bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic coordination with timing frictions: Theory and applications
Authors: Guimaraes Bernardo , Machado Caio , Pereira Ana E.
Published: February 2020

We present a general framework of dynamic coordination with timing frictions. A continuum of agents receive random chances to choose between two actions and remain locked in the selected action until their next opportunity to reoptimize. The instantaneous utility from each action depends on an exogenous fundamental that moves stochastically and on the mass of agents currently playing each action. Agents' decisions are strategic complements and history matters. We review some key theoretical results and show a general method to solve the social planner's problem. We then review applications of this framework to different economic problems: network externalities, statistical discrimination, and business cycles. The positive implications of these models are very similar, but the social planner's solution points to very different results for efficiency in each case. Last, we review extensions of the framework that allow for endogenous hazard rates and ex ante heterogeneous agents.
Social welfare, parental altruism, and inequality
Authors: Reichlin Pietro
Published: February 2020

When individuals have heterogeneous and persistent degrees of one‐sided parental altruism, inequality may grow large and standard social welfare criteria are problematic. If the planner selects Pareto optimal allocations based on some target level of consumption inequality, the solution implies an aggregation of individuals' utilities that is strongly asymmetric and biased toward the less altruistic dynasties. If instead, the planner uses a symmetric utilitarian criterion, the solution is likely to generate a large degree of long‐run inequality (even relative to laissez‐faire competitive equilibria), it can only be decentralized with negative estate taxes or lower bounds on bequests, and it is time‐inconsistent.
CT evaluation of elbow congruity in dogs: radial incisure versus apical medial coronoid process fragmentation
Authors: Baud K. , Griffin S. , Martinez‐Taboada F. , Burton N. J.
Published: February 2020

Objectives

To compare elbow congruity in two cohorts of Labrador retrievers affected with either radial incisure or apex fragmentation of the medial coronoid process.

Materials and Methods

Dogs were included if they had elbow lameness and a CT diagnosis of a fissure or fragmentation of the medial coronoid process occurring either along the radial incisure or at the coronoid apex. Radioulnar joint space was measured incrementally from the lateral to the medial coronoid process on transverse slice images. Axial radioulnar congruency was also measured at the apex and mid‐coronoid in the dorsal plane and at the base of the coronoid in the sagittal plane.

Results

We studied 99 elbows (in 66 dogs) of which 56 had a fissure or fragmentation along the radial incisure and 43 had an apical fragment. No difference was found between the two groups at the different measuring points – with the exception of a transverse plane radioulnar joint space measurement in the radial incisure group that was smaller adjacent to the lateral coronoid process.

Clinical Significance

Abnormal ulnar morphology in the radial incisure group could result in a fulcrum effect within the radioulnar joint, overloading the radial incisure and predisposing to osteochondral damage at this site.
Contactless detection of periodic leg movements during sleep: A 3D video pilot study
Authors: Seidel Stefan , Garn Heinrich , Gall Markus , Kohn Bernhard , Wiesmeyr Christoph , Waser Markus , Coronel Carmina , Stefanic Andrijana , Böck Marion , Wimmer Markus , Mandl Magdalena , Högl Birgit , Klösch Gerhard
Published: February 2020

In clinical practice, the quality of polysomnographic recordings in children and patients with neurodegenerative diseases may be affected by sensor displacement and diminished total sleep time due to stress during the recording. In the present study, we investigated if contactless three‐dimensional (3D) detection of periodic leg movements during sleep was comparable to polysomnography. We prospectively studied a sleep laboratory cohort from two Austrian sleep laboratories. Periodic leg movements during sleep were classified according to the standards of the World Association of Sleep Medicine and served as ground truth. Leg movements including respiratory‐related events (A1) and excluding respiratory‐related events (A2 and A3) were presented as A1, A2 and A3. Three‐dimensional movement analysis was carried out using an algorithm developed by the Austrian Institute of Technology. Fifty‐two patients (22 female, mean age 52.2 ± 15.1 years) were included. Periodic leg movement during sleep indexes were significantly higher with 3D detection compared to polysomnography (33.3 [8.1–97.2] vs. 30.7 [2.9–91.9]: +9.1%, p = .0055/27.8 [4.5–86.2] vs. 24.2 [0.00–88.7]: +8.2%, p = .0154/31.8 [8.1–89.5] vs. 29.6 [2.4–91.1]: +8.9%, p = .0129). Contactless automatic 3D analysis has the potential to detect restlessness mirrored by periodic leg movements during sleep reliably and may especially be suited for children and the elderly.
Epidemiological trends in HCV transmission and prevalence in the Viennese HIV+ population
Authors: Schmidbauer Caroline , Chromy David , Schmidbauer Victor , Bauer David , Apata Michael , Nguyen Dung , Mandorfer Mattias , Simbrunner Benedikt , Rieger Armin , Mayer Florian , Schmidt Ralf , Holzmann Heidemarie , Trauner Michael , Gschwantler Michael , Reiberger Thomas
Published: February 2020

Background & Aims

Human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfection is common in people who inject drugs (PWIDs). Recently, ‘high‐risk’ behaviour among men who have sex with men (MSM) has emerged as another main route of HCV transmission. We analysed temporal trends in HCV epidemiology in a cohort of Viennese HIV+ patients.

Methods

Hepatitis C virus parameters were recorded at HIV diagnosis (baseline [BL]) and last visit (follow‐up [FU]) for all HIV+ patients attending our HIV clinic between January 2014 and December 2016. Proportions of HIV+ patients with anti‐HCV(+) and HCV viraemia (HCV‐RNA(+)) at BL/FU were assessed and stratified by route of transmission.

