Juncus concentration‐dependent manner after both 2‐ and 4‐ day cultures. SEM observation showed that the amount of C. albicans on Juncus‐mixed specimens drastically decreased, and biofilm formation was markedly inhibited. Moreover, both mechanical properties were found to be within the ranges regulated and specified by ISO.

Conclusion

These findings demonstrated that the tissue conditioner including Juncus powder has a significant growth inhibitory effect against C. albicans, and it is suggested that the application of Juncus‐mixed tissue conditioner may prevent denture stomatitis and oral candidiasis in denture wearers.
Administration of erythropoiesis‐stimulating agents in patients undergoing haemodialysis: A time and motion study
Authors: Johnson David W. , Cleland Bruce , Eris Josette , Rafferty Tom , Sud Kamal , Chow Josephine S.
Published: September 2017

Background

International guidelines recommend treatment of anaemia due to chronic kidney disease (CKD) with erythropoiesis‐stimulating agents (ESAs).

Objective

To document the time required and the cost in terms of nursing time to prepare and administer ESAs to patients on facility based haemodialysis (HD) with anaemia due to CKD before and after the introduction of long‐acting ESAs.

Design

A time and motion study was implemented at four HD units in Australia to determine the time and costs associated with preparing and administering ESAs before and after the introduction of long‐acting ESAs.

Participants

This was a prospective, observational study of workplace practices at four HD units in Australia.

Measurements

Outcome data included the time taken to prepare, and administer ESAs.

Results

The time costs of preparation and administration per patient per year had a wide variability within each unit and ranged from Australian AUD$55.75 (38 euros) to AUD$90.49 (62 euros) before the introduction of long‐acting ESAs. This dropped by 73–80% following the introduction of long‐acting ESAs, representing an annual cost savings of between AUD$2,591 and AUD$5,914 if all patients on HD were switched to a long acting ESA.

Conclusion

Switching from a short‐acting to a long‐acting ESA in HD units leads to a significant reduction in time costs of health professionals in preparation and administration of ESAs by up to 80%.

Practical application: This time and motion study has added further evidence on reduction of human effort by taking advantages of new research development, such as the long acting ESAs.
Arousal responses to respiratory events during sleep: the role of pulse wave amplitude
Authors: Bosi Marcello , Milioli Giulia , Riccardi Silvia , Melpignano Andrea , Vaudano Anna E. , Cortelli Pietro , Poletti Venerino , Parrino Liborio
Published: September 2017

The study aims at assessing the changes in electroencephalography (as measured by the A‐phases of cyclic alternating pattern) and autonomic activity (based on pulse wave amplitude) at the recovery of airway patency in patients with obstructive sleep apnea syndrome. Analysis of polysomnographic recordings from 20 male individuals with obstructive sleep apnea syndrome was carried out in total sleep time, non‐rapid eye movement and rapid eye movement sleep. Scoring quantified the combined occurrence (time range of 4 s before and 4 s after respiratory recovery) or separate occurrence of A‐phases (cortical activation), and pulse wave amplitude drops (below 30%) to apneas, hypopneas or flow limitation events. A dual response (A‐phase associated with a pulse wave amplitude drop) was the most frequent response (71.8% in total sleep time) for all types of respiratory events, with a progressive reduction from apneas to hypopneas and flow limitation events. The highly significant correlation in total sleep time (r = 0.9351; P < 0.0001) between respiratory events combined with A‐phases and respiratory events combined with pulse wave amplitude drops was confirmed both in non‐rapid eye movement (r = 0.9622; P < 0.0001) and rapid eye movement sleep (r = 0.7162; P < 0.0006). In conclusion, a dual cortical and autonomic activation is the most common manifestation at the recovery of airway patency. The significant correlation between A‐phases and relevant pulse wave amplitude drops suggests a possible role of pulse wave amplitude as a marker of cerebral response to respiratory events.
Factors affecting false guilty pleas in a mock plea bargaining scenario
Authors: Zimmerman David M. , Hunter Samantha
Published: September 2017

Purpose

We sought to investigate key factors that legal scholars believe are contributing to false guilty pleas.

