bluuebunny/crossref_metadata_2025 huggingface dataset:
Wie wird das Problem des sexuellen Kindesmissbrauchs auf
YouTube thematisiert?
Authors: Döring Nicola
Published: December 2018

Einleitung: Sexueller Kindesmissbrauch (SKM) ist ein weit verbreitetes und
gravierendes gesellschaftliches Problem. Eine verbesserte Problemlösung im Sinne
wirkungsvoller Prävention und Intervention hängt von vielen Faktoren ab – nicht
zuletzt davon, wie die Medien die breite Öffentlichkeit und die Politik über das
komplexe Problem informieren. Aus diesem Grund wurde bereits mehrfach
untersucht, wie SKM in Presse und Fernsehen, Büchern und Kinofilmen dargestellt
wird.

Forschungsziele: Die vorliegende Studie betrachtet erstmals, wie sexueller
Kindesmissbrauch auf der Videoplattform YouTube thematisiert wird. Die
Untersuchung von YouTube ist besonders relevant, da es sich national wie
international um die reichweitenstärkste Social-Media-Plattform handelt.

Methoden: Auf der Basis einer Analyse von N = 300 deutschsprachigen
sowie ausgewählten englischsprachigen SKM-bezogenen YouTube-Videos wird
herausgearbeitet, 1) von wem diese Videos stammen, 2) welche Form und welche
Inhalte sie haben, 3) wie ihre Qualität einzuschätzen ist, und 4) welche
Nutzungsweisen ihre Social-Media-Metriken erkennen lassen.

Ergebnisse: Im Vergleich zur massenmedialen Behandlung von SKM zeigen sich
in der SKM-Thematisierung auf YouTube spezifische Stärken (z. B. verstärkte
Beteiligung Betroffener am Diskurs), aber auch neue Schwächen (z. B.
ideologische Instrumentalisierung des Missbrauchsproblems). Ebenso zeigen sich
Differenzen in der Repräsentation des Missbrauchsproblems zwischen der deutsch-
und der englischsprachigen YouTube-Sphäre.

Schlussfolgerung: Viele Forschungslücken zur SKM-Thematisierung auf
YouTube sind noch zu schließen. Die pädagogische, beraterische und
journalistische Praxis sind gefordert, die SKM-Thematisierung auf YouTube
konstruktiv mitzugestalten.
Fallstricke bei der Diabetesdiagnostik: Wird zu lax mit Laborwerten umgegangen?
Authors: Landgraf Rüdiger , Nauck Matthias , Freckmann Guido , Müller Ulrich , Heinemann Lutz , Kellerer Monika , Müller-Wieland Dirk
Published: December 2018

The diagnosis of diabetes is associated with pre-analytical and analytical problems. Fasting glucose (FG), oral glucose tolerance test (oGTT) and HbA1c have advantages and shortcomings and have no equal diagnostic validity. oGTT is the most sensitive test, but its reproducibility is rather poor (CV ± 15 %). FG detects only 70 – 80 % of overt diabetes. FG is falsified by inappropriate blood sampling, intra-individual fluctuations and mistakes with the oGTT. HbA1c despite IFCC-standardization, but with a tolerable coefficient of variation of ± 18 % in round robin tests and use of not commutable control material is not easy to interpret. HbA1c analysis shows also interferences and is therefore of limited diagnostic value. Its threshold value of ≥ 6.5 % (≥ 48 mmol/mol Hb) is based on consensus and not on evidence. The diagnostic effort (FG and/or oGTT + HbA1c) with serious consequences is minimal invasive, reasonable and cheap. It prevents over- and underdiagnosis.
Diabetes mellitus vor und nach Nierentransplantation
Authors: Guthoff Martina
Published: December 2018

Der Diabetes mellitus ist heutzutage die häufigste Ursache für eine terminale Niereninsuffizienz. Ein manifester Diabetes limitiert für die Patienten oft den Zugang zur Transplantation als bestem Nierenersatzverfahren und ist für die Prognose nach erfolgreicher Transplantation weiter entscheidend. Ein Diabetes nach der Transplantation (PTDM) hat ebenfalls erhebliche prognostische Implikationen für das Patienten- und das Transplantatüberleben. Nach der Transplantation weisen mehr als 50 % der Patienten einen gestörten Glukosestoffwechsel auf. Präventive Strategien sind daher unabdingbar und umfassen alle Phasen der Transplantation. Sie lassen sich aus den bekannten Risikofaktoren ableiten und beinhalten insbesondere die strukturierte Lebensstilintervention sowie Maßnahmen zur Betazellprotektion. Ein konsequentes Screening und frühzeitiges Eingreifen sind für die Patienten nach einer Nierentransplantation von entscheidender Bedeutung, um sowohl das Patienten- als auch das Transplantatüberleben langfristig zu verbessern.
Nephroprotektive Effekte des SGLT2-Inhibitors Empagliflozin
Authors: Artunc Ferruh
Published: December 2018

Die Behandlung der diabetischen Nephropathie umfasst neben einer guten Blutzucker- und Blutdruckkontrolle eine Hemmung des Renin-Angiotensin-Systems (RAS). Die Hemmung des renalen Glukosetransporters SGLT2 („sodium glucose cotransporter 2“) ist ein neuartiger und wirkungsvoller Ansatz zur Senkung der Hyperglykämie, da dadurch bis zu 70 g Glukose mit dem Urin zur Ausscheidung gebracht werden können. In einer aktuellen Studie konnte gezeigt werden, dass durch diesen Ansatz auch die diabetische Nephropathie günstig beeinflusst wird und der Eintritt in die Dialysepflichtigkeit verhindert werden kann.
Arzneimittelentwicklung – Arzneimittelentwicklung aus einer
Hand spart Kosten und Zeit
Authors: Fietz Cornelia
Published: December 2018