Results

In all, 1806/1874 (96.4%) HIV+ patients were tested for HCV at BL. Anti‐HCV(+) was detected in 93.2% (276/296) of PWIDs and in 3.7% (31/839) of MSM. After a median FU of 6.9 years, 1644 (91.0%) patients underwent FU HCV‐testing: 167 (90.3%) of PWIDs and 49 (6.7%) of MSM showed anti‐HCV(+). Among 208 viraemic HCV‐RNA(+) patients at BL, 30 (14.4%) had spontaneously cleared HCV, 76 (36.5%) achieved treatment‐induced eradication and 89 (42.8%) remained HCV‐RNA(+) at last FU. Among 1433 initially HCV‐naive patients, 45 (3.5%) acquired de‐novo HCV infection (11.1% PWIDs/80.0% MSM; incidence rate (IR) 0.004%; 95% confidence interval [CI] 0.0%‐0.022%) and 14 had HCV reinfections (85.7% PWIDs/14.3% other; IR 0.001%; 95% CI 0.0%‐0.018%) during a median FU of 6.7 years (interquartile range 7.4).

Conclusion

Hepatitis C virus testing was successfully implemented in the Viennese HIV(+) patients. Anti‐HCV(+) prevalence remained stable in HIV+ PWIDs but almost doubled in HIV+ MSM. De‐novo HCV infection occurred mostly in MSM, while HCV reinfections were mainly observed in PWIDs. HCV treatment uptake was suboptimal with 42.8% remaining HCV‐RNA(+) at FU.
How Citizens Want Their Legislator to Vote
Authors: Dassonneville Ruth , Blais André , Sevi Semra , Daoust Jean‐François
Published: February 2020

Different people have different views about what elected representatives should do in a democracy. Some people think legislators should follow their own conscience (personal view), others think they should do what the majority of citizens in their constituency want (view of the constituency), and yet others think they should do what they promised during the election campaign (campaign promise). Sometimes, these considerations converge, that is, the legislator is personally in favor of a proposed legislation, he or she promised to vote for that legislation in the previous election campaign, and there is majority support for it in the legislator's constituency. However, which of these consideration(s) should matter the most when there is a conflict? Using an experimental design, we ascertain how these principles of representation affect citizens' views about how legislators should vote on a salient policy (immigration). Of the three styles of representation, we find that citizens pay the greatest attention to the state of public opinion in their constituency.
The evolution, progress, and future direction of Nepal's universal salt iodization program
Authors: Paudyal Naveen , Chitekwe Stanley , Rijal Sanjay , Parajuli Kedar , Pandav Chandrakant , Maharjan Macha , Houston Robin , Gorstein Jonathan
Published: February 2020

Nepal is located in what was once known as the Himalayan Goitre Belt and once had one of the highest prevalence's of iodine deficiency disorders in the world. However, through a well‐executed universal salt iodization program implemented over the past 25 years, it has achieved optimal iodine intake for its population, effectively eliminating the adverse consequences of iodine deficiency disorders. A comprehensive review of policy and legislation, surveys, and program reports was undertaken to examine the key elements contributing to the success of this program. The paper reviews the origins and maturation of salt iodization in Nepal, as well as trends in the coverage of iodized salt, the iodine content in salt, and population iodine status over the past two decades. The paper describes critical components of the program including advocacy efforts, trade issues with India, the role of the Salt Trading Corporation, monitoring, and periodic program reviews. The paper discusses the recent findings from the 2016 national micronutrient survey demonstrating the success of the salt iodization program and describes emerging challenges facing the program in the future.
Visual‐only assessments of skin lesions on free‐ranging common bottlenose dolphins (Tursiops truncatus): Reliability and utility of quantitative tools
Authors: Toms Christina N. , Stone Tori , Och‐Adams Traci
Published: February 2020

Photo analysis offers a simple, noninvasive approach to characterizing and quantifying skin lesions in cetaceans; however, this process involves methodological considerations that have often gone unaddressed or have varied in approach among investigators. Subjectivity associated with classifying skin lesion types of unknown etiology and quantifying measures of skin lesion prevalence and extent from photo data raises questions about observer bias and agreement (i.e., interrater reliability), which are often ignored. The purpose of the present study was to improve upon data quality control and assessment practices when studying skin lesions using only photo data. Specifically, we tested interrater reliability of a skin lesion classification system, compared methods of quantifying skin lesion extent, and determined the validity of the dorsal fin as a proxy for skin lesions on the entire body. Acceptable levels of interrater reliability were achieved for only 7 of 17 defined lesion types, but reliability was high for the two tested measures of lesion extent. Skin lesion extent measured from the dorsal fin alone was not a decent proxy for the whole visible surface; disparities between measures were as high as 43%. We discuss the potential pitfalls discovered and provide recommendations for others attempting similar approaches.
Turkish nationalism and the evolutionary idea (1923–1938)
Authors: Karaömerlioğlu M Asım , Yolun Murat
Published: February 2020

