bluuebunny/crossref_metadata_2025 huggingface dataset:
Definitions
Authors: Nilsson Anna
Published: March 2019

This chapter examines Article 2 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). The article explains the meaning of key terms of the Convention. The reasons for incorporating a specific article on definitions was primarily to clarify the scope of the state obligations laid down in the CRPD and thereby to contribute to the effective implementation of the treaty. Under international human rights law, the term ‘discrimination’ has acquired a specific meaning which may differ from how it is interpreted in domestic law. ‘Universal design’, on the contrary, is a fairly new expression in human rights law and thus in need of clarification. In addition, the drafters of the treaty sought to make visible the disability-specific aspects of the terms listed in article 2 so that they are not excluded or forgotten.
General Principles
Authors: Arduin Sarah
Published: March 2019

This chapter examines Article 3 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which sets out the general principles of the CRPD. Prior to the CRPD, general principles were inferred from core articles of a treaty or from preambles. In this sense, the introduction of a stand-alone article on general principles departs from the architecture of previous international human rights treaties. The chapter is divided into two parts. First, it provides an overview of the drafting process of Article 3. Second, it discusses each of the eight principles set out in Article 3, which may be identified as falling within one of the two prevalent themes of the Convention, namely equality and non-discrimination, and participation and inclusion—the latter theme constituting a common feature of an experimental governance regime.
Reservations
Authors: Bantekas Ilias
Published: March 2019

This chapter examines Article 46 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which deals with the issue of reservations. Reservations are a common feature of multilateral treaties, although there are calls to reduce their frequency or volume in human rights or treaties of a humanitarian nature. The legal effect of a reservation is to exclude or modify the binding nature of a treaty provision for the reserving state. In the context of a universal human rights treaty this entails several dangers. For one thing, since the CRPD claims not to create new rights but instead relies on existing ones, any reservation thereto will automatically constitute a regression on entrenched rights, something that is unacceptable. In equal manner, since the vast majority of the ‘existing’ rights in the CRPD are also part of customary international law, reservations thereto will negate customary obligations, which is again unacceptable.
Amendments
Authors: Magliveras Konstantinos
Published: March 2019

This chapter examines Article 47 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which deals with amendments. The rationale for the need to have an amendment clause in multilateral conventions is that each treaty has a life of its own and it is highly probable that at some future point circumstances or conditions may change necessitating one or more amendments. Treaties do not have to stipulate expressly their amendment because it is generally accepted that contracting parties have the unfettered right to change their provisions, provided that they observe the general rules envisaged in the Vienna Convention on the Law of Treaties. However, by inserting an amendment clause, contracting parties are offered the opportunity to stipulate detailed and often very detailed provisions, and this is the case with the CRPD.
Authentic Texts
Authors: Bantekas Ilias
Published: March 2019

This chapter examines Article 50 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which states that the Arabic, Chinese, English, French, Russian, and Spanish texts of the present Convention shall be equally authentic. These languages are all official languages of the United Nations and it is standard practice for all of these to be designated as equally authentic in treaties adopted under its aegis. That all six languages are authentic entails that all texts are authoritative when determining the meaning of any provision in the CRPD. Consequently, it is crucial that the language in all texts is precise and the terminology corresponds to the greatest possible degree in all languages.
Geophysical evidence that Saturn’s Moon Phoebe originated from a C-type asteroid reservoir
Authors: Castillo-Rogez Julie , Vernazza Pierre , Walsh Kevin
Published: March 2019

Saturn’s Moon Phoebe has been suggested to originate from the Kuiper Belt. However, its density is twice that of Kuiper Belt objects (KBOs) in the same size class, which challenges that relationship. Since the internal evolution of mid-sized planetesimals (100–300 km in diameter) is primarily driven by the amount of accreted short-lived radioisotopes, it is possible to constrain the relative times of formation of these bodies based on their bulk porosity content, hence their densities. From modelling the thermal evolution of KBOs, we infer a difference in formation timing between these bodies and Phoebe. This confirms prior suggestions for a delayed accretion timeframe with increasing distance from the Sun. This geophysical finding combined with spectral observations suggests Phoebe formed in the same region as C-type asteroids and support recent dynamical models for a C-type body reservoir between the orbits of the giant planets. On the other hand, the similarly low densities of mid-sized D-type asteroids, Trojan asteroids, and KBOs add to the growing evidence that these objects shared a common reservoir near or beyond the orbit of Neptune and were heat starved overall.
Stellar influence on heavy ion escape from unmagnetized exoplanets
Authors: Egan Hilary , Jarvinen Riku , Brain David
Published: March 2019