DiMasi JA et al. Assessing the Financial Benefits of Faster Development Times:
The Case of Single-source Versus Multi-vendor Outsourced Biopharmaceutical
Manufacturing. Clin Ther 2018; 40: 963–972

Die Entwicklung neuer Arzneimittel ist sehr zeit- und kostenaufwändig. Zudem
birgt sie ein hohes Risiko, da schlussendlich nur wenige Substanzen die
Marktzulassung erlangen. Sponsoren ist daher an einer Verkürzung der
Forschungs- und Entwicklungszeit gelegen, um Entwicklungskosten einzusparen
und früher Gewinne mit dem Produkt zu erzielen. Die Autoren vergleichen dazu
Gesamtanbieter mit Multi-Lieferanten der Biopharma-Produktion.
Kosteneffektivität – Kosteneffektivität durch
Trainingsprogramme im Zusammenhang mit Krebserkrankungen
Authors: Potempa Christoph
Published: December 2018

Van Waart et al. Cost-utility and cost-effectiveness of physical exercise during
adjuvant chemotherapy. Eur J Health Econ 2018; 19: 893–904

Körperliche Aktivität auf Basis angeleiteter Trainingsprogramme soll die
Begleiterscheinungen von Krebserkrankungen und Chemotherapie mildern und
gleichzeitig eine schnellere Rückkehr ins Erwerbsleben der betroffenen
Patienten ermöglichen. Die Autoren um van Waart et al. untersuchen in ihrer
Kosten-Effektivitäts-Analyse zwei solcher Trainingsprogramme.
Patienten-Navigation – Kann ein
Patienten-Navigations-Programm soziale Ungleichheiten bei der
Darmkrebsfrüherkennung beseitigen?
Authors: Fietz Cornelia
Published: December 2018

De Mil R et al. Cost-Effectiveness Analysis of a Navigation Program for
Colorectal Cancer Screening to Reduce Social Health Inequalities: A French
Cluster Randomized Controlled Trial. Value Health 2018; 21: 685–691

Trotz vollständiger Kostenübernahme und regelmäßiger postalischer Erinnerung
nehmen nur rund 30 % der Bevölkerung in Frankreich an einem
Darmkrebsscreening teil. Vor allem in Bevölkerungsschichten mit niedrigem
sozioökonomischem Status ist die Beteiligung gering. Die Autoren haben ein
Patienten-Navigations-Programm entwickelt, um die Beteiligung an der
Krebsfrüherkennung zu erhöhen und soziale Ungleichheiten zu
minimieren.
Reduced Fat Oxidation During Exercise in Post-Menopausal
Overweight-Obese Women with Higher Lipid Accumulation Product
Index
Authors: Stein Elana , Silva Igor Martins , Dorneles Gilson P. , Lira Fabio Santos , Romão Pedro , Peres Alessandra
Published: December 2018

Background and Aims The main aim of this study was to analyze how the
lipid accumulation affects the whole-body fat oxidation over a range of
intensities during a submaximal incremental exercise test in post-menopausal
overweight-obese women.

Patients and Methods The maximal fat oxidation (MFO), the intensity
where the MFO occurs (FatMax), fat oxidation were measured over a range of
intensities during a submaximal incremental exercise test through indirect
calorimetry in 60 postmenopausal overweight-obese women (aged>49
years; body mass index 28.0 to 39.0 kg/m²). The
metabolic profile of participants was evaluated and the LAP index was
calculated (waist-58×triglycerides [mmol/L]). A cutoff point
of 34.5 was adopted and participant were designed as low LAP index
(n=30) or high LAP index (n=30).

Results During submaximal exercise postmenopausal overweight-obese
women with low LAP index showed a higher fat oxidation at 50%
(0.53±0.05 vs. 0.45±0.12 g/min;
p=0.01), 60% (0.40±0.06 vs.
0.31±0.16 g/min; p=0.02) and 70%
(0.34±0.08 vs. 0.25±0.15 g/min;
p=0.03) of VO2Peak than those with high LAP index. No
significant difference was observed in carbohydrate oxidation between groups
(p>0.05) during exercise. Moreover, a significant difference in
absolute MFO (p=0.018), MFO relative to free fat mass
(p=0.043) and FatMax (p=0.002) was identified.

Conclusion Postmenopausal overweight-obese women who showed unhealthy
metabolic phenotype evaluated through LAP index presented low fat oxidation
during a submaximal incremental exercise.
Endoscopic Bariatric/Metabolic Surgery
Authors: Kazi Daanish , Khaitan Leena
Published: December 2018

Endoscopic approaches to the bariatric patient have increased significantly in the last two decades. Obese patients present a challenge to surgeons as they are at higher risk of having perioperative complications. Patients also are seeking less and less invasive ways to have procedures performed. The combination of these two demands has led to the development of new technologies in the bariatric arena. Now there are several new endoscopic approaches for primary weight loss. Endoscopic metabolic procedures are developing for the management of diabetes. This article reviews the latest in these technologies.
Analytical Observational Study of Frozen Shoulder among Patients with Diabetes Mellitus
Authors: Alhashimi Redha
Published: December 2018

Purpose This study aims to identify the prevalence of frozen shoulder (FS) among diabetic patients and its relation to demographic features.

Methods This observational study of 216 patients randomly included those with diabetes mellitus (DM) attending the Misan Rheumatology and Medical Rehabilitation Department at Al-Sadder Teaching Hospital in Misan Province of Iraq and was conducted during the period from April 2014 to March 2015. Detailed medical histories were taken from patients and scratch test and hemoglobin A1C were used in diagnostic procedure to confirm diagnosis of FS and DM, respectively.

