bluuebunny/crossref_metadata_2025 huggingface dataset:
The new fossil lacewings of Grammolingiidae (Neuroptera) from the Jurassic of Central Asia and Mongolia, with notes on biogeography of the family
Authors: KHRAMOV ALEXANDER V.
Published: January 2020

A new genus and three new species of the family Grammolingiidae are described: Protolingia mira gen. et sp. nov. andLitholingia longa sp. nov. from the Sai-Sagul locality (Kyrgyzstan, upper Lower Jurassic–lower Middle Jurassic) and Lep-tolingia oblonga sp. nov. from the Houtiyn-Hotgor locality (Mongolia, Upper Jurassic). Grammolingiidae are recordedfrom the Karatau locality (Kazakhstan, Upper Jurassic). This fossil lacewing family occurred in the South of Central Asiaand in East Asia during the Middle and Upper Jurassic; its distribution was limited by Mongol-Okhotsk and Turgai seas.Grammolingiidae from Sai-Sagul is the oldest record of this family. They demonstrate unusual characteristics for the family, such as the pectinate CuP and the distal fusion of Sc and R1.
Review of the New Caledonian species of Paroxyethira Mosely, 1924 (Trichoptera: Hydroptilidae)
Authors: WELLS A. , JOHANSON K. A.
Published: January 2020

New Caledonian representation of the New Zealand-New Caledonian hydroptilid caddisfly genus Paroxyethira Mosely, 1924, is reviewed on the basis of a considerable collection from widespread New Caledonian localities. Description of 8 new species brings to 10 the known fauna for the island. Males of all New Caledonian species are illustrated, a key to adult males is provided, and the associated females are described for 6 species.
Descriptions of five new species of the genus Rhopobota Lederer (Lepidoptera, Tortricidae) in China, along with a checklist of all the described Chinese species
Authors: ZHANG AIHUAN , LI HOUHUN
Published: January 2020

Five new species of the genus Rhopobota are described from China: R. baoxingensis, sp. nov., R. biloba, sp. nov., R.hamata, sp. nov., R. zhengi, sp. nov. and R. latispina, sp. nov. Photographs of adults and genitalia are given, along with a checklist of all the known Chinese species.
The genus Afrasura Durante, 2009 in Gabon, with description of five new species and a new species group (Erebidae: Arctiinae: Lithosiini)
Authors: DURANTE ANTONIO
Published: January 2020

The author presents the first work on two surveys in the National Park of Ivindo in Gabon. He examines the genusAfrasura Durante, 2009, describes the female of A. emma Durante, 2009, and five new species: A. trunca sp. n., A. camillasp. n., A. duplex sp. n., A. aetheria sp. n., A. fracta sp. n., of which the last four belong to the newly proposed A. submarmorata species group.
A new species of the genus Lithostege (Geometridae: Larentiinae) from China
Authors: SH. HOSSEIN RAJAEI , XUE DAYONG
Published: January 2020

Lithostege Hübner [1825] 1816, is a widely distributed and species-rich genus, reported from nearly all continents except Australia, but with the main focus of distribution in the Palaearctic region (African species are only known from the Palaearctic northern areas). Parsons et al. (1999) listed 49 species and 8 subspecies. The updated list of Geometridae of the World (Scoble & Hausmann 2007) mentioned 50 species worldwide, 39 of them with Palaearctic origin. In a recent paper (Lehmann 2011) and a review of Lithostege from the Middle East (Rajaei et al. 2011), two new species from Iran and one from Pakistan have been added. In addition, one species has been synonymized and a subspecies was upgraded to species rank, which did not change the total number of 53 known species.
A review of the genus Dasypolia Guenée, 1852 from the Russian part of the Altai Mountain Country, with descriptions of two new species (Lepidoptera, Noctuidae)
Authors: VOLYNKIN ANTON V.
Published: January 2020

Five species of the genus Dasypolia Guenée, 1852 from Russian Altai are reviewed. Two new species, D. maria sp.n. andD. bubnovae sp.n. are described. The status for D. lama Staudinger, 1896 stat. rev. is revised. Differential diagnosis andredescription of the little known species D. tuektiensis Zolotarenko, 1993 are presented. The adults, male and female genitalia of all Altaian and related species are illustrated.
New Griphophanes Grootaert & Meuffels (Diptera, Dolichopodidae, Peloropeodinae) from Southeast Asia
Authors: GROOTAERT PATRICK , MEUFFELS HENK
Published: January 2020