Planetary habitability is in part determined by the atmospheric evolution of a planet; one key component of such evolution is escape of heavy ions to space. Ion-loss processes are sensitive to the plasma environment of the planet, dictated by the stellar wind and stellar radiation. These conditions are likely to vary from what we observe in our own Solar system when considering a planet in the habitable zone around an M-dwarf. Here, we use a hybrid global plasma model to perform a systematic study of the changing plasma environment and ion escape as a function of stellar input conditions, which are designed to mimic those of potentially habitable planets orbiting M-dwarfs. We begin with a nominal case of a solar wind experienced at Mars today, and incrementally modify the interplanetary magnetic field orientation and strength, dynamic pressure, and Extreme Ultraviolet input. We find that both ion-loss morphology and overall rates vary significantly, and in cases where the stellar wind pressure was increased, the ion loss began to be diffusion or production limited with roughly half of all produced ions being lost. This limit implies that extreme care must be taken when extrapolating loss processes observed in the Solar system to extreme environments.
Detection of a giant white-light flare on an L2.5 dwarf with the Next Generation Transit Survey
Authors: Jackman James A G , Wheatley Peter J , Bayliss Daniel , Burleigh Matthew R , Casewell Sarah L , Eigmüller Philipp , Goad Mike R , Pollacco Don , Raynard Liam , Watson Christopher A , West Richard G
Published: March 2019

We present the detection of a ΔV ∼ −10 flare from the ultracool L2.5 dwarf ULAS J224940.13−011236.9 with the Next Generation Transit Survey (NGTS). The flare was detected in a targeted search of late-type stars in NGTS full-frame images and represents one of the largest flares ever observed from an ultracool dwarf. This flare also extends the detection of white-light flares to stars with temperatures below 2000 K. We calculate the energy of the flare to be $3.4^{+0.9}_{-0.7}\times 10^{33}$ erg, making it an order of magnitude more energetic than the Carrington event on the Sun. Our data show how the high-cadence NGTS full-frame images can be used to probe white-light flaring behaviour in the latest spectral types.
DNA barcodes for rapid, whole genome, single-molecule analyses
Authors: Wand Nathaniel O , Smith Darren A , Wilkinson Andrew A , Rushton Ashleigh E , Busby Stephen J W , Styles Iain B , Neely Robert K
Published: March 2019

We report an approach for visualizing DNA sequence and using these ‘DNA barcodes’ to search complex mixtures of genomic material for DNA molecules of interest. We demonstrate three applications of this methodology; identifying specific molecules of interest from a dataset containing gigabasepairs of genome; identification of a bacterium from such a dataset and, finally, by locating infecting virus molecules in a background of human genomic material. As a result of the dense fluorescent labelling of the DNA, individual barcodes of the order 40 kb pairs in length can be reliably identified. This means DNA can be prepared for imaging using standard handling and purification techniques. The recorded dataset provides stable physical and electronic records of the total genomic content of a sample that can be readily searched for a molecule or region of interest.
Staged Laser Interstitial Thermal Therapy (LITT) Treatments to Left Insular Low-Grade Glioma
Authors: Hafez Daniel M , Liekweg Caroline , Leuthardt Eric C
Published: March 2019

BACKGROUND AND IMPORTANCE

Low-grade insular gliomas remain challenging tumors for aggressive resection because of the numerous functional and vascular structures surrounding them. Because of the potential morbidities associated with open surgical resection, less invasive techniques may confer a more optimal balance between cytoreduction and surgical complications. For this reason, we evaluated the use of laser interstitial thermal therapy (LITT) for resection of a dominant hemisphere oligodendroglioma World Health Organization (WHO) grade II in a 68-yr-old patient by use of multiple staged surgeries for its resection.

CLINICAL PRESENTATION

Patient KK was a 68-yr-old female who was found to have a large, left-sided insular mass that was shown to be an oligodendroglioma WHO grade II, positive for codeletion 1p/19q and IDH1 mutant on biopsy. Over the course of 3 mo, KK underwent 2 stages of LITT, targeting different areas of the 5-cm tumor. The 60-d magnetic resonance imaging (MRI) demonstrated a reduction in size of the tumor from 5.2 × 3.3 × 2.4 cm to 3.6 × 1.9 × 1.4 cm. She returned for a second stage targeting the anterior portion of the tumor. KK did well postoperatively and went on to postsurgical chemoradiation. At the 2-yr follow-up, the lesion showed near resolution on MRI.

CONCLUSION

This case report demonstrates successful use of LITT for staged surgeries to treat a left hemisphere-dominant insular lesion. This establishes the use of LITT as a viable, minimally invasive option to treat tumors that are difficult to access or pose concerns for increased morbidity through an open surgery.
Fish–derived proteins and their potential to improve human health
Authors: Dale Hanna Fjeldheim , Madsen Lise , Lied Gülen Arslan
Published: March 2019

Emerging evidence from studies evaluating the effect of lean fish consumption in humans suggests that proteins from fish have several beneficial metabolic effects. Rest, or waste, material from the fishing industry contains high-quality proteins, and utilization of this material offers novel possibilities for the development of protein-containing products that might be beneficial for human consumption. Fish-derived peptides containing bioactive amino acid sequences suggested to beneficially influence pathways involved in body composition, hypertension, lipid profile, and regulation of glucose metabolism are of particular interest, although the results of published studies are conflicting. This review aims to summarize current knowledge from animal studies and clinical interventions in humans evaluating the effects of lean fish, fish proteins, and fish-derived peptides on outcomes related to metabolic health. Fish proteins have a high content of taurine, and animal trials suggest that taurine mediates some of the beneficial effects observed thus far, although the mechanisms by which fish peptides exert their action are not yet elucidated. At this time, the literature is inconsistent, and there is insufficient mechanistic evidence to support a beneficial effect of fish-derived peptides on metabolic health.
Trade, Merchants, and the Lost Cities of the Bronze Age*
Authors: Barjamovic Gojko , Chaney Thomas , Coşar Kerem , Hortaçsu Ali
Published: March 2019

