bluuebunny/crossref_metadata_2025 huggingface dataset:
Auditing as a tool of government accountability? Exploring divergent causal mechanisms through three Honduran cases
Authors: Sabet Daniel M.
Published: October 2020

Audits of government entities offer a potential tool to hold public officials to account and to improve the functioning of public administration; however, empirical studies of audit impacts show mixed results. This is largely due to the diversity of audit regimes with different goals and accountability mechanisms, which yield different causal chains. In this study, I compare three distinct audit regimes with distinct casual mechanisms in Honduras. I find that backward‐looking audits, which aim to hold officials accountable for past behavior or performance, require effective horizontal accountability mechanisms to investigate and prosecute cases. Forward‐looking audits, which aim to hold officials accountable for future behavior or performance, require independent accountability mechanisms, a systematic follow‐up methodology, public dissemination, and pressure from the media and civil society. Complementary initiatives that build on audit recommended reforms are found to strengthen these weaknesses in the causal mechanism linking audits to outcomes.
Ultrasound has limited diagnostic utility in children with acute lymphoblastic leukemia developing pancreatitis
Authors: Richardson Rebecca , Morin Cara E. , Wheeler Charles A. , Guo Yian , Li Yimei , Jeha Sima , Inaba Hiroto , Pui Ching‐Hon , Karol Seth E. , McCarville M. Beth
Published: October 2020

Purpose

Acute pancreatitis (AP) due to chemotherapy‐induced pancreatic injury is a common side effect of treatment for acute lymphoblastic leukemia (ALL), the most common childhood malignancy. The American College of Radiology recommends ultrasound (US) for initial imaging of AP in all populations to assess for ductal obstruction. However, US may be insensitive to diagnose and assess chemotherapy‐associated AP.

Methods and Materials

The institutional review board approved this retrospective study. Patients with ALL and AP were identified from protocol databases, using Common Terminology Criteria for Adverse Events (CTCAE) version 3. Chemotherapy dosing, amylase/lipase levels, clinical symptoms, and US/computed tomography (CT) reports within 10 days of diagnosis were recorded. All CT images were reviewed for revised Atlanta classification and CT severity index (CTSI).

Results

Sixty‐nine patients, aged 2‐21 years, experienced 88 episodes of AP, undergoing 98 US and 44 CT. Seventy‐two events (82%) occurred within 30 days of asparaginase administration. Sixty‐nine episodes (78%) were initially diagnosed by the presence of abdominal pain and pancreatic enzyme elevation. Overall sensitivities for AP detection were 47% using US and 98% for CT. US sensitivity was greatest in CTCAE grade 4 (86%) and necrotizing pancreatitis (67%).

Conclusions

Most cases of AP in children with ALL can be diagnosed with clinical history and labs. US has limited sensitivity in detecting pancreatitis in this population. Imaging to diagnose AP in this patient population could be limited to clinically equivocal cases.
Ambulatory microdose induction of buprenorphine‐naloxone in two adolescent patients with sickle cell disease
Authors: Buchheit Bradley M. , Joslin Timothy , Turner Helen N. , Wong Trisha E.
Published: October 2020

Sickle cell disease (SCD) is a hematologic disorder defined by presence of sickle‐shaped red blood cells that can occlude blood vessels and cause tissue ischemia and pain. Treating SCD pain adequately and safely is difficult given today's opioid climate. Buprenorphine‐naloxone has been described as an alternative option to treat chronic pain in the adult literature; however, it historically required discontinuation of full‐agonist opioids before initiation, resulting in opioid withdrawal. Herein we present two adolescents with SCD who successfully weaned off large doses of full‐agonist opioids by using microdose induction of buprenorphine‐naloxone in clinic, without experiencing significant opioid withdrawal. Ambulatory microdose induction may remove hurdles that otherwise would discourage patients from trying this regimen while still controlling pain safely.
Associations between different forms of peer victimization and school absences: The moderating role of teacher attachment and perceived school safety
Authors: Williford Anne , Fite Paula , Diaz Kathleen , Singh Mehar
Published: October 2020

Given the significant negative impacts of peer victimization on youth development, studies have sought to understand what buffers against these consequences. To that end, the present study examined whether teacher attachment and perceptions of school safety moderated the associations between different forms of victimization and school absences over the course of an academic year among a sample of 272 high school students. Findings indicated that teacher attachment moderated the associations between relational and cyber victimization and absences, while perceived school safety moderated associations between relational victimization and absences. However, findings pertaining to cyber victimization were not as anticipated. Implications for prevention and intervention efforts in high schools are discussed.
A meta‐analysis of Tier 2 interventions implemented within School‐Wide Positive Behavioral Interventions and Supports
Authors: Cho Blair Kwang‐Sun , Park Eun‐Young , Kim Won‐Ho
Published: October 2020

This meta‐analysis synthesized 26 published single‐case design (SCD) studies on Tier 2 behavior interventions implemented within the educational framework of school‐wide positive behavioral interventions and supports. We used Tau‐U indices to determine the overall magnitudes of effect of the Tier 2 behavior interventions and the potential variables that moderate improved student behavioral outcomes. The 26 studies that were analyzed included a total of 243 student participants. The studies were evaluated to determine whether and to what extent they met What Works Clearinghouse (WWC) SCD standards. Of these, 10 studies were confirmed as meeting WWC SCD standards with or without reservations. Notable findings were that outcomes for students in kindergarten and secondary grade levels were limited, and insufficient screening methods were used to identify and select students needing Tier 2 interventions. The results indicate that the literature reports Tier 2 interventions with effect sizes ranging from 0.26 to 0.98. Average effect size for social skills instruction was found to be large, whereas Check‐in/Check‐out, group contingency, and intervention packages had medium effect sizes. Moderator analyses indicated different effect sizes across intervention types, outcomes, and implementers. The results are discussed in relation to implications for practice, limitations, and future research.
Biodegradable Black‐Phosphorus‐Nanosheet‐Based Nanoagent for Enhanced Chemo‐Photothermal Therapy
Authors: Xu Xin , Jiang Yifan , Wang Min , Wang Huimeng , Lu Chunhua , Yang Huanghao
Published: October 2020