Results The occurrence rate of FS was 11.5% among patients, with a higher prevalence in females versus males. The most commonly afflicted age group was 60 to 70 years old at 33.3%. Dominant shoulder was more commonly affected than nondominant one. DM presented in large number of patients with FS with a prevalence of 90.3% of cases. The onset of FS in patients with DM was most common within the chronic phase of the disease at 32.3 and 33.8% for durations of 1 to 5 and 5 to 10 years, respectively.

Conclusion There is a strong association between DM and FS. Females were more commonly affected than males. Aging increased shoulder disorder distribution with dominant side being mostly affected. Chronic and noncontrolling diabetic patients were more commonly affected.

Level of Evidence This is a Level III, analytical, observational study.
Sepsis and Pediatric Acute Respiratory Distress Syndrome
Authors: Thomas Neal , Yehya Nadir
Published: December 2018

The epidemiology of the acute respiratory distress syndrome (ARDS) in pediatric sepsis is poorly defined. With significant data extrapolated from adult studies in sepsis and ARDS, sometimes with uncertain applicability, better pediatric-specific guidelines and dedicated investigations are warranted. The recent publication of a consensus definition for pediatric ARDS (PARDS) is the first step in addressing this knowledge gap. The aim of this review is to frame our current understanding of PARDS as it relates to pediatric sepsis, encompassing epidemiology, pathophysiology, and management. We argue that addressing the role of PARDS in pediatric sepsis requires significant attention to details with respect to how PARDS and sepsis are defined to accurately describe their epidemiology, natural history, and outcomes. Finally, we highlight certain aspects of PARDS management as they relate to the septic child and offer suggestion for future directions in this field.
Complications of Retrievable Inferior Vena Cava Filters: A Retrospective Comparison of Denali and Option-ELITE Filters
Authors: Hightower Jessica , Alexander Richard , Lehrman Evan , Kohlbrenner Ryan , Fidelman Nicholas , Taylor Andrew , Kolli Kanti , Westphalen Antonio , Kohi Maureen
Published: December 2018

Purpose To compare the complication rate of the Denali and Option-ELITE inferior vena cava (IVC) filters.

Materials and Methods All patients who had a Denali or Option-ELITE IVC filter placed between March 2014 and March 2016 were retrospectively identified from the electronic medical records. Of the 245 IVC filters placed, the positions of 93 devices (21 Denali and 72 Option-ELITE) were documented on follow-up computed tomography (CT) examinations obtained for reasons unrelated to filter placement. In situations where multiple CT studies were obtained after placement, each study was reviewed, for a total of 200 examinations. Images were assessed for filter complication including caval wall penetration by filter components, associated damage to pericaval tissues, filter tilt, migration, and fracture.

Results Penetration of at least one strut was observed in 13% of all filters imaged by CT, (Denali: 14%; Option-ELITE: 13%; p = 1.00). No patients had damage to pericaval tissues or documented symptoms attributed to penetration. Neither the Denali nor the Option-ELITE filters demonstrated significant tilt (> 15 degrees of tilt), migration, or fracture. Compared with Denali; the Option-ELITE filter demonstrated an increasing strut penetration rate with longer indwell times (z = –3.67, p < 0.01).

Conclusions No significant difference was observed between the rates of caval penetration of the Denali and Option-ELITE IVC filters assessed by CT. Additionally, no findings of filter fracture or migration were noted, suggesting that the Denali filter is non-inferior to the Option-ELITE filter with respect to penetration, fracture, tilt, and migration. The Option-ELITE filter demonstrated a time-dependent tendency toward greater strut penetration with longer indwell times.
Endoscopic Resection of Pediatric Skull Base Tumors: An Evidence-Based Review
Authors: Shenouda Kerolos , Yuhan Brian T. , Mir Ahsan , Gonik Nathan , Eloy Jean Anderson , Liu James K. , Folbe Adam J. , Svider Peter F.
Published: December 2018

Objectives To perform a systematic review examining experiences with endoscopic resection of skull base lesions in the pediatric population, with a focus on outcomes, recurrence, and surgical morbidities.

Methods PubMed/MEDLINE, Cochrane Library, Embase, and Web of Science databases were evaluated. Studies were assessed for level of evidence. Bias risk was evaluated using the Cochrane Bias tool, Grades of Recommendation, Assessment, Development and Evaluation (GRADE), and Methodological Index for Non-Randomized Studies (MINORS) criteria. Patient characteristics, pathology, site of primary disease, presenting symptoms, stage, procedure specific details, and complications were evaluated. Results were reported using the Preferred Reporting Systems for Systematic Reviews and Meta-Analysis guidelines.

Results Ninety-three studies met criteria for inclusion, encompassing 574 patients with skull base tumors. The GRADE and MINORS criteria determined the overall evidence to be moderate quality. The most common benign and malignant pathologies included juvenile nasopharyngeal angiofibromas (n = 239) and chondrosarcomas (n = 11) at 41.6 and 1.9%, respectively. Of all juvenile nasopharyngeal angiofibroma tumors, most presented at stage IIIa and IIIb (25.8 and 27.3%, respectively). Nasal obstruction (16.5%) and headache (16.0%) were common symptoms at initial presentation. Surgical approaches included endoscopic endonasal (n = 193, 41.2%) and endoscopic extended transsphenoidal (n = 155, 33.1%). Early (< 6 weeks) and late (>6 weeks) complications included cerebrospinal fluid leak (n = 36, 17.3%) and endocrinopathy (n = 43, 20.7%). Mean follow-up time was 37 months (0.5–180 months), with 86.5% showing no evidence of disease and 2.1% having died from disease at last follow-up.