We analyze a large data set of commercial records produced by Assyrian merchants in the nineteenth century BCE. Using the information from these records, we estimate a structural gravity model of long-distance trade in the Bronze Age. We use our structural gravity model to locate lost ancient cities. In many cases, our estimates confirm the conjectures of historians who follow different methodologies. In some instances, our estimates confirm one conjecture against others. We also structurally estimate ancient city sizes and offer evidence in support of the hypothesis that large cities tend to emerge at the intersections of natural transport routes, as dictated by topography. Finally, we document persistent patterns in the distribution of city sizes across four millennia, find a distance elasticity of trade in the Bronze Age close to modern estimates, and show suggestive evidence that the distribution of ancient city sizes, inferred from trade data, is well approximated by Zipf’s law.
Our Forgotten Constitutional Guardians: Preserving Respect for the Law
Authors: Jones Brian Christopher
Published: March 2019

A focus on back-end constitutional actors remains the norm when we think of typical constitutional guardians. This piece challenges that perception, examining the uniquely situated UK constitution, with a focus on two significant front-end constitutional guardians: bill drafters within the Office of Parliamentary Counsel and senior clerks within the House of Commons. These two groups of actors provide a first—and in some cases possibly even the last—port of call for assessing the constitutionality of legislation. Yet after another period of constitutional change, they appear to have been largely forgotten in the literature. This is unfortunate, as research interviews with both groups, and also with experts of the legislative process, demonstrate that these actors remain key players in the UK constitutional system. Furthermore, these two groups are essential to upholding our respect for the law, at a time when disenchantment for parliamentary democracy appears to be growing.
Alternative Hosts of Cercospora beticola in Field Surveys and Inoculation Trials
Authors: Knight Noel L. , Vaghefi Niloofar , Kikkert Julie R. , Pethybridge Sarah J.
Published: March 2019

Cercospora beticola, the cause of Cercospora leaf spot (CLS) of sugar beet and table beet, has a broad range of potential alternative hosts. The role of these hosts as inoculum sources in the field is unclear and has had limited investigation since the advent of DNA-based pathogen identification. The presence of C. beticola on alternative hosts associated with table beet fields of New York was assessed in field surveys during 2016. Lesions were collected, and 71 cercosporoid conidia were isolated for phylogenetic comparison. C. beticola was identified from Solanum ptycanthum (n = 4), Chenopodium album (n = 2), and Spinacia oleracea (n = 1), whereas C. chenopodii was identified on Chenopodium album (n = 51). Artificial inoculation of 21 plants species demonstrated that C. beticola was pathogenic to Brassica kaber, Chenopodium album, Carthamus tinctorius, Rumex obtusifolius, and Spinacia oleracea. These results indicate that although C. beticola may be pathogenic to a range of plant species, the role of symptomatic tissue for inoculum production on alternative hosts in the field appears limited. Observations of C. beticola on necrotic and naturally senescent tissue suggest saprophytic survival on plant debris of a range of species, which has implications for CLS epidemics and disease management.
Characterization of Fusarium solani Populations Associated with Spanish Strawberry Crops
Authors: Villarino M. , De la Lastra E. , Basallote-Ureba M. J. , Capote N. , Larena I. , Melgarejo P. , De Cal A.
Published: March 2019

Fusarium solani is an emerging pathogen reported on Spanish strawberry crops both in nurseries and in fruit production fields, causing wilt and root rot. Pathogenicity, morphocultural characteristics, and sensitivity to biocides of 103 F. solani isolates recovered from symptomatic strawberry plants and soils from both Spanish strawberry areas were determined. The differences of isolates within and between nurseries and field crops in relation to these parameters were analyzed. Considerable variability in morphological and pathogenic characteristics was observed among the isolates in both areas. The majority of isolates were not pathogenic (62%), and only 38 F. solani isolates (37.62%) caused disease on strawberry plants under controlled conditions; 52.63% of pathogenic isolates induced low severity symptoms. Almost 70% of pathogenic isolates caused stunting on plants. The morphological characters that best explain the F. solani variability (86.85%) were colony color and the presence of macroconidia on culture medium. The sensitivity to the fumigants tested was similar between the isolates from nurseries and fruit production fields, showing greater sensitivity to the field doses of dazomet and chloropicrin. However, the isolates were less sensitive to metam sodium and poorly sensitive to 1,3-dichloropropene. This work can contribute to the advancement of sustainable production of strawberry.
Detection and Characterization ofFusarium oxysporumf. sp.vasinfectumVCG0114 (Race 4) Isolates of Diverse Geographic Origins
Authors: Bell Alois A. , Gu Aixing , Olvey Jim , Wagner Tanya A. , Tashpulatov Javlon J. , Prom Sandria , Quintana Jose , Nichols Robert L. , Liu Jinggao
Published: March 2019