Black phosphorus nanosheet (BPNS) is a promising multifunctional material in the biomedical field with biodegradability and low side effects, however its features are always weakened severely owing to its poor stability. Here, a novel method is developed for improving the defect of BPNS based on the effective protection of poly(lactic‐co‐glycolic acid) (PLGA), which preserves the stable photothermal therapy (PTT) effect of BPNS and biodegradability of the material. Meanwhile, doxorubicin (DOX) is loaded on BPNS/PLGA to get BPNS/PLGA/DOX for further chemotherapy and preventing the recurrence of tumor after PTT. The presented combined therapeutic strategy exploits the strengths and improves the defects of BPNS, thus developing an efficient and safe nanoagent for cancer therapy, which affords and reveals the great potential of BPNS in nanomedicine.
Summary of ERS/ATS guideline on managing severe asthma
Authors: Chaplin Steve
Published: October 2020

The 2020 European Respiratory Society (ERS) and American Thoracic Society (ATS) joint guideline on the management of severe asthma builds on the original 2014 guidance and includes the use of biological treatments for the management of severe eosinophilic disease. This article provides an overview of the main recommendations.
Enhancing the Diode Characteristics of Pulsed Laser–Deposited n‐MgxZn1−xO/p‐Si Heterojunction: Role of Oxygen Ambient Pressure
Authors: Chetia Shantanu Kaushik , Das Amit Kumar , Ajimsha Rohini Shreedharan , Sahu Vikas Kumar , Misra Pankaj
Published: October 2020

Herein, diode characteristics of n‐MgxZn1−xO/p‐Si heterojunctions grown by pulsed laser deposition at different oxygen ambient pressures are investigated. It is found that the heterojunctions grown at lower oxygen growth pressure of 1.0 × 10−2 mbar and below do not show rectifying diode‐like behavior, whereas those grown at higher oxygen pressures at and above 2.5 × 10−2 mbar exhibit perfect diode‐like rectifying characteristics. The diode characteristics are found to improve significantly with increasing oxygen ambient pressure during the growth of MgxZn1−xO film. The current–voltage measurements show that the n‐MgxZn1−xO/p‐Si heterojunction diode grown at a higher oxygen ambient pressure of ≈1.0 × 10−1 mbar has the lowest reverse saturation current of ≈19 nA and highest rectification ratio of ≈1.4 × 104. The capacitance–voltage measurements reveal that the depletion layer width of heterojunction diodes increases manifold with increasing oxygen ambient pressure during the growth of MgxZn1−xO, which is understood in terms of decrease in carrier concentrations in the MgxZn1−xO thin films grown at higher oxygen ambient pressures. The n‐MgxZn1−xO/p‐Si heterojunction diodes, grown at high oxygen ambient pressures, with low reverse saturation current, high rectification ratio, and large depletion width may have potential application in wide‐bandgap nanoelectronic devices and UV enhanced photodetectors.
Ligustilide alleviates neurotoxicity in SH‐SY5Y cells induced by Aβ25‐35 via regulating endoplasmic reticulum stress and autophagy
Authors: Gao Li‐juan , Li Ping , Ma Tengyun , Zhong Zhan‐qiong , Xu Shi‐jun
Published: October 2020

Ligustilide is a phenolic compound isolated from Asian plants of Umbelliferae family. This study was aimed at exploring the neuroprotective effects of Ligustilide from the perspective of endoplasmic reticulum stress (ERS) and autophagy. The Alzheimer's disease (AD) cell models were constructed by SH‐SY5Y cell line, which was exposed to 20 μM Aβ25‐35. CCK‐8 was used to evaluate the cell viability of Ligustilide on AD cell model. Hoechst staining and LysoTracker Red were used to test the cell apoptosis and Lysosome function, respectively. ERS in living cells were detected by Thioflavin T. The expression of autophagy‐related proteins (LC3B‐II/I, P62/SQSTM1, Beclin1, and Atg5), ERS marker proteins (PERK, GRP78, and CHOH), and apoptosis proteins (Bax, Bcl‐2, and Caspase‐12) were analyzed by Western blot analyses. Aβ25‐35 could induce ERS and autophagy in a time‐dependent manner in SH‐SY5Y cells. We demonstrated that Ligustilide significantly decreased the rate of apoptosis, and improved the viability of cells. Simultaneously, Ligustilide effectively modulated ERS via inhibiting the over‐activation of GRP78/PERK/CHOP signaling pathway. In addition, Ligustilide alleviated the accumulation of autophagy vacuoles, reduced the ratio of LC3B‐II/I and the level of P62/SQSTM1. Ligustilide significantly up‐regulated lysosomal acidity and the expression of Cathepsin D (CTSD). Ligustilide could rescue lysosomal function to promote autophagy flux and inhibit the over‐activation of ERS. This finding may contribute to the development of new therapeutic strategies for AD.
Multivariable nonparametric learning: A robust iterative inversion‐based control approach
Authors: de Rozario Robin , Oomen Tom
Published: October 2020

