bluuebunny/crossref_metadata_2025 huggingface dataset:
First Report of the Local Spread of Vancomycin-Resistant Enterococci Ascribed to the Interspecies Transmission of a
vanA
Gene Cluster-Carrying Linear Plasmid
Authors: Hashimoto Yusuke , Kita Izumi , Suzuki Masato , Hirakawa Hidetada , Ohtaki Hirofumi , Tomita Haruyoshi
Published: April 2020

Increasing multidrug resistance, including vancomycin resistance, in enterococci is a major concern in clinical settings. Horizontal gene transfer, such as via plasmids, has been shown to play a crucial role in the acquisition of vancomycin resistance. Among vancomycin resistance types, the VanA type is one of the most prevalent, and outbreaks caused by VanA-type vancomycin-resistant enterococci (VRE) have occurred worldwide. Here, we describe an enterococcal linear plasmid responsible for multispecies local spread of VanA-type VRE. Such a study is important because although hospital outbreaks caused by mixed enterococcal species have been reported, this particular spread indicates plasmid transfer across species. This is a crucial finding because the high risk for such a spread of antimicrobial resistance calls for regular monitoring and surveillance.
Consumption of fat-free dairy products is not associated with a lower risk of maternofetal adverse events
Authors: Assaf-Balut Carla , Garcia de la Torre Nuria , Bordiu Elena , del Valle Laura , Valerio Johanna , Jimenez Inés , Duran Alejandra , Fuentes Manuel , Herraiz Miguel Angel , Izquierdo Nuria , Runkle Isabelle , de Miguel Paz , Familiar Cristina , Montañez Maria Carmen , Barabash Ana , Melero Veronica , Cuesta Martín , Rubio Miguel , Calle-Pascual Alfonso Luis
Published: April 2020

Background

The consumption of dairy products in pregnancy is widely extended. However, whether the consumption of low or high fat dairy produce is more beneficial for maternofetal health has yet to be established.

Research design and methods

This prospective cohort study evaluated the effect of consumption of dairy products during pregnancy on the frequency of gestational diabetes mellitus (GDM) and a composite of adverse maternofetal outcomes (CMFO). Pregnant women receiving obstetric care between 2014 and 2017 were eligible. Those who consumed ≥3 servings/day of dairy products at 24–28 gestational weeks (GWs) were included and analyzed (n=2004). The population was stratified into three groups according to intake of fat-free dairy products—skimmed milk and fat-free yoghurt and cheese—(days/week): infrequent (1–2), average (3–6) and regular (7). Logistic regression analysis compared ORs (95% CI) for GDM and CMFO between the three groups (where the group of reference was the ‘infrequent’ intake group).

Results

After adjusting for confounding factors, no significant associations were found between the degree of consumption of fat-free dairy products and the risk of GDM and a CMFO. Moreover, when categorized by the degree of adherence to the Mediterranean diet (above or below the median score), associations were found between the ‘regular’ intake group and an increased risk of having a CMFO in women with a high adherence to the Mediterranean diet (OR: 1.50; 95% CI: 1.01 to 2.22; p<0.05). Weight gain during pregnancy did not differ among groups.

Conclusions

The consumption of fat-free dairy products during pregnancy does not seem to be beneficial for maternofetal health.
Changes in metabolic complications in patients with alcoholic fatty liver disease monitored over two decades: NAGALA study
Authors: Hamaguchi Masahide , Obora Akihiro , Okamura Takuro , Hashimoto Yoshitaka , Kojima Takao , Fukui Michiaki
Published: April 2020

Objective

The social conditions are changing in the world, which may contribute to the change in lifestyle, including alcohol consumption and dietary intake; however, changes in metabolic complications in patients with alcoholic fatty liver disease (AFLD) have never been reported. Therefore, here we compare the metabolic complications in current AFLD with those of two decades ago.

Methods

We performed this cross-sectional study in a Japanese health check-up centre. Consecutive participants who visited the facilities between June 1994 and December 1997 or between January 2014 and December 2017 were enrolled. A total of 7499 participants (4804 men, 2695 women) in the past cohort and 20 029 participants (11 676 men, 8353 women) in the current cohort were entered to this study.

Results

The prevalence of drinkers in the current cohort was significantly lower (4.7%) than that in the past cohort in men (5.9%, p<0.001) but significantly higher in women (1.9% in the current vs 1.1% in the past, p<0.001). The prevalence of fatty liver in drinkers has increased in men (22.3% in the past cohort, 36.6% in the current cohort; p<0.001) but not in women (13.3% in the past cohort, 14.7% in the current cohort; p=1.0), while the prevalence of all fatty liver has increased in men and women (men: 24.0% in the past cohort, 36.2% in the current cohort, p<0.001; women: 9.3% in the past cohort, 12.8% in the current cohort, p<0.001). Regarding metabolic abnormalities, the prevalence of hyperglycaemia increased from 25.4% to 43.0% in men with AFLD (p<0.001) and from 25.1% to 39.1% in women with AFLD (p=1.0).

Conclusions

AFLD currently tends to be accompanied by hyperglycaemia. The prevalence of fatty liver in drinkers increased in men, although alcoholic consumptions did not increase. We should pay attention to fatty liver combined with hyperglycaemia for individuals who consume alcohol today.
Modifiable risk factors predict incident atrial fibrillation and heart failure
Authors: Wong Jorge A , Conen David , Healey Jeff S , Johnson Linda S B
Published: April 2020

Objective

Heart failure (HF) frequently complicates atrial fibrillation (AF) and significantly increases mortality risk. Limited data exist on the modifiable risk factors associated with development of HF in AF patients.