This paper sheds light on the role of evolutionary ideas in the making of Turkish nationalism during the Kemalist era (1923–1938). By so doing, it aims to challenge some of the dominant historiographical viewpoints as to the nature of Turkish nationalism. One is related to the Kemalist elites' predisposition towards the so‐called “scientism” seen as one of the bases for nationalism. We intend to turn upside–down the relation between the Kemalists' use of science and Turkish nationalism. Second, we problematize the “culturalist” origins of Turkish nationalism arguing that the seemingly “culturalist” reflections of the time were, indeed, materialist formulations based on the science of the times. We discuss in this respect the Kemalist elites' use of evolutionary ideas. By synthesizing the ways in which these elites employed evolutionary ideas in the fields of history, language, geography, anthropology, biology, eugenics, and pedagogy, we aim to understand the specific nature of Turkish nationalism before 1945. This secular nationalism conceived culture as having materialist bases and differed fundamentally from the culturalist varieties of Turkish nationalism coloured by Islam in the post‐1945 era. Furthermore, the paper empirically enriches the complex and entangled story of evolutionary ideas in the early Turkish Republic.
Begonia puerensis sp. nov. (Begoniaceae), a new tuberous species from Yunnan, China
Authors: Wang Wen‐Guang , Ma Xing‐Da , Li Ren‐Kun , Shi Ji‐Pu , Zhang Shou‐Zhou , Shen Jian‐Yong
Published: February 2020

Begonia puerensis sp. nov., a new tuberous species of Begonia sect. Reichenheimia (Begoniaceae) from Yunnan, China is described and illustrated. The morphological similarity between the new species and the similar species B. discreta, B. harmandii and B. qingchengshanensis is compared and discussed and a key to Begonia sect. Reichenheimia in China is provided. The new species is assessed as Endangered (EN) following the IUCN Red List Categories and Criteria.
Oral immunotherapy in pediatrics
Authors: Arasi Stefania , Castagnoli Riccardo , Pajno Giovanni B.
Published: February 2020

IgE‐mediated food allergy (FA) has been emerging as a public health priority, mainly in children. It represents a heavy burden for the entire society and not only for the patients and their families. There is evidence that in children with persistent FA, at least to cow's milk, hen's egg, and peanut, oral immunotherapy (OIT) may increase the reaction threshold to food allergen(s), while receiving active therapy (the so‐called “desensitization”). Furthermore, OIT protects patients from the occurrence of severe reactions in the event of accidental ingestion of the culprit food during treatment. However, many gaps are still unsolved, including safety issues, identification of predictive biomarkers, and post‐desensitization efficacy. This article briefly summarizes the current evidence and the main needs in OIT to stimulate the development of longitudinal, prospective, well‐designed studies able to fill the current gaps soon.
Update on rhinitis and rhinosinusitis
Authors: Zicari Anna Maria , De Castro Giovanna , Leonardi Lucia , Duse Marzia
Published: February 2020

Rhinitis is a common, under‐diagnosed condition in childhood and adolescence. Pathogenic classification of rhinitis includes allergic rhinitis (AR) and non‐allergic rhinitis (NAR); the latter is characterized by non‐infectious and infectious subtypes; non‐infectious subtype is by far the most prevalent in infancy. Endotyping may help to predict chronic rhinosinusitis (CRS) risk factors, as well as disease progression and response to different treatments. The validation of pediatric algorithms and the implementation of novel biotherapeutics in the endotype‐driven integrated pathways of CRS will lead in the next future to more successful disease management.
Diagnostic approach of hypogammaglobulinemia in infancy
Authors: Plebani Alessandro , Palumbo Laura , Dotta Laura , Lougaris Vassilios
Published: February 2020

Primary B‐cell immunodeficiency is the most frequent immune defect in infancy. Selective absence of serum and secretory immunoglobulin IgA is the most common, with rates ranging from 1/333 persons to 1/16 000, among different races. By contrast, it has been estimated that hypo/agammaglobulinemia occurs with a frequency of 1/50 000 persons. Patients with antibody deficiency are usually recognized because they have recurrent infections with encapsulated bacteria or a history of failure to respond adequately to antibiotic treatment. However, some individuals, mainly those affected by IgA deficiency (SIgAD) or transient hypogammaglobulinemia of infancy , may have few or no infections.
Effects of 12‐month exercise intervention on physical and cognitive functions of nursing home residents requiring long‐term care: a non‐randomised pilot study
Authors: Tsugawa Akito , Shimizu Soichiro , Hirose Daisuke , Sato Tomohiko , Hatanaka Hirokuni , Takenoshita Naoto , Kaneko Yoshitsugu , Ogawa Yusuke , Sakurai Hirofumi , Hanyu Haruo
Published: February 2020

Aims

We performed a 12‐month exercise intervention for ‘nursing home for the elderly’ residents requiring long‐term care. We evaluated changes in their muscular strength, muscle mass, and cognitive function.

Methods

Thirty‐seven nursing home residents (Mini‐Mental State Examination (MMSE): 14.7 ± 7.0, Barthel Index: 44.2 ± 18.9) were enrolled. We divided the participants into the exercise intervention group (n = 19) and non‐intervention group (n = 18) ensuring no significant difference in the participants' characteristics at baseline. For the exercise intervention group, exercise was performed for about 40 min twice a week for 12 months. Skeletal Mass Index and grip force were determined to evaluate muscle mass and muscle strength, respectively. MMSE, Trail Making Test (TMT) part A, and Geriatric Depression Scale 15 (GDS15) were used for cognitive function evaluation, with their changes investigated.

Results

After 12 months, the MMSE scores were significantly improved in the exercise intervention group compared with the non‐intervention group (change from baseline to 12 months: Non‐intervention: −1.0 ± 2.8, Intervention: 1.2 ± 3.0; P = 0.04). Moreover, the grip force of the dominant arm was significantly improved in the exercise intervention group compared with the non‐intervention group (change from baseline to 12 months: Non‐intervention: −1.3 ± 2.8 kg, Intervention: 1.4 ± 4.6 kg; P = 0.007). The prevalence of sarcopenia was significantly increased after 12 months compared with baseline in the non‐intervention group (Non‐intervention: 61.1% → 75.0%, Intervention: 77.8% → 71.4%; P < 0.02). There were no significant changes in GDS15, Barthel Index and TMT after 12 months in intervention and non‐intervention groups.