Methods

Undergraduates playing the role of an innocent defendant in a plea bargaining scenario (N = 382) were randomly assigned to condition in a 2 (trial penalty: mandatory minimum of 10 years, judicial discretion of 4–6 years) × 3 (likelihood of conviction: 10%, 50%, 90%), × 2 (attorney recommendation: take the plea deal, use best judgement) between‐subjects design – false guilty pleas (2 years in prison) were the primary dependent variable.

Results

Participants faced with a mandatory minimum were more likely to falsely plead guilty, and this effect was mediated by perceptions that life would be more difficult serving the sentence associated with losing at trial compared to that of the plea. Participants given a 90% likelihood of conviction at trial were more likely to falsely plead guilty than those in the 50% and 10% conditions, and this effect was mediated by perceptions of case strength. Finally, female participants (via increased perceptions of case strength) were more likely to falsely plead guilty than male participants. Contrary to our predictions, attorney recommendation did not impact false guilty pleas, perhaps due to the absence of a proper social influence component to the manipulation.

Conclusions

Overall, the findings provide evidence supporting the apparent causal mechanisms underlying the ‘innocence problem’ in plea bargaining, and we discuss future directions for plea bargaining research pertaining to both research questions and methodology.
Weapons of maths destruction: How big data increases inequality and threatens democracy
Authors: Hollis Leo
Published: September 2017

A former Wall Street analyst, mathematician Cathy O'Neil's new book dissects the mathematical models that pervade modern life and threaten to rip apart our social fabric.

Here she tells Leo Hollis how the age of the algorithm risks undermining our democracy and sharpening inequality – and what we can do to tame the dark side of ‘big data’.
Comparison of anaesthetic regime in patients undergoing third molar extraction
Authors: McCarthy C. , Warren E. , Sleeman D.
Published: September 2017

Aims

Part 1: To determine whether intra‐operative local infiltration with lidocaine improves patient satisfaction following third molar extraction and the effect if any, its use has on the magnitude of acute pain.

Part 2: To determine if bupivacaine has a prolonged effect on the period of acute post‐operative pain when compared to lidocaine. To analyse patient's preference in terms of local anaesthetic choice.

Materials and methods

This two part, double blind, randomised, interventional clinical trial included 120 patients in total. All patients had symmetrically impacted lower third molars removed under general anaesthetic. Part 1 of the study involved 52 patients who received local anaesthetic in the form of 2% lidocaine with 1: 80,000 epinepherine on one randomly allocated side. Pain was measured at 0, 30 and 60 min post‐surgery using a visual analogue scale (VAS). Part 2 enrolled 68 patients who received plain 0.5% bupivacaine on one randomly allocated side, with 2% lidocaine with 1: 80,000 epinepherine administered on the opposite side. Pain was measured at 0, 30, 60 min (phase 1) and 3, 4, 6 and 8 h (phase 2) post‐surgery. Both studies involved psychological evaluations and patient reported outcomes, including patient satisfaction.

Results

The difference in mean pain scores was statistically significant (P < 0.001) for part 1 of this study. A significant difference (P<0.05) was seen during phase 2 in part 2 of this study.

Conclusions

Local anaesthetic is effective in reducing post‐surgical pain. Longer lasting anaesthetics such as bupivacaine can offer a longer period of analgesia, and improve overall patient satisfaction.
Successful venoarterial extracorporeal membrane oxygenation for postoperative septic shock in a child with liver transplantation: A case report
Authors: Abe Michiko , Ide Kentaro , Nishimura Nao , Nakagawa Satoshi , Fukuda Akinari , Sakamoto Seisuke , Kasahara Mureo
Published: September 2017

Refractory septic shock after LT is a life‐threatening complication. VA ECMO is used to treat refractory cardiorespiratory failure. We present herein the case of a 5‐year‐old girl with post‐Kasai biliary atresia, who underwent a living donor LT and suffered refractory septic shock. VA ECMO was indicated due to progressive cardiac deterioration. After full recovery of her EF, she has been steadily improving and has shown good liver function and no neurological sequelae. This is the first report of successful VA ECMO in a post‐ LT patient with refractory septic shock.
Total Leishmania antigens with Poly(I:C) induce Th1 protective response
Authors: Sanchez M. V. , Eliçabe R. J. , Di Genaro M. S. , Germanó M. J. , Gea S. , García Bustos M. F. , Salomón M. C. , Scodeller E. A. , Cargnelutti D. E.
Published: September 2017