A highly virulent cotton wilt pathogen, Fusarium oxysporum f. sp. vasinfectum VCG0114 (race 4) was found in West Texas in 2017, after being known in California since 2001. Isolates obtained from wilted plants collected in 2017 from Texas, in 2015 from China, and during 2001 to 2014 from California and isolates from historical collections including the race 4 reference isolate were characterized by soil-infestation pathogenicity assays, DNA sequence analysis, and vegetative compatibility analysis. All obtained F. oxysporum f. sp. vasinfectum isolates belonged to VCG0114. All of these isolates, except one isolate from China, caused disease in a soil-infestation assay without nematodes. Thus, they belong to the nematode-independent pathotype. Texas isolates were significantly more virulent than were isolates from China or California on Gossypium barbadense ‘Pima S-7’. Four different genotypes (N, T, MT, and MiT) were identified based on the transposable element Tfo1 insertion into the PHO gene and independent MULE or MITE insertions into the Tfo1 transposon. Some significant differences in virulence were detected among the genotypes in some locations. No differences in pathogenicity were observed between the California and China collection isolates on Pima S-7, and the virulence of the major genotypes was similar on the Gossypium hirsutum cultivar ‘Stoneville 474’ or the Barbren 713 germplasm line. Simple polymerase chain reaction (PCR) methods were developed to specifically determine and detect the four genotypes within VCG0114. A specific PCR method to detect all VCG0114 isolates was also developed. These methods will facilitate the timely identification of infested fields and seed lots and the elucidation of evolutionary relationships among the isolates. This should help to closely monitor the movement of the pathogen and reduce dissemination of these devastating pathogens.
Do Brief Educational Sessions Increase Electronic Health Literacy of Low-Income Persons Living With HIV/AIDS?
Authors: Nokes Kathleen M. , Reyes Darcel M.
Published: March 2019

This research explored whether participating in a brief educational intervention using the National Library of Medicine video, Evaluating Health Information: A Tutorial From the National Library of Medicine, would increase electronic health literacy. A quasi-experimental longitudinal design was used in two randomly selected settings of a treatment program for low-income persons living with HIV/acquired immune deficiency syndrome (N = 100). Individuals in both intervention groups watched the video and completed an at-home assignment brought to the second session 1 week later; one group received an additional 15 minutes with an HIV nurse clinician who reinforced video content. Generalized linear models were used in order to account for the longitudinal nature of the data; a full model was fitted first that included age, gender, race, ethnicity, education, acquired immune deficiency syndrome diagnosis, time, group, and the interaction of time by intervention group with electronic health literacy as the dependent variable. Group means were not significantly different, and the overall group pattern were the same; the only significant variable was older age, which is consistent with the findings of other literature. Electronic health literacy can be increased by viewing a free video; making this video available in a variety of settings and encouraging clients to use the Internet as a source of health information may improve self-management strategies of persons living with chronic illnesses.
Predictors of HIV Risk Reduction in Adolescent Girls
Authors: Long-Middleton Ellen R. , Burke Pamela J. , Rankin Sally H.
Published: March 2019

Purpose:

The purpose of the study was to explore the associations among mastery, self-esteem, and HIV risk reduction behaviors in a culturally diverse group of adolescent girls. It is important to identify and assess psychological determinants of HIV risk reduction behaviors such as mastery and self-esteem so that healthcare interventions may be tailored to maximize an adolescent's preventive efforts.

Study Design and Methods:

Black, Latina, and White adolescent girls were recruited from an urban primary care setting in a tertiary care center. A descriptive, correlational design was used. Measures included the Pearlin Mastery Scale, Rosenberg Self-Esteem Scale, and the Adolescent Problem Severity Index. Data were collected through written surveys completed anonymously. Data were analyzed using multiple regression analysis.

Results:

There were 224 participants. Mastery and self-esteem, variables that commonly explain health-enhancing behaviors, were not associated with HIV risk reduction behaviors either in the entire sample or cultural subgroups. There was an inverse relationship between age and HIV risk reduction behaviors in all cultural groups. There were no significant differences in HIV risk reduction behaviors among the three cultural groups.

Clinical Nursing Implications:

Findings suggest HIV prevention efforts by nurses should be universal regardless of an adolescent girl's presumed level of mastery and self-esteem, and that these efforts need to intensify as they age.
Cardiometabolic Challenges Provided by Variable Assisted Exoskeletal Versus Overground Walking in Chronic Motor-incomplete Paraplegia: A Case Series
Authors: Kressler Jochen , Domingo Antoinette
Published: March 2019

Background and Purpose:

People with spinal cord injury (SCI) experience secondary complications including low levels of cardiometabolic activity and associated health risks. It is unknown whether overground bionic ambulation (OBA) enhances cardiometabolic challenge during walking in those with motor-incomplete SCI, thereby providing additional therapeutic benefits.