Methods

We examined two large, prospective, population-based cohorts without prior AF or HF at baseline: Malmö Preventive Project (MPP, n=32 625) and Malmö Diet and Cancer Study (MDCS, n=27 695). Using Lunn-McNeil competing risks, multivariable Cox models were constructed to determine hazard ratios (HR) and 95% confidence intervals (CI) of risk factors for incident HF with AF, and AF alone.

Results

Mean follow-up in MPP and MDCS was 27.6±8.4 and 17.7±5.3 years. In MPP, body mass index (HR 1.11, 95% CI 1.09 to 1.13 vs HR 1.05, 95% CI 1.04 to 1.06 per kg/m2), systolic blood pressure (HR 1.20, 95% CI 1.24 to 1.26 vs HR 1.08, 95% CI 1.06 to 1.10 per 10 mm Hg) and current cigarette smoking (HR 1.73, 95% CI 1.54 to 1.95 vs HR 1.23, 95% CI 1.15 to 1.32) had stronger associations with incident AF with HF compared with AF alone (all p for difference <0.0001). Similar results were observed in MDCS (all p for difference <0.009). These three risk factors and diabetes accounted for 51.8% and 54.1% of the population attributable risk (PAR) for AF with HF in MPP and MDCS, respectively, compared with 20.1% and 27.0% for AF alone.

Conclusions

Obesity, hypertension and active smoking preferentially associated with AF with HF, compared with AF alone, and accounted for >50% of the PAR. Randomised trials are needed to assess whether risk factor modification can reduce the incidence of AF with HF and reduce mortality.
Coronary artery ectasia: prevalence, angiographic characteristics and clinical outcome
Authors: Willner Nadav Asher , Ehrenberg Scott , Musallam Anees , Roguin Ariel
Published: April 2020

Objective

Determine coronary artery ectasia (CAE) prevalence and clinical outcome in a large cohort of patients underwent coronary angiography.

Methods

In an 11-year period, between 2006 and 2017, 20 455 coronary angiography studies were performed at a large university centre. Patients diagnosed with CAE based on procedure report were included in the final analysis.

Results

CAE was diagnosed in 174 out of 20 455 studies (0.85% per total angiograms, 161 patients). Patients’ average age was 59.6±11.2 years old with male predominance (90.7%). Diffuse ectasia morphology was most common (78.9%), followed by fusiform (16.1%) and saccular (5%). Mixed CAE and atherosclerotic heart disease (ASHD) was present in 75.2% of the patients and isolated CAE in 24.8%. The most common coronary artery involved was the right coronary artery (RCA) (79%). Following index angiography, all the isolated CAE group was managed conservatively, while 67% of the mixed CAE-ASHD group underwent coronary intervention. In an average follow-up of 6±3.6 years, adverse clinical event (a composite endpoint of any death, cerebrovascular accident, myocardial infarction, thromboembolic event, bleeding and stent thrombosis) occurred in 48.8% of the mixed CAE-ASHD group compared with 25% in the isolated CAE group (p<0.05).

Conclusions

CAE is a rare phenomenon. The most common artery involved was the RCA, and the diffused type of CAE was the most frequent. Most patients with CAE have also concomitant ASHD, and those patients have higher mortality and complications rate, compared with isolated CAE disease.
CT imaging prior to transcatheter aortic valve implantation in the UK
Authors: Harries Iwan , Weir-McCall Jonathan R , Williams Michelle C , Shambrook James , Roditi Giles , Bull Russel , Morgan-Hughes Gareth J , Nicol Edward D , Moss Alastair J
Published: April 2020

Objective

This cross-sectional observational study sought to describe variations in CT in the context of transcatheter aortic valve implantation (CT-TAVI) as currently performed in the UK.

Methods

408 members of the British Society of Cardiovascular Imaging were invited to complete a 27-item online CT-TAVI survey.

Results

47 responses (12% response rate) were received from 40 cardiac centres, 23 (58%) of which performed TAVI on-site (TAVI centres). Only six respondents (13%) performed high-volume activity (>200 scans per year) compared with 13 (28%) performing moderate (100–200 scans per year) and 27 (59%) performing low (0–99 scans per year) volume activity. Acquisition protocols varied (41% retrospective, 12% prospective with wide padding, 47% prospective with narrow padding), as did the phase of reporting (45% systolic, 37% diastolic, 11% both, 6% unreported). Median dose length product was 675 mGy.cm (IQR 477–954 mGy.cm). Compared with non-TAVI centres, TAVI centres were more likely to report minimum iliofemoral luminal diameter (n=25, 96% vs n=7, 58%, p=0.003) and optimal tube angulation for intervention (n=12, 46% vs n=1, 8%, p=0.02).

Conclusions

This national survey formally describes current CT-TAVI practice in the UK. High-volume activity was only present at one in seven cardiac CT centres. There is wide variation in scan acquisition, scan reporting and radiation dose exposure in cardiac CT centres.
Polypharmacy and health outcomes in atrial fibrillation: a systematic review and meta-analysis
Authors: Gallagher Celine , Nyfort-Hansen Karin , Rowett Debra , Wong Christopher X , Middeldorp Melissa E , Mahajan Rajiv , Lau Dennis H , Sanders Prashanthan , Hendriks Jeroen M
Published: April 2020

Objective

To undertake a systematic review and meta-analysis examining the impact of polypharmacy on health outcomes in atrial fibrillation (AF).