Five species of Griphophanes Grootaert & Meuffels are reported from Malaysia. The type species, Griphophanes grav-icaudatus (Grootaert & Meuffels) originally described from South Thailand is recorded from North Malaysia (Langkawi)as well as from South Malaysia. Three species are described from Endau Rompin National Park: G. furcatulus sp. nov.,G. furcatus sp. nov. and G. obscurus sp. nov. Griphophanes tiomanensis sp. nov. is described from the island of Pulau Tioman. A key to the species of Southeast Asia is given.
A new Mediterranean species of Dolistenus (Diplopoda, Platydesmida, Andrognathidae), with an updated key for the genus and the first contribution for a barcode database of European Platydesmida
Authors: RECUERO ERNESTO , RODRÍGUEZ-FLORES PAULA C.
Published: January 2020

Dolistenus Fanzago, 1874 is a widespread Mediterranean millipede genus of the order Platydesmida, currently including three valid species, each with relict distributions. Here we describe a fourth species of Dolistenus, and characterize it using morphological and molecular (mitochondrial DNA) characters. We provide an updated key to the species of Dolistenus and the first COI barcode sequences for the new species and several other European representatives of the Andrognathidae (Platydesmida).
Taxonomic notes on Amaurobius (Araneae: Amaurobiidae), including the description of a new species
Authors: MARUSIK YURI M. , OTTO S. , JAPOSHVILI G.
Published: January 2020

A new species, Amaurobius caucasicus sp. n., is described based on the holotype male and two male paratypes from Eastern Georgia. A similar species, A. hercegovinensis Kulczyński, 1915, known only from the original description is redescribed. The taxonomic status of Amaurobius species considered as nomina dubia and species described outside the Holarctic are also assessed. Amaurobius koponeni Marusik, Ballarin & Omelko, 2012, syn. n. described from northern India is a junior synonym of A. jugorum L. Koch, 1868 and Amaurobius yanoianus Nakatsudi, 1943, syn. n. described from Micronesia is synonymised with the titanoecid species Pandava laminata (Thorell, 1878) a species known from Eastern Africa to Polynesia. Considerable size variation in A. antipovae Marusik et Kovblyuk, 2004 is briefly discussed.
Changes of Notch-1 Expression in Sinoatrial Node Fat Pad of Canines with Chronic Atrial Fibrillation
Authors: Juan Sun , Kun Wang , Mahemuti Ailiman
Published: January 2020

Objective: To investigate the changes of Notch-1 protein expression and the changes of Notch-1 and NICD contents in the sinoatrial node fat pad (SAN-FP) nerve plexus of canines with chronic atrial fibrillation in which atrial fibrillation of the left atrium was induced in chronic
pacing canines, in order to elucidate the relationship between the Notch signaling pathway of the SAN-FP nerve plexus and the occurrence and development of atrial fibrillation. Methods: Healthy Beagle dogs weighing 18 ± 2.66 kg, aged 7 to 9 years were randomly divided into a
sham operation (SO) group (n = 5) and an atrial fibrillation (AF) group (n = 5), respectively. Results: Atrial fibrillation was successfully induced in canines in the AF group by rapid pacing on the left atrium appendage. The scattered nerve plexus was observed in fat
cells of the SAN-FP. In contrast with the SO group, Notch-1 protein expression in the AF group was significantly increased (P < 0.05). No significantly statistical differences were observed in the concentration of Notch-1 and NICD between the AF group and the SO group (P >
0.05). In addition, no statistical differences in baseline Notch-1 and NICD concentrations were observed between the AF group and the SO group (P > 0.05). After an 8-week study, the concentrations of Notch-1 and NICD in the AF group were significantly increased compared with the
SO group (P < 0.05). Conclusion: During the occurrence and development of AF, Notch-1 was expressed in different phases in the SAN-FP nerve plexus. After combining with ligands, Notch-1 was activated as NICD to affect the downstream target genes.
Bone Marrow Mesenchymal Stem Cell-Derived Exosomes Improve Osteoporosis by Inhibiting Osteoblasts Apoptosis
Authors: Liu Wei , Zhang Bin , Xiao Yan , Liu Qiang , Yan Zhiqiang , Li Bei , Huang Ruiliang , Ou Guangpeng , Deng Songyun , Xu Shaoyong
Published: January 2020

