bluuebunny/crossref_metadata_2025 huggingface dataset:
Measles outbreak in a public hospital, Szczecin, Poland, January 2019
Authors: Koenig C , Wojtynska O , Paradowska-Stankiewicz I
Published: November 2019

Background

In January 2019, a measles infection in an employee in a 168-bed hospital was reported to the local sanitary station (PSSE) in Szczecin, Poland. Further transmission occurred in the hospital and more cases were reported in the community. We investigated to identify transmission routes and implement control measures.

Methods

An outbreak case was any hospital staff, visitor, or patient, or any person in contact with them, meeting clinical criteria, from 3rd January. Cases were interviewed by PSSE to identify contacts and verify vaccination status. Susceptible contacts were offered post exposure vaccination (PEV). Clinical specimens were sent to the National Reference Laboratory for RT-PCR and serology confirmation. We collected vaccination status, geographical location and queried hospital authorities about control measures.

Results

The index case, the hospital employee, returned from Ukraine one day before onset of symptoms. We identified 17 (8 confirmed, 7 probable, 2 suspect) outbreak cases including 11 hospital personnel. Four of the personnel provided vaccine documentation (36%), of which three had received 2 doses. Contacts identified as susceptible (130) received PEV. Eight cases were contacts of the index case but were not promptly identified and did not receive PEV. The hospital refused new admissions for 19 days.

Another 16 cases were identified in the community, with exposure information not sufficient to establish an epidemiologic link with the outbreak.

Conclusions

The introduction of measles into a susceptible population and missing contacts for PEV led to a hospital-associated outbreak. For the community cases, exposure may have occurred in multiple public spaces around the hospital.

Most of the hospital staff who developed measles lacked vaccination records. The PSSE has recommended MMR vaccination for all hospital personnel without such documentation.

Key messages

This study shows how a single imported case, in an environment poorly immunized could lead to an outbreak and potentially transmit it to the community. It is very important to keep a high rate of measles vaccination (95% recommended by WHO) in the community and insure of immunization status of health workers.
A common European framework on how to create healthy living environments on the local level
Authors: Quilling E , Plantz C
Published: November 2019

In a consensus-process, 17 national and regional Public Health authorities from 13 European countries agreed upon a common Policy Framework of Action (PFA) that summarizes the current evidence making the case for healthy living environments and the role of municipalities. The PFA provides a conceptual model for interventions including an ideal process, quality criteria and guiding principles that municipal approaches should be based on.

The PFA is a consensus document based on the results and decisions of the first meeting of the JAHEE-work package partners. It was then circulated among the Work package partners and the JAHEE Steering Committee in two feedback rounds. The PFA development was supported by an interdisciplinary German expert group in the field of public health. To draw up a catalogue of criteria to identify promising practice projects, a number of existing quality assurance instruments for health promotion and prevention focusing on reducing health inequalities were examined and central aspects of the various instruments were identified. The suggested catalogue of criteria is based on good practice as defined by European experience (EQUIHP, JANPA, CHRODIS, INHERIT and the good practice criteria of the German network Equity in Health). These instruments were systematically compared and the criteria found in most instruments were included in the criteria catalogue for the PFA.

Result: 16 good-practice-criteria could be identified - such as “target group orientation”, “concept driven strategy”, “empowerment”, “networking” etc. These criteria form an essential basis for the further partner process in the Joint Action. Furthermore, the PFA provides a conceptual model for interventions including an ideal process based on the public health action cycle and guiding principles that municipal approaches should include.
Mobilizing knowledge in behaviour change to promote health; the case of the Behaviour Change Wheel
Authors: Belanger-Gravel A
Published: November 2019

Issue/problem

Over the past decades, researchers from many fields have built an impressive body of knowledge regarding behaviour change. However, the use of this knowledge for accurately designing/delivering/executing behaviour change programs is challenging for many public health practitioners.

Description of the problem

To support effective knowledge mobilization in behaviour change and to build a coherent and useful body of scientific evidence, leading researchers in behavioural sciences have developed and refined a number of tools for designing interventions. Among these tools, the Behaviour Change Wheel (BCW) was built on an impressive effort to synthetize available evidence regarding intervention development frameworks, behaviour change theories, and behaviour change techniques. However, studies highlighted some issues associated with the use of these methodological innovations. Working with our public health partners in the field of health communication, we realized that applying models such as the BCW is far from being mundane practices. To support optimal knowledge mobilization in behavioural sciences, we are developing a research agenda to understand perceptions and motivations of public health practitioners toward innovations such as the BCW and to develop and evaluate knowledge mobilization strategies.

Results

The initiative will contribute to the development of new scientific knowledge regarding mechanisms underlying effective knowledge mobilization in behaviour change and will further support the adoption of these evidence-based practices within the field of public health.