Data sources

PubMed and Embase databases were searched from inception until 31 July 2019. Studies including post hoc analyses of prospective randomised controlled trials or observational design that examined the impact of polypharmacy on clinically significant outcomes in AF including mortality, hospitalisations, stroke, bleeding, falls and quality of life were eligible for inclusion.

Results

A total of six studies were identified from the systematic review, with three studies reporting on common outcomes and used for a meta-analysis. The total study population from the three studies was 33 602 and 37.2% were female. Moderate and severe polypharmacy, defined as 5–9 medicines and >9 medicines, was observed in 42.7% and 20.7% of patients respectively, and was associated with a significant increase in all-cause mortality (Hazard ratio [HR] 1.36, 95% CI 1.20 to 1.54, p<0.001; HR 1.84, 95% CI 1.40 to 2.41, p<0.001, respectively), major bleeding (HR 1.32, 95% CI 1.14 to 1.52, p<0.001; HR 1.68, 95% CI 1.35 to 2.09, p<0.001, respectively) and clinically relevant non-major bleeding (HR 1.12, 95% CI 1.03 to 1.22, p<0.01; HR 1.48, 95% CI 1.33 to 1.64, p<0.01, respectively). There was no statistically significant association between polypharmacy and stroke or systemic embolism or intracranial bleeding. Among other examined outcomes, polypharmacy was associated with cardiovascular death, hospitalisation, reduced quality of life and poorer physical function.

Conclusions

Polypharmacy is highly prevalent in the AF population and is associated with numerous adverse outcomes.

PROSPERO registration number

CRD42018105298.
“When All Seems Lost”: The Ultralong Estrogen Priming (ULEP) Cycle Offers Good Pregnancy Outcomes in Poor Responder Patients
Authors: Lahoud Robert
Published: April 2020

Background: Treating patients with a history of poor ovarian response (POR) presents many challenges for the clinician. Poor in vitro fertilization (IVF) outcomes are a common end result. The aim of this article is to provide a detailed description of an ultralong estrogen priming (ULEP) cycle in the treatment of patients with a history of POR and to compare the outcomes to matched controls which were treated with other IVF protocols.

Methods: In a retrospective study, 50 patients who meet the Bologna criteria for POR were treated with 50 ULEP cycles. The results of these cycles were compared to 50 matched controls, who were treated with other IVF protocols.

Results: Patients who underwent the ULEP cycles required 3.2 more days of controlled ovarian hyperstimulation (COH) and required an extra 579 IU of follicle-stimulating hormone (FSH). The ongoing pregnancy rates per transfer were significantly greater in the ULEP group (35.1% vs. 9.1%, OR 5.4, 95% CI 1.4-21.2, p = 0.005) and per cycle started (26% vs. 6%, OR 5.5, 95% CI 1.5-20.8, p = 0.003).

Conclusions: Even though the ULEP cycle is long and demanding for the patients, the outcomes suggest that this treatment regime offers a viable alternative in patients with a history of POR.
Self-contained development environments
Authors: Chari Guido , Pimás Javier , Vitek Jan , Flückiger Olivier
Published: April 2020

Operating systems are traditionally implemented in low- level, performance-oriented programming languages. These languages typically rely on minimal runtime support and provide unfettered access to the underlying hardware. Tra- dition has benefits: developers control the resources that the operating system manages and few performance bottle- necks cannot be overcome with clever feats of programming. On the other hand, this makes operating systems harder to understand and maintain. Furthermore, those languages have few built-in barriers against bugs. This paper is an ex- periment in side-stepping operating systems, and pushing functionality into the runtime of high-level programming languages. The question we try to answer is how much sup- port is needed to run an application written in, say, Smalltalk or Python on bare metal, that is, with no underlying oper- ating system. We present a framework named NopSys that allows this, and we validate it with the implementation of CogNos a Smalltalk virtual machine running on bare x86 hardware. Experimental results suggest that this approach is promising.
Pattern matching in an open world
Authors: Zhang Weixin , Oliveira Bruno C. d. S.
Published: April 2020

Pattern matching is a pervasive and useful feature in functional programming. There have been many attempts to bring similar notions to Object-Oriented Programming (OOP) in the past. However, a key challenge in OOP is how pattern matching can coexist with the open nature of OOP data structures, while at the same time guaranteeing other desirable properties for pattern matching.