Our proposal was to develop a vaccine based on total Leishmania antigens (TLA) adjuvanted with polyinosinic‐polycytidylic acid [Poly(I:C)] able to induce a Th1 response which can provide protection against Leishmania infection. Mice were vaccinated with two doses of TLA‐Poly(I:C) administered by subcutaneous route at 3‐week interval. Humoral and cellular immune responses induced by the immunization were measured. The protective efficacy of the vaccine was evaluated by challenging mice with infective promastigotes of Leishmania (Leishmania) amazonensis into the footpad. Mice vaccinated with TLA‐Poly(I:C) showed a high anti‐Leishmania IgG titre, as well as increased IgG1 and IgG2a subclass titres compared with mice vaccinated with the TLA alone. The high IgG2a indicated a Th1 bias response induced by the TLA‐Poly(I:C) immunization. Accordingly, the cellular immune response elicited by the formulation was characterized by an increased production of IFN‐γ and no significant production of IL‐4. The TLA‐Poly(I:C) immunization elicited good protection, which was associated with decreased footpad swelling, a lower parasite load and a reduced histopathological alteration in the footpad. Our findings demonstrate a promising vaccine against cutaneous leishmaniasis that is relatively economic and easy to develop and which should be taken into account for preventing leishmaniasis in developing countries.
Dose‐Optimal Vaccine Allocation over Multiple Populations
Authors: Duijzer Lotty E. , vanJaarsveld Willem L. , Wallinga Jacco , Dekker Rommert
Published: September 2017

Vaccination is an effective way to prevent an epidemic. It results in immunity for the vaccinated individuals, but it also reduces the infection pressure for unvaccinated people. Thus people may actually escape infection without being vaccinated: the so‐called “herd effect.” We analytically study the relation between the herd effect and the vaccination fraction for the seminal SIR compartmental model, which consists of a set of differential equations describing the time course of an epidemic. We prove that the herd effect is in general convex‐concave in the vaccination fraction and give precise conditions on the epidemic for the convex part to arise. We derive the significant consequences of these structural insights for allocating a limited vaccine stockpile to multiple non‐interacting populations. We identify for each population a unique vaccination fraction that is most efficient per dose of vaccine: our dose‐optimal coverage. We characterize the solution of the vaccine allocation problem and we show the crucial importance of the dose‐optimal coverage. A single dose of vaccine may be a drop in the ocean, but multiple doses together can save a population. To benefit from this, policy makers should select a subset of populations to which the vaccines are allocated. Focusing on a limited number of populations can make a significant difference, whereas allocating equally to all populations would be substantially less effective.
Dyspnea catastrophizing and neural activations during the anticipation and perception of dyspnea
Authors: Stoeckel M. Cornelia , Esser Roland W. , Gamer Matthias , Büchel Christian , von Leupoldt Andreas
Published: September 2017

Dyspnea is an aversive symptom in various diseases. High levels of negative affectivity are typically associated with increased dyspnea and changes in its neural processing. Recently, more dyspnea‐specific forms of negative affectivity such as dyspnea catastrophizing were suggested to contribute to increased perception of dyspnea beyond effects of rather unspecific negative affectivity such as general anxiety levels. The involved neural mechanisms have not yet been explored. Therefore, the present retrospective analysis examined the associations of dyspnea catastrophizing with neural activations during the anticipation and perception of dyspnea. Sixty‐six healthy volunteers underwent 20 blocks of inspiratory resistive load breathing with parallel acquisition of fMRI data. Loads inducing either severe or mild dyspnea (dyspnea conditions) were presented in alternating order, with each condition being visually cued (anticipation conditions). Dyspnea catastrophizing and general trait anxiety were measured with the Breathlessness Catastrophizing Scale (BCS) and the State‐Trait Anxiety Inventory, respectively. Correlating the BCS scores with neural activations during the perception of dyspnea yielded no significant results. However, during the anticipation of dyspnea, BCS scores correlated positively with activations of the anterior cingulate cortex (ACC), even after controlling for general anxiety levels. These activations in the ACC were not related to concurrent respiratory parameters. Results suggest that dyspnea catastrophizing in healthy volunteers is associated with stronger ACC recruitment during dyspnea anticipation. Given the established role of the ACC in processing affective states, affect regulation, and antinociception, this might reflect increased affective and/or top‐down modulatory processing in individuals with higher dyspnea catastrophizing when anticipating dyspnea.
Relative standing and temporary migration: Empirical evidence from the South Caucasus
Authors: Antinyan Armenak , Corazzini Luca
Published: September 2017