Lessons

Although rapidly adopted by the community of researchers, it is not clear whether or not public health practitioners would be as willing, or capable of using the BCW to design and deliver programs. Issues regarding knowledge mobilization in behaviour change should be addressed to improve the uptake of this knowledge in practice.
MARSHAL, a novel tool for virtual phenotyping of maize root system hydraulic architectures
Authors: Meunier Félicien , Heymans Adrien , Draye Xavier , Couvreur Valentin , Javaux Mathieu , Lobet Guillaume
Published: November 2019

Functional-structural root system models combine functional and structural root traits to represent the growth and development of root systems. In general, they are characterized by a large number of growth, architectural and functional root parameters, generating contrasted root systems evolving in a highly non-linear environment (soil, atmosphere), which makes the link between local traits and functioning unclear. On the other end of the root system modelling continuum, macroscopic root system models associate to each root system a set of plant-scale, easily interpretable parameters. However, as of today, it is unclear how these macroscopic parameters relate to root-scale traits and whether the upscaling of local root traits is compatible with macroscopic parameter measurements. The aim of this study was to bridge the gap between these two modelling approaches. We describe here the MAize Root System Hydraulic Architecture soLver (MARSHAL), a new efficient and user-friendly computational tool that couples a root architecture model (CRootBox) with fast and accurate algorithms of water flow through hydraulic architectures and plant-scale parameter calculations. To illustrate the tool’s potential, we generated contrasted maize hydraulic architectures that we compared with root system architectural and hydraulic observations. Observed variability of these traits was well captured by model ensemble runs. We also analysed the multivariate sensitivity of mature root system conductance, mean depth of uptake, root system volume and convex hull to the input parameters to highlight the key model parameters to vary for virtual breeding. It is available as an R package, an RMarkdown pipeline and a web application.
Giant ovarian mucinous cystadenoma, a challenging situation in resource-limited countries
Authors: Moyon Miguel Angel , León Daysi Alejandra , Aguayo William G , Mecias Alejandro R , Moyon F Xavier , Tufiño Jorge , Yu Alberto , Molina Gabriel
Published: November 2019

Mucinous cystadenomas are a common benign neoplasm of the ovaries that can grow much larger than other adnexal masses; they are recognized as precursors of ovarian cancer and may slowly transform to borderline tumors and invasive ovarian cancer. Prompt and accurate treatment is essential as these tumors can grow to massive sizes and be potentially lethal if left untreated. Health care providers must understand the patient, their expectations and their problems; without proper communication and follow-up, any treatment is destined to disappoint. We present a case of a 76-year-old female with limited access to health care. She presented with a giant cystadenoma that grew over 1 year. Complete resection was decided and the patient underwent complete recovery. On follow-up control patient is doing well.
Molecular networks regulating cell division during Arabidopsis leaf growth
Authors: Vercruysse Jasmien , Baekelandt Alexandra , Gonzalez Nathalie , Inzé Dirk
Published: November 2019

Leaves are the primary organs for photosynthesis, and as such have a pivotal role for plant growth and development. Leaf development is a multifactorial and dynamic process involving many genes that regulate size, shape, and differentiation. The processes that mainly drive leaf development are cell proliferation and cell expansion, and numerous genes have been identified that, when ectopically expressed or down-regulated, increase cell number and/or cell size during leaf growth. Many of the genes regulating cell proliferation are functionally interconnected and can be grouped into regulatory modules. Here, we review our current understanding of six important gene regulatory modules affecting cell proliferation during Arabidopsis leaf growth: ubiquitin receptor DA1–ENHANCER OF DA1 (EOD1), GROWTH REGULATING FACTOR (GRF)–GRF-INTERACTING FACTOR (GIF), SWITCH/SUCROSE NON-FERMENTING (SWI/SNF), gibberellin (GA)–DELLA, KLU, and PEAPOD (PPD). Furthermore, we discuss how post-mitotic cell expansion and these six modules regulating cell proliferation make up the final leaf size.
Jet Propagation in Neutron Star Mergers and GW170817
Authors: Hamidani Hamid , Kiuchi Kenta , Ioka Kunihito
Published: November 2019

The gravitational wave event from the binary neutron star (BNS) merger GW170817 and the following multi-messenger observations present strong evidence for i) merger ejecta expanding with substantial velocities and ii) a relativistic jet which had to propagate through the merger ejecta. The ejecta’s expansion velocity is not negligible for the jet head motion, which is a fundamental difference from the other systems like collapsars and active galactic nuclei. Here we present an analytic model of the jet propagation in an expanding medium. In particular, we notice a new term in the expression of the breakout time and velocity. In parallel, we perform a series of over a hundred 2D numerical simulations of jet propagation. The BNS merger ejecta is prepared based on numerical relativity simulations of a BNS merger with the highest-resolution to date. We show that our analytic results agree with numerical simulations over a wide parameter space. Then we apply our analytic model to GW170817, and obtain two solid constraints on: i) the central engine luminosity as Liso, 0 ∼ 3 × 1049 − 2.5 × 1052 erg s−1, and on ii) the delay time between the merger and engine activation t0 − tm < 1.3 s. The engine power implies that the apparently-faint short gamma-ray burst (sGRB) sGRB 170817A is similar to typical sGRBs if observed on-axis.
Galaxy simulation with the evolution of grain size distribution
Authors: Aoyama Shohei , Hirashita Hiroyuki , Nagamine Kentaro
Published: November 2019