Osteoporosis (OP) is a metabolic bone disease which is characterized by loss of bone mineral content, decreased bone density, destruction of bone microstructure, and declined bone biomechanical evaluation index. In recent years, it was shown that bone marrow mesenchymal stem cells (MSCs)
are involved in the form of exosomes, which has become a hot spot in the research of the pathogenesis of metabolic diseases. In this study, we intend to explore the effects of exosomes derived from MSCs on osteoblast apoptosis and OP. MSC-derived exosomes were obtained by ultracentrifugation
and characterized by transmission electron microscopy (TEM). Exosomes were used to treat osteoblasts to observe cell apoptosis. The expression of apoptosis-related protein was detected by Western blot. Cell viability was examined by MTT assay. Cell apoptosis was assessed by TUNEL staining.
TEM confirmed successfully extracted MSCs-derived exosomes. Exosomes intervention significantly reduced the expression of apoptosis-related pro-apoptotic proteins cytochrome c and caspase3, enhanced cell viability, and attenuated cell apoptosis in osteoblasts. MSCs-derived exosomes can inhibit
osteoblasts apoptosis by suppressing apoptosis signaling pathways, thus improving osteoporosis, indicating that they might be used for the treatment of osteoporosis.
Modernity and ‘publicness’: The career of the Mysore matha, 1880–1940
Authors: Nair Janaki
Published: January 2020

Fin de siècle Mysore witnessed the gathering force of interminable rivalries of prestige between mathas (monastic institutions). Contests over the types and number of honours enjoyed by travelling gurus in Mysore became frequent, reaching a crescendo in the late nineteenth and early twentieth centuries. By this time, the contests were also being adjudicated in courts, as the Mysore administration began to exert greater bureaucratic control over these institutions. The widening sphere of engagements of the modernising matha reveals that a new notion of publicness was taking shape, co-constituted by a triangulation of forces: on one side was the rapidly bureaucratising Mysore state which brought a different visibility and public accountability to the matha; a second side comprised the matha itself developing a new, socially purposive public life. Finally, the matha’s redefinition was aided and shaped by the adherents of the matha, emerging as a ‘public’ which both drew on and remained at a remove from its caste identity. This period of reform had enduring consequences, as the Mysore matha took on a supplementary state form after Indian Independence in 1947.
Long-distance trade in ancient India: Evidence from Kauṭilya’s Arthaśāstra
Authors: Olivelle Patrick
Published: January 2020

Much of the significant data for long-distance and maritime trade across South Asia in the ancient period comes from archaeological sources. Nevertheless, textual sources too have some significant things to say about material culture and trade in the ancient world. In a special way, texts give insights into what people thought about trans-regional trade, the globalisation of the ancient world, both the good and the bad that came with it, insights that cannot be culled solely from archaeological data. This article’s focus is on the Arthaśāstra, which Kauṭilya wrote around middle of the first century ce, drawing on sources that predate him by a century or more. The Arthaśāstra does not have a separate section on trade, but trade data are scattered over at least four areas: (a) the treasury and its need for luxury goods: pearls, gems, diamonds, coral, sandalwood, aloe, incense, skins and furs, and cloth; (b) military needs: horses and elephants; (c) developing and guarding land and water routes and shipping; and (d) duties and taxes on imported goods. Significant data on trade are also provided in Kauṭilya’s discussion of trade routes and their protection, as well as data on duties and taxes on imported goods.
Britain’s religion and belief landscape
Authors: Rodell Jeremy
Published: January 2020

An overview of the scale and multi-dimensional nature of the current change in British religious belief, belonging and identity with a concluding reflection from a humanist perspective.
Elastic-plastic analysis and riveting energy control for dual-robot pneumatic riveting system
Authors: Cheng Liang , Huan Honglun , Ke Yinglin
Published: January 2020

To ensure the riveting quality and avoid riveting defects such as overdriven head or underdriven head, elastic and plastic mechanical analysis of the riveting process has been studied and a riveting energy control method is proposed in this paper. According to the target size of the driven head, the material properties, and the interference, the total riveting energy is calculated. Then, the relation of riveting duration and riveting energy is established to realize the control of the riveting impact energy in practical engineering. Furthermore, plastic dynamic impact buckling of the rivet is also analyzed to get impact buckling critical speed. Due to the dual-robot posture adjustment and countersunk self-centering ability, the working axes of the riveting tools, rivet, and hole are found to be well coaxial. The analysis shows there is little phenomenon of rivet bending in the dual-robot pneumatic riveting system and the impact buckling critical speed is much higher than the piston impact speed. Finally, finite element model is built for riveting dynamic simulation and dual-robot pneumatic riveting cell for fuselage panel assembly is developed to obtain experimental results. The comparison shows the proposed method has a good performance. The research results enhance the knowledge of energy effect of dual-robot pneumatic riveting, and thus offer positive guidance for practical application in aircraft assembly.
Attitudes towards HPV self-sampling among women in Chengdu, China: A cross-sectional survey
Authors: He Lixia , He Junyong
Published: January 2020

Objective

Cervical cancer screening participation in China remains insufficient, possibly because of embarrassment or discomfort. We assessed knowledge of HPV and its link to cervical cancer, and whether HPV self-sampling might be an acceptable alternative to clinician-based screening, among Sichuan women.