Learning control enables significant performance improvement for systems by utilizing past data. Typical design methods aim to achieve fast convergence by using prior system knowledge in the form of a parametric model. To ensure that the learning process converges in the presence of model uncertainties, it is essential that robustness is appropriately introduced, which is particularly challenging for multivariable systems. The aim of the present article is to develop an optimization‐based design framework for fast and robust learning control for multivariable systems. This is achieved by connecting robust control and nonparametric frequency response function identification, which results in a design approach that enables the synthesis of learning and robustness parameters on a frequency‐by‐frequency basis. Application to a multivariable benchmark motion system confirms the potential of the developed framework.
BigDataSDNSim: A simulator for analyzing big data applications in software‐defined cloud data centers
Authors: Alwasel Khaled , Calheiros Rodrigo N. , Garg Saurabh , Buyya Rajkumar , Pathan Mukaddim , Georgakopoulos Dimitrios , Ranjan Rajiv
Published: October 2020

The integration and crosscoordination of big data processing and software‐defined networking (SDN) are vital for improving the performance of big data applications. Various approaches for combining big data and SDN have been investigated by both industry and academia. However, empirical evaluations of solutions that combine big data processing and SDN are extremely costly and complicated. To address the problem of effective evaluation of solutions that combine big data processing with SDN, we present a new, self‐contained simulation tool named BigDataSDNSim that enables the modeling and simulation of the big data management system YARN, its related programming models MapReduce, and SDN‐enabled networks in a cloud computing environment. BigDataSDNSim supports cost‐effective and easy to conduct experimentation in a controllable, repeatable, and configurable manner. The article illustrates the simulation accuracy and correctness of BigDataSDNSim by comparing the behavior and results of a real environment that combines big data processing and SDN with an equivalent simulated environment. Finally, the article presents two uses cases of BigDataSDNSim, which exhibit its practicality and features, illustrate the impact of data replication mechanisms of MapReduce in Hadoop YARN, and show the superiority of SDN over traditional networks to improve the performance of MapReduce applications.
Practical guide for circular RNA analysis: Steps, tips, and resources
Authors: Tsitsipatis Dimitrios , Gorospe Myriam
Published: October 2020

Recent technological advances in RNA sequencing and analysis have allowed an increasingly thorough investigation of a previously unexplored class of transcripts, circular (circ)RNAs. Accumulating evidence suggests that circRNAs have unique functions which often rely on their association with microRNAs and RNA‐binding proteins. Through these interactions, circRNAs have been implicated in major cellular processes and hence in the pathophysiology of a range of diseases. Here, we provide guidelines to consider when developing studies on circRNAs, including detecting and selecting the circRNAs, identifying their binding partners and sites of interaction, modulating circRNA levels, assessing copy numbers and stoichiometry, and addressing other points unique to circRNA analysis.

This article is categorized under:

Regulatory RNAs/RNAi/Riboswitches > Regulatory RNAs
An Interface Theory for Program Verification
Authors: Beyer Dirk , Kanav Sudeep
Published: October 2020

Program verification is the problem, for a given program $$P$$and a specification $$\phi $$, of constructing a proof of correctness for the statement “program $$P$$satisfies specification $$\phi $$” ($$P \models \phi $$) or a proof of violation ("Equation missing"). Usually, a correctness proof is based on inductive invariants, and a violation proof on a violating program trace. Verification engineers typically expect that a verification tool exports these proof artifacts. We propose to view the task of program verification as constructing a behavioral interface (represented e.g. by an automaton). We start with the interface $$I_{P}$$of the program itself, which represents all traces of program executions. To prove correctness, we try to construct a more abstract interface $$I_{C}$$of the program (overapproximation) that satisfies the specification. This interface, if found, represents more traces than $$I_{P}$$that are allcorrect(satisfying the specification). Ultimately, we want a compact representation of the program behavior as acorrectness interface $$I_{C}$$in terms ofinductive invariants. We can then extract a correctness witness, in standard exchange format, out of such a correctness interface. Symmetrically, to prove violation, we try to construct a more concrete interface $$I_{V}$$of the program (underapproximation) that violates the specification. This interface, if found, represents fewer traces than $$I_{P}$$that are allfeasible(can be executed). Ultimately, we want a compact representation of the program behavior as aviolation interface $$I_{V}$$in terms of aviolating program trace. We can then extract a violation witness, in standard exchange format, out of such a violation interface. This viewpoint exposes the duality of these two tasks — proving correctness and violation. It enables the decomposition of the verification process, and its tools, into (at least!) three components: interface synthesizers, refinement checkers, and specification checkers. We hope the reader finds this viewpoint useful, although the underlying ideas are not novel. We see it as a framework towards modular program verification.
Model-independent constraints with extended dark matter EFT
Authors: Alanne Tommi , Arcadi Giorgio , Goertz Florian , Tenorth Valentin , Vogl Stefan
Published: October 2020