This paper empirically investigates the relationship between households’ relative deprivation and the intentions of their members to temporarily migrate abroad in three transition economies of the South Caucasus: Armenia, Azerbaijan and Georgia. To capture respondents’ relative deprivation, we use self‐reported information on respondents’ perception of the relative standing of their household in comparison to those of their neighbors. Controlling for households’ absolute income and other relevant subjective dimensions, we illustrate that households’ relative position vis‐à‐vis their reference groups plays an important role in determining the intentions of their members to migrate abroad. In particular, individuals are more willing to engage in temporary emigration if they perceive themselves to be poorer than the reference group. Our results may have important policy implications. A conjectural suggestion of our empirical exercise is that if migration has to be curbed, reducing absolute poverty alone may not be sufficient. In addition, policy‐makers may need to decrease relative income differentials within the country.
Using a multi‐feature paradigm to measure mismatch responses to minimal sound contrasts in children with cochlear implants and hearing aids
Authors: Uhlén Inger , Engström Elisabet , Kallioinen Petter , Nakeva von Mentzer Cecilia , Lyxell Björn , Sahlén Birgitta , Lindgren Magnus , Ors Marianne
Published: September 2017

Our aim was to explore whether a multi‐feature paradigm (Optimum‐1) for eliciting mismatch negativity (MMN) would objectively capture difficulties in perceiving small sound contrasts in children with hearing impairment (HI) listening through their hearing aids (HAs) and/or cochlear implants (CIs). Children aged 5–7 years with HAs, CIs and children with normal hearing (NH) were tested in a free‐field setting using a multi‐feature paradigm with deviations in pitch, intensity, gap, duration, and location. There were significant mismatch responses across all subjects that were positive (p‐MMR) for the gap and pitch deviants (F(1,43) = 5.17, p = 0.028 and F(1,43) = 6.56, p = 0.014, respectively) and negative (MMN) for the duration deviant (F(1,43) = 4.74, p = 0.035). Only the intensity deviant showed a significant group interaction with MMN in the HA group and p‐MMR in the CI group (F(2,43) = 3.40, p = 0.043). The p‐MMR correlated negatively with age, with the strongest correlation in the NH subjects. In the CI group, the late discriminative negativity (LDN) was replaced by a late positivity with a significant group interaction for the location deviant. Children with severe HI can be assessed through their hearing device with a fast multi‐feature paradigm. For further studies a multi‐feature paradigm including more complex speech sounds may better capture variation in auditory processing in these children.
Phylogeny of the rove beetle tribe Gymnusini sensu n. (Coleoptera: Staphylinidae: Aleocharinae): implications for the early branching events of the subfamily
Authors: YAMAMOTO SHÛHEI , MARUYAMA MUNETOSHI
Published: September 2017

The rove beetle subfamily Aleocharinae is the largest subfamily of animals known in terms of species richness. Two small aleocharine tribes, Gymnusini and Deinopsini, are believed to be a monophyletic clade, sister to the rest of the Aleocharinae. Although the phylogenetic relationships of the extant lineages have been well investigated, the monophyly of Gymnusini has been questioned due to a series of previous studies and the recent discovery of the aleocharine †Cretodeinopsis Cai & Huang (Deinopsini) from mid‐Cretaceous Burmese amber. Using an additional specimen of †Cretodeinopsis and well‐preserved specimens of †Electrogymnusa Wolf‐Schwenninger from Eocene Baltic amber, we present here two types of morphology‐based phylogenetic analyses, employing all extant/extinct genera of Gymnusini and Deinopsini for the first time. The maximum parsimony and Bayesian analyses recovered a monophyletic clade of the two tribes combined, but each analysis suggested nonmonophyly of Gymnusini. In agreement with the results of the present study, we synonymize Deinopsini syn.n. under Gymnusini sensu n., by priority.