Conclusion Endoscopic skull base surgery has been shown to be a safe and effective method of treating a variety of pediatric skull base tumors. If appropriately employed, the minimally invasive approach can provide optimal results in the pediatric population.
Choice of Renal Function Estimator Influences Adverse Outcomes with Dabigatran Etexilate in Patients with Atrial Fibrillation
Authors: Simpson Bryan , Reith David , Medlicott Natalie , Smith Alesha
Published: December 2018

Background Clinical significance of dosing dabigatran with different estimates of renal function for treatment of atrial fibrillation (AF) is unknown. Renal function is routinely estimated by the chronic kidney disease epidemiology initiative equation (CKD-EPI) and used to guide dosing. The aim of this study was to investigate the risk of adverse outcomes for patients with AF when different estimators of renal function are used.

Material and Methods AF patient data were extracted from national administrative databases. Renal function was estimated using Cockcroft–Gault, CKD-EPI, and CKD-EPI adjusted for body surface area (CKD-EPI-BSA). Outcomes of cerebrovascular accident (CVA), systemic embolism (SE), and hemorrhage were extracted.

Results In total, 2,425 patients were identified, of which there were hospitalizations for 138 (5.7%) hemorrhagic events, 45 (1.9%) CVA/SE, and 33 (1.4%) unspecified CVA. The level of agreement between Cockcroft–Gault with CKD-EPI and CKD-EPI-BSA yielded a weighted kappa statistic of 0.47 and 0.71, respectively. CKD-EPI and CKD-EPI-BSA significantly overestimated renal function in elderly patients resulting in higher recommended doses compared with Cockcroft–Gault. The hazard ratio for a hemorrhagic event was 2.32 (95% confidence interval, 1.22–4.42; p = 0.01) when a high dose was given compared with normal dose, based on Cockcroft–Gault.

Conclusion Both CKD-EPI and CKD-EPI-BSA equations significantly overestimated renal function in the elderly population compared with the Cockcroft–Gault equation. This may lead to dose selection errors for dabigatran, particularly for those with severe impairment, increasing the risk of adverse outcome. Hence, CKD-EPI and CKD-EPI-BSA equations should not be substituted for the Cockcroft–Gault equation in the elderly for the purpose of renal dosage adjustments.
Beyond the 2% fetishism: studying the practice of collective action in transatlantic affairs
Authors: Zyla Benjamin
Published: December 2018

NATO burden sharing is currently hotly contested. While it has been measured at the political, economic, and military levels and being looked at from the input and output side, the most commonly used variable to measure NATO BS is considering the percentage of GDP that a country spends on defense, which NATO agreed upon in 2014 should be 2%. The aim of this article is twofold. First, we review the most commonly used system- and state-level variables to explain burden sharing behavior and to carve out their explanatory limitations due to their strong rationality assumptions, positivist epistemologies, deductive, hypothesis testing research designs, and methodological individualism. The gap in the burden sharing literature currently is that it is unable to explain why a particular burden sharing behavior exists (i.e., free-riding) and why it occurred (or not) at a particular point in time. Our second aim is to make suggestions on how to fill these gaps by offering a selective number of post-positivist theories to study NATO burden sharing. We argue that we need to unravel the BS logics and social mechanisms that underpin BS decisions and behaviors, and hypothesize that states may, for example, not exclusively be informed in their burden sharing behavior by a logic of consequentiality but one of appropriateness. However, in order to gain access to this logic and social mechanisms, we need to employ post-positivist theories (and thus methodologies).
Perspective: Ga2O3 for ultra-high power rectifiers and MOSFETS
Authors: Pearton S. J. , Ren Fan , Tadjer Marko , Kim Jihyun
Published: December 2018

Gallium oxide (Ga2O3) is emerging as a viable candidate for certain classes of power electronics with capabilities beyond existing technologies due to its large bandgap, controllable doping, and the availability of large diameter, relatively inexpensive substrates. These applications include power conditioning systems, including pulsed power for avionics and electric ships, solid-state drivers for heavy electric motors, and advanced power management and control electronics. Wide bandgap (WBG) power devices offer potential savings in both energy and cost. However, converters powered by WBG devices require innovation at all levels, entailing changes to system design, circuit architecture, qualification metrics, and even market models. The performance of high voltage rectifiers and enhancement-mode metal-oxide field effect transistors benefits from the larger critical electric field of β-Ga2O3 relative to either SiC or GaN. Reverse breakdown voltages of over 2 kV for β-Ga2O3 have been reported, either with or without edge termination and over 3 kV for a lateral field-plated Ga2O3 Schottky diode on sapphire. The metal-oxide-semiconductor field-effect transistors fabricated on Ga2O3 to date have predominantly been depletion (d-mode) devices, with a few demonstrations of enhancement (e-mode) operation. While these results are promising, what are the limitations of this technology and what needs to occur for it to play a role alongside the more mature SiC and GaN power device technologies? The low thermal conductivity might be mitigated by transferring devices to another substrate or thinning down the substrate and using a heatsink as well as top-side heat extraction. We give a perspective on the materials’ properties and physics of transport, thermal conduction, doping capabilities, and device design that summarizes the current limitations and future areas of development. A key requirement is continued interest from military electronics development agencies. The history of the power electronics device field has shown that new technologies appear roughly every 10-12 years, with a cycle of performance evolution and optimization. The older technologies, however, survive long into the marketplace, for various reasons. Ga2O3 may supplement SiC and GaN, but is not expected to replace them.
Fe2O3 nanowires for thermoelectric nitrogen dioxide gas sensor
Authors: Lin J. Y. , Zhang A. J. , Huang S. H.
Published: December 2018