Conclusion

Exercise intervention may be effectively used for improving the physical and cognitive functions of nursing home residents requiring long‐term care.
Therapeutic whole blood exchange in the management of methaemoglobinemia: Case series and systematic review of literature
Authors: Singh Pawan , Rakesh Kodati , Agarwal Ritesh , Tripathi Paramatma P. , Dhooria Sahajal , Sehgal Inderpaul S. , Prasad Kuruswamy T. , Hans Rekha , Sharma Rattiram , Sharma Navneet , Lad Deepesh , Aggarwal Ashutosh N. , Muthu Valliappan
Published: February 2020

Background

Therapeutic whole blood exchange (TWBE) has been used as an alternative when methylene blue (MB) fails in severe methaemoglobinemia. However, there are limited data on the efficacy and safety of TWBE.

Objectives

Our aim was to report our institutional experience with TWBE. We also perform a systematic review of published literature.

Methods

We retrospectively reviewed our respiratory intensive care unit database to identify cases of methaemoglobinemia managed with TWBE. A systematic review of the PubMed database was performed to identify similar cases (≥12 years). We report the indications, utility, and safety of therapeutic exchange in methaemoglobinemia. The procedural details were also noted.

Results

We identified five subjects who received TWBE for methaemoglobinemia (median methaemoglobin level 39%; range 19.6‐42.4%). TWBE was successful in all five cases and no adverse events were encountered. Our review identified 27 additional subjects. The median methaemoglobin level was 37.5% (range 3.7‐81%). The most common indication (n = 24, 75%) for therapeutic exchange was a lack of response to MB. A majority of the subjects (n = 26/32, 81.2%) survived. No procedure‐related complications were reported.

Conclusion

TWBE is a safe and effective salvage modality for adults with methaemoglobinemia, when MB is either contraindicated or ineffective. Future studies should standardise therapeutic exchange in the management of methaemoglobinemia.
Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy
Authors: Luedke Lauren K. , Cheetham Jonathan , Mohammed Hussni O. , Ducharme Norm G.
Published: February 2020

Objective

To evaluate the efficacy of various treatments for dysphagia after laryngeal surgery.

Study design

Retrospective.

Animals

Horses treated for dysphagia after laryngeal surgery.

Methods

Medical records of horses treated for dysphagia after prosthetic laryngoplasty (PLP) or partial arytenoidectomy (PA) were reviewed. Signalment, prior surgery, preoperative videoendoscopic diagnosis, and surgical treatments were recorded. Short‐ and long‐term follow‐up were obtained. Chi‐square and logistical regression were performed to correlate independent variables and outcomes.

Results

Forty‐four percent of horses with prior PLP and 88% of horses with prior PA had persistent resting dorsal displacement of the soft palate (DDSP). Vocal fold augmentation (VFA) as a single treatment was most commonly performed (n = 22), followed by laryngoplasty removal (LPR; n = 1). Fifteen horses received a combination of treatments: VFA (n = 15), LPR (n = 4), laryngeal tie‐forward (LTF; n = 2), and esophageal release (n = 1). Short‐term clinical outcomes were reported; 80% of horses treated with VFA (n = 35) had resolution of dysphagia, and 20% were improved. Among the 33 horses available to long‐term follow‐up, 31 (94%) returned to some level of work, and DDSP during work was reportedly resolved in 23 of 25 horses.

Conclusion

Vocal fold augmentation resulted in resolution of symptoms relating to dysphagia in 81% of horses. Twenty percent of horses treated with LPR had sustained resolution of dysphagia. A combination of LPR, VFA, LTF was performed in 18% of horses.

Clinical significance

Treatment options directed at altering laryngeal geometry and/or position of the larynx were successful in resolving 86% of dysphagia in horses previously regarded as very difficult to treat.
A Numerical and Experimental Study on the Effects of CO2 on Laminar Diffusion Methane/Air Flames
Authors: Zhang Lei , Ren Xiaohan , Sun Rui , Levendis Yiannis A.
Published: February 2020

Flue gas recirculation (FGR) is an effective method to reduce NOx emissions from the combustion of fuels, such as natural gas. Nitrogen, carbon dioxide, and water are the main components of flue gas. Nitrogen is an inert gas, and water can be condensed out of the effluent before FGR. However, recycled CO2 can alter the physical and chemical combustion characteristics of a fuel. This research investigated the effects of CO2 on CH4/air laminar diffusion flames, both experimentally and numerically. Experiments used laser-induced fluorescence to measure OH and CH distributions in the resulting flames, at different CO2 concentrations. Numerical methods were used to investigate the reaction mechanism and predict temperature and species concentration fields, as well as the NOx formation. Experiments showed that the CH fluorescence intensities decreased with the addition of CO2, while the OH fluorescence intensities increased. Both the directed relation graph method and the sensitivity analysis method were used to reduce the GRI-mech 3.0 mechanism. The chemical kinetics of methane combustion were analyzed using the reduced mechanism with the diffusion opposed-flow flame model in the chemkin 4.1 software package to determine the main reactions among the major species. Numerical simulations showed that as the amount of CO2 in the fuel increased, the concentration of CH decreased. These CFD simulations using the reduced mechanism were in agreement with the experimental data. Thus, the reduced mechanism was then used to predict NO concentrations. Numerical simulations showed that as the amount of CO2 in the fuel increased, the concentration of CH decreased, and, as a result, lower amounts of NO were predicted.
Activation of ASC Inflammasome Driven by Toll-Like Receptor 4 Contributes to Host Immunity against Rickettsial Infection
Authors: Rumfield Claire , Hyseni Ilirjana , McBride Jere W. , Walker David H. , Fang Rong
Published: February 2020