This published work has been registered in ZooBank, http://zoobank.org/urn:lsid:zoobank.org:pub:F09EB444‐C6CA‐4525‐A986‐3CFC826F5877.
Acute poisonings during pregnancy and in other non‐pregnant women in emergency departments of four government hospitals, Addis Ababa, Ethiopia: 2010‐2015
Authors: Eyasu Mebrahtu , Dida Tolesa , Worku Yoseph , Worku Solomon , Shafie Mensur
Published: September 2017

Objective

To characterise acute poisonings in pregnant and non‐pregnant women treated at emergency departments of government hospitals in Addis Ababa, Ethiopia, between 2010 and 2015.

Methods

All data for acutely poisoned women were retrospectively collected from patient medical charts at the emergency departments of Saint Paul's Hospital Millennium Medical College, Ras Desta Memorial Hospital, Yekatit 12 Hospital Medical College and Zewditu Memorial Hospital. Data were collected by extraction questionnaire and analysed using SPSSv. 20 statistical software.

Results

During the study period, 998 cases of acutely poisoned women were listed in the hospital registries. Of these, complete data for inclusion in the study were available for 592. 36.3% of the study participants were in the age group of 20–24, with a mean (±SD) age of 23.03 (±6.3) years. 80.9% were from Addis Ababa; 4.6% were pregnant. The mean arrival time of all cases was 4.14 h. 85.5% of all study cases were due to intentional self‐poisoning, of whom 42.1% were discharged without complications. The most common poisons were bleach and organophosphates; 25.9% of pregnant cases and 32.6% of non‐pregnant cases were poisoned by bleach; and 18.5% of pregnant cases and 18.9% of non‐pregnant cases had organophosphate poisoning. 0.7% had a history of poisoning; all were non‐pregnant women. The common route of poison exposure was oral, and the case fatality rate of organophosphate poisoning in pregnant and non‐pregnant women was 20 and 1.87%, respectively. The pre‐hospital intervention for the majority of the women was milk, in 12.0% of cases.

Conclusion

Acute poisoning remains a public health problem in our community. Bleach is the most common poisons. Our present findings indicate the necessity of educational programmes on preventable reasons of acute poisonings and their outcomes on pregnant and non‐pregnant women.
MGRN1‐mediated ubiquitination of α‐tubulin regulates microtubule dynamics and intracellular transport
Authors: Mukherjee Rukmini , Majumder Priyanka , Chakrabarti Oishee
Published: September 2017

MGRN1‐mediated ubiquitination of α‐tubulin regulates microtubule stability and mitotic spindle positioning in mitotic cells. This study elucidates the effect of MGRN1‐mediated ubiquitination of α‐tubulin in interphase cells. Here, we show that MGRN1‐mediated ubiquitination regulates dynamics of EB1‐labeled plus ends of microtubules. Intracellular transport of mitochondria and endosomes are affected in cultured cells where functional MGRN1 is depleted. Defects in microtubule‐dependent organellar transport are evident in cells where noncanonical K6‐mediated ubiquitination of α‐tubulin by MGRN1 is compromised. Loss of MGRN1 has been previously correlated with late‐onset spongiform neurodegeneration. Mislocalised cytosolically exposed PrP (CtmPrP) interacts with MGRN1 leading to its loss of function. Expression of CtmPrP generating mutants of PrP[PrP(A117V) and PrP(KHII)] lead to decrease in MGRN1‐mediated ubiquitination of α‐tubulin and intracellular transport defects. Brain lysates from PrP(A117V) transgenic mice also indicate loss of tubulin polymerization as compared to non‐transgenic controls. Depletion of MGRN1 activity may hamper physiologically important processes like mitochondrial movement in neuronal processes and intracellular transport of ligands through the endosomal pathway thereby contributing to the pathogenesis of neurodegeneration in certain types of prion diseases.
Application of low‐voltage UVC light and synthetic ZnO nanoparticles to photocatalytic degradation of ciprofloxacin in aqueous sample solutions
Authors: Eskandari Mahboube , Goudarzi Nasser , Moussavi Seyyed Gholamreza
Published: September 2017