A thermoelectric nitrogen dioxide gas sensor developed based on Fe2O3 nanowires is capable of outputting DC voltages of tens of millivolts, which facilitates signal amplification and processing. In this paper, the Fe2O3 nanowires were synthesized in a horizontal electrical furnace under air pressure at 600°C for 8 h. SEM and XRD techniques as well as gas sensing performance of prepared sensors towards NO2 gas were studied. The gas sensing studies demonstrate that, The voltage signal, corresponding to the 10 ppm of NO2 gas was 17.9 mV, the response time and the recovery time were 23 s and 17 s, respectively, when the temperature difference was set at 120°C. Furthermore, the plausible response mechanism of the thermoelectric gas sensor based on Fe2O3 was discussed that demonstrates a feasible method for nitrogen dioxide detection.
Defective respiration and one-carbon metabolism contribute to impaired naïve T cell activation in aged mice
Authors: Ron-Harel Noga , Notarangelo Giulia , Ghergurovich Jonathan M. , Paulo Joao A. , Sage Peter T. , Santos Daniel , Satterstrom F. Kyle , Gygi Steven P. , Rabinowitz Joshua D. , Sharpe Arlene H. , Haigis Marcia C.
Published: December 2018

Significance

T cell-mediated immune responses are compromised in aged individuals, leading to increased morbidity and reduced response to vaccination. Finding new ways to boost T cell immunity in the elderly is key for enhancing their immune competence. In this work, we performed a systematic analysis of proteins and metabolites in young versus aged T cells. Metabolic rewiring occurs in young T cells following stimulation but is dampened in aged T cells. Moreover, we show that aged T cell functions can be enhanced by metabolite addition.
New insights into the evolution of wheat avenin-like proteins in wild emmer wheat (
Triticum dicoccoides
)
Authors: Zhang Yujuan , Hu Xin , Islam Shahidul , She Maoyun , Peng Yanchun , Yu Zitong , Wylie Steve , Juhasz Angela , Dowla Mirza , Yang Rongchang , Zhang Jingjuan , Wang Xiaolong , Dell Bernard , Chen Xueyan , Nevo Eviatar , Sun Dongfa , Ma Wujun
Published: December 2018

Fifteen full-length wheat grain avenin-like protein coding genes (
TaALP
) were identified on chromosome arms 7AS, 4AL, and 7DS of bread wheat with each containing five genes. Besides the a- and b-type ALPs, a c type was identified in the current paper. Both a and b types have two subunits, named x and y types. The five genes on each of the three chromosome arms consisted of two x-type genes, two y-type genes, and one c-type gene. The a-type genes were typically of 520 bp in length, whereas the b types were of 850 bp in length, and the c type was of 470 bp in length. The
ALP
gene transcript levels were significantly up-regulated in
Blumeria graminis
f. sp.
tritici (Bgt)
-infected wheat grain caryopsis at early grain filling. Wild emmer wheat [(WEW),
Triticum dicoccoides
] populations were focused on in our paper to identify allelic variations of
ALP
genes and to study the influence of natural selection on certain alleles. Consequently, 25 alleles were identified for
TdALP-bx-7AS
, 13 alleles were identified for
TdALP-ax-7AS
, 7 alleles were identified for
TdALP-ay-7AS
, and 4 alleles were identified for
TdALP-ax-4AL
. Correlation studies on
TdALP
gene diversity and ecological stresses suggested that environmental factors contribute to the
ALP
polymorphism formation in WEW. Many allelic variants of
ALPs
in the endosperm of WEW are not present in bread wheat and therefore could be utilized in breeding bread wheat varieties for better quality and elite plant defense characteristics.
Child heritage speakers’ production and comprehension of direct object clitic gender in Spanish
Authors: Shin Naomi , Rodríguez Barbara , Armijo Aja , Perara-Lunde Molly
Published: December 2018

This study investigates 37 child heritage speakers’ direct object (DO) clitics in Spanish. Results from a production task show that DO expression versus omission was related to Spanish vocabulary: the lower the vocabulary score, the more omitted DOs. In contrast, DO clitic gender was related to English: children who used more English in the home and who had higher English vocabulary scores produced more gender mismatches, most notablyloreferring to feminine referents. Results from a comprehension task suggest that children do not attend to clitic gender for referent identification. We argue that the disambiguation function of DO clitic gender, which is infrequent in discourse, may take a long time to develop. Overall, the study suggests that the extent to which restricted input and crosslinguistic influence affect child heritage speakers’ minority language grammar may be mediated by the nature of the linguistic phenomenon in question.
Multimodal Parcellations and Extensive Behavioral Profiling Tackling the Hippocampus Gradient
Authors: Plachti Anna , Eickhoff Simon B , Hoffstaedter Felix , Patil Kaustubh R , Laird Angela R , Fox Peter T , Amunts Katrin , Genon Sarah
Published: December 2018

The hippocampus displays a complex organization and function that is perturbed in many neuropathologies. Histological work revealed a complex arrangement of subfields along the medial–lateral and the ventral–dorsal dimension, which contrasts with the anterior–posterior functional differentiation. The variety of maps has raised the need for an integrative multimodal view. We applied connectivity-based parcellation to 1) intrinsic connectivity 2) task-based connectivity, and 3) structural covariance, as complementary windows into structural and functional differentiation of the hippocampus. Strikingly, while functional properties (i.e., intrinsic and task-based) revealed similar partitions dominated by an anterior–posterior organization, structural covariance exhibited a hybrid pattern reflecting both functional and cytoarchitectonic subdivision. Capitalizing on the consistency of functional parcellations, we defined robust functional maps at different levels of partitions, which are openly available for the scientific community. Our functional maps demonstrated a head–body and tail partition, subdivided along the anterior–posterior and medial–lateral axis. Behavioral profiling of these fine partitions based on activation data indicated an emotion–cognition gradient along the anterior–posterior axis and additionally suggested a self-world-centric gradient supporting the role of the hippocampus in the construction of abstract representations for spatial navigation and episodic memory.
Age threshold for the use of non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with atrial fibrillation: insights into the optimal assessment of age and incident comorbidities
Authors: Chao Tze-Fan , Lip Gregory Y H , Lin Yenn-Jiang , Chang Shih-Lin , Lo Li-Wei , Hu Yu-Feng , Tuan Ta-Chuan , Liao Jo-Nan , Chung Fa-Po , Chen Tzeng-Ji , Chen Shih-Ann
Published: December 2018