Methods

A sample of healthy women undergoing routine physical examinations in 2017 at the West China Hospital, Sichuan University, completed a questionnaire.

Results

From 3000 questionnaires distributed, 1810 were completed and analyzed. Only 29.94% of respondents ( n = 542) had heard of HPV, among whom 65.75% knew that it caused cervical cancer. Among the 766 (42.32%) who considered that HPV self-sampling for cervical cancer screening was an acceptable option, over 90% thought it would be convenient, private, not embarrassing, and not painful. However, 1044 women (57.68%) did not consider self-sampling acceptable, mainly because the result might not be accurate (85.63%), specimens may have gone bad (83.05%), and they may not perform the test correctly (79.98%). Respondents who believed HPV self-sampling was acceptable were more likely than other respondents to be young, and to have completed at least secondary education. Of the 1810 respondents, 1312 (72.49%) reported that they would be willing to be vaccinated against HPV.

Conclusion

Most women in Chengdu lack basic knowledge about HPV. Over 40% of women believed HPV self-sampling for cervical cancer screening was an acceptable option. To increase screening coverage, public health efforts to educate the public about HPV and HPV self-sampling for cervical cancer screening should be strengthened and expanded.
The rise and fall of the progressive drag queen: Westernization of cross-dressing in 1990s Poland
Authors: Janion Ludmiła
Published: January 2020

The article studies the meanings of drag in the Polish media in the period 1989–2002. A textual analysis of mainstream as well as gay and lesbian media texts on drag queens was conducted to examine strategies that explained and legitimated drag in the context of the westernization of Polish culture, the socioeconomic changes of the 1990s, and the politics of respectability of the early Polish gay rights movement. The article shows that drag lacked the western political meanings that focused on gender performativity and gay rights; instead, it assumed connotations specific to the time and place. Drag queens turned out to embody the socioeconomic changes and widely shared class and geopolitical aspirations related to the 1990s westernization of Poland, but they also attested to the persisting distance between Poland and the imagined West. The article calls for critical attention when applying western theoretical concepts to the East.
Performance of prestressed concrete box bridge girders under hydrocarbon fire exposure
Authors: Song Chaojie , Zhang Gang , Hou Wei , He Shuanhai
Published: January 2020

This article presents an approach for investigating performance of prestressed concrete box bridge girders under hydrocarbon fire exposure. A three-dimensional nonlinear finite element model, developed in computer program ANSYS, is utilized to analyze the response of prestressed concrete box bridge girders under combined effects of fire exposure duration and simultaneous structural loading. The model validation is performed using a scaled prestressed concrete box girder exposed to ISO834 fire in furnace. Subsequently, the validated model is used to investigate fire performance of prestressed concrete box bridge girders through taking into consideration some variables, namely concrete cover thickness to prestressing strands, prestress degree, load level, fire exposure length, and position. Through a case study, results from numerical analysis show that concrete cover thickness to prestressing strands and load level has significant effect on fire resistance of prestressed concrete box bridge girders. Increasing prestress degree in prestressing strands can speed up the progression of deflection (sudden collapse) in prestressed concrete box bridge girder toward the final fire exposure stage. Reducing fire exposure length or preventing fire exposure on mid-span zone can highly enhance the fire resistance of simply supported prestressed concrete box bridge girders. Failure of prestressed concrete box bridge girder, under hydrocarbon fire exposure conditions, is governed by rate of deflection failure criterion in particular cases.
Diesel engine optimization and exhaust thermal management by means of variable valve train strategies
Authors: Arnau Francisco J , Martín Jaime , Pla Benjamín , Auñón Ángel
Published: January 2020