Abstract

We systematically explore the phenomenology of the recently proposed extended dark matter effective field theory (eDMeft), which allows for a consistent effective description of DM scenarios across different energy scales. The framework remains applicable at collider energies and is capable of reproducing the correct relic abundance by including a dynamical mediator particle to the dark sector, while maintaining correlations dictated by gauge invariance in a ‘model-independent’ way. Taking into account present and future constraints from direct- and indirect-detection experiments, from collider searches for missing energy and for scalar resonances in vector-boson, di-jet, and Higgs-pair final states, as well as from the relic abundance as measured by Planck, we determine viable regions in the parameter space, both for scalar and pseudoscalar mediator. In particular, we point out regions where cancellations in the direct-detection cross section appear leading to allowed islands for scalar mediators that could be missed in a naive simplified-model approach, but are present in the full D = 5 effective theory, as well as a general opening of the parameter space due to consistently considering all operators at a given mass dimension. Thus, canonical WIMP-like scenarios can survive even the next generation of direct-detection experiments in different mass regimes, while potentially becoming testable at the high-luminosity LHC.
Scotogenic dark matter in an orbifold theory of flavor
Authors: de Anda Francisco J. , Antoniadis Ignatios , Valle José W. F. , Vaquera-Araujo Carlos A.
Published: October 2020

Abstract

We propose a flavour theory in which the family symmetry results naturally from a six-dimensional orbifold compactification. “Diracness” of neutrinos is a consequence of the spacetime dimensionality, and the fact that right-handed neutrinos live in the bulk. Dark matter is incorporated in a scotogenic way, as a result of an auxiliary ℤ3 symmetry, and its stability is associated to the conservation of a “dark parity” symmetry. The model leads naturally to a “golden” quark-lepton mass relation.
Conjugations in $$L^2(\mathcal {H})$$
Authors: Câmara M. Cristina , Kliś-Garlicka Kamila , Łanucha Bartosz , Ptak Marek
Published: October 2020

Conjugations commuting with $$\mathbf {M}_z$$

M
z

and intertwining $$\mathbf {M}_z$$

M
z

and $$\mathbf {M}_{{\bar{z}}}$$

M

z

¯

in $$L^2(\mathcal {H})$$

L
2

(
H
)

, where $$\mathcal {H}$$
H
is a separable Hilbert space, are characterized. We also investigate which of them leave invariant the whole Hardy space $$H^2(\mathcal {H})$$

H
2

(
H
)

or a model space $$K_\Theta =H^2(\mathcal {H})\ominus \Theta H^2(\mathcal {H})$$

K
Θ

=

H
2

(
H
)

⊖
Θ

H
2

(
H
)

, where $$\Theta $$
Θ
is a pure operator valued inner function.
Interdisziplinäres COVID-Board bei SARS-CoV-2-getriggerter hyperferritinämischer Inflammation
Authors: La Rosée P. , Bremer H.-C. , La Rosée F. , Mohm P. , Hochhaus A. , Gehrke I. , Kumle B. , Benzing A. , Russo S.
Published: October 2020

Hintergrund

Patienten mit schwerer COVID-19-Erkrankung entwickeln eine hyperferritinämische Inflammation, ein sepsisähnliches Immundysregulationssyndrom.

Methode

Retrospektive Kohortenanalyse nach Therapiestratifizierung in einer standortübergreifenden telemedizinischen Fallkonferenz. Frühzeitige, standardisierte Identifizierung von Patienten mit einem Risiko für einen schweren Verlauf (COVID-Inflammation-Score; CIS) und Intubationsvermeidung mit Schwerpunkt auf nichtinvasive Ventilation (NIV) sind Kernelemente des Behandlungsalgorithmus. Patienten mit lebensbedrohlicher Inflammation wurde ein individueller Heilversuch mit dem Immunmodulator Ruxolitinib angeboten.

Ergebnisse

Zwischen 04.03.2020 und 26.06.2020 wurden 196 COVID-19-Patienten behandelt. Der Altersmedian (70 Jahre) und die Komorbidität waren im Interstudienvergleich hoch. Die Gesamtmortalität lag bei 17,3 %, wobei bei der Hälfte der verstorbenen Patienten eine A‑priori-Therapielimitierung festgelegt war. Das CIS-Monitoring der mit Ruxolitinib behandelten Hochrisikopatienten (n = 20) ergab nach 5, 7 und 15 Tagen eine Inflammationssuppression um 42 % (15–70), 54 % (15–77) und 60 % (15–80). In dieser Gruppe lag die Mortalität bei 20 % (4/20). Die Gesamtmortalität adjustiert auf Patienten mit intendierter Maximaltherapie lag bei 8,7 % (17/196).

Schlussfolgerung

Die COVID-19-Pneumonie mit hyperferritinämischer Inflammation ist verwandt mit der Makrophagen-Aktivierungssyndrom-ähnlichen Sepsis. Eine interdisziplinäre Fallkonferenz als Qualitätsinstrument der Intensivmedizin zur Erfassung seltener sepsisähnlicher Krankheitsbilder wird vorgestellt.
Persönliche Präferenz, Erfahrung, Intuition und operative Schule dominieren die Verwendung postoperativer Wunddrainagen in der Dermatochirurgie
Authors: Ruers Stephanie Sophia , Wagenpfeil Stefan , Gauglitz Gerd , Felcht Moritz , Wetzig Tino , Bechara Falk G. , Koenen Wolfgang , Kunte Christian , Bruning Guido , Müller Cornelia S. L.
Published: October 2020

Hintergrund

Die Verwendung von Drainagesystemen in der Dermatochirurgie erfolgt bislang ohne evidenzbasierte Daten. Indikationen, Komplikationen und Kontraindikationen werden traditionell von Operateur zu Operateur weitergegeben, sind jedoch bisher nicht definiert.