Aims

The stroke risk of patients with atrial fibrillation (AF) is not static, since AF patients get older and accumulate more comorbidities after AF is diagnosed. Therefore, the stroke risk of AF patients given certain comorbidities in different age strata should ideally be analysed using an assessment which considers incident comorbidities and the actual age when ischaemic stroke occurred. The goal of the present study is to report the age treatment thresholds for the use of non-vitamin K antagonist oral anticoagulants (NOACs) for AF patients without or with only one comorbidity of the CHA2DS2-VASc score, based on an ‘ideal method’ of stroke risk assessments.

Methods and results

The study cohort included 31 039 and 39 020 AF patients who did not have any or had only one risk factor comorbidity of the CHA2DS2-VASc score except for age and sex. The risks of ischaemic stroke in each age strata for each comorbidities were analysed in three ways, as follows: (i) the conventional way (based on baseline risk factors and age), (ii) dynamic method (patients were censored when new comorbidities occurred), and (iii) an ideal method (patients were censored when new comorbidities occurred and the stroke risk was related to the actual age when stroke happened). The tipping point for the use of NOACs was set at a stroke risk of 0.9%/year. The overall risk of ischaemic stroke using the conventional way was overestimated compared to the dynamic or ideal assessment with the incidence rate ratio of 1.24 for patients with hypertension, 1.20 for heart failure, 1.37 for diabetes mellitus, and 1.38 for vascular diseases; all P-values <0.01. The risk of ischaemic stroke for each age strata was generally higher with the conventional or dynamic methods compared with the ideal assessment. With heart failure, the tipping point (age 35 years) of NOACs was similar, irrespective of methods used for stroke risk assessment. According to the results of ideal assessment, the age thresholds for the use of NOACs for patients with hypertension, diabetes mellitus, and vascular diseases were 50 years, 50 years, and 55 years, respectively.

Conclusion

Ischaemic stroke risk in AF is heterogeneous, depending on different risk factors with age being as an important driver of stroke risk. Age thresholds for the use of NOACs were different for AF patients having different single risk factors beyond sex despite the same CHA2DS2-VASc score point (1 for males and 2 for females); that is, 35 years for heart failure, 50 years for hypertension or diabetes, and 55 years for vascular diseases.
Derived Functors of Differential Operators
Authors: Jeffries Jack
Published: December 2018

In their work on differential operators in positive characteristic, Smith and Van den Bergh define and study the derived functors of differential operators; these arise naturally as obstructions to differential operators reducing to positive characteristic. In this paper, we provide formulas for the ring of differential operators as well as these derived functors of differential operators. We apply these descriptions to show that differential operators behave well under reduction to positive characteristic under certain hypotheses. We show that these functors also detect a number of interesting properties of singularities.
Relative Effectiveness of Cell-Cultured and Egg-Based Influenza Vaccines Among Elderly Persons in the United States, 2017–2018
Authors: Izurieta Hector S , Chillarige Yoganand , Kelman Jeffrey , Wei Yuqin , Lu Yun , Xu Wenjie , Lu Michael , Pratt Douglas , Chu Steve , Wernecke Michael , MaCurdy Thomas , Forshee Richard
Published: December 2018

Background

The low influenza vaccine effectiveness (VE) observed during the A(H3N2)-dominated 2017–2018 season may be due to vaccine virus adaptation to growth in eggs. We compared the effectiveness of cell-cultured and egg-based vaccines among Medicare beneficiaries.

Methods

Retrospective cohort study on Medicare beneficiaries aged ≥65 years who received an influenza vaccine (cell-cultured, egg-based quadrivalent; egg-based high-dose, adjuvanted, or standard-dose trivalent) during the 2017–2018 season. We used Poisson regression to evaluate relative VE (RVE) in preventing influenza-related hospital encounters.

Results

Of >13 million beneficiaries, RVE for cell-cultured vaccines relative to egg-based quadrivalent vaccines was 10% (95% confidence interval [CI], 7%–13%). In a midseason interim analysis, this estimate was 16.5% (95% CI, 10.3%–22.2%). In a 5-way comparison, cell-cultured (RVE, 11%; 95% CI, 8%–14%) and egg-based high-dose (RVE, 9%; 95% CI, 7%–11%) vaccines were more effective than egg-based quadrivalent vaccines.

Conclusions

The modest VE difference between cell-cultured and egg-based vaccines only partially explains the low overall VE reported by the Centers for Disease Control and Prevention, suggesting that egg adaptation was not the main contributor to the low VE found among individuals aged ≥65 years. The midseason interim analysis we performed demonstrates that our methods can be used to evaluate VE actively during the influenza season.
Comparative antifungal susceptibility analyses of Cryptococcus neoformans VNI and Cryptococcus gattii VGII from the Brazilian Amazon Region by the Etest, Vitek 2, and the Clinical and Laboratory Standards Institute broth microdilution methods
Authors: Nishikawa Marília Martins , Almeida-Paes Rodrigo , Brito-Santos Fabio , Nascimento Carlos Roberto , Fialho Miguel Madi , Trilles Luciana , Morales Bernadina Penarrieta , da Silva Sérgio Alves , Santos Wallace , Santos Lucilaide Oliveira , Fortes Silvana Tulio , Cardarelli-Leite Paola , Lázera Márcia dos Santos
Published: December 2018