Rickettsiae are cytosolically replicating, obligately intracellular bacteria causing human infections worldwide with potentially fatal outcomes. We previously showed thatRickettsia australisactivates ASC inflammasome in macrophages. In the present study, host susceptibility of ASC inflammasome-deficient mice toR. australiswas significantly greater than that of C57BL/6 (B6) controls and was accompanied by increased rickettsial loads in various organs. Impaired host control ofR. australis in vivoin ASC−/−mice was associated with dramatically reduced levels of interleukin 1β (IL-1β), IL-18, and gamma interferon (IFN-γ) in sera.
Is the Oral Microbiome Important in HIV-Associated Inflammation?
Authors: Fulcher Jennifer A.
Published: February 2020

Alterations in the gut microbiome during HIV infection have been implicated in chronic inflammation, but the role of the oral microbiome in this process is less clear. The article by M. K. Annavajhala, S. D. Khan, S. B. Sullivan, J.
EFG1
Mutations, Phenotypic Switching, and Colonization by Clinical a/α Strains of Candida albicans
Authors: Park Yang-Nim , Conway Kayla , Pujol Claude , Daniels Karla J. , Soll David R.
Published: February 2020

Close to half of a collection of 27 clinical
a
/α isolates of
Candida albicans
underwent white-to-opaque switching. Complementation experiments revealed that while approximately half of the
a
/α switchers were due to
EFG1
mutations, the remaining half were due to mutations in other genes. In addition, the results of competition experiments in a mouse GI tract colonization model support previous observations that
efg1
/
efg1
cells rapidly outcompete
EFG1/EFG1
strains, but direct microscopic analysis reveals that the major colonizing cells were opaque, not gray.
Global Network Analysis of Neisseria gonorrhoeae Identifies Coordination between Pathways, Processes, and Regulators Expressed during Human Infection
Authors: McClure Ryan , Sunkavalli Ashwini , Balzano Phillip M. , Massari Paola , Cho Christine , Nauseef William M. , Apicella Michael A. , Genco Caroline A.
Published: February 2020

Neisseria gonorrhoeae
is the causative agent of the sexually transmitted infection (STI) gonorrhea, a disease with high morbidity worldwide with an estimated 87 million cases annually. Current therapeutic and pharmacologic approaches to treat gonorrhea have been compromised by increased antibiotic resistance worldwide, including to the most recent FDA-approved antibiotic. New treatment strategies are urgently needed to combat this organism. In this study, we used network analysis to interrogate and define the coordination of pathways and processes in
N. gonorrhoeae
. An analysis of the gonococcal network was also used to assign categories to genes and to expand our understanding of regulatory strategies. Network analysis provides important insights into pathogenic mechanisms of this organism that will guide the design of new strategies for disease treatment.
Septic arthritis in a previously healthy man with pan-negative infectious and rheumatologic work-up
Authors: Wang Ann Andee , Linson Elyse Anna
Published: February 2020

Neisseria gonorrhoeaeis the causative organism in 0.6%–1.2% of septic arthritis cases in North America and Europe, and classically presents as migratory polyarthralgias and tenosynovitis, with later development of septic oligoarthritis. In men, urine gonorrhoea nucleic amplification testing (NAAT) is the preferred diagnostic test, as its sensitivity surpasses that of joint and blood culture in disseminated infections. We present a case of a previously healthy man who presented with septic arthritis of the wrist. He denied any sexual activity in the previous year. Urine gonorrhoea NAAT and cultures were negative. However,N. gonorrhoeaewas later identified via 16s PCR of the patient’s synovial fluid, leading to a delayed diagnosis of gonococcal arthritis. In patients with septic arthritis, gonococcal infection should remain on the differential despite reported sexual history and negative urine NAAT. Clinicians should continue to follow cultures and provide antibiotic coverage until a causative organism is identified.
Screening for non-alcoholic fatty liver disease in type 2 diabetes using non-invasive scores and association with diabetic complications
Authors: Ciardullo Stefano , Muraca Emanuele , Perra Silvia , Bianconi Eleonora , Zerbini Francesca , Oltolini Alice , Cannistraci Rosa , Parmeggiani Paola , Manzoni Giuseppina , Gastaldelli Amalia , Lattuada Guido , Perseghin Gianluca
Published: February 2020

Objective

Non-alcoholic fatty liver disease (NAFLD) is prevalent in patients with type 2 diabetes. Here, we estimate the proportion of patients with type 2 diabetes that should be referred to hepatologists according to the European Association for the Study of the Liver (EASL)-European Association for the Study of Diabetes (EASD)-European Association for the Study of Obesity (EASO) Guidelines and evaluate the association between non-invasive biomarkers of steatosis and fibrosis and diabetic complications.