Methodik

Es wurde eine internetbasierte Umfrage erstellt und unter den Mitgliedern der DGDC e. V. (Deutsche Gesellschaft für Dermatochirurgie e. V.) ausgesandt. Abgefragt wurden das allgemeine Behandlungsverhalten im deutschsprachigen Raum in Bezug auf die Anwendung der Wunddrainage nach dermatologischen Operationen sowie die Nutzungsgewohnheiten und Erfahrungen der Kollegen mit Drainage-assoziierten Komplikationen.

Ergebnisse

Es haben 12,73 % der angeschriebenen DGDC-Mitglieder den Fragebogen beantwortet. Drainagen werden überwiegend im klinischen Umfeld eingesetzt, es werden alle abgefragten Drainagesysteme verwendet. Ausmaß und Komplexität des Eingriffs sind die wesentlichen Kriterien bei der Indikationsstellung. Der Einsatz von Drainagen ist abhängig vom Alter des Teilnehmers und erfolgt mehrheitlich bei Patienten, bei denen Komplikationen im postoperativen Verlauf erwartet werden (Adipositas, Nikotinabusus, Diabetiker).

Diskussion

Zusammenfassend verwendet die Mehrzahl der Teilnehmer Wunddrainagen und dies mehrheitlich intuitiv. Einheitliche fixe evidenzbasierte Parameter rund um die Verwendung von Wunddrainagen fehlen. Bei der Beurteilung der Notwendigkeit einer Wunddrainage scheint ein individuell unterschiedlich ausgeprägtes Sicherheitsbedürfnis bei den einen und „eminenzbasiertes“ Handeln bei den anderen Dermatochirurgen eine große Rolle zu spielen.
Trends in psoriatic arthritis epidemiology in Poland
Authors: Tłustochowicz Małgorzata , Wierzba Waldemar , Marczak Michał , Tłustochowicz Witold , Śliwczyński Andrzej , Raciborski Filip , Kwiatkowska Brygida , Brzozowska Melania , Jacyna Andrzej , Kisiel Bartłomiej
Published: October 2020

Psoriatic arthritis (PsA) is a heterogeneous inflammatory arthritis, usually seronegative and associated with psoriasis (Ps). The prevalence and incidence of psoriatic arthritis show strong ethnic and geographic variations. The aim of the study was to assess the epidemiological trends in psoriatic arthritis in Poland. The National Health Fund (NHF) database for the period 2008–2018 was analyzed. PsA was defined as ICD-10 codes L40.5, M07, M07.0, M07.1, M07.2 and M07.3, while psoriasis as ICD-10 codes L40 and L40.X (L40.0 to L40.9). A steady increase in the number of PsA patients (from 16,790 to 32,644) and in PsA recorded prevalence (from 38.47 per 100,000 in 2008 to 73.11 per 100,000 in 2018) was observed between 2008 and 2018. The PsA/Ps ratio increased to a similar extent (from 8.3 to 17.5%). The percentage of PsA patients receiving rehabilitation services remained constant throughout the observation period (mean: 17.35%; range 16.7–18.9%). The study showed a steady and continuous increase in PsA recorded prevalence. A simultaneous increase in the PsA/Ps ratio suggests that the main reason for the observed trend is greater disease detection .
Safety and patient-reported outcomes in index ablation versus repeat ablation in atrial fibrillation: insights from the German Ablation Registry
Authors: Kany Shinwan , Brachmann Johannes , Lewalter Thorsten , Kuck Karl-Heinz , Andresen Dietrich , Willems Stephan , Hoffmann Ellen , Eckardt Lars , Thomas Dierk , Hochadel Matthias , Senges Jochen , Metzner Andreas , Rillig Andreas
Published: October 2020

Background

Pulmonary vein isolation is an established strategy for catheter ablation of atrial fibrillation (AF). However, in a significant number of patients, a repeat procedure is mandatory due to arrhythmia recurrence. In this study, we report safety data and procedural details of patients undergoing index ablation versus repeat ablation in a registry-based real-life setting.

Methods

Patients from the German Ablation Registry, a prospective, multicentre registry of patients undergoing ablation between January 2007 and January 2010 were included.

Results

A total of 4155 patients were enrolled in the study. Group I (index ablation) consisted of 3377/4155 (82.1%) and group II (repeat ablation) of 738/4155 (17.9%). Patients in group I had a significantly higher ratio of paroxysmal AF (69.3% vs 61.9%, p < 0.001) and significantly less persistent AF (30.7% vs 38.1%, p < 0.001). The repeat group showed significantly lower mean RF application duration (2580 s. vs 1960, p < 0.001), less fluoroscopy time (29 min. vs. 27 min., p < 0.001), less mean dose area product (DAP) (3744 cGy × cm2 vs 3325 cGy × cm2, p = 0.001), and shorter study duration (181.2 min. vs 163.6 min., p < 0.001). No statistical difference between the groups was found in terms of mortality (0.3% vs 0.1%, p = 0.39), MACE (0.4% vs 0.3%, p = 0.58), MACCE (0.8% vs 0.6%, p = 0.47), composite safety endpoint (1.5% vs 1.4%, p = 0.76), and arrhythmia recurrence (43.8% vs 41.9%, p = 0.37) during 1-year follow-up. Both groups reported to have improved or no symptoms (80.4% vs 77.8%, p = 0.13).

Conclusion

Repeat catheter ablation is safe and provides a symptomatic relief comparable to index ablation. Repeat procedures are significantly shorter and use less fluoroscopy.
Characterizing the face in facioscapulohumeral muscular dystrophy
Authors: Loonen T. G. J. , Horlings C. G. C. , Vincenten S. C. C. , Beurskens C. H. G. , Knuijt S. , Padberg G. W. A. M. , Statland J. M. , Voermans N. C. , Maal T. J. J. , van Engelen B. G. M. , Mul K.
Published: October 2020

Objective

To evaluate facial weakness in patients with FSHD to better define clinical signs, and pilot a facial weakness severity score.