This paper discusses several desirable properties for pattern matching in an OOP context and shows how existing approaches are lacking some of these properties. We argue that the traditional semantics of pattern matching, which is based on the
order
of patterns and adopted by many approaches, is in conflict with the openness of data structures. Therefore we suggest that a more restricted, top-level pattern matching model, where the order of patterns is irrelevant, is worthwhile considering in an OOP context. To compensate for the absence of ordered patterns we propose a complementary mechanism for case analysis with defaults, which can be used when nested and/or multiple case analysis is needed. To illustrate our points we develop Castor: a meta-programming library inScala that adopts both ideas. Castor generates code that uses type-safe extensible visitors, and largely removes boilerplate code typically associated with visitors. We illustrate the applicability of our approach with a case study modularizing the interpreters in the famous book ”Types and Programming Languages”.
Funcons for HGMP: the fundamental constructs of homogeneous generative meta-programming (short paper)
Authors: van Binsbergen L. Thomas
Published: April 2020

The PLanCompS project proposes a component-based approach to programming-language development in which fundamental constructs (funcons) are reused across language definitions. Homogeneous Generative Meta-Programming (HGMP) enables writing programs that generate code as data, at run-time or compile-time, for manipulation and staged evaluation. Building on existing formalisations of HGMP, this paper introduces funcons for HGMP and demonstrates their usage in component-based semantics.
A domain-specific language for exploratory data visualization
Authors: Smeltzer Karl , Erwig Martin
Published: April 2020

With an ever-growing amount of collected data, the importance of visualization as an analysis component is growing in concert. The creation of good visualizations often doesn't happen in one step but is rather an iterative and exploratory process. However, this process is currently not well supported in most of the available visualization tools and systems. Visualization authors are forced to commit prematurely to particular design aspects of their creations, and when exploring potential variant visualizations, they are forced to adopt ad hoc techniques such as copying code snippets or keeping a collection of separate files.

We propose variational visualizations as a model supporting open-ended exploration of the design space of information visualization. Together with that model, we present a prototype implementation in the form of a domain-specific language embedded in Purescript.
Mixed Carbon-Graphene Supports for Cobalt (II) Phthalocyanine as Fuel Cell Cathode
Authors: Dursun Sümeyye , Yazici M. Suha
Published: April 2020

Cobalt (II) phthalocyanine (CoPc) supported on graphene (CVD), carbon black (Vulcan XC72), multi walled carbon nanotube (MWCNT) and their mixtures were evaluated as electrocatalysts for oxygen reduction reaction in acid electrolytes and polymer electrolyte membrane fuel cells (PEMFC). Graphene (G) and carbon supported CoPc catalysts were prepared by impregnation method. Three different temperatures (800 °C, 650 °C and 500 °C) were studied to examine the effect of heat treatment on CoPc and the best fuel cell performance was obtained with samples heat-treated at 800 °C. Maximum power densities of CoPc/G, CoPc/Vulcan-G, CoPc/MWCNT-G, CoPc/MWCNT, CoPc/Vulcan and CoPc/Vulcan-MWCNT at 60 °C cell temperature, 100% humidity and 5 psi back pressure were found as 102, 171, 179, 189, 296, 303 mW cm−2, respectively. CVD graphene with CoPc was forming impermeable layer-structure causing mass transport limitations and lower performance. Performance enhancements were achieved by heat-treatment of the samples, higher catalyst loading, operating at high temperatures and higher pressures under 100% humidity. Hybridization of CVD graphene with Vulcan and MWCNT led improved fuel cell performance at 25 psi back pressure compare to individual support materials.
Investigation of Short Channel Effects in SOI MOSFET with 20 nm Channel Length by a β-Ga2O3 Layer
Authors: Madadi Dariush , Orouji Ali A.
Published: April 2020

This paper presented a fully depleted silicon on insulator (FD-SOI) MOSFET in nano scale size with deployment the quasi two dimensional β-Ga2O3 material to improvement electrical properties. The main idea of the proposed structure is embedding a layer of the β-Ga2O3 in the drain region. Due to the β-Ga2O3 material features, the electric field distribution near the drain and gate side will be change and peak of the electric field of the proposed structure is diminish. The embedded layer of the β-Ga2O3 material in our work has an important effects on the electrical and thermal characteristics. In this paper, characteristics of the proposed structure is compared with the prevalent SOI and improvement of characteristics in our work are shown. The features such as the electric field, the potential distribution, the sub-threshold slope, the kink effect, the self-heating effect, punch through effect and DIBL effect are investigated and compared with prevalent SOI.
Sacral Anatomical Orientation in the Lebanese Population
Authors: Maalouly Joseph , Jabbour Fouad , Saidy Elias , Lati Georgio , El-Hajj Gerard , Aouad Dany , Ayoubi Rami , Nehme Alexandre
Published: April 2020

Introduction. PI is currently used as the gold standard measurement in spinopelvic anatomy. There is a need for a reliable method to calculate sacral anatomic orientation (SAO) independent of posture and to establish its association with PI, which was previously established in a single study (Peleg et al., 2007). Therefore, the aim of our study is the application and verification of this association on a Lebanese sample. Methods. Methods for measuring SAO and PI on living individuals are described. The study was carried out on 200 adult individuals using CT 3D images (volume-rendering method). Reliability (intratester and intertester) was evaluated using the intraclass correlation test. A regression analysis was carried out to evaluate the association between the two measurements. Results. There were 103 females (51%) and 97 males (49%) with a mean age of 58.68 ± 19.6 years (min = 20; max = 93). The mean SAO and PI in our population were found to be 52.65° (SD = 8.16°) and 59.08° (SD = 12.53°), respectively. SAO and PI measurements were highly correlated (Pearson correlation test; r = −0.296, P<0.0001 for our general population). PI can be predicted via SAO, i.e., SAO = (−0.193 × PI) + 64.057. Conclusions. SAO may be an important tool, alongside PI, in defining the sagittal shape of the spine and useful for understanding its association with spinal diseases as they are not affected by postural changes.
Verteporfin Inhibits PD-L1 through Autophagy and the STAT1–IRF1–TRIM28 Signaling Axis, Exerting Antitumor Efficacy
Authors: Liang Jiyong , Wang Lulu , Wang Chao , Shen Jianfeng , Su Bojin , Marisetty Anantha L. , Fang Dexing , Kassab Cynthia , Jeong Kang Jin , Zhao Wei , Lu Yiling , Jain Abhinav K. , Zhou Zhicheng , Liang Han , Sun Shao-Cong , Lu Changming , Xu Zhi-Xiang , Yu Qinghua , Shao Shan , Chen XiaoHua , Gao Meng , Claret Francois X. , Ding Zhiyong , Chen Jian , Chen Pingsheng , Barton Michelle C. , Peng Guang , Mills Gordon B. , Heimberger Amy B.
Published: April 2020