Due to the need to achieve a fast warm-up of the after-treatment system in order to fulfill the pollutant emission regulations, a growing interest has arisen to adopt variable valve timing technology for automotive engines. Several variable valve timing strategies can be used to achieve an increment in the after-treatment upstream temperature by increasing the residual gas amount. In this study, a one-dimensional gas dynamics engine model has been used to carry out a simulation study comparing several exhaust variable valve actuation strategies. A steady-state analysis has been done in order to evaluate the potential of the different strategies at different operating points. Finally, the effect on the after-treatment warm-up, fuel economy and pollutant emission levels was evaluated over the worldwide harmonized light vehicles test cycle. As a conclusion, the combination of an advanced exhaust (early exhaust valve opening and early exhaust valve closing) and a delayed intake (late intake valve opening and late intake valve closing) presented the best trade-off between exhaust temperature increment and fuel consumption, which achieved a mean temperature increment during low-speed phase of the worldwide harmonized light vehicles test cycle of 27 °C with a fuel penalty of 6%. The exhaust valve re-opening technique offers a worse trade-off. However, the exhaust valve re-opening leads to lower nitrogen oxide (29% less) and carbon monoxide (11% less) pollutant emissions.
Review of neuroimaging findings in congenital Zika virus syndrome and its relation to the time of infection
Authors: Radaelli Graciane , Lahorgue Nunes Magda , Bernardi Soder Ricardo , de Oliveira Júlia Monteiro , Thays Konat Bruzzo Fernanda , Kalil Neto Felipe , Leal-Conceição Eduardo , Wetters Portuguez Mirna , Costa da Costa Jaderson
Published: January 2020

Background

Many original articles and case series have been published emphasizing the neuroimaging findings of congenital Zika virus (ZIKV) infection. The majority of these studies do not follow a neuroradiological methodology to describe malformations and brain abnormalities resulting from ZIKV infection. The cause-and-effect correlation between the gestational period of maternal infection and the severity of encephalic changes at birth has rarely been reported. A systematic literature review was conducted on the neuroimaging findings in children affected with microcephaly due to ZIKV.

Methods

PubMed, Cochrane Library and Web of Science were searched for full-text articles published up to July 2019. Duplicate entries were removed. Two independent reviewers performed a quality assessment of all the studies included.

Results

A total of 2214 publications were identified. Of these 2170 were excluded by analysis of titles and abstracts, resulting in the inclusion of only eight articles. Chi-square and Fisher’s exact tests were performed with a 95% confidence interval to verify the statistically significant differences in the neuroradiological findings between the cases of ZIKV infection in the first or second trimester of gestation. The studies published so far have described image abnormalities at random, without utilizing any pre-established neuroradiological criteria, and imaging modalities with different sensitivity and accuracy have been used, which jeopardizes a reliable and adequate statistical analysis.

Conclusions

Neuroimaging abnormalities are much more prevalent and severe when the infection by ZIKV is contracted in the first or second trimester of pregnancy.
Predictors for the extent of pial collateral recruitment in acute ischemic stroke
Authors: Christoforidis Gregory A , Saadat Niloufar , Kontzialis Marinos , Karakasis Christopher J , Slivka Andrew P
Published: January 2020

Background

Pial arterioles can provide a variable degree of collateral flow to ischemic vascular territories during acute ischemic stroke. This study sought to identify predictive factors of the degree of pial collateral recruitment in acute ischemic stroke.

Methods

Clinical information and arteriograms from 62 consecutive patients with stroke due to either middle cerebral artery (MCA) M1 segment or internal carotid artery (ICA) terminus occlusion within 6 h following symptom onset were retrospectively reviewed. Pial collaterals were defined based on the extent of reconstitution of the MCA territory. Patients with slow antegrade flow distal to the occlusion site were excluded and no anesthetics were used prior or during angiography. Results were analyzed using multivariate nominal logistic regression.

Results

Better pial collateral recruitment was associated with proximal MCA versus ICA terminus occlusion ( p = 0.005; odds ratio (OR) = 9.3; 95% confidence interval (CI), 2.16–53.3), lower presenting National Institutes of Health Stroke Scale Score (NIHSSS) ( p = 0.023; OR = 6.51; 95% CI, 1.49–41.7), and lower diastolic blood pressure ( p = 0.0411; OR = 5.05; 95% CI, 1.20–29.2). Age, gender, symptom duration, diabetes, laterality, systolic blood pressure, glucose level, hematocrit, platelet level, and white blood cell count at presentation were not found to have a statistically significant association with pial collateral recruitment.

Conclusions

Extent of pial collateral recruitment is strongly associated with the occlusion site (MCA M1 segment versus ICA terminus) and less strongly associated with presenting NIHSSS and diastolic blood pressure.
Clinical Function Improves After Subacromial Injection of Local Anesthetic in Full-Thickness Rotator Cuff Tears: A Randomized Control Trial
Authors: Forsythe Brian , Agarwalla Avinesh , Puzzitiello Richard N. , Patel Bhavik H. , Lu Yining , Verma Nikhil N. , Romeo Anthony A. , Cole Brian J.
Published: January 2020

Background:

Rotator cuff pathology is the most common cause of shoulder pain in adults, accounting for nearly 70% of shoulder-related visits to clinicians. However, physical examination findings may be limited because of pain or patient inhibition.