Early diagnosis, efficient clinical support, and proper antifungal therapy are essential to reduce death and sequels caused by cryptococcosis. The emergence of resistance to the antifungal drugs commonly used for cryptococcosis treatment is an important issue of concern. Thus, the in vitro antifungal susceptibility of clinical strains from northern Brazil, including C. neoformans VNI (n = 62) and C. gattii VGII (n = 37), to amphotericin B (AMB), 5-flucytosine, fluconazole, voriconazole, and itraconazole was evaluated using the Etest and Vitek 2 systems and the standardized broth microdilution (CLSI-BMD) methodology. According to the CLSI-BMD, the most active in vitro azole was voriconazole (C. neoformans VNI modal MIC of 0.06 μg/ml and C. gattii VGII modal MIC of 0.25 μg/ml), and fluconazole was the least active (modal MIC of 4 μg/ml for both fungi). Modal MICs for amphotericin B were 1 μg/ml for both fungi. In general, good essential agreement (EA) values were observed between the methods. However, AMB presented the lowest EA between CLSI-BMD and Etest for C. neoformans VNI and C. gattii VGII (1.6% and 2.56%, respectively, P < .05 for both). Considering the proposed Cryptococcus spp. epidemiological cutoff values, more than 97% of the studied isolates were categorized as wild-type for the azoles. However, the high frequency of C. neoformans VNI isolates in the population described here that displayed non-wild-type susceptibility to AMB is noteworthy. Epidemiological surveillance of the antifungal resistance of cryptococcal strains is relevant due to the potential burden and the high lethality of cryptococcal meningitis in the Amazon region.
Caring for Children Who Are Technology-Dependent and Their Families
Authors: Breneol Sydney , Goldberg Lisa , Watson Jean
Published: December 2018

Advancements in the medical field have resulted in an increased number of children with complex chronic conditions that may depend on technology to sustain or optimize life. Given that nurses provide substantial physical and emotional care for these children and families during their frequent hospitalizations, the development of an authentic caring relationship is imperative. A critical review of the literature examining the experiences and unmet care needs of this population was carried out and analyzed using Watson's Caring Science to explore how nurses can create an authentic caring relationship and environment for children who are technology-dependent and their families.
Limited Sequence MRIs for Early Onset Scoliosis Patients Detected 100% of Neural Axis Abnormalities While Reducing MRI Time by 68%
Authors: Murgai Rajan R. , Tamrazi Benita , Illingworth Kenneth D. , Skaggs David L. , Andras Lindsay M.
Published: December 2018

Study Design.

Diagnostic accuracy.

Objective.

The purpose of this study was to determine if neural axis abnormalities in early onset scoliosis (EOS) patients can be reliably detected with limited magnetic resonance imaging (MRI) sequences (sagittal T1, sagittal T2).

Summary of Background Data.

MRIs are often performed in EOS patients as studies have shown there are neural axis abnormalities in up to 40% of this population. MRIs are expensive, lengthy, and often require general anesthesia. In young children prolonged or repeated exposure to general anesthesia may be associated with neurocognitive damage.

Methods.

A retrospective review of consecutive EOS patients from February to December 2017 who received an MRI of the cervical, thoracic, and lumbar spine was conducted. MRI images were reviewed for neural axis abnormalities. Two sequences (sagittal T1, sagittal T2) of these previously reviewed MRIs were read at a separate time by an attending pediatric neuroradiologist. The imaging findings from these two select sequences were then compared with the prior radiology report based on all of the standard MRI sequences.

Results.

Fifty patients met criteria. Ten patients (20%) had neural axis abnormalities detected by the full MRI. All of these neural axis abnormalities were detected on the combination of sagittal T1 + sagittal T2 images. Standard MRIs lasted 66 ± 20 minutes and patients required 90 ± 22 minutes of anesthesia. Sagittal T1 + sagittal T2 sequences lasted 21 ± 7 minutes (P < 0.0001).

Conclusion.

Limited sequence MRIs with sagittal T1 and T2 sequences for EOS patients had 100% sensitivity for the detection of neural axis abnormalities and would allow for a 68% reduction in the length of MRI and significant reduction in anesthesia time.

Level of Evidence: 3
Effect of an mHealth Intervention to Improve Health Literacy in Immigrant Populations
Authors: Fernández-Gutiérrez Martina , Bas-Sarmiento Pilar , Poza-Méndez Miriam
Published: December 2018

Health literacy is a social determinant of the basic health of populations and is especially important to enhancing and developing the empowerment of migrant populations. To evaluate the effectiveness of an mHealth intervention to improve the cognitive and social skills that enable migrants to access and use health services, we developed a quasi-experimental design to encompass a single group of enrolled immigrants (N = 93). They completed preintervention and postintervention questionnaires of the European Health Literacy Survey Questionnaire, the self-created questionnaire HL-APP-Q14 (Health Literacy App Questionnaire), and a practical simulation test. Health literacy improved significantly after the intervention, increasing from a problematic level (mean, 9.55 [SD, 4.35]) to a sufficient level (mean, 14.03 [SD, 2.68]). Differences were statistically significant for males and females as well as for participants of all nationalities, except the Chinese group. The application e_SaludAble empowered the migrant participants through the improvement of their health literacy.
Nested Polymerase Chain Reaction and Cutaneous Tuberculosis
Authors: Maldonado-Bernal Carmen , Ramos-Garibay Alberto , Rios-Sarabia Nora , Serrano Héctor , Carrera Manuel , Navarrete-Franco Gisela , Jurado-Santacruz Fermín , Isibasi Armando
Published: December 2018