Programmed cell death 1 ligand 1 (PD-L1) is a key driver of tumor-mediated immune suppression, and targeting it with antibodies can induce therapeutic responses. Given the costs and associated toxicity of PD-L1 blockade, alternative therapeutic strategies are needed. Using reverse-phase protein arrays to assess drugs in use or likely to enter trials, we performed a candidate drug screen for inhibitors of PD-L1 expression and identified verteporfin as a possible small-molecule inhibitor. Verteporfin suppressed basal and IFN-induced PD-L1 expression in vitro and in vivo through Golgi-related autophagy and disruption of the STAT1–IRF1–TRIM28 signaling cascade, but did not affect the proinflammatory CIITA-MHC II cascade. Within the tumor microenvironment, verteporfin inhibited PD-L1 expression, which associated with enhanced T-lymphocyte infiltration. Inhibition of chromatin-associated enzyme PARP1 induced PD-L1 expression in high endothelial venules (HEV) in tumors and, when combined with verteporfin, enhanced therapeutic efficacy. Thus, verteporfin effectively targets PD-L1 through transcriptional and posttranslational mechanisms, representing an alternative therapeutic strategy for targeting PD-L1.
Patterns of Late Relapse after Allogeneic Hematopoietic Stem Cell Transplantation in Patients with T-Cell Prolymphocytic Leukemia
Authors: Shumilov Evgenii , Hasenkamp Justin , Szuszies Christoph Johannes , Koch Raphael , Wulf Gerald Georg
Published: April 2020

Initial treatment with the monoclonal anti-CD52 antibody alemtuzumab induces responses in the majority of patients with T-cell prolymphocytic leukemia (T-PLL). In eligible patients, allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an option to consolidate hematological remissions. Here, we report our experience with 10 patients who received allo-HSCT against T-PLL. Notably, 3 patients with complete remission at transplantation and durable full-donor chimerism relapsed at months 12, 59, and 84 after transplantation, respectively. This relapse was associated with rapid progressive leukemia in 1 patient and extralymphatic lymphoma growth in the other 2. Despite CD52 positivity at relapse, alemtuzumab retreatment, donor lymphocyte infusions, and/or chemotherapy including salvage therapy, allo-HSCT yielded a transient partial response, only. Alemtuzumab induction and consolidative allo-HSCT enabled prolonged disease-free survival in these patients but failed to procure cure.
The taxonomic identity of two neglected Sprengel names, Galinsoga megapotamica and G. uniflora (Asteraceae), with remarks upon Friedrich Sellow’s collections galore

Authors: MORAES PEDRO LUÍS RODRIGUES DE
Published: April 2020

The names Galinsoga megapotamica and G. uniflora (Asteraceae) are investigated. Specimens from Kurt Sprengel’s private herbarium, currently at the Paris Herbarium (P), are designated as lectotypes. These names are currently recognized under Hymenoxys and Helenium, respectively. Galinsoga megapotamica is proposed as a new heterotypic synonym of Hymenoxys tweediei, having nomenclatural priority over the latter, therefore I here propose its nomenclatural transfer as Hymenoxys megapotamica comb. nov. (≡ G. megapotamica). Similarly, Galinsoga uniflora is proposed as a new heterotypic synonym of Actinea heterophylla and Helenium radiatum (≡ Cephalophora radiata). Although Actinea heterophylla has nomenclatural priority over both G. uniflora and C. radiata, the epithet heterophyllum is unavailable in Helenium due to H. heterophyllum published by Candolle. Since Galinsoga uniflora is the next earliest legitimate name at the same rank, its final epithet is to be used instead, under Art. 14.1 of the ICN, thus a new combination is proposed: Helenium uniflorum comb. nov. (≡ G. uniflora). Additionally, lectotypes for the names Conyza oblongifolia, Hymenoxys tweediei and Onoseris stricta are designated, and remarks about the provenance of Friedrich Sellow’s collections related to Sprengel’s names in Asteraceae are also provided.
A new Microlicia (Melastomataceae: Microlicieae) from the Southern Cadeia do Espinhaço, Minas Gerais, Brazil

Authors: ALMEDA FRANK , FIDANZA KARINA
Published: April 2020

Microlicia pacificoi is described as a new species from a limited area of the southern Cadeia do Espinhaço in Minas Gerais, Brazil. Line drawings, photographs, a distribution map, and comparative notes on morphologically similar species are provided. This species is readily distinguished by its wiry habit, narrowly lanceolate sessile leaf blades that are 2.5–4 × 0.5–1 mm and resinous-punctate on both surfaces, delicate gland-tipped trichomes on distal internodes and hypanthia, and glabrous irregularly rugulate calyx lobes that are caducous following anthesis.
Role and Management of a Head and Neck Department during the COVID‐19 Outbreak in Lombardy
Authors: Saibene Alberto Maria , Allevi Fabiana , Biglioli Federico , Felisati Giovanni
Published: April 2020