We compute the evolution of interstellar dust in a hydrodynamic simulation of an isolated disc galaxy. We newly implement the evolution of full grain size distribution by sampling 32 grid points on the axis of the grain radius. We solve it consistently with the chemical enrichment and hydrodynamic evolution of the galaxy. This enables us to theoretically investigate spatially resolved evolution of grain size distribution in a galaxy. The grain size distribution evolves from a large-grain-dominated ($\gtrsim 0.1\,\rm{\mu m}$) phase to a small-grain production phase, eventually converging to a power-law-like grain size distribution similar to the so-called MRN distribution. We find that the small-grain abundance is higher in the dense ISM in the early epoch (t ≲ 1 Gyr) because of efficient dust growth by accretion, while coagulation makes the small-grain abundance less enhanced in the dense ISM later. This leads to steeper extinction curves in the dense ISM than in the diffuse ISM in the early phase, while they show the opposite trend later. The radial trend of extinction curves is described by faster evolution in the inner part. We also confirm that the simulation reproduces the observed relation between dust-to-gas ratio and metallicity, and the radial gradients of dust-to-gas ratio and dust-to-metal ratio in nearby galaxies. Since the above change in the grain size distribution occurs in t ∼ 1 Gyr, the age and density dependence of grain size distribution has a significant impact on the extinction curves even at high redshift.
The impact of atmospheric dispersion in the performance of high-resolution spectrographs
Authors: Wehbe B , Cabral A , Martins J H C , Figueira P , Santos N C , Ávila G
Published: November 2019

Differential atmospheric dispersion is a wavelength-dependent effect introduced by the atmosphere. It is one of the instrumental errors that can affect the position of the target as perceived on the sky and its flux distribution. This effect will affect the results of astronomical observations if not corrected by an atmospheric dispersion corrector (ADC). In high-resolution spectrographs, in order to reach a radial velocity (RV) precision of 10 cm s−1, an ADC is expected to return residuals at only a few tens of milliarcseconds (mas). In fact, current state-of-the-art spectrograph conservatively require this level of residuals, although no work has been done to quantify the impact of atmospheric dispersion. In this work, we test the effect of atmospheric dispersion on astronomical observations in general, and in particular on RV precision degradation and flux losses. Our scientific objective was to quantify the amount of residuals needed to fulfil the requirements set on an ADC during the design phase. We found that up to a dispersion of 100 mas, the effect on the RV is negligible. However, on the flux losses, such a dispersion can create a loss of ∼2 per cent at 380 nm, a significant value when efficiency is critical. The requirements set on ADC residuals should take into consideration the atmospheric conditions where the ADC will function, and also all the aspects related with not only the RV precision requirements but also the guiding camera used, the tolerances on the flux loss, and the different melt data of the chosen glasses.
Pre-operative proteinuria and post-operative acute kidney injury in noncardiac surgery: the NARA-Acute Kidney Injury cohort study
Authors: Nishimoto Masatoshi , Murashima Miho , Kokubu Maiko , Matsui Masaru , Eriguchi Masahiro , Samejima Ken-Ichi , Akai Yasuhiro , Tsuruya Kazuhiko
Published: November 2019

Background

Little is known about the association between pre-operative proteinuria and post-operative acute kidney injury (AKI) in noncardiac surgery.

Methods

This is a retrospective cohort study. Adults who underwent noncardiac surgery under general anesthesia from 2007 to 2011 at Nara Medical University Hospital were included. Those with obstetric or urological surgery, missing data for analyses or pre-operative dialysis were excluded. Exposure of interest was pre-operative proteinuria, defined as (+) or more by dipstick test. The outcome variable was post-operative AKI, defined by Kidney Disease: Improving Global Outcomes criteria, within 1 week after surgery. Multivariable logistic regression analyses were performed.

Results

Among 5168 subjects, 309 (6.0%) developed AKI. Pre-operative proteinuria was independently associated with post-operative AKI, with an odds ratio (OR) [95% confidence interval (CI)] of 1.80 (1.30–2.51). A sensitivity analysis restricted to elective surgery yielded a similar result. As proteinuria increased, the association with AKI became stronger [OR (95% CI) 1.14 (0.75–1.73), 1.24 (0.79–1.95), 2.75 (1.74–4.35) and 3.95 (1.62–9.62) for urinary protein (+/−), (+), (2+) and (3+), respectively]. Subgroup analyses showed proteinuria was especially associated with post-operative AKI among subjects with renin–angiotensin system inhibitors, other anti-hypertensives, hypoalbuminemia or impaired renal function (P for interaction = 0.05, 0.003, 0.09 or 0.02, respectively).