Purpose:

To establish whether a relationship exists between pain, range of motion, and strength in patients with a full-thickness rotator cuff tear.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

A single-blind, randomized controlled study of 40 patients undergoing rotator cuff repair for full-thickness rotator cuff tears was performed. Patients were randomized to receive either a subacromial 10-mL 2% lidocaine injection or a sham injection, with no contents being injected into the subacromial space. Before the injection, patients were assessed using a visual analog scale for pain (VAS-Pain) as well as the Constant-Murley subjective questionnaire and objective physical examination. The examination was repeated 10 minutes after injection and 6 months postoperatively. VAS-Pain after injection was not assessed. The assessment at 6 months was performed to demonstrate improvement of rotator cuff function after operative management. Statistical analysis included Student t and chi-square tests as well as multivariate binomial logistic regression analyses to identify predictors for improvement after injection. Results were considered significant if P < .05.

Results:

Range of motion, strength, and Constant-Murley score significantly improved after a subacromial lidocaine injection ( P < .05). Range of motion, strength, Constant-Murley score, and VAS-Pain significantly improved at final follow-up compared with the preinjection assessment for both groups ( P < .05); however, there was no difference ( P > .05) between groups at 6 months postoperatively.

Conclusion:

After subacromial lidocaine injections, patients exhibited modest but significant improvements in range of motion, strength, and the Constant-Murley score. Pain may limit range of motion and strength in patients with full-thickness rotator cuff tears independent of the mechanical impact of the tear itself.

Registration:

NCT02693444 ( ClinicalTrials.gov identifier).
Virtual reality technology for teaching neurosurgery of skull base tumor
Authors: Shao Xuefei , Yuan Quan , Qian Daqing , Ye Zheng , Chen Gao , le Zhuang Kang , Jiang Xiaochun , Jin Yuelong , Qiang Di
Published: January 2020

Background

Neurosurgery represents one of the most challenging and delicate of any surgical procedure. Skull base tumors in particular oftentimes present as a very technically difficult procedures in the setting of neurosurgical teaching. Virtual reality technology is one of the most promising surgical planning tools. It can perform fast three-dimensional (3D) reconstruction of computed tomography (CT), magnetic resonance imaging (MRI) and other imaging data sets under conditions of virtual reality (VR). Surgical simulation can more intuitively understand the anatomical relationship of the surgical area in significantly greater detail.

Methods

Thirty clinical undergraduates from the class of 2016 were randomly divided into two groups: the traditional teaching group and the virtual reality teaching group. After the study concluded, the teaching effectiveness was evaluated by combining basic theoretical knowledge, case analysis and questionnaire survey methods.

Results

Comparative analysis between both groups showed the response effect of the virtual reality teaching group was better than that of the traditional teaching group (P < 0.05). There was also no difference between both groups in terms of the design of the surgical approach and the listing of surgical matters that required attention (P > 0.05).The results of theoretical knowledge assessment between both groups showed that the scores of basic theory, location, adjacent structure, clinical manifestation, diagnosis and analysis, surgical methods and total scores in the VR group exceeded those in the traditional teaching group (P < 0.05).

Conclusions

This study showed that VR technology might improve neurosurgical skull base teaching quality, which should be promoted in the teaching of clinical subjects.
Causes of misdiagnoses by thyroid fine-needle aspiration cytology (FNAC): our experience and a systematic review
Authors: Zhu Yanli , Song Yuntao , Xu Guohui , Fan Zhihui , Ren Wenhao
Published: January 2020

Objective

FNA is a simple, safe, cost-effective and accurate diagnostic tool for the initial screening of patients with thyroid nodules. The aims of this study were to determine the diagnostic utility of FNAC performed in our institution, assess the cytomorphologic features that contribute to diagnostic errors and propose improvement measures.

Methods

A total of 2781 FNACs were included in the study, and 1122 cases were compared with their histological diagnoses. We retrospectively reexamined our discordant (both false-negative and false-positive) cases and performed a systematic review of previous studies on causes of misdiagnoses.