Case Descriptions:

One man and one woman with chronic motor-incomplete paraplegia due to SCI.

Intervention:

Assessment of functional walking capacity with the 10-m and 6-minute walk tests. Participants underwent cardiometabolic measurements including heart rate (HR), oxygen consumption (

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), energy expenditure (EE), and substrate utilization patterns during OBA and overground walking for 6 minutes each.

Outcomes:

The female participant had low functional walking capacity (walking speed = 0.23 m/s; 6-minute walk = 230 ft). She had higher cardiorespiratory responses during OBA versus overground walking (Δ

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= −3.6 mL/kg/min, ΔEE = 12 kcal) despite similar mean HR values (ΔHR = −1 beats per minute). She was able to sustain continuous walking only during the OBA trial. The male participant had greater walking capacity (walking speed = 0.33 m/s, 6 minutes = 386ft) and lower responses during OBA versus overground walking (Δ

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= −6.0 mL/kg/min, ΔEE = −18 kcal, ΔHR = −6 beats per minute). He was able to walk continuously in both conditions.

Discussion:

The participant with lower walking capacity experienced a higher cardiometabolic challenge and was able to sustain exercise efforts for longer period with OBA versus overground walking. Therefore, OBA presents a superior alternative to overground training for cardiometabolic conditioning and associated health benefits in this participant. For the participant with higher walking capacity, OBA represented a lower challenge and appears to be an inferior cardiometabolic training option to overground walking. The cardiometabolic response to OBA differs depending on functional capacity; OBA warrants study as an approach to cardiometabolic training for individuals with motor-incomplete SCI who have limited lower extremity function.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A259).
Substance Use in a Domestic Minor Sex Trafficking Patient Population
Authors: Moore Jessica L. , Goldberg Amy P. , Barron Christine
Published: March 2019

Substance use and abuse have been documented as both a risk factor in and consequence of involvement in domestic minor sex trafficking (DMST). Domestic minor sex trafficking is defined as the commercial sexual exploitation of children in exchange for money, food, shelter, or any other valued entity. The current investigation sought to describe substance use in a cohort of DMST patients who present for medical evaluation. Findings revealed that 68 patients referred for DMST involvement reported high rates of alcohol/substance use and parental substance abuse. Further, many patients who had a urine toxicology screen had a positive result, most often identifying the presence of cannabinoids. Our data may inform the importance of comprehensive assessments and specialized interventions for substance abuse in this unique patient population.
Atypical Presentation of Chiari I Malformation in a 13-Year-Old Adolescent
Authors: Bronheim Rachel S. , Tyagi Rachana
Published: March 2019

In this report, we describe a 13-year-old with opisthotonos as the presenting symptom of Chiari I malformation. This presentation is rare and has previously been reported only in infants. We describe the physical and radiologic findings, literature regarding Chiari malformation, and differential diagnosis of opisthotonos in this patient.
A Call to Restore Your Calling
Authors: Mull Colette C. , Thompson Amy D. , Selbst Steven M. , Miller Elissa G. , Rappaport David I. , Gartner J. Carlton , Bowman Wesley R.
Published: March 2019

Few practicing emergency physicians will avoid life-changing stressors such as a medical error, personal illness, malpractice litigation, or death of a patient. Many will be unprepared for the toll they will take on their lives. Some may ultimately experience burnout, post-traumatic stress disorder, and suicidal ideation. Medical education, continuing education, and maintenance of certification programs do not teach physicians to recognize helplessness, moral distress, or maladaptive coping mechanisms in themselves. Academic physicians receive little instruction on how to teach trainees and medical students the art of thriving through life-changing stressors in their career paths. Most importantly, handling a life-changing stressor is that much more overwhelming today, as physicians struggle to meet the daily challenge of providing the best patient care in a business-modeled health care environment where profit-driven performance measures (eg, productivity tracking, patient reviews) can conflict with the quality of medical care they wish to provide.

Using personal vignettes and with a focus on the emergency department setting, this 6-article series examines the impact life-changing stressors have on physicians, trainees, and medical students. The authors identify internal constraints that inhibit healthy coping and tools for individuals, training programs, and health care organizations to consider adopting, as they seek to increase physician satisfaction and retention. The reader will learn to recognize physician distress and acquire strategies for self-care and peer support. The series will highlight the concept that professional fulfillment requires ongoing attention and is a work in progress.
Incidentally Detected Oropharyngeal Squamous Cell Carcinoma on 18F-Fluciclovine PET/CT
Authors: Raghavan Kesav , Wen Kwun Wah , Small Eric J. , Ha Patrick , Flavell Robert R.
Published: March 2019

We present a case of oropharyngeal squamous cell carcinoma (SCC) of the tongue base incidentally detected on 18F-fluciclovine PET/CT. A 79-year-old man with history of locally advanced prostate cancer (Gleason score 4 + 5 = 9; cT2cN1M0) previously treated with androgen deprivation therapy (luprolide + bicalutamide) presented with a slowly rising serum prostate-specific antigen over 3 years, concerning for recurrent disease. 18F-fluciclovine PET/CT, obtained to identify potential sites of recurrence, demonstrated prostate bed uptake with possible left seminal vesicle involvement. Additionally, an exophytic, tracer-avid right tongue base mass was incidentally noted and later confirmed to be p16+ SCC on biopsy.
Diffuse Subcutaneous and Muscular Langerhans Cell Histiocytosis on FDG PET/CT
Authors: Shao Dan , Wang Shuxia
Published: March 2019