Ciprofloxacin (CIP) is used synthetic therapeutic antibiotic that is not easily biodegradable and is a water pollutant. The advanced oxidation process method is heterogeneous photocatalysis and for the first time, we used the photocatalytic UVC light/ZnO reaction for the degradation of CIP in contaminated water. The ZnO nanoparticles were synthesized via the sol‐gel method. We used a 9‐W mercury lamp, which was inserted in the solution to emit UVC light. The optimum conditions for the degradation of CIP in aqueous solution containing 10 mg/L of CIP were a pH of 5.0, 0.15 g/L of ZnO, a stirring speed of 600 rpm and an irradiation time of 140 min. Also the relative standard deviation (RSD) did not exceed 7%. From the kinetic studies, the reactions followed approximately a pseudo‐first‐order kinetic with the rate constant of 0.032 min−1. This method was efficiently used for the degradation of CIP in aqueous solutions.
Persistent aberrant cortical phase–amplitude coupling following seizure treatment in absence epilepsy models
Authors: Maheshwari Atul , Akbar Abraham , Wang Mai , Marks Rachel L. , Yu Katherine , Park Suhyeorn , Foster Brett L. , Noebels Jeffrey L.
Published: September 2017

Key points

In two monogenic models of absence epilepsy, interictal beta/gamma power is augmented in homozygous stargazer (stg/stg) but not homozygous tottering (tg/tg) mice.

There are distinct gene‐linked patterns of aberrant phase–amplitude coupling in the interictal EEG of both stg/stg and tg/tg mice, compared to +/+ and stg/+ mice.

Treatment with ethosuximide significantly blocks seizures in both genotypes, but the abnormal phase–amplitude coupling remains.

Seizure‐free stg/+ mice have normal power and phase–amplitude coupling, but beta/gamma power is significantly reduced with NMDA receptor blockade, revealing a latent cortical network phenotype that is separable from, and therefore not a result of, seizures.

Altogether, these findings reveal gene‐linked quantitative electrographic biomarkers free from epileptiform activity, and provide a potential network correlate for persistent cognitive deficits in absence epilepsy despite effective treatment.

In childhood absence epilepsy, cortical seizures are brief and intermittent; however there are extended periods without behavioural or electrographic ictal events. This genetic disorder is associated with variable degrees of cognitive dysfunction, but no consistent functional biomarkers that might provide insight into interictal cortical function have been described. Previous work in monogenic mouse models of absence epilepsy have shown that the interictal EEG displays augmented beta/gamma power in homozygous stargazer (stg/stg) mice bearing a presynaptic AMPA receptor defect, but not homozygous tottering (tg/tg) mice with a P/Q type calcium channel mutation. To further evaluate the interictal EEG, we quantified phase–amplitude coupling (PAC) in stg/stg, stg/+, tg/tg and wild‐type (+/+) mice. We found distinct gene‐linked patterns of aberrant PAC in stg/stg and tg/tg mice compared to +/+ and stg/+ mice. Treatment with ethosuximide significantly blocks seizures in both stg/stg and tg/tg, but the abnormal PAC remains. Stg/+ mice are seizure free with normal baseline beta/gamma power and normal theta‐gamma PAC, but like stg/stg mice, beta/gamma power is significantly reduced by NMDA receptor blockade, a treatment that paradoxically enhances seizures in stg/stg mice. Stg/+ mice, therefore, have a latent cortical network phenotype that is veiled by NMDA‐mediated neurotransmission. Altogether, these findings reveal gene‐linked quantitative electrographic biomarkers in the absence of epileptiform activity and provide a potential network correlate for persistent cognitive deficits in absence epilepsy despite effective treatment.
Vibration of Flexible Structures Under Nonlinear Boundary Conditions
Authors: Mao Xiao-Ye , Ding Hu , Chen Li-Qun
Published: September 2017