The recent Italian outbreak of coronavirus disease 2019 led to an unprecedented burden on our health care system. Despite head and neck–otolaryngology not being a front‐line specialty in dealing with this disease, our department had to face several specific issues. Despite a massive reallocation of resources in the hospital, we managed to keep the service active, improving safety measures for our personnel, specifically during common otolaryngologic maneuvers known to produce aerosols. Furthermore, we strived to maintain our teaching role, giving residents an inclusive role in managing the response to the emergency state, and we progressively integrated our inactive specialists into other service rotations to relieve front‐line colleagues’ burden. Specific issues and management decisions are discussed in detail in the article.
Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression
Authors: A-Tjak Jacqueline G. L. , Morina Nexhmedin , Boendermaker Wouter J. , Topper Maurice , Emmelkamp Paul M. G.
Published: April 2020

Background

Attachment theory predicts that patients who are not securely attached may benefit less from psychological treatment. However, evidence on the predictive role of attachment in the effectiveness of treatment for depression is limited.

Methods

Explicit attachment styles, levels of attachment anxiety and attachment avoidance, as well as implicit relational self-esteem and implicit relational anxiety were assessed in 67 patients with major depressive disorder (MDD) receiving Acceptance and Commitment Therapy (ACT) or Cognitive Behavioral Therapy (CBT). ANOVA and hierarchical regression analyses were performed to investigate the predictive power of explicit and implicit attachment measures on treatment outcome.

Results

Explicit attachment avoidance at pre-treatment significantly predicted reduction of depressive symptoms following treatment. Reductions in attachment anxiety and avoidance from pre- to post-treatment predicted better treatment outcomes. Neither one of the implicit measures, nor change in these measures from pre- tot post-treatment significantly predicted treatment outcome.

Conclusions

Our findings show that attachment avoidance as well as reductions in avoidant and anxious attachment predict symptom reduction after psychological treatment for depression. Future research should use larger sample sizes to further examine the role of attachment orientation as moderator and mediator of treatment outcome.

Trial registration

clinicaltrials.gov; NCT01517503.
Subacute reconstruction using flap transfer for complex defects of the upper extremity
Authors: Kang Yongqiang , Pan Xiaoyun , Wu Yongwei , Ma Yunhong , Liu Jun , Rui Yongjun
Published: April 2020

Background

Despite advances in microsurgical techniques of flap transfer, complex upper extremity trauma reconstruction remains a challenge for surgeons. This study aimed to present the outcomes in using flaps in the subacute reconstruction of complex upper extremity injuries.

Methods

From July 2013 to December 2016, 35 patients ranging in age from 23 to 69 years with complicated upper extremity traumatic injuries were treated using flap reconstruction in subacute period. The number and causes of injury were 12 machine crush injuries, 18 machine strangulation injuries, two chainsaw accidents, two traffic accidents, and one incident of heavy bruising. Thirty-five patients underwent flap procedures, including 24 anterolateral thigh flaps (68.57%), five latissimus dorsi flaps (14.29%), and six lateral arm flaps (17.14%). Flap sizes ranged from 3 × 4 to 42 × 16 cm2. The mean time of flap reconstruction was 14 days (range 5–29). During postoperative follow-up, flap appearance, sensory recovery, scarring and satisfaction were assessed.

Results

The overall flap survival rate was 94.3%.Two flaps developed partial necrosis, both of which were later treated with skin grafting. Traumatic wound infections occurred in three patients. All upper limb injuries were completely covered. The follow-up periods ranged from 18 to 62 months with an average of 2.9 months. All skin flap textures were soft with varying degrees of pigmentation. Flap sensory recovery was S1 in three cases, S2 in eight cases, S3 in 15 cases, and S4 in nine cases. There were no donor site complications other than three cases with scar hyperplasia.

Conclusions

The severe upper limb soft tissue defects still achieved satisfactory function and appearance with negligible complications and low amputation rates during the subacute period.
PF4V1 affects the progression of oral squamous cell carcinoma by regulating Wnt/β-catenin pathway and angiogenesis
Authors: Li Cuiping , Jiang Weidong , Zhou Yang , Huang Xuanping , Zhou Nuo
Published: April 2020