Research design and methods

This is a retrospective analysis of type 2 diabetes patients who attended on a regular basis our diabetes clinic between 2013 and 2018 (n=2770). Steatosis was assessed using Fatty Liver Index (FLI), Hepatic Steatosis Index and NAFLD Ridge Score and fibrosis using NAFLD Fibrosis Score (NFS), Fibrosis-4 (FIB-4), aspartate aminotransferase (AST) to platelet ratio index (APRI) and AST/alanine aminotransferase (ALT) ratio. Outcome measures were altered albumin excretion rate (AER), chronic kidney disease (CKD) and cardiovascular disease (CVD).

Results

The prevalence of advanced fibrosis varied from 1% (APRI) to 33% (NFS). The application of the guidelines using a sequential combination of FLI and FIB-4 would lead to referral of 28.3% of patients when using standard FIB-4 cut-offs, while this number dropped to 13.4% when age-adjusted FIB-4 thresholds were applied. A higher prevalence of altered AER was associated with liver steatosis (FLI: OR: 3.49; 95% CI 2.05 to 5.94, p<0.01), whereas liver fibrosis was associated with CKD (FIB-4: OR: 6.39; 95% CI 4.05 to 10.08, p<0.01) and CVD (FIB-4: OR: 2.62; 95% CI 1.69 to 4.04, p<0.01).

Conclusions

While specific fibrosis scores identify different proportion of patients with advanced fibrosis, the use of age-adjusted FIB-4 cut-offs leads to a drop in gray-zone results, making referrals to hepatologists more sustainable. Interestingly non-invasive biomarkers were consistently associated with a different pattern of diabetic complications.
Systematic review protocol examining the influence of surgeon personality on perioperative decision making in abdominal surgery
Authors: Bisset Carly Nichola , McKee Tracey , Tilling Elliot , Cawley Mary , Moug Susan
Published: February 2020

Introduction

There is limited published literature exploring how the personality traits of surgeons may influence preoperative decision making, particularly in the context of visceral/abdominal surgery. Multiple validated personality scoring systems exist and have been used to describe surgeon personalities previously. The degree to which each trait is expressed by abdominal surgeons is neither currently known, nor the impact of these traits on postoperative outcomes. The protocol has been written in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist.

Methods and analysis

The search strategy has been developed by a Health Scientist Librarian in collaboration with the review team. The search was conducted on 1st October 2019.

Database subject headings and text words relating to ‘abdominal/general surgeons’, ‘personality’, ‘postoperative outcomes’ and ‘decision making’ formed the basis of our literature search strategy; the MEDLINE, EMBASE, PsycInfo and Cochrane databases will be searched. Three reviewers will independently screen and appraise articles, with a fourth reviewer utilised if disagreements arise.

A systematic narrative synthesis will be performed, with information presented in text and table format. These will summarise the findings and characteristics of any included studies. Using guidance from the Centre for Reviews and Dissemination, the reviewers will describe the potential relationship and findings between studies using the narrative synthesis. Studies will only be reported if they are felt to have low or mid-levels of bias. Studies felt to display high levels of bias will be excluded.

Ethics and dissemination

This study does not require ethical approval. The formal systematic review will be submitted for peer reviewed publication and presented at relevant conferences. The methods may inform future reviews in other surgical specialties regarding surgeon personality.

PROSPERO registration number

CRD42019151375.
Role of biological rhythm dysfunction in the development and management of bipolar disorders: a review
Authors: Chen Yiming , Hong Wu , Fang Yiru
Published: February 2020

Disturbance of biological rhythms contributes to the onset of bipolar disorders and is an important clinical feature of the condition. To further explore the role of biological rhythms in bipolar disorders, 95 English articles published between 1968 and 2019 were retrieved from the PubMed database and analysed. We herein review the outcomes of studies on biological rhythm disturbance in bipolar disorders, including the epidemiology, aetiology, clinical features (eg, sleep, feeding and eating disorders) and treatment of the condition evaluated by patients’ self-report and biological indicators such as melatonin. Our report supports the characterisation of biological rhythm disturbance as a significant clinical feature affecting the onset and development of bipolar disorders and reviews classical and novel treatments, such as chronotherapy, that can be applied in the clinical practice. Our analysis indicates that a more comprehensive study of the pathophysiology, clinical phenomenology and treatment of biological rhythm disturbance is required.
Machine learning methods in psychiatry: a brief introduction
Authors: Zhou Zhirou , Wu Tsung-Chin , Wang Bokai , Wang Hongyue , Tu Xin M , Feng Changyong
Published: February 2020

Machine learning (ML) techniques have been widely used to address mental health questions. We discuss two main aspects of ML in psychiatry in this paper, that is, supervised learning and unsupervised learning. Examples are used to illustrate how ML has been implemented in recent mental health research.
How polluted is your fat? What the study of adipose tissue can contribute to environmental epidemiology
Authors: Mustieles Vicente , Arrebola Juan P
Published: February 2020

The study of the potential contribution of low-dose exposure to environmental chemicals on the development of chronic conditions in human populations is often hampered by methodological issues, including exposure misclassification and the inability to assess biological effects in target organs. White adipose tissue (WAT) presents the unique feature of being both an advantageous matrix for assessing long-term exposure to mixtures of persistent organic pollutants and an interesting tissue to investigate early preclinical effects. Moreover, other lipophilic non-persistent chemicals and heavy metals have been recently quantified in fat, suggesting that human WAT contains chemical mixtures more complex than initially thought. However, WAT has been scarcely used in environmental epidemiology due to collection difficulties. In this essay we discuss the potential of using human WAT as a source of both exposure and effect biomarkers, with the aim of advancing the epidemiological research of obesity-related diseases, including metabolic syndrome and cancer. Overall, we discuss the implications of investigating WAT in a multidisciplinary framework combining toxicological and epidemiological knowledge in order to improve the inference of causal relationships in observational settings. We finalise by suggesting feasible designs and scenarios in which WAT samples may be reasonably collected.
Case–control study of brain and other central nervous system cancer among workers at semiconductor and storage device manufacturing facilities
Authors: Rodrigues Ema G , Herrick Robert F , Stewart James , Palacios Helena , Laden Francine , Clark William , Delzell Elizabeth
Published: February 2020

Objective

This study evaluated the relationship between brain and other central nervous system cancer (‘CNS cancer’) and exposures at two semiconductor and electronic module manufacturing facilities and at a storage device manufacturing facility.