Langerhans cell histiocytosis (LCH) is a rare cancer that represents a set of pathological outcomes due to the abnormal proliferation of Langerhans cells, which is more commonly seen in pediatric patients. FDG PET/CT findings of an adult LCH patient with extensive infiltration in the subcutaneous tissue and muscles was described in this case.
Inadvertent Injection of a Breast Implant During Lymphoscintigraphy
Authors: Manganaro Mark S. , Millet John D. , Manganaro Matthew S.
Published: March 2019

A 34-year-old woman with history of bilateral saline implants, invasive ductal carcinoma of the right breast, and suspicious left breast calcifications was referred for left breast lymphoscintigraphy before bilateral mastectomy. A total of 3.2 mCi of 99mTc-filtered sulfur colloid was administered with 3 subdermal injections in the superior, lateral, and inferior periareolar left breast in the late afternoon preceding the day of surgery. Imaging identified radiotracer uptake within a dense, circular area deep to the injection sites within the left breast, compatible with implant puncture and radiotracer administration within the indwelling breast implant.
18F-FDG PET/CT in Urachal Abscess
Authors: Flaus Anthime , Longo Maria-Giulia , Dematons Marine , Granjon Denise , Prevot Nathalie
Published: March 2019

We report interesting images of a pelvic mass in an 11-year-old girl. She presented with fever, chronic fatigue, and weight loss without abdominal pain. Abdominal ultrasound, contrast-enhanced CT, and 18F-FDG PET/CT were equivocal. 18F-FDG PET/CT revealed an irregular, intense FDG-avid pelvic mass in close contact with the bladder. Both infectious and malignancy complications were suspected, but pathological examination confirmed a urachal abscess. As most of the urachal carcinomas are mucinous adenocarcinomas with low or non-FDG uptake, intense uptake might indicate an abscess rather than a carcinoma.
Uncommon Penio-Scrotal Metastases of Prostate Cancer Detected on 68Ga PSMA PET/CT
Authors: Seniaray Nikhil , Verma Ritu , Khanna Sudhir , Belho Ethel , Malik Dharmender
Published: March 2019

A 68-year-old man, a known case of carcinoma prostate (Gleason score 4 + 4), status post transurethral resection of prostate cancer and radiotherapy, on hormonal treatment with rising prostate-specific antigen 9.0 ng/mL and penile swelling underwent 68Ga-PSMA PET/CT scan for metastatic workup and restaging. The study revealed abnormal tracer uptake in the prostatic bed region, the pelvic and inguinal lymph nodes, and metastases to the glans of penis and scrotum. The penile and scrotal lesion was proved to be metastatic adenocarcinoma from prostate on fine-needle aspiration cytology.
High Patient Satisfaction With Local Anesthesia and Light Sedation in a Novel Fast-Track Setup for Sacrospinous Fixation
Authors: Lydiksen Henriette Arenholt , Glavind-Kristensen Marianne , Greisen Susanne
Published: March 2019

Objectives

Simple prolapse operations can be performed using local anesthesia. However, this has not been the case for advanced pelvic organ prolapse operations. The aim of this study was to investigate the patient-reported feasibility and acceptability of local anesthesia and light sedation for sacrospinous fixation (SSF).

Methods

This is a prospective observational study on 105 women who underwent SSF in a public outpatient setting from April 2016 to October 2017. They received infiltration anesthesia with mepivacaine or lidocaine together with a pudendal nerve block with Marcaine. Local anesthesia was supplemented by intravenous light sedation and pain reliever. A Local Anesthetic Intraoperative Experience Questionnaire was used to evaluate patient experience.

Results

One patient was converted to general anesthesia. Eighty-eight women answered the questionnaires. Ninety-nine percent defined themselves as satisfied or very satisfied with the anesthesia. Little or no pain during the operation was reported by 92% and 92% would choose the same type of anesthesia again. No adverse effect of the anesthetic procedure was observed. The median (range) admission time was 12 (4.5–48) hours, and 81% of the patients could be discharged on the day of surgery. At follow-up after 8 weeks and 6 months, no patients reported adverse events to the anesthesia.