Conclusions

In noncardiac surgery, pre-operative proteinuria was independently associated with post-operative AKI. Subjects with proteinuria should be managed with caution to avoid AKI peri-operatively.
Reliable application of the MATH taxonomy sheds light on assessment practices
Authors: Kinnear George , Bennett Max , Binnie Rachel , Bolt Róisín , Zheng Yinglan
Published: November 2019

The MATH taxonomy classifies questions according to the mathematical skills required to answer them. It was created to aid the development of more balanced assessments in undergraduate mathematics and has since been used to compare different assessment regimes across school and university. To date, there has been no systematic investigation of the reliability of the taxonomy when applied by multiple coders, and it has only been applied in a limited range of contexts. In this paper, we outline a calibration process which enabled four novice coders to attain a high level of inter-rater reliability. In addition, we report on the results of applying the taxonomy to different secondary school exams and to all assessment questions in a first-year university mathematics module. The results confirm previous findings that there is a difference between the mix of skills assessed in school and university mathematics exams, although we find a notably different assessment profile in the university module than in previous work. The calibration process we describe has the potential to be used more widely, enabling reliable use of the MATH taxonomy to give insight into assessment practices.
Risk-based price of mortgages
Authors: Cruz Rambaud Salvador , Del Pino Álvarez María de los Ángeles
Published: November 2019

Purpose

The purpose of this paper is the analysis of the mortgage prices derived from the increase of defaults and the withdrawal of floor clauses in the mortgages offered by banking institutions in Spain. More specifically, this manuscript focuses on the evolution of the spread applied to mortgages contracted with a variable interest rate.

Design/methodology/approach

Two models have been considered to make a proper estimation of the yield curve to assess the loss due to the withdrawal of the floor clauses and quantify the component of the price used to cover the interest rate risk. Two different scenarios have been considered to avoid an underestimation of the aforementioned valuation.

Findings

The authors have shown that the increase in the percentage of doubtful mortgages has led to an increase in the spread of adjustable-rate mortgages. Moreover, the authors have shown that around 40 per cent of spreads are used to cover the interest rate risk.

Originality/value

The main contribution of this manuscript is the quantification of the loss expected by lenders and its impact in the spread. Due to this fact, the loan spread can be disaggregated into a component dependent on the credit risk associated with the borrower, and another component dependent on the interest rate risk to which the lender is exposed.
Inside-out: the forgotten side of ICT-enabled open innovation
Authors: Aloini Davide , Lazzarotti Valentina , Pellegrini Luisa , Zerbino Pierluigi
Published: November 2019

Purpose

The role of information and communication technologies (ICTs) and digital platforms in enabling connectivity and collaboration among actors is neglected when dealing with outbound open innovation (OI). Moreover, the outbound OI process is not currently defined in a univocal way. Thus, this paper aims to outline the outbound OI phases and to explore role and capabilities of ICTs in supporting it.

Design/methodology/approach

Through a literature review approach, the authors specified the outbound OI process. Hence, the authors leveraged the similarities between the knowledge management process phases and the outbound OI phases for developing a conceptual framework that could match the outbound OI phases with acknowledged categories of ICT tools.

Findings

Through a process-view, the authors outlined outbound OI as a three-phase process. The authors developed a matrix-shaped framework in which the columns represent the three outbound OI process phases, while the rows are three ICT categories that could be suitable for supporting the outbound OI process.

Practical implications

The framework is designed to guide a deep understanding of how ICTs could support specific phases of the outbound OI process. In so doing, it could be useful for software developers interested in the preliminary design of an ICT platform for outbound OI.

Originality/value

The conceptual framework proposal as follows: specifies a detailed, process-oriented definition of the outbound OI; allows to identify the main ICT categories supporting the phases of the outbound OI process; and provides guidance for further exploration about the role of ICT in outbound OI.
Comparing global spatial patterns of crime
Authors: Boivin Rémi , de Melo Silas Nogueira
Published: November 2019

Purpose

The purpose of this paper is to analyze the spatial patterns of different phenomena in the same geographical space. Andresen’s spatial point pattern test computes a global index (the S-index) that informs on the similarity or dissimilarity of spatial patterns. This paper suggests a generalized S-index that allows perfect similarity and dissimilarity in all situations.

Design/methodology/approach

The relevance of the generalized S-index is illustrated with police data from the San Francisco Police Department. In all cases, the original S-index, its robust version – which excludes zero-crime areas – and the generalized alternative were computed.

Findings

In the first example, the number of crimes greatly exceeds the number of areas and there are no zero-value areas. A key feature of the second example is that most street segments were free of any criminal activity in both patterns. Finally, in the third case, one type of event is considerably rarer than the other. The original S-index is equal to the generalized index (Case 1) or theoretically irrelevant (Cases 2 and 3). Furthermore, the robust index is unnecessary and potentially biased when the number of at least one phenomenon being compared is lower than the number of areas under study. Thus, this study suggests to replace the S-index with its generalized version.

Originality/value

The generalized S-index is relevant for situations when events are relatively rare –as is the case with crime – and the unit of analysis is small but plentiful – such as addresses or street segments.
Labour flexibility practices in Dutch SMEs
Authors: De Leede Jan , Drupsteen Linda , Schrijver Esther , Goudswaard Anneke , Dağ Nihat , Van der Weide Joost , Verbiest Sarike
Published: November 2019

Purpose

The purpose of this paper is to understand how small and medium enterprises (SMEs) cope with the need for labour flexibility. Most previous studies ignore the labour flexibility practices of SMEs, especially in times of economic growth and tight labour markets.

Design/methodology/approach

A multiple case study approach is applied, with ten Dutch SMEs located in one small province with a similar labour market. A survey was executed as an intake, followed by 48 interviews with the entrepreneurs, HR and other managers and employees, and two focus groups in each company. The findings are based on an analysis of the approved case descriptions.