The role of Mycobacterium tuberculosis in the etiology and pathogenesis of cutaneous tuberculosis is controversial because of the difficulties associated with demonstrating the presence of these mycobacteria in tuberculid cutaneous lesions by routinely available microbiological and histological techniques. In this study, we aimed to demonstrate the presence of M. tuberculosis in cutaneous tuberculosis. Multiple polymerase chain reaction (PCR) followed by nested PCR was used to amplify genomic fragments from 3 different mycobacteria species. DNA was isolated from 30 paraffin-embedded skin biopsies. Samples were selected randomly from patients with a clinical and histopathological diagnosis of the most frequent groups of cutaneous tuberculosis in Mexico as follows: 5 cases of scrofuloderma tuberculosis; 2 cases of lupus vulgaris tuberculosis; and 5 cases of tuberculosis verrucosa cutis. The other cases denominated tuberculids in some countries such as Mexico and included the following: 7 cases of rosacea-like tuberculosis; one case of papulonecrotic tuberculosis; and 10 cases of erythema induratum of Bazin. Four normal skin biopsies were included as controls. M. tuberculosis DNA was amplified successfully by nested PCR in 80% of the samples (24 of the 30 samples) assayed. Mycobacterial DNA was not detected in the normal skin biopsies used as controls. Detection of M. tuberculosis DNA in 80% of cutaneous tuberculosis analyzed implicates this mycobacterium in the pathogenesis of multiple clinical forms of cutaneous tuberculosis.
FLUORESCEIN ANGIOGRAPHY FINDINGS IN UNILATERAL PERSISTENT FETAL VASCULATURE
Authors: Shen Jen-Hsiang , Liu Laura , Wang Nan-Kai , Hwang Yih-Shiou , Chen Kuan-Jen , Chao An-Ning , Lai Chi-Chun , Chen Tun-Lu , Wu Wei-Chi
Published: December 2018

Objective:

This study aims to examine retinal vascular findings for affected eyes and contralateral eyes as well in typical cases of unilateral persistent fetal vasculature.

Methods:

We retrospectively reviewed all patients evaluated at Chang Gung Memorial Hospital, Linkou, for unilateral persistent fetal vasculature between January 2008 and July 2017. All patients underwent fluorescein angiography (FA) examination under general anesthesia. FA was performed using RetCam 3 (Clarity Medical Systems, Inc, Pleasanton, CA).

Results:

Ten patients (eight male and two female) were identified as having adequate clinical data for the final analysis. The mean age at diagnosis was 13.7 ± 17.2 months (range 1–58). The mean axial length was shorter in the affected eyes as compared to the fellow eyes (17.27 ± 2.8 vs. 20.2 ± 1.7 mm; P = 0.024). In the affected eyes, nine cases (90.0%) showed a concomitant retrolental stalk, avascular peripheral retina, regional capillary dropout, and absence of foveal avascular zone. Hyperfluorescent stalk was seen in seven cases (70.0%). Four eyes (40.0%) showed leaking vessels. Terminal supernumerary branching was seen in two cases (20.0%). Popcorn hyperfluorescence was noted in one case (10.0%). In the fellow eyes, peripheral avascular zone was noted in nine eyes (90.0%), of which six (60.0%) had peripheral zones greater than two-disk diameters. Seven eyes (70.0%) presented with regional capillary dropout and abnormal choroidal filling. Three eyes (30.0%) had abnormal vessel straightening. Aberrant circumferential vessels and leaking spots were seen in two eyes (20.0%). Regional dilation of disk vessels, peripheral vessel dilation, and terminal bulbing were noted in one eye (10.0%). The mean best-corrected visual acuity of the fellow eyes was 20/39 (0.29 in logarithm of the minimum angle of resolution).

Conclusion:

Retinal vascular abnormalities in the affected eyes and fundoscopically normal fellow eyes of unilateral persistent fetal vasculature patients were found in 100% and 90.0% of patients, respectively. Fellow eyes had some subtle abnormalities that were only revealed through FA. These unilateral persistent fetal vasculature cases were still bilaterally affected.
How Do Race and Insurance Status Affect the Care of Pediatric Anterior Cruciate Ligament Injuries?
Authors: Bram Joshua T. , Talathi Nakul S. , Patel Neeraj M. , DeFrancesco Christopher J. , Striano Brendan M. , Ganley Theodore J.
Published: December 2018

Objective:

To identify associations between race or insurance status and preoperative, intraoperative, and postoperative findings in a large cohort of pediatric anterior cruciate ligament (ACL) reconstructions.

Design:

Retrospective cohort study.

Setting:

Division of Orthopaedics at an urban tertiary care children's hospital.

Patients:

915 pediatric (<21) patients undergoing primary ACL reconstruction between January 2009 and May 2016.

Independent Variables:

Insurance status and race.

Main Outcome Measures:

Delay to surgery, concurrent meniscal injury, sports clearance, postoperative complications, physical therapy, range of motion, and isokinetic strength reduction.

Results:

Multivariate analysis revealed a significantly longer delay to surgery for black/Hispanic and publicly insured children compared to their counterparts (P = 0.02 and P = 0.001, respectively). Black/Hispanic patients were more likely to sustain irreparable meniscus tears resulting in meniscectomy than white/Asian patients (odds ratio 2.16, 95% confidence interval, 1.10-2.29, P = 0.01). Black/Hispanic and publicly insured children averaged fewer physical therapy (PT) visits (P < 0.001 for both). Nine months after surgery, black/Hispanic patients had significantly greater strength reduction than white/Asian patients. There were no differences in postoperative complications, including graft rupture, contralateral ACL injury, or new meniscus tear along the lines of race, although privately insured patients were more likely to suffer a graft rupture than publicly insured patients (P = 0.006).

Conclusions:

After ACL rupture, black/Hispanic children and publicly insured children experience a greater delay to surgery. Black/Hispanic patients have more irreparable meniscus tears and less PT visits. Black/Hispanic patients have greater residual hamstrings and quadriceps weakness 9 months after surgery.