Methods

87 FSHD patients and 55 controls were video recorded while performing seven facial tasks. The videos were assessed by three independent examiners to compile an overview of signs of facial weakness. Next, videos were semi-quantitatively assessed using a newly developed 4-point facial weakness score (FWS). This score was evaluated and correlated to other FSHD disease characteristics.

Results

Patients had lower scores on the total FWS than controls (mean score 43 ± 28, range 4–118, vs 14 ± 9, range 0–35,p < 0.001) and on all seven individual facial tasks (allp < 0.001). 54% of patients had FWS scores outside the range of controls. Patients had more asymmetry between the left and right side of the face than controls. About 10% of the patients had very mild facial weakness. These were mostly males (89%) with longer D4Z4 repeat sizes of 7–9 units. More severe facial weakness correlated to more severe overall disease severity and shorter D4Z4 repeat size, but not to disease duration. Interobserver agreement for the FWS between three raters was low with a Fleiss Kappa of 0.437.

Conclusion

This study provides an overview of the clinical spectrum of facial weakness and its relation to other disease characteristics. The 4-point scale we introduced to grade the severity of facial weakness enables correlation of facial weakness to disease characteristics, but is not suited as clinical outcome measure for longitudinal studies.
Fractures of the trochanteric region in children and young adolescents—a treatment algorithm for a rare injury
Authors: Payr Stephan , Payr Ellen , Chocholka Britta , Jaindl Manuela , Luxl Monika , Schwendenwein Elisabeth , Tiefenboeck Thomas
Published: October 2020

For femoral fractures of the trochanteric region in children and adolescents, only two mechanisms have been identified to cause a fracture of the proximal femur: high-energy trauma or predisposing bone pathologies with inadequate trauma (e.g., simple fall, movement). We identified 20 patients between 1993 and 2018 with a trochanteric fracture under the age of 18 (12 males; 8 females; mean age, 12 years; range, 4–17 years) who were treated operatively at our department. The mean follow-up of all patients was 50.06 months. All 20 patients were treated operatively. Complications occurred after a mean time of 6.27 months (range, 0.47 to 12.07 months) in two patients. Harris Hip Score was evaluated in all patients with a mean score of 94.16 (range 11 to 100). Eighty-five percent of the patients reached an excellent clinical outcome after treatment.Trochanteric femoral fractures in children and adolescents are very rare accounting for only 1% of all trochanteric fractures. Excellent long-term results can be achieved with an adequate fracture reduction.

Conclusion: Physicians treating pediatric trauma have to be aware of other predisponding diseases when low-energy trauma leads to a trochanteric fracture as in this study, 50% of the trochanteric fractures were associated with bone pathologies.What is Known:• Trochanteric femoral fractures in children and adolescents are very rare• In all patients with trochanteric femoral fractures, malignancies have to be ruled outWhat is New:• Awareness of an underlying bone pathology in a high number of cases• Awareness for necessity of a good fracture reduction leading to highly satisfactory results
Major latex protein-like encoding genes contribute to Rhizoctonia solani defense responses in sugar beet
Authors: Holmquist Louise , Dölfors Fredrik , Fogelqvist Johan , Cohn Jonathan , Kraft Thomas , Dixelius Christina
Published: October 2020

Sugar beets are attacked by several pathogens that cause root damages. Rhizoctonia (Greek for “root killer”) is one of them. Rhizoctonia root rot has become an increasing problem for sugar beet production and to decrease yield losses agronomical measures are adopted. Here, two partially resistant and two susceptible sugar beet genotypes were used for transcriptome analysis to discover new defense genes to this fungal disease, information to be implemented in molecular resistance breeding. Among 217 transcripts with increased expression at 2 days post-infection (dpi), three resistance-like genes were found. These genes were not significantly elevated at 5 dpi, a time point when increased expression of three Bet v I/Major latex protein (MLP) homologous genes BvMLP1, BvMLP2 and BvML3 was observed in the partially resistant genotypes. Quantitative RT-PCR analysis on diseased sugar beet seedlings validated the activity of BvMLP1 and BvMLP3 observed in the transcriptome during challenge by R. solani. The three BvMLP genes were cloned and overexpressed in Arabidopsis thaliana to further dissect their individual contribution. Transgenic plants were also compared to T-DNA mutants of orthologous MLP genes. Plants overexpressing BvMLP1 and BvMLP3 showed significantly less infection whereas additive effects were seen on Atmlp1/Atmlp3 double mutants. The data suggest that BvMLP1 and BvMLP3 may contribute to the reduction of the Rhizoctonia root rot disease in sugar beet. Impact on the defense reaction from other differential expressed genes observed in the study is discussed.
Contrast-enhanced paravertebrogram to confirm paravertebral catheter position in elective thoracic surgery: a proof of concept study
Authors: Klevebro Fredrik , Kuppusamy Madhan Kumar , Han Shiwei , Nikravan Sara , Neal Joseph M. , Strodtbeck Wyndam , Coy David L. , Warren Daniel , Hubka Michal , Hanson Neil , Low Donald E.
Published: October 2020

Background

Paravertebral pain catheters have been shown to be equally effective as epidural pain catheters for postoperative analgesia after thoracic surgery with the possible additional benefit of less hemodynamic effect. However, a methodology for verifying correct paravertebral catheter placement has not been tested or objectively confirmed in previous studies. The aim of the current study was to describe a technique to confirm the correct position of a paravertebral pain catheter using a contrast-enhanced paravertebrogram.