Methods

The case–control study, nested in a cohort of 126 836 employees, compared 120 CNS cancer cases and 1028 matched controls with respect to employment in 10 process groups and estimated cumulative exposure to 31 known or possible carcinogens.

Results

CNS cancer was associated with module manufacturing operations at two facilities. Module manufacturing is a process that begins with production of ceramic substrates followed by attachment of completed semiconductor chips and metal-containing circuitry resulting in a high performing electronic device. Positive associations with the highest tertile of estimated cumulative exposure were found for several chemicals, including 2-butoxyethanol, cyclohexanone, ortho-dichlorobenzene, cadmium, molybdenum, trichloroethylene and vinyl chloride.

Conclusions

Results suggested positive associations between CNS cancer and specific operations and chemicals experienced in the semiconductor and electronic module manufacturing industry. However, lack of external support for these findings precludes a causal interpretation, and the observed associations may have been due to chance.
Mediastinal T‐cell lymphoma with presumed secondary monostotic long bone involvement in the absence of local recurrence
Authors: Mosca Andrea , Greville‐Heygate Oliver , Constantino‐Casas Fernando , Giuliano Antonio , Dobson Jane M
Published: February 2020

A 7‐year‐old male neutered cocker crossbreed was presented with a 1‐month history of tachypnoea and exercise intolerance. Initial investigations confirmed a pleural effusion due to a mediastinal T‐cell lymphoma. L‐asparaginase and a 23‐week lomustine, vincristine, prednisolone protocol were pursued and complete response was recorded at the end of the protocol. Ten months later, he was presented at the referring veterinary practice with a non‐bearing lameness of his left forelimb, and a transcondylar screw was placed following the suspicion of a fracture of the lateral humeral epicondyle. During surgery, a sample of bone was collected and submitted for histopathology. Histopathology and immunohistochemistry were consistent with a T‐cell lymphoma. Total body CT scan revealed a monostotic aggressive lesion of the distal humerus with no evidence of infiltration into bone at any other sites, and no other signs of lymphoma relapse were seen elsewhere in the body. Based on these findings, secondary bone lymphoma was hypothesised.
Combined partial lateral corpectomy and pediculectomy in a Dachshund
Authors: Santifort Koen Maurits
Published: February 2020

A 5‐year‐old 8. 2‐kg Dachshund was presented with progressive paraparesis and ataxia of several weeks’ duration and signs of pain persisting despite conservative treatment consisting of (cage) rest and analgesic treatment with gabapentin (12.2‐mg/kg three times a day) and meloxicam (0.1‐mg/kg once a day). Neurological examination was consistent with a T3–L3 myelopathy. CT images showed a mineralised mass in the ventrolateral (right) vertebral canal with severe compression of the spinal cord, taking up >50% of the vertebral canal. An intervertebral disc extrusion (Hansen type I intervertebral disc herniation) with compressive myelopathy was (presumptively) diagnosed. A combination of a partial lateral corpectomy and pediculectomy (‘mini‐hemilaminectomy’) was performed. This surgical approach was deemed best suited to provide adequate access and to remove as much material as possible without compromising the spinal cord. There were no intraoperative complications. Signs did not recur postsurgically, and 2 weeks postsurgery, neurological signs were resolved.
Velocity-based resistance training: impact of velocity loss in the set on neuromuscular performance and hormonal response
Authors: Rodríguez-Rosell David , Yáñez-García Juan Manuel , Mora-Custodio Ricardo , Pareja-Blanco Fernando , Ravelo-García Antonio G. , Ribas-Serna Juan , González-Badillo Juan José
Published: February 2020

This study aimed to compare the effects of 2 resistance training (RT) programs with different velocity losses (VLs) allowed in each set: 10% (VL10%) versus 30% (VL30%) on neuromuscular performance and hormonal response. Twenty-five young healthy males were randomly assigned into 2 groups: VL10% (n = 12) or VL30% (n = 13). Subjects followed a velocity-based RT program for 8 weeks (2 sessions per week) using only the full-squat (SQ) exercise at 70%–85% 1-repetition maximum (1RM). Repetition velocity was recorded in all training sessions. A 20-m running sprint, countermovement jump (CMJ), 1RM, muscle endurance, and electromyogram (EMG) during SQ exercise and resting hormonal concentrations were assessed before and after the RT program. Both groups showed similar improvements in muscle strength and endurance variables (VL10%: 7.0%–74.8%; VL30%: 4.2%–73.2%). The VL10% resulted in greater percentage increments in CMJ (9.2% vs. 5.4%) and sprint performance (–1.5% vs. 0.4%) than VL30%, despite VL10% performing less than half of the repetitions than VL30% during RT. In addition, only VL10% showed slight increments in EMG variables, whereas no significant changes in resting hormonal concentrations were observed. Therefore, our results suggest that velocity losses in the set as low as 10% are enough to achieve significant improvements in neuromuscular performance, which means greater efficiency during RT.