Findings

SMEs, like big companies, do not rely on one flexibility practice. Volume fluctuations are countered with all flexibility strategies, the mix fluctuations and the product innovations are mostly countered with flexible functions and flexible production technology. In general, the data suggest that flexibility strategies of SMEs can be characterised as ad hoc, reactive and with a short-term orientation.

Research limitations/implications

Future research should include other sectors and regions enabling to generalise the findings. Future research should have a longitudinal design to include the pathway dependencies of flexibility practices.

Practical implications

This study identifies the need to analyse flexibility demands; reduce flexibility demands before investments in flexibility practices; create production process flexibility; invest in labour flexibility practices only after the first three steps are taken; and develop basic and more advanced levels of flexible contracts, flexible functions and flexible working times.

Originality/value

This study contributes to the authors’ knowledge on the use of labour flexibility practices in SMEs. In addition, it brings empirical data on how these labour flexibility practices relate to the needs for flexibility and how they relate to other sources of organisational flexibility, such as a flexible market approach and flexible production technologies. Dynamic capabilities should include the suggested operationalisation of the flexibility practices.
Upcoming diagnostic biomarkers with promising prospects in neurological disorders
Authors: Ahmad Wasim , Ali Abuzer , Ali Amena , Khan Sana , Khan Saba , Husain Ibraheem
Published: November 2019

An exponential increase in the prevalence of neurological disorders requires substantial steps to be taken for their prevention and treatment. Neurodiagnostic biomarkers are gaining momentum presently in order to enhance the diagnostic accuracy of neurodegenerative disorders, to precisely assess their advancement and to monitor the efficiency of therapeutic interventions. Therefore, the primary focus of the present review is the recent development in this field of neurodiagnostic biomarkers, and the current state of biomarker exploration in the context of various neurodegenerative diseases. This review encompasses an updated and detailed account of specific (β‐Amyloid, Tau and Phospho‐tau 181, Tar‐DNA binding protein‐43, Progranulin, a‐synuclein, Clusterin, etc) and non‐specific (genetic, synaptic, inflammatory and coagulation) neurodiagnostic biomarkers and the recent advances in this growing field. This comprehensive review also suggests the utilization of neurodiagnostic markers in network approaches and personalized medication that will eventually improvise the existing diagnostic and therapeutic complexities of neurodiagnostic biomarkers.
Epochs of Embodiment: Men, Women and the Material Body
Authors: Harvey Karen
Published: November 2019

Using middling‐sort letters dating from 1726 to 1827, this article explores individuals' physical, affective, mental and spiritual experiences and their understanding of the relationship between mind, body and self. The everyday and metaphorical language used in these letters gives the historian arguably more authentic evidence about the complexity of embodiment – a person's perception or experience of the body – than do works of medicine or philosophy. Gender was not found to be a principal factor in determining individuals' sense of embodiment; instead, correspondents' relationship, religion and life stage were key to how they discussed their experience of the body.
Ferulago angulata extract ameliorates epididymal sperm toxicity in mice induced by lead and diazinon
Authors: Naderi Nushin , Souri Manouchehr , Nasr Esfahani Mohammad Hossein , Hajian Mehdi , Tanhaei Vash Nima
Published: November 2019

Background

The potential toxicity that results from environmental xenobiotics is not completely known. Increasing levels of heavy metals and the use of organophosphate pesticides (OPs) and their co‐existence in the environment could be associated with an increasing incidence of male reproductive system disorders in humans and animals. Ferulago angulata is a dietary source of phenolic compounds with reported health benefits.

Objective

This study was conducted to investigate whether an extract of Ferulago angulata could protect adult male NMRI mice against reproductive toxicity induced by lead acetate (PbAc), diazinon (DZN), or PbAc + DZN.

Materials and methods

Adult male NMRI mice were exposed to either 0.5% PbAc in drinking water, DZN (3 mg/kg/day, intraperitoneal [i.p.] injection), or PbAc + DZN in the presence or absence of 400 mg/kg/day Ferulago angulata hydroalcoholic extract (FAE) that was administered via gavage for 6 weeks.

Results

Chronic exposure to PbAc, DZN, and PbAc + DZN decreased sperm quality, sperm chromatin maturity and integrity, increased oxidative stress and lipid peroxidation, and could reduce male fertility indices. Co‐administration of FAE could reduce these negative effects.

Conclusion

The Ferulago angulata extract should be considered as a useful natural extract for the treatment of male infertility, especially in males exposed to conditions which induce reproductive toxicity.
Declining early mortality after hip and knee arthroplasty
Authors: Harris Ian A. , Hatton Alesha , de Steiger Richard , Lewis Peter , Graves Stephen
Published: November 2019

Background

We aimed to measure the period effect (change over time) in 30‐day mortality after total hip arthroplasty (THA) and total knee arthroplasty (TKA) using data from the Australian Orthopaedic Association National Joint Replacement Registry.