Methods

A retrospective cohort proof of concept study was performed including 10 consecutive patients undergoing elective thoracic surgery with radiographic contrast-enhanced confirmation of intraoperative paravertebral catheter placement (paravertebrogram).

Results

The results of the paravertebrograms, which were done in the operating room at the end of the procedure, verified correct paravertebral catheter placement in 10 of 10 patients. The radiographs documented dissemination of local anesthetic within the paravertebral space.

Conclusion

This proof of concept study demonstrated that a contrast-enhanced paravertebrogram could be used in conjunction with standard postoperative chest radiography to add valuable information for the assessment of paravertebral catheter placement. This technique has the potential to increase the accuracy and efficiency of postoperative analgesia, and to set a quality standard for future studies of paravertebral pain catheters.
Evaluating the reliability of time series land cover maps by exploiting the hidden Markov model
Authors: Yang Guang , Fang Shenghui , Gong Wenbing , Zhao Yaolong , Ge Mengyu
Published: October 2020

Time series land cover maps are important materials for the work related to land use and land cover change. Satellite remote sensing images prove advantageous in fast mapping with low cost. In most time series land cover products yielded by the satellite remote sensing images, a number of illogical transitions exist between different time phases. The time series land cover products cannot exactly reflect the real land cover types and land cover changes for each pixel. The accuracy evaluation based on the limited ground truth cannot well guide the users because the reliability of different pixels of the land cover products is unknown. A generic model for the reliability evaluation of time series land cover products should be developed based on a strong theoretical frame. In order to better guide the use of the land cover products, this paper proposed an approach to evaluate the reliability of time series land cover products by exploiting the joint probability of hidden Markov model (HMM), in which the classification performance and the spatio-temporal relationships were taken into account. We applied the proposed evaluation method on the time series land cover maps of Poyang Lake Eco-economic Region in China. The reliability of the land cover products was presented by the grading of the joint probability of HMM. The results effectively reflected the classification performance, the spatio-temporal relationships and even the quality of the data source.
Modelling human active search in optimizing black-box functions
Authors: Candelieri Antonio , Perego Riccardo , Giordani Ilaria , Ponti Andrea , Archetti Francesco
Published: October 2020

Modelling human function learning has been the subject of intense research in cognitive sciences. The topic is relevant in black-box optimization where information about the objective and/or constraints is not available and must be learned through function evaluations. In this paper, we focus on the relation between the behaviour of humans searching for the maximum and the probabilistic model used in Bayesian optimization. As surrogate models of the unknown function, both Gaussian processes and random forest have been considered: the Bayesian learning paradigm is central in the development of active learning approaches balancing exploration/exploitation in uncertain conditions towards effective generalization in large decision spaces. In this paper, we analyse experimentally how Bayesian optimization compares to humans searching for the maximum of an unknown 2D function. A set of controlled experiments with 60 subjects, using both surrogate models, confirm that Bayesian optimization provides a general model to represent individual patterns of active learning in humans.
Effects of anesthetic agents on contractions of the pregnant rat myometrium in vivo and in vitro
Authors: Kimizuka Motonobu , Tokinaga Yasuyuki , Azumaguchi Ryu , Hamada Kosuke , Kazuma Satoshi , Yamakage Michiaki
Published: October 2020

Background

Several anesthetic agents are used in cesarean sections for both regional and general anesthesia purposes. However, there are no data comparing the in vivo effects of propofol, sevoflurane, and dexmedetomidine on the contraction of the myometrium in pregnant rats. The aim of this study was to investigate the effect of these anesthetic agents on myometrial contraction and elucidate the underlying mechanisms.

Methods

Contraction force and frequency changes in response to propofol, dexmedetomidine, or sevoflurane were evaluated in vivo and in vitro. To test the effect of arachidonic acid on myometrial contraction enhanced by dexmedetomidine, changes in myometrial contraction with dexmedetomidine after administration of indomethacin were evaluated. The amount of phosphorylated myosin phosphatase target subunit 1 (MYPT1) in the membrane fraction was expressed as a percentage of the total fraction by Western blot analysis.

Results

This study demonstrated that dexmedetomidine enhances oxytocin-induced contraction in the myometrium of pregnant rats, whereas propofol and sevoflurane attenuate these contractions. The dexmedetomidine-induced enhancement of myometrial contraction force was abolished by the administration of indomethacin. Propofol did not affect oxytocin-induced MYPT1 phosphorylation, whereas sevoflurane attenuated oxytocin-induced MYPT1 phosphorylation.