Results

When DC V and DC VI were both considered cytologic-positive, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were 98.3, 30.9, 94.9, 58.3 and 93.5%, respectively. If DC VI was considered cytologic-positive, the sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC were 98.0, 84.0, 99.4, 58.3, and 97.5% respectively. The main cause of false-negative diagnoses was sampling error (13/15, 86.7%), while interpretation error led to the majority of the false-positive diagnoses (38/47, 80.9%). Overlapping cytological features in adenomatous hyperplasia, thyroiditis and cystic lesions were the major factors contributing to interpretation errors, while the size and number of nodules may have led to false-negative diagnoses because of heterogeneity and unsampled areas.

Conclusions

The sensitivity and PPV of thyroid FNAC in our institution were higher than those in the published data, while the specificity and NPV were lower. Regarding the FNA category DC V, a frozen section analysis during diagnostic lobectomy is necessary. Multiple passes should be performed in various parts of a large nodule or from different nodules to reduce the risk of false-negative findings. Cytopathologists should strengthen their criteria for the identification of adenomatous hyperplasia, thyroiditis and cystic lesions to avoid false-positive diagnoses. NIFTP has little effect on diagnostic accuracy and the distribution of diagnostic errors.
The challenges of living with and managing epidermolysis bullosa: insights from patients and caregivers
Authors: Bruckner Anna L. , Losow Michael , Wisk Jayson , Patel Nita , Reha Allen , Lagast Hjalmar , Gault Jamie , Gershkowitz Jayne , Kopelan Brett , Hund Michael , Murrell Dedee F.
Published: January 2020

Background

Little information is available regarding the burden of living with and managing epidermolysis bullosa, including the distinct challenges faced by patients with different disease types/subtypes.

Methods

A 90-question/item survey was developed to collect demographics, diagnostic data, management practices, and burden of illness information for patients with epidermolysis bullosa living in the United States. Recruitment was conducted via email and social media in partnership with epidermolysis bullosa patient advocacy organizations in the United States, and the survey was conducted via telephone interview by a third-party health research firm. Respondents aged ≥ 18 years with a confirmed diagnosis of epidermolysis bullosa or caring for a patient with a confirmed diagnosis of epidermolysis bullosa were eligible to participate in the survey.

Results

In total, 156 responses were received from patients (n = 63) and caregivers (n = 93) representing the epidermolysis bullosa types of simplex, junctional, and dystrophic (subtypes: dominant and recessive). A large proportion of patients (21%) and caregivers (32%) reported that the condition was severe or very severe, and 19% of patients and 26% of caregivers reported a visit to an emergency department in the 12 months prior to the survey. Among the types/subtypes represented, recessive dystrophic epidermolysis bullosa results in the greatest wound burden, with approximately 60% of patients and caregivers reporting wounds covering > 30% of total body area. Wound care is time consuming and commonly requires significant caregiver assistance. Therapeutic options are urgently needed and reducing the number and severity of wounds was generally ranked as the most important treatment factor.

Conclusions

Survey responses demonstrate that epidermolysis bullosa places a considerable burden on patients, their caregivers, and their families. The limitations caused by epidermolysis bullosa mean that both patients and caregivers must make difficult choices and compromises regarding education, career, and home life. Finally, survey results indicate that epidermolysis bullosa negatively impacts quality of life and causes financial burden to patients and their families.
Bovine ticks harbour a diverse array of microorganisms in Pakistan
Authors: Ghafar Abdul , Cabezas-Cruz Alejandro , Galon Clemence , Obregon Dasiel , Gasser Robin B. , Moutailler Sara , Jabbar Abdul
Published: January 2020

Background

Ticks and tick-borne pathogens (TTBP) are a major constraint to livestock production in Pakistan; despite a high prevalence of TTBPs, knowledge on the capacity of Pakistani ticks to carry pathogens and endosymbionts is limited. Furthermore, mixed infections with multiple microorganisms further complicate and limit the detection potential of traditional diagnostic methods. The present study investigated the tick-borne microorganisms in bovine ticks in Pakistan, employing a high-throughput microfluidic real-time PCR based technique.

Methods

Ticks were collected from clinically healthy cattle (n = 116) and water buffaloes (n = 88) from 30 villages across six districts located in five agro-ecological zones (AEZs) of Pakistan from September to November 2017. The microfluidic real-time PCR was used to test the genomic DNA of individual ticks for the presence of 27 bacterial and eight parasitic microorganisms. Phylogenetic methods were used to assess the genetic relationship of DNA sequences determined herein.