The nonlinear response of a flexible structure, subjected to generally supported conditions with nonlinearities, is investigated for the first time. An analytical procedure is proposed first. Moreover, a simulation technique usually employed in static analysis is developed for confirmation. Generally, ordinary perturbation methods could analyze dynamics of flexible structures with linear boundary conditions. As nonlinear boundaries are taken into account, they are out of operation for the modal shape that is hardly to be obtained, which is the key to the analysis. In order to overcome this, nonlinear boundary conditions are rescaled and the technique of modal revision is employed. Consequently, each governing equation with different time-scales could be analyzed exactly according to corresponding rescaled boundary conditions. The total response of any point at the flexible structure will be composed by harmonic responses yielded by the analytical method. Furthermore, the differential quadrature element method (DQEM), a numerical simulation technique could satisfy boundary conditions strictly, is introduced to certify analytical results. The comparison shows a reasonable agreement between these two methods. In fact, the accuracy of the analytical method for nonlinear boundaries could be explained in theory. Based on the certification, boundary nonlinearities are discussed in detail analytically and found to play an important role in responses. Because of the important role played by the nonlinear factors in the vibration and control of the flexible structure, this paper will open the vibration analysis and numerical study of the flexible structure with nonlinear constraints.
On Decentralized Optimization for a Class of Multisubsystem Codesign Problems
Authors: Liu Tianchen , Azarm Shapour , Chopra Nikhil
Published: September 2017

Codesign refers to the process of integrating the optimization of the physical plant design and control of a system. In this paper, a new class of codesign problems with a multisubsystem architecture in both design and control is formulated and solved. Our work here extends earlier research on models and solution approaches from single system to multisubsystem codesign. In this class, the optimization model for the physical design part in each subsystem is assumed to have a convex objective function with convex inequality and linear equality constraints. The optimization model for the control part of each subsystem belongs to a class of finite time-horizon linear quadratic regulator (LQR) feedback control. A new multilevel decentralized method is proposed that can obtain optimal or near-optimal solutions for this class of codesign problems. Details of the model and approach are presented and demonstrated by a numerical as well as a more complex spring–mass–damper system example. The proposed decentralized approach has been compared with a centralized approach. Using a scalable test problem, it is shown that as the size of the problem is increased, the computation effort for the decentralized approach increases linearly while that of the centralized approach increases nonlinearly.
The Human Salivary Microbiome Is Shaped by Shared Environment Rather than Genetics: Evidence from a Large Family of Closely Related Individuals
Authors: Shaw Liam , Ribeiro Andre L. R. , Levine Adam P. , Pontikos Nikolas , Balloux Francois , Segal Anthony W. , Roberts Adam P. , Smith Andrew M.
Published: September 2017

The human microbiome is affected by multiple factors, including the environment and host genetics. In this study, we analyzed the salivary microbiomes of an extended family of Ashkenazi Jewish individuals living in several cities and investigated associations with both shared household and host genetic similarities. We found that environmental effects dominated over genetic effects. While there was weak evidence of geographical structuring at the level of cities, we observed a large and significant effect of shared household on microbiome composition, supporting the role of the immediate shared environment in dictating the presence or absence of taxa. This effect was also seen when including adults who had grown up in the same household but moved out prior to the time of sampling, suggesting that the establishment of the salivary microbiome earlier in life may affect its long-term composition. We found weak associations between host genetic relatedness and microbiome dissimilarity when using family pedigrees as proxies for genetic similarity. However, this association disappeared when using more-accurate measures of kinship based on genome-wide genetic markers, indicating that the environment rather than host genetics is the dominant factor affecting the composition of the salivary microbiome in closely related individuals. Our results support the concept that there is a consistent core microbiome conserved across global scales but that small-scale effects due to a shared living environment significantly affect microbial community composition.