Methods

We performed an observational study using national registry data from all hospitals performing THA and TKA in Australia including people undergoing primary elective conventional THA and TKA for osteoarthritis from 2003 to 2017, inclusive. Data from the Australian Orthopaedic Association National Joint Replacement Registry, the National Death Index and the Australian Bureau of Statistics were used to generate unadjusted 30‐day mortality, the incident rate ratio for mortality adjusted for age and gender, and the standardized mortality ratio at 30 days for each year separately.

Results

For the years 2003 and 2017, respectively, for THA, the unadjusted 30‐day mortality was 0.23% and 0.06%, and the standardized mortality ratio was 1.11 (95% CI: 0.73, 1.49) and 0.38 (95% CI: 0.16, 0.59). The incident rate ratio was significantly higher than the reference year (2017) from 2003 to 2010, and for 2012, 2013 and 2016, decreasing over time. For the years 2003 and 2017, respectively, for TKA, the unadjusted 30‐day mortality was 0.17% and 0.08%, and the standardized mortality ratio was 0.84 (95% CI: 0.55, 1.13) and 0.61 (95% CI: 0.38, 0.83). The incident rate ratio was significantly higher than the reference year (2017) from 2003 to 2009 inclusive, decreasing over time.

Conclusions

Thirty‐day mortality after THA and TKA declined from 2003 to 2017. This may be due to improvements in intra‐operative and post‐operative patient management.
Does green tea extract enhance the anti‐inflammatory effects of exercise on fat loss?
Authors: Bagheri Reza , Rashidlamir Amir , Ashtary‐Larky Damoon , Wong Alexei , Alipour Meysam , Motevalli Mohamad S. , Chebbi Amel , Laher Ismail , Zouhal Hassane
Published: November 2019

Aims

Green tea extract (GTE) can exert antiobesity and anti‐inflammatory effects. Our study determined whether the benefits of GTE are summative with exercise‐induced changes in anthropometric indices, and the levels of inflammatory cytokines, adiponectin and irisin in inactive overweight women.

Methods

Thirty overweight female participants were randomized to 3 groups: endurance training + placebo (ET + P); endurance training + GTE (ET + GTE); and Control (no exercise) + placebo (Control, n = 10). The exercise intervention consisted of an 8‐week endurance‐training programme of 3 sessions per week (aerobics, aerobic circuit training, and fast walking or jogging at a moderate intensity of 40–59% of the heart rate reserve). The dose of GTE used was 500 mg/day in the form of a green tea capsule.

Results

Body weight, body mass index, waist to hip ratio and body fat percentage were decreased in both ET + P and ET + GTE interventions (P < .001 for both interventions). The reduction of anthropometric values in the ET + GTE group was significantly higher than ET + P interventions (P < .001). Both exercise interventions also significantly (P < .001) increased adiponectin (ET + GTE = 5.28 mg/mL [95% confidence interval {CI}, 4.48 to 6.08] and ET + P = 3.34 mg/mL [95% CI, 2.76 to 3.92]) and decreased high‐sensitivity C‐reactive protein (hs‐CRP; ET + GTE = −0.95 mg/L [95% CI, −1.15 to −0.75] and ET + P = −0.35 mg/L [95% CI, −0.46 to −0.24]). Changes in adiponectin and hs‐CRP were greater (P < .05) in ET + GTE compared to ET + P. There were no significant differences in irisin, interleukin‐6 or tumour necrosis factor‐α between the 3 groups (P > .05).

Conclusions

GTE improves exercise‐induced body composition by further decreasing exercise‐induced changes in weight, body mass index, waist to hip ratio and body fat percentage. The combination of GTE and exercise also produced greater changes in anti‐inflammatory (increases in adiponectin) and metabolic (decreases in hs‐CRP) markers than exercise alone.
Gamabufotalin induces a negative feedback loop connecting ATP1A3 expression and the AQP4 pathway to promote temozolomide sensitivity in glioblastoma cells by targeting the amino acid Thr794
Authors: Lan Yu‐Long , Chen Cheng , Wang Xun , Lou Jia‐Cheng , Xing Jin‐Shan , Zou Shuang , Hu Ji‐Liang , Lyu Wen , Zhang Bo
Published: November 2019

Objectives

Temozolomide (TMZ) is one of the most commonly used clinical drugs for glioblastoma (GBM) treatment, but its drug sensitivity needs to be improved. Gamabufotalin (CS‐6), the primary component of the traditional Chinese medicine “ChanSu,” was shown to have strong anti‐cancer activity. However, more efforts should be directed towards reducing its toxicity or effective treatment doses.

Methods

Target fishing experiment, Western blotting, PCR, confocal immunofluorescence and molecular cloning techniques were performed to search for possible downstream signalling pathways. In addition, GBM xenografts were used to further determine the potential molecular mechanisms of the synergistic effects of CS‐6 and TMZ in vivo.

Results

Mechanistic research revealed a negative feedback loop between ATP1A3 and AQP4 through which CS‐6 inhibited GBM growth and mediated the synergistic treatment effect of CS‐6 and TMZ. In addition, by mutating potential amino acid residues of ATP1A3, which were predicted by modelling and docking to interact with CS‐6, we demonstrated that abrogating hydrogen bonding of the amino acid Thr794 interferes with the activation of ATP1A3 by CS‐6 and that the Thr794Ala mutation directly affects the synergistic treatment efficacy of CS‐6 and TMZ.