Platelet factor-4 variant 1 (PF4V1) was recently described as a natural non-allelic gene variant of platelet factor-4 (PF4), which has been closely associated with the growth and metastasis of various cancers. Our previous research showed that PF4V1 was related to oral squamous cells carcinoma (OSCC) metastasis. Howerver, it is still not clear about the functional role of PF4V1 in OSCC. In this study, stably transfected cell lines were constructed and the expression level of PF4V1 was verified by real‐time polymerase chain reaction (RT-PCR) and western blot. The effect of PF4V1 on proliferation, migration, invasion, and apoptosis of oral cancer (OC) cells were detected. Moreover, a xenograft tumor model was constructed to evaluate the effect of PF4V1 on OSCC in vivo. Indicators of Wnt/β-catenin, angiogenesis and epithelial-mesenchymal transition (EMT) pathways were also examined. Stable cell lines with overexpression and inhibited expression of PF4V1 were constructed successfully. After stable transfection, PF4V1 significantly promoted the proliferation, migration, and invasion of OC cells in vitro, and their tumor formation in vivo. Furthermore, PF4V1 remarkably promoted the expression of β-catenin, VEGF, and FGF but suppressed the expression of GSK-3β. There was no statistically significant correlation between PF4V1 and EMT pathway. This study provides evidence that PF4V1 promotes the proliferation, migration, invasion and tumor formation of OC cells by regulating the Wnt/β-catenin pathway and angiogenesis. Our findings suggest that PF4V1 could be a very promising target of OSCC therapy in the future.
Decentration and tilt of plate-haptic multifocal intraocular lenses in myopic eyes
Authors: Meng Jiaqi , He Wenwen , Rong Xianfang , Miao Ao , Lu Yi , Zhu Xiangjia
Published: April 2020

Background

To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses (MfIOLs) in myopic eyes.

Methods

Myopic (axial length [AXL] > 24.5 mm) and non-myopic (21.0 mm < AXL ≤ 24.5 mm) cataract eyes were enrolled in this prospective study and randomly assigned to receive implantation of Zeiss AT LISA tri 839MP lenses (Group A) or Tecnis ZMB00 lenses (Group B). In total, 122 eyes of 122 patients were available for analysis. Decentration and tilt of MfIOLs, high-order aberrations (HOAs), and modulation transfer functions (MTFs) were evaluated using the OPD-Scan III aberrometer 3 months postoperatively. Subjective symptoms were assessed with a Quality of Vision questionnaire.

Results

Near and distance visual acuities, tilt and horizontal decentration did not differ between the two groups, postoperatively. However, myopic eyes of Group B showed greater vertical decentration than those of Group A (− 0.17 ± 0.14 mm vs. -0.03 ± 0.09 mm, respectively), particularly when the MfIOLs were placed horizontally or obliquely. Overall decentration of myopic eyes was greater in Group B than in Group A (0.41 ± 0.15 mm vs. 0.16 ± 0.10 mm, respectively). In Group B, AXL was negatively correlated with vertical decentration and positively correlated with overall decentration. No such correlations were found in Group A. Intraocular total HOAs, coma, trefoil and spherical aberrations were lower in Group A than in Group B for a 6.0 mm pupil among myopic eyes. Generally, Group A had better MTFs and fewer subjective symptoms than Group B among myopic eyes.

Conclusions

Plate-haptic design of MfIOLs may be a suggested option for myopic cataract eyes due to the less inferior decentration and better visual quality postoperatively.
Clinical and patient-reported outcome of implant restorations with internal conical connection in daily dental practices: prospective observational multicenter trial with up to 7-year follow-up
Authors: Ackermann Karl-Ludwig , Barth Thomas , Cacaci Claudio , Kistler Steffen , Schlee Markus , Stiller Michael
Published: April 2020

Background

The interpretation of the results of randomized clinical trials is often questioned in relation with daily circumstances in practices. This prospective observational multicenter study was instigated to reflect the need for information in real-life situations with dental implants with internal conical implant-abutment connection (Conelog implant system). The implants were followed up at least 5-year post-loading; survival analysis (Kaplan-Meier), changes of soft tissue, and bone level over time, as well as patient satisfaction were evaluated.

Results

In total, 130 dental implants were placed in 94 patients (64 female, 30 male). Mean age of patients was 50.4 ± 13.7. At 5-year post-loading, 104 implants in 76 patients were available for evaluation. The cumulative implant survival rate was 96.6%. After an initial bone remodeling process post-surgery (bone loss of − 0.52 ± 0.55 mm), the bone level change remained clinically stable from loading to 5-year post-loading (− 0.09 ± 0.43 mm). Patient satisfaction surveyed by questionnaire (comfort, ability to chew and taste, esthetics, general satisfaction) steadily increased towards the end. At the last study follow-up, all the patients rated their general satisfaction as either very satisfied (87.5%) or satisfied (12.5%).

Conclusion

The study implants have shown to be highly effective with reliable peri-implant tissue stability over the 5 to 7 years of observation for both single tooth restorations and fixed partial dentures while used in standard conditions in daily dental practice. The results obtained are comparable with those obtained in controlled clinical trials.
First trimester fetal echocardiography limitations and its expected clinical values
Authors: Kamel Heba , Yehia Amr
Published: April 2020

Background

Fetal cardiac activity could be observed between 6th and 7th gestational weeks, early performance of fetal echocardiography could be implemented to screen for fetal heart disease. The effectiveness of early first trimester fetal echocardiography has not been adequately investigated, especially with modern sonographic technological advances. The purpose of the study is to evaluate the capability to visualize fetal cardiac structures within the first trimester as early as 10th gestational weeks and to elucidate the value of using color Doppler in visualization of cardiac structures within early gestation. A prospective clinical trial conducted on 150 study subjects, 44 of them were twin gestations. Cases were fully assessed by fetal echocardiographic examination from 10th gestational week to 13 gestational weeks in a sequential manner weekly. The research study was conducted at cardiology department fetal unit in one of the tertiary hospitals.