IMPORTANCE
Previous research shows that the salivary microbiomes of relatives are more similar than those of nonrelatives, but it remains difficult to distinguish the effects of relatedness and shared household environment. Furthermore, pedigree measures may not accurately measure host genetic similarity. In this study, we include genetic relatedness based on genome-wide single nucleotide polymorphisms (SNPs) (rather than pedigree measures) and shared environment in the same analysis. We quantify the relative importance of these factors by studying the salivary microbiomes in members of a large extended Ashkenazi Jewish family living in different locations. We find that host genetics plays no significant role and that the dominant factor is the shared environment at the household level. We also find that this effect appears to persist in individuals who have moved out of the parental household, suggesting that aspects of salivary microbiome composition established during upbringing can persist over a time scale of years.
Multiresistant E. coli urine infections in children: a case–control study
Authors: Raman Gayathri , McMullan Brendan , Taylor Peter , Mallitt Kylie-Ann , Kennedy Sean E
Published: September 2017

Objective

Urinary tract infections (UTIs) caused by resistant organisms are increasing which poses challenges when selecting empirical antimicrobial therapy. The aim of this study is to determine risk factors for multiresistant Escherichia coli UTIs in children.

Design

We included all reported urinary isolates from a children’s hospital collected between January 2010 and June 2013. Patients who had multiresistant E. coli UTIs were identified and a retrospective review of medical records performed. Patient-specific clinical and demographic factors were compared with age-matched and gender-matched controls with non-multiresistant E. coli UTIs. Univariable and multivariable statistical analysis were performed to determine significant risk factors for multiresistant organism E.coli UTIs.

Results

In total, there were 2692 positive urine cultures, 1676 (62.3%) from 1169 patients were E. coli. Multiresistant E. coli was isolated from 139 (8.3% of all E. coli) cultures in 99 patients. Thirteen incomplete medical records were excluded, leaving 86 patients, matched with 86 controls. In multivariable regression, the only significant risk factor was antibiotic use in the previous month (adjusted OR 3.0, 95% CI 1.4 to 6.2), but not previous hospital admission (adjusted OR 1.4, 95% CI 0.6 to 2.9), being an inpatient at the time of diagnosis (adjusted OR 2.4, 95% CI 0.8 to 7.4) and previous instrumentation (adjusted OR 1.0, 95% CI 0.4 to 2.4).

Conclusions

This is the first case–control study to examine multiresistant UTI in Australian children. Clinicians should be judicious in the use of antibiotics in treatment and prophylaxis of UTIs. In children presenting with UTI and recent antibiotic exposure, amoxicillin-clavulanic acid appears to be an appropriate empiric antibiotic choice in our population.
Do the stars align? Distribution of high-quality ratings of healthcare sectors across US markets
Authors: Figueroa Jose , Feyman Yevgeniy , Blumenthal Daniel , Jha Ashish
Published: September 2017

Background

The US government created five-star rating systems to evaluate hospital, nursing homes, home health agency and dialysis centre quality. The degree to which quality is a property of organisations versus geographical markets is unclear.

Objectives

To determine whether high-quality healthcare service sectors are clustered within US healthcare markets.

Design

Using data from the Centers for Medicare and Medicaid Services’ Hospital, Dialysis, Nursing Home and Home Health Compare databases, we calculated the mean star ratings of four healthcare sectors in 304 US hospital referral regions (HRRs). For each sector, we ranked HRRs into terciles by mean star rating. Within each HRR, we assessed concordance of tercile rank across sectors using a multirater kappa. Using t-tests, we compared characteristics of HRRs with three to four top-ranked sectors, one to two top-ranked sectors and zero top-ranked sectors.

Results

Six HRRs (2.0% of HRRs) had four top-ranked healthcare sectors, 38 (12.5%) had three top-ranked health sectors, 71 (23.4%) had two top-ranked sectors, 111 (36.5%) had one top-ranked sector and 78 (25.7%) HRRs had no top-ranked sectors. A multirater kappa across all sectors showed poor to slight agreement (K=0.055). Compared with HRRs with zero top-ranked sectors, those with three to four top-ranked sectors had higher median incomes, fewer black residents, lower mortality rates and were less impoverished. Results were similar for HRRs with one to two top-ranked sectors.

Conclusions

Few US healthcare markets exhibit high-quality performance across four distinct healthcare service sectors, suggesting that high-quality care in one sector may not be dependent on or improve care quality in other sectors. Policies that promote accountability for quality across sectors (eg, bundled payments and shared quality metrics) may be needed to systematically improve quality across sectors.