Novelty The VL10% group showed similar or even greater percentage of changes in physical performance compared with VL30%. No significant changes in resting hormonal concentrations were observed for any training group. Curvilinear relationships between percentage VL in the set and changes in strength and CMJ performance were observed.
Hydropower intake-induced fish entrainment risk zone analysis
Authors: Langford Mathew T. , Zhu David Z. , Leake Alf , Cooke Steven J.
Published: February 2020

Evaluating the impacts of hydropower intake operations on upstream aquatic habitat is important for the development of environmentally sustainable hydropower and flood protection. A computational fluid dynamics model was used to simulate the flow field in the forebay of a high dam, Mica Dam in British Columbia, Canada. The model was used to evaluate the upstream hydraulics under various operational conditions and reservoir levels. This model, which was verified by a novel means of collected acoustic Doppler current profiler field measurements, highlights how appropriate intake selection may limit the volume of the forebay occupied by the entrainment risk zone. Additionally, a potential flow solution was applied to predict the velocity field induced by the intakes and the limitation of the potential flow solution was assessed. By linking the detailed knowledge developed of the forebay hydraulics to the established body of knowledge of fish behaviour, fish habitat use within the entrainment risk zone is also discussed in the context of hydropower optimization.
Biofilm formation by South African non-O157 Shiga toxigenic Escherichia coli on stainless steel coupons
Authors: Bumunang Emmanuel W. , Ateba Collins N. , Stanford Kim , McAllister Tim A. , Niu Yan D.
Published: February 2020

This study examined the biofilm-forming ability of six non-O157 Shiga-toxin-producing Escherichia coli (STEC) strains: O116:H21, wzx-Onovel5:H19, O129:H21, O129:H23, O26:H11, and O154:H10 on stainless steel coupons after 24, 48, and 72 h of incubation at 22 °C and after 168 h at 10 °C. The results of crystal violet staining revealed that strains O129:H23 and O154:H10 were able to form biofilms on both the submerged surface and the air–liquid interface of coupons, whereas strains O116:H21, wzx-Onovel5:H19, O129:H21, and O26:H11 formed biofilm only at the air–liquid interface. Viable cell counts and scanning electron microscopy showed that biofilm formation increased (p < 0.05) over time. The biofilm-forming ability of non-O157 STEC was strongest (p < 0.05) at 22 °C after 48 h of incubation. The strongest biofilm former regardless of temperature was O129:H23. Generally, at 10 °C, weak to no biofilm was observed for isolates O154:H10, O116:H21, wzx-Onovel5:H19, O26:H11, and O129:H21 after 168 h. This study found that temperature affected the biofilm-forming ability of non-O157 STEC strains. Overall, our data indicate a high potential for biofilm formation by the isolates at 22 °C, suggesting that non-O157 STEC strains could colonize stainless steel within food-processing facilities. This could serve as a potential source of adulteration and promote the dissemination of these potential pathogens in food.
Expression of cholinesterases and their anchoring proteins in rat heart
Authors: Kilianova Zuzana , Ciznarova Natalia , Szmicsekova Kristina , Slobodova Lubica , Hrabovska Anna
Published: February 2020

Acetylcholine (ACh)-mediated vagal transmission as well as nonneuronal ACh release are considered cardioprotective in pathological situations with increased sympathetic drive such as ischemia–reperfusion and cardiac remodeling. ACh action is terminated by hydrolysis by the cholinesterases (ChEs), acetylcholinesterase, and butyrylcholinesterase. Both ChEs exist in multiple molecular variants either soluble or anchored by specific anchoring proteins like collagen Q (ColQ) anchoring protein and proline-rich membrane anchoring protein (PRiMA). Here we assessed the expression of specific ChE molecular forms in different heart compartments using RT-qPCR. We show that both ChEs are expressed in all heart compartments but display different expression patterns. The acetylcholinesterase-T variant together with PRiMA and ColQ is predominantly expressed in rat atria. Butylcholinesterase is found in all heart compartments and is accompanied by both PRiMA and ColQ anchors. Its expression in the ventricular system suggests involvement in the nonneuronal cholinergic system. Additionally, two PRiMA variants are detected throughout the rat heart.
UHECRs mass composition from $$X_{\mathrm{max}}$$ distributions
Authors: Arsene Nicusor , Sima Octavian
Published: February 2020

The atmospheric depth where the energy deposit profile of secondary particles from extensive air showers (EAS) reaches its maximum, $$X_{\mathrm{max}}$$Xmax, is related to the primary particle mass. The mass composition of the ultra-high energy cosmic rays (UHECRs) can be inferred from measurements of $$X_{\mathrm{max}}$$Xmax distributions in each energy interval, by fitting these distributions with Monte Carlo (MC) templates for four primary species (p, He, N and Fe). On the basis of simulations, we show that a high abundance of some intermediate elements in the $$X_{\mathrm{max}}$$Xmax distributions, e.g. Ne or Si, may affect the quality of the fit and also the reconstructed fractions of different species with respect to their true values. We propose a method for finding the “best combination” of elements in each energy interval from a larger set of primaries (p, He, C, N, O, Ne, Si and Fe) which best describes the $$X_{\mathrm{max}}$$Xmax distributions. Applying this method to the $$X_{\mathrm{max}}$$Xmax distributions measured by the Pierre Auger Observatory (2014), we found that the “best combination” of elements which best describe the data suggest the presence of Ne or Si in some low energy bins for the EPOS-LHC model.