Conclusions

Inhibition of myofilament calcium sensitivity may underlie the inhibition of myometrial contraction induced by sevoflurane. Arachidonic acid may play an important role in the enhancement of myometrial contraction induced by dexmedetomidine by increasing myofilament calcium sensitivity. Dexmedetomidine may be used as a sedative agent to promote uterine muscle contraction and suppress bleeding after fetal delivery.
Object manufacture based on a memorized template: Goffin’s cockatoos attend to different model features
Authors: Laumer I. B. , Jelbert S. A. , Taylor A. H. , Rössler T. , Auersperg A. M. I.
Published: October 2020

Although several nonhuman animals have the ability to recognize and match templates in computerized tasks, we know little about their ability to recall and then physically manufacture specific features of mental templates. Across three experiments, Goffin cockatoos (Cacatua goffiniana), a species that can use tools in captivity, were exposed to two pre-made template objects, varying in either colour, size (long or short) or shape (I or L-shaped), where only one template was rewarded. Birds were then given the opportunity to manufacture versions of these objects themselves. We found that all birds carved paper strips from the same colour material as the rewarded template, and half were also able to match the size of a template (long and short). This occurred despite the template being absent at test and birds being rewarded at random. However, we found no evidence that cockatoos could carve L-shaped pieces after learning that L-shaped templates were rewarded, though their manufactured strips were wider than in previous tests. Overall, our results show that Goffin cockatoos possess the ability to physically adjust at least the size dimension of manufactured objects relative to a mental template. This ability has previously only been shown in New Caledonian crows, where template matching was suggested as a potential mechanism allowing for the cumulative cultural transmission of tool designs. Our results show that within avian tool users, the ability to recreate a physical template from memory does not seem to be restricted to species that have cumulative tool cultures.
Predicting in-hospital mortality for sepsis: a comparison between qSOFA and modified qSOFA in a 2-year single-centre retrospective analysis
Authors: Guarino Matteo , Gambuti Edoardo , Alfano Franco , De Giorgi Alfredo , Maietti Elisa , Strada Andrea , Ursini Francesco , Volpato Stefano , Caio Giacomo , Contini Carlo , De Giorgio Roberto
Published: October 2020

Sepsis is a life-threating organ dysfunction caused by a dysregulated host response to infection. This study proposed a new tool, i.e. modified qSOFA, for the early prognostic assessment of septic patients. All cases of sepsis/septic shock consecutively observed in 2 years (January 2017–December 2018), at St. Anna University Hospital of Ferrara, Italy, were included. Each patient was evaluated with qSOFA and a modified qSOFA (MqSOFA), i.e. adding a SpO2/FiO2 ratio to qSOFA. Logistic regression and survival analyses were applied to compare the two scores. A total number of 1137 consecutive cases of sepsis and septic shock were considered. Among them 136 were excluded for incomplete report of vital parameters. A total number of 668 patients (66.7%) were discharged, whereas 333 (33.3%) died because of sepsis-related complications. Data analysis showed that MqSOFA (AUC 0.805, 95% C.I. 0.776–0.833) had a greater ability to detect in-hospital mortality than qSOFA (AUC 0.712, 95% C.I. 0.678–0.746) (p < 0.001). Eighty-five patients (8.5%) were reclassified as high-risk (qSOFA< 2 and MqSOFA≥ 2) resulting in an improvement of sensitivity with a minor reduction in specificity. A significant difference of in-hospital mortality was observed between low-risk and reclassified high-risk (p < 0.001) and low-risk vs. high-risk groups (p < 0.001). We demonstrated that MqSOFA provided a better predictive score than qSOFA regarding patient’s outcome. Since sepsis is an underhanded and time-dependent disease, physicians may rely upon the herein proposed simple score, i.e. MqSOFA, to establish patients’ severity and outcome.
Genomic and Transcriptomic Analyses of Bioluminescence Genes in the Enope Squid Watasenia scintillans
Authors: Yoshida Masa-aki , Imoto Junichi , Kawai Yuri , Funahashi Satomi , Minei Ryuhei , Akizuki Yuki , Ogura Atsushi , Nakabayashi Kazuhiko , Yura Kei , Ikeo Kazuho
Published: October 2020

Watasenia scintillans, a sparkling enope squid, has bioluminescence organs to illuminate its body with its own luciferase activity. To clarify the molecular mechanism underlying its scintillation, we analysed high-throughput sequencing data acquired previously and obtained draft genome sequences accomplished with comparative genomic data among the cephalopods. The genome mapped by transcriptome data showed that (1) RNA editing contributed to transcriptome variation of lineage specific genes, such asW. scintillansluciferase, and (2) two types of luciferase enzymes were characterized with reasonable 3D models docked to a luciferin molecule. We report two different types of luciferase in one organism and possibly related to variety of colour types in theW. scintillansfluorescent organs.
Green, yellow, red, or out of the blue? An assessment of Traffic Light Schemes to mitigate the impact of hydraulic fracturing-induced seismicity
Authors: Verdon James P. , Bommer Julian J.
Published: October 2020

Mitigating hydraulic fracturing-induced seismicity (HF-IS) poses a challenge for shale gas companies and regulators alike. The use of Traffic Light Schemes (TLSs) is the most common way by which the hazards associated with HF-IS are mitigated. In this study, we discuss the implicit risk mitigation objectives of TLSs and explain the advantages of magnitude as the fundamental parameter to characterise induced seismic hazard. We go on to investigate some of the key assumptions on which TLSs are based, namely that magnitudes evolve relatively gradually from green to yellow to red thresholds (as opposed to larger events occurring “out-of-the-blue”), and that trailing event magnitudes do not increase substantially after injection stops. We compile HF-IS datasets from around the world, including the USA, Canada, the UK, and China, and track the temporal evolution of magnitudes in order to evaluate the extent to which magnitude jumps (i.e. sharp increases in magnitude from preceding events within a sequence) and trailing events occur. We find in the majority of cases magnitude jumps are less than 2 units. One quarter of cases experienced a post-injection magnitude increase, with the largest being 1.6. Trailing event increases generally occurred soon after injection, with most cases showing no increase in magnitude more than a few days after then end of injection. Hence, the effective operation of TLSs may require red-light thresholds to be set as much as two magnitude units below the threshold that the scheme is intended to avoid.