Results

Four chamber view was mostly visualized from 12 gestational weeks, whereas cardiac axis was fully visualized in all cases from 12 gestational weeks; on the other hand, IVC assessment by 2D was satisfactorily visualized in 78.26% of cases and by color Doppler in 82.61% of cases at 13 gestational weeks, pulmonary veins were visualized in 21.74% of cases by 2D and 43.5% of cases by color Doppler at 13 gestational weeks, and interestingly, ventricular inflows were satisfactorily visualized in almost all cases from 10th gestational weeks.

Conclusions

First trimester fetal echo is an outstanding enhancement in management pathways of cases susceptible to have fetal cardiac abnormalities permitting early detection of structural cardiac anomalies triggering a cascade of scanning for extra cardiac anomalies to aid in evaluation and assessment of the best management course for those affected cases.
Hobbyhorses: New Approaches in the Physical Activity of Children and Adolescents
Authors: Ovchinnikov Yu. , Stoylov A.
Published: April 2020

Modern additional education and upbringing of children reaches a new level of social needs. In the article, the authors present a new leisure for young people – hobby horsing (jumping on a toy horse), which shows the aesthetics and beauty in the movements of teenagers. The method of conducting a master class on the production of horses for teachers of additional education and the method of opening the movement of horses on the basis of centers of additional education of children is proposed. In the course of scientific and pedagogical research, it was revealed that hobbyhorses perform a type of movement with a certain cycle. Moving movements allow not only to increase the motor activity of a person for a certain period of time, but also to develop coordination of movements. The practical significance of the study is that students of Kuban State University of Physical Culture, Sports and Tourism promote a new sports movement of youth and offer to introduce it in institutions of additional education in various regions of Russia as a socially-oriented project that performs the function of health-saving education. Additional education of children with the participation of students can get a new practice-oriented stage in the development of motor activity and creative cooperation of young people of different ages.
Aging of Polymer Composites in Extremely Cold Climates
Authors: Startsev O.V. , Lebedev M. P. , Kychkin A.K.
Published: April 2020

A review of studies of effects of temperature, moisture, solar radiation, and other aggressive environmental factors on the properties of polymer composite materials are presented to substantiate the mechanism of their aging in extremely cold climates. It has been shown that composites develop internal stresses caused by unequal thermal expansion of reinforcing fibers and polymer matrices. These internal stresses cause the occurrence of microcracks, their coalescence, and formation of macro-damages in the bulk of the binder or at the interface with fibers. Fiberglass, carbon fiber, and other reinforced materials exposed to climatic conditions can accumulate water in pores and capillaries, which can turn into a solid phase at temperatures below 0 °C and increase internal stresses. Even in cold climates, the surface of materials undergoes destruction and microcracking under the impacts of UV components of solar radiation, thus increasing the number of sources of internal stresses. The mechanical properties of composite materials deteriorate under the effects of seasonal and daily thermal cycles.
Comparative Analysis of Iterative Processes of Equilibrium Calculation in Oligopoly Models
Authors: Algazin G.I. , Algazina D.G.
Published: April 2020

The problem of choosing the optimal behavior of agents in the classic one-product model of the competitive market under linear functions of demand and costs of agents is considered. The dynamic decision-making processes under conditions of uncertainty of decision making by competitors, performed as repeatable static games within a range of admissible answers, are investigated. The analysis targets processes with rational agents using approaches of multi-step reflexive games and models of collective behavior to refine the solutions while observing the current market prices of goods. The processes are distinguished by choosing the current targets: in one case, the agents choose their current output as the current targets when refining the solutions; in another case, the current targets are perceptions of agents about the current equilibrium marginal cost of other agents. It is shown that for oligopolies with Cournot and/ or Stackelberg competition, processes with agents focused on the expected optimum output are more preferable than processes with agents focused on their perceptions of the equilibrium marginal costs of competitors because there are greater opportunities for finding equilibrium states.
A communication and participation-oriented model proposal for current urban transformation processes
Authors: Gür Miray
Published: April 2020

Research Problem: Urban transformation planning policies, which have been the focus during the last decade in Turkey, have begun to progress with renewal of risky areas with the introduction of Law No. 6306. While it was stated that increasing the quality of life and social rehabilitation of area residents were targeted in transformations where neighborhoods are transformed into urban land, in fact, resident expectations were not met and the residents, who experienced dissatisfaction in the transformed environments that were not suitable for their lifestyles, left these areas or continued their lives in despair due to economic reasons. Ignorance of resident expectations in transformation process reduces their quality of life and only through participation the residents, who are the actors that experience the impact of transformation the most, could express their preferred lifestyle. Aim: The present study aimed to propose a participatory transformation model in transforming the current transformation framework into a user-oriented approach. Method: In the development of the model, the participation scenarios / strategies were integrated into the break points in the process defined in Law No. 6306 which underlines the current urban transformation dynamics. Findings: Each experience that different transformation processes which the proposed model could be applied based on its own dynamics would create new structuring processes that would contribute to the model. Based on the model, it was aimed to establish continuous communication and information flow between users, architects, authorities and other stakeholders, to increase socio-physical satisfaction of the residents since the residence and residential environment would be built based on resident demands and to sustain the sense of belonging and satisfaction of the residents with the preferences. Conclusion: The process based on the proposals that were determined with participation principle and continuous communication between all stakeholders and especially the architect and residents would establish the foundation for not only to secure risky buildings, but also for socially and economically sustainable urban transformation projects that would provide added value to the city and improve the quality of life of urban residents.