Conclusions

The SSF can be performed using local anesthesia and light sedation with high degree of patient satisfaction. These preliminary data indicate that the concept of ambulatory surgery might be implemented more widely if the use of local anesthesia is also applied to more advanced surgical procedures.
Mechanical characterization of functionally graded soft materials with ultrasound elastography
Authors: Li Guo-Yang , Zhang Zhao-Yi , Qian Jialin , Zheng Yang , Liu Wenli , Wu Huijuan , Cao Yanping
Published: March 2019

Functionally graded soft materials (FGSMs) with microstructures and mechanical properties exhibiting gradients across a spatial volume to satisfy specific functions have received interests in recent years. How to characterize the mechanical properties of these FGSMs
in vivo/in situ
and/or in a non-destructive manner is a great challenge. This paper investigates the use of ultrasound elastography in the mechanical characterization of FGSMs. An efficient finite-element model was built to calculate the dispersion relation for surface waves in FGSMs. For FGSMs with large elastic gradients, the measured dispersion relation can be used to identify mechanical parameters. In the case where the elastic gradient is smaller than a certain critical value calculated here, our analysis on transient wave motion in FGSMs shows that the group velocities measured at different depths can infer the local mechanical properties. Experiments have been performed on polyvinyl alcohol (PVA) cryogel to demonstrate the usefulness of the method. Our analysis and the results may not only find broad applications in mechanical characterization of FGSMs but also facilitate the use of shear wave elastography in clinics because many diseases change the local elastic properties of soft tissues and lead to different material gradients.

This article is part of the theme issue ‘Rivlin's legacy in continuum mechanics and applied mathematics’.
Revisiting the wrinkling of elastic bilayers I: linear analysis
Authors: Alawiye Hamza , Kuhl Ellen , Goriely Alain
Published: March 2019

Wrinkling is a universal instability occurring in a wide variety of engineering and biological materials. It has been studied extensively for many different systems but a full description is still lacking. Here, we provide a systematic analysis of the wrinkling of a thin hyperelastic film over a substrate in plane strain using stream functions. For comparison, we assume that wrinkling is generated either by the isotropic growth of the film or by the lateral compression of the entire system. We perform an exhaustive linear analysis of the wrinkling problem for all stiffness ratios and under a variety of additional boundary and material effects. Namely, we consider the effect of added pressure, surface tension, an upper substrate and fibres. We obtain analytical estimates of the instability in the two asymptotic regimes of long and short wavelengths.

This article is part of the theme issue ‘Rivlin's legacy in continuum mechanics and applied mathematics’.
Data Distribution for Phylogenetic Inference with Site Repeats via Judicious Hypergraph Partitioning
Authors: Baar Ivo , Hübner Lukas , Oettig Peter , Zapletal Adrian , Schlag Sebastian , Stamatakis Alexandros , Morel Benoit
Published: March 2019

The so-called site repeats (SR) technique can be used to accelerate the widely-used phylogenetic likelihood function (PLF) by identifying identical patterns among multiple sequence alignment (MSA) sites, thereby omitting redundant calculations and saving memory. However, this complicates the optimal data distribution of MSA sites in parallel likelihood calculations, as the cost of computing the likelihood for individual sites strongly depends on the sites-to-cores assignment. We show that finding a ‘good’ sites-to-cores assignment can be modeled as a hypergraph partitioning problem, more specifically, a specific instance of the so-called judicious hypergraph partitioning problem. We initially develop, parallelize, and make available HyperPhylo, an efficient open-source implementation for this flavor of judicious partitioning where all vertices have the same degree. Using empirical MSA data, we then show that sites-to-core assignments computed via HyperPhylo are substantially better than those obtained via a previous na ï ve approach for phylogenetic data distribution under SRs.
The Fruit Fly Brain Observatory: From Structure to Function
Authors: Ukani Nikul H. , Yeh Chung-Heng , Tomkins Adam , Zhou Yiyin , Florescu Dorian , Ortiz Carlos Luna , Huang Yu-Chi , Wang Cheng-Te , Turkcan Mehmet K. , Liu Tingkai , Richmond Paul , Lo Chung-Chuan , Coca Daniel , Chiang Ann-Shyn , Lazar Aurel A.
Published: March 2019

The fruit fly is a key model organism for studying the activity of interconnected brain circuits. A large scattered global research community of neurobiologists and neurogeneticists, computational and theoretical neuroscientists, and computer scientists and engineers has been developing a vast trove of experimental and modeling data that has yet to be distilled into new knowledge and understanding of the functional logic of the brain. Developing open shared models, modelling tools and data repositories that can be accessed from anywhere in the world is the necessary engine for accelerating our understanding of how the brain works.

To that end we developed the Fruit Fly Brain Observatory (FFBO), the next generation open-source platform to support open, collaborative Drosophila neuroscience research. FFBO provides a (i) hub for storing and integrating fruit fly brain research data from multiple data sources worldwide, (ii) unified repository of tools and methods to build, emulate and compare fruit fly brain models in health and disease, and (iii) an open framework for fruit fly brain data processing and model execution. FFBO provides access to application tools for visualizing, configuring, simulating and analyzing computational models of brain circuits of the (i) cell type map, (ii) connectome, (iii) synaptome, and (iv) activity map using intuitive queries in plain English. Tools are provided to extract the function inherent in these structural maps. All applications can be accessed with any modern browser.
A Sex-Specific Switch in Platelet Receptor Signaling Following Myocardial Infarction
Authors: Kim Beom Soo , Auerbach David A. , Sadhra Hamza , Ling Frederick S. , Toth Sandra , Mohan Amy , Tura Sara , Goldenberg Ilan , Rich David Q. , Cameron Scott J.
Published: March 2019

BACKGROUND

A Sex-specific, personalized approach to anti-platelet therapy may be important in patients with myocardial infarction (MI).