Conclusions

As the main potential target of CS‐6, ATP1A3 activation critically depends on the hydrogen bonding of Thr794 with CS‐6. The combination of CS‐6 and TMZ could significantly reduce the therapeutic doses and promote the anti‐cancer efficacy of CS‐6/TMZ monotherapy.
Molecular and morphological characterization of Ektaphelenchoides maafiae n. sp. (Nematoda: Ektaphelenchinae) from northern forests of Iran
Authors: Golhasan Behrouz , Esmaeili Mehrab , Fang Yiwu , Abolafia Joaquín , Heydari Ramin
Published: November 2019

Ektaphelenchoides maafiae n. sp. was isolated during a survey of nematodes associated with bark samples of an oak tree (Quercus castaneifolia) in Gorgan, Golestan Province, northern Iran. The new species has a body length of 480–546 μm (in females) and 431–480 μm (in males). The cuticle is weakly annulated, with three lateral lines. Lip region offset. The stylet is 13–15 μm long without basal swellings. The excretory pore is located at the level of the metacorpus base to slightly posterior, and hemizonid is at 15–17 μm posterior to the excretory pore. The post‐uterine sac is short, 6–8 μm long. Spicules having rounded condylus, rostrum short, conical with bluntly pointed tip, a cucullus (apophysis) presented on the dorsal distal end. Male tail bearing four (2 + 2) caudal papillae, conical, with sharply pointed terminus. The new species is close to four known species of the genus, including E. hunti, E. ruehmi, E. caspiensis and E. poinari, but differs from them by body size, shape of tail terminus, stylet length, shape and size of spicules, length of post‐vulval uterine sac and number of caudal papillae. Phylogenetic analysis based on small subunit (SSU) and partial large subunit (LSU) sequences of rDNA confirmed its status as a new species.
Wild chimeras: Enthusiasm and intellectual virtue in Kant
Authors: Thomason Krista K.
Published: November 2019

Kant typically is not identified with the tradition of virtue epistemology. Although he may not be a virtue epistemologist in a strict sense, I suggest that intellectual virtues and vices play a key role in his epistemology. Specifically, Kant identifies a serious intellectual vice that threatens to undermine reason, namely enthusiasm (Schwärmerei). Enthusiasts become so enamored with their own thinking that they refuse to subject reason to self‐critique. The particular danger of enthusiasm is that reason colludes in its own destruction: Enthusiasm occurs when self‐conceit and reason's desire to transcend its boundaries mutually reinforce each other. I conclude by sketching an account of Kantian intellectual virtue that is consistent with Kantian moral virtue.
Migratory divides coincide with reproductive barriers across replicated avian hybrid zones above the Tibetan Plateau
Authors: Scordato Elizabeth S. C. , Smith Chris C. R. , Semenov Georgy A. , Liu Yu , Wilkins Matthew R. , Liang Wei , Rubtsov Alexander , Sundev Gomboobaatar , Koyama Kazuo , Turbek Sheela P. , Wunder Michael B. , Stricker Craig A. , Safran Rebecca J.
Published: November 2019

Migratory divides are proposed to be catalysts for speciation across a diversity of taxa. However, it is difficult to test the relative contributions of migratory behaviour vs. other divergent traits to reproductive isolation. Comparing hybrid zones with and without migratory divides offers a rare opportunity to directly examine the contribution of divergent migratory behaviour to reproductive barriers. We show that across replicate sampling transects of two pairs of barn swallow (Hirundo rustica) subspecies, strong reproductive isolation coincided with a migratory divide spanning 20 degrees of latitude. A third subspecies pair exhibited no evidence for a migratory divide and hybridised extensively. Within migratory divides, overwintering habitats were associated with assortative mating, implicating a central contribution of divergent migratory behaviour to reproductive barriers. The remarkable geographic coincidence between migratory divides and genetic breaks supports a long‐standing hypothesis that the Tibetan Plateau is a substantial barrier contributing to the diversity of Siberian avifauna.
The probability of seizures during continuous EEG monitoring in high‐risk neonates
Authors: Worden Lila T. , Chinappen Dhinakaran M. , Stoyell Sally M. , Gold Jacquelyn , Paixao Luis , Krishnamoorthy Kalpathy , Kramer Mark A. , Westover Michael B. , Chu Catherine J.
Published: November 2019

Objective

We evaluated the impact of monitoring indication, early electroencephalography (EEG), and clinical features on seizure risk in all neonates undergoing continuous EEG (cEEG) monitoring following a standardized monitoring protocol.

Methods

All cEEGs from unique neonates 34‐48 weeks postmenstrual age monitored from 1/2011‐10/2017 (n = 291) were included. We evaluated the impact of cEEG monitoring indication (acute neonatal encephalopathy [ANE], suspicious clinical events [SCEs], or other high‐risk conditions [OHRs]), age, medication status, and early EEG abnormalities (including the presence of epileptiform discharges and abnormal background continuity, amplitude, asymmetry, asynchrony, excessive sharp transients, and burst suppression) on time to first seizure and overall seizure risk using Kaplan‐Meier survival curves and multivariable Cox proportional hazards models.

Results

Seizures occurred in 28% of high‐risk neonates. Discontinuation of monitoring after 24 hours of seizure‐freedom would have missed 8.5% of neonates with seizures. Overall seizure risk was lower in neonates monitored for ANE compared to OHR (P = .004) and trended lower compared to SCE (P = .097). The time course of seizure presentation varied by group, where the probability of future seizure was less than 1% after 17 hours of seizure‐free monitoring in the SCE group, but required 42 hours in the OHR group, and 73 hours in the ANE group. The presence of early epileptiform discharges increased seizure risk in each group (ANE: adjusted hazard ratio [aHR] 4.32, 95% confidence interval [CI] 1.23‐15.13, P = .022; SCE: aHR 10.95, 95% CI 4.77‐25.14, P < 1e‐07; OHR: aHR 56.90, 95% CI 10.32‐313.72, P < 1e‐05).

Significance

Neonates who undergo cEEG are at high risk for seizures, and risk varies by monitoring indication and early EEG findings. Seizures are captured in nearly all neonates undergoing monitoring for SCE within 24 hours of cEEG monitoring. Neonates monitored for OHR and ANE can present with delayed seizures and require longer durations of monitoring. Early epileptiform discharges are the best early EEG feature to predict seizure risk.
Nationwide survey on activities of regional core centers for the management of liver disease in Japan: Cumulative analyses by the Hepatitis Information Center 2009–2017
Authors: Setoyama Hiroko , Korenaga Masaaki , Kitayama Yuko , Oza Noriko , Masaki Naohiko , Kanto Tatsuya
Published: November 2019

Aim

Regional core centers for the management of liver disease, which are located in every prefecture in Japan, not only take the lead in hepatitis care in their respective regions, but also serve a wide range of other functions, such as education, promotion of hepatitis testing, treatment, and research.

Method

Since fiscal year 2010, the Hepatitis Information Center has conducted surveys of regional core centers throughout Japan regarding information about their facilities, programs for patient support, training, and education of medical personnel.

Results

By compiling and analyzing the results of these surveys, we have elucidated the status of regional core centers and the issues they currently have. We found that regional core centers have come to play widely varied roles in hepatitis treatment and have expanded their programs. These surveys also suggest that uniform accessibility of hepatitis treatment has been implemented throughout Japan.

Conclusion

To continue serving their diverse roles, regional core centers require further development of hepatitis care networks that include specialized institutions, primary care physicians, and local and central governments; as well as collaboration with other professions and groups.
The impact of an adult intellectual disability screening questionnaire on service providers and users
Authors: McKenzie Karen , Murray George , Murray Aja , Martin Rachel
Published: November 2019

Background

One contributor to the health inequalities that people with an intellectual disability face is failure to identify their intellectual disability. The Learning Disability Screening Questionnaire (LDSQ) can identify adults who are likely to have an intellectual disability, but little is known about its impact.

Methods

A modified Delphi approach (literature search, interviews with staff and those using services [n = 28], and completion of an online survey by professionals [n = 29]) was used to develop a framework to evaluate the impact of the LDSQ.

Results

Items endorsed by 60% or more of respondents (9/18) were included in the final framework. These all related to benefits of the LDSQ, including identifying people not previously known to have an intellectual disability; helping prioritize diagnostic assessment; informing support needs; and helping increase wellbeing and life chances.

Conclusion

The LDSQ may offer one way of helping address the health inequalities that people with an intellectual disability face.
Egg load is a cue for offspring sex ratio adjustment in a fig‐pollinating wasp with male‐eggs‐first sex allocation
Authors: Zhang Xiao‐Wei , Dunn Derek W. , Wang Rui Wu
Published: November 2019

Fig‐pollinating wasps (Agaonidae) only reproduce within fig tree inflorescences (figs). Agaonid offspring sex ratios are usually female‐biased and often concur with local mate competition theory (LMC). LMC predicts less female‐bias when several foundresses reproduce in a fig due to reduced relatedness among intra‐sexually competing male offspring. Clutch size, the offspring produced by each foundress, is a strong predictor of agaonid sex ratios and correlates negatively with foundress number. However, clutch size variation can result from several processes including egg load (eggs within a foundress), competition among foundresses and oviposition site limitation, each of which can be used as a sex allocation cue. We introduced into individual Ficus racemosa figs single Ceratosolen fusciceps foundresses and allowed each to oviposit from zero to five hours thus variably reducing their eggs‐loads and then introduced each wasp individually into a second fig. Offspring sex ratio (proportion males) in second figs correlated negatively with clutch size, with males produced even in very small clutches. Ceratosolen fusciceps lay mainly male eggs first and then female eggs. Our results demonstrate that foundresses do not generally lay or attempt to lay a ‘fixed’ number of males, but do ‘reset to zero’ their sex allocation strategy on entering a second fig. With decreasing clutch size, gall failure increased, probably due to reduced pollen. We conclude that C. fusciceps foundresses can use their own egg loads as a cue to facultatively adjust their offspring sex ratios and that foundresses may also produce more ‘insurance’ males when they can predict increasing rates of offspring mortality.