OBJECTIVES

Our goal was to determine whether platelets activate differently in healthy men and women compared to following MI.

METHODS

Blood was obtained from healthy subjects or patients presenting acutely with ST-segment Elevation Myocardial Infarction (STEMI) and non-ST Segment Elevation Myocardial Infarction (NSTEMI). Platelet function through surface receptor activation was examined in healthy subjects, in patients with MI, and in age- and strain-matched mice before and after MI. Multivariate regression analyses revealed clinical variables associated with platelet receptor sensitivity at the time of MI.

RESULTS

Platelets from healthy women are dose-dependently more active compared to men, particularly through the platelet thromboxane signaling pathway (7.8-fold increase in women vs. 3.0-fold in men, P=0.02). At the time of MI, platelet activation through surface protease-activated receptor 1 (PAR1) was less in women than men (3.5-fold vs. 8.5-fold, respectively, P=0.0001). Multivariate regression analyses revealed male sex (P=0.04) and NSTEMI (P=0.003) as independent predictors of enhanced platelet PAR1 signaling at the time of MI. Similar to humans, healthy female mice showed preferential thrombin-mediated platelet activation compared to male mice (8.7-fold vs. 4.8-fold, respectively; P<0.001). In the immediate post-MI environment, male mice showed preferential thrombin-mediated platelet activation compared to female mice (12.4-fold vs. 5.5-fold, respectively; P<0.001).

CONCLUSIONS

These results outline a previously unrecognized sex-dependent platelet phenotype where inhibition of thrombin signaling in the peri-MI environment—particularly in males—may be an important consideration.

CONDENSED ABSTRACT

Preclinical studies evaluating anti-platelet drugs are generally conducted in platelets isolated from healthy individuals. Growing evidence suggests changes in platelet signaling properties in certain disease conditions compared to healthy platelets may alter the response to anti-platelet medications. This investigation revealed that platelets from men and women who are healthy and following MI signal differently, particularly through thromboxane and PAR1 receptors. This effect was especially noted in patients with NSTEMI compared to STEMI. These observations raise the possibility of considering a sex-specific anti-platelet regimen for males and females in atheroembolic vascular diseases such as NSTEMI.
An investigation into serotonergic and environmental interventions against depression in a simulated delayed reward paradigm
Authors: Porr Bernd , Trew Alex , Miller Alice
Published: March 2019

The disruption of the serotonergic (5HT) system has been implicated in causing major depression and the standard view is that a lack of serotonin is to blame for the resulting symptoms. Consequently, pharmacological interventions aim to increase serotonin concentration in its target areas or stimulating excitatory 5HT receptors. A standard approach is to use serotonin reuptake inhibitors (SSRIs) which cause a higher accumulation of serotonin. Another approach is to stimulate excitatory serotonin receptors with psychedelic drugs. This paper compares these two approaches by first setting up a system level limbic system model of the relevant brain areas and then modelling a delayed reward paradigm which is known to be disrupted by a lack of 5HT. Central to our model is how serotonin changes the response characteristics of decision making neurons where low levels of 5HT allows small signals to pass through whereas high levels of 5HT create a barrier for smaller signals but amplifying larger ones. We show with both standard behavioural simulations and model checking that SSRIs perform significantly better against interventions with psychedelics. However, psychedelics might work better in other paradigms where a high level of exploration is beneficial to obtain rewards.
Synthesizing Disparate LiDAR and Satellite Datasets through Deep Learning to Generate Wall-to-Wall Regional Forest Inventories
Authors: Ayrey Elias , Hayes Daniel J. , Kilbride John B. , Fraver Shawn , Kershaw John A. , Cook Bruce D. , Weiskittel Aaron R.
Published: March 2019

Light detection and ranging (LiDAR) has become a commonly-used tool for generating remotely-sensed forest inventories. However, LiDAR-derived forest inventories have remained uncommon at a regional scale due to varying parameters between LiDAR datasets, such as pulse density. Here we develop a regional model using a three-dimensional convolutional neural network (CNN), a form of deep learning capable of scanning a LiDAR point cloud as well as coincident satellite data, identifying features useful for predicting forest attributes, and then making a series of predictions. We compare this to the standard modeling approach for making forest predictions from LiDAR data, and find that the CNN outperformed the standard approach by a large margin in many cases. We then apply our model to publicly available data over New England, generating maps of fourteen forest attributes at a 10 m resolution over 85 % of the region. Our estimates of attributes that quantified tree size were most successful. In assessing aboveground biomass for example, we achieved a root mean square error of 36 Mg/ha (44 %). Our county-level mapped estimates of biomass were in good agreement with federal estimates. Estimates of attributes quantifying stem density and percent conifer were moderately successful, with a tendency to underestimate of extreme values and banding in low density LiDAR acquisitions. Estimate of attributes quantifying detailed species groupings were less successful. Ultimately we believe these maps will be useful to forest managers, wildlife ecologists, and climate modelers in the region.