Results

PCR detected DNA of at least one microorganism in each of 221 ticks tested (94.4%, 221/234). DNA-based detection inferred that single pathogens/endosymbionts were the most common (43.4%, 96/221) followed by double (38.9%, 86/221), triple (14.5%, 32/221), quadruple (2.3%, 5/221) and quintuple (0.9%, 2/221) mixed infections. Piroplasms (Babesia/Theileria spp.) were the most prevalent (31.6%, 74/234), followed by Ehrlichia spp. (20%, 47/234) and Anaplasma marginale (7.7%, 18/234). Anaplasma phagocytophilum, A. ovis, A. centrale, Babesia ovis, Borrelia spp., Rickettsia spp., R. massiliae, Bartonella spp. and Hepatozoon spp. were also detected. Endosymbionts such as Francisella-like (91.5%, 214/234) and Coxiella-like (1.3%, 3/234) organisms were also detected in ticks. The highest diversity of microorganisms was detected in Hyalomma anatolicum ticks (test-positive for 14/14 microorganisms), followed by Rhipicephalus microplus (4/14), Hy. hussaini (3/14) and Rh. annulatus (2/14). Ticks collected from cattle carried significantly more frequently piroplasms (41.2%, 54/131; P < 0.05) than those from buffaloes (19.4%, 20/103). However, the overall prevalence of microorganisms did not vary significantly among ticks from the two host species as well as across different AEZs.

Conclusions

To our knowledge, this is the first study to investigate a wide range of tick-borne microorganisms in bovine ticks using a high-throughput diagnostic method from different AEZs in Pakistan. These findings will aid in establishing the distribution patterns and the control of tick-borne pathogens of bovines in Pakistan.
Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper
Authors: Hox Valerie , Lourijsen Evelijn , Jordens Arnout , Aasbjerg Kristian , Agache Ioana , Alobid Isam , Bachert Claus , Boussery Koen , Campo Paloma , Fokkens Wytske , Hellings Peter , Hopkins Claire , Klimek Ludger , Mäkelä Mika , Mösges Ralph , Mullol Joaquim , Pujols Laura , Rondon Carmen , Rudenko Michael , Toppila-Salmi Sanna , Scadding Glenis , Scheire Sophie , Tomazic Peter-Valentin , Van Zele Thibaut , Wagenmann Martin , van Boven Job F. M. , Gevaert Philippe
Published: January 2020

Because of the inflammatory mechanisms of most chronic upper airway diseases such as rhinitis and chronic rhinosinusitis, systemic steroids have been used for their treatment for decades. However, it has been very well documented that—potentially severe—side-effects can occur with the accumulation of systemic steroid courses over the years. A consensus document summarizing the benefits of systemic steroids for each upper airway disease type, as well as highlighting the potential harms of this treatment is currently lacking. Therefore, a panel of international experts in the field of Rhinology reviewed the available literature with the aim of providing recommendations for the use of systemic steroids in treating upper airway disease.
ICU-acquired weakness, diaphragm dysfunction and long-term outcomes of critically ill patients
Authors: Saccheri Clément , Morawiec Elise , Delemazure Julie , Mayaux Julien , Dubé Bruno-Pierre , Similowski Thomas , Demoule Alexandre , Dres Martin
Published: January 2020

Background

Intensive care unit (ICU)-acquired weakness and diaphragm dysfunction are frequent conditions, both associated with poor prognosis in critically ill patients. While it is well established that ICU-acquired weakness severely impairs long-term prognosis, the association of diaphragm dysfunction with this outcome has never been reported. This study investigated whether diaphragm dysfunction is associated with negative long-term outcomes and whether the coexistence of diaphragm dysfunction and ICU-acquired weakness has a particular association with 2-year survival and health-related quality of life (HRQOL).

Methods

This study is an ancillary study derived from an observational cohort study. Patients under mechanical ventilation were enrolled at the time of their first spontaneous breathing trial. Diaphragm dysfunction was defined by tracheal pressure generated by phrenic nerve stimulation < 11 cmH2O and ICU-acquired weakness was defined by Medical Research Council (MRC) score < 48. HRQOL was evaluated with the SF-36 questionnaire.

Results

Sixty-nine of the 76 patients enrolled in the original study were included in the survival analysis and 40 were interviewed. Overall 2-year survival was 67% (46/69): 64% (29/45) in patients with diaphragm dysfunction, 71% (17/24) in patients without diaphragm dysfunction, 46% (11/24) in patients with ICU-acquired weakness and 76% (34/45) in patients without ICU-acquired weakness. Patients with concomitant diaphragm dysfunction and ICU-acquired weakness had a poorer outcome with a 2-year survival rate of 36% (5/14) compared to patients without diaphragm function and ICU-acquired weakness [79% (11/14) (p < 0.01)]. Health-related quality of life was not influenced by the presence of ICU-acquired weakness, diaphragm dysfunction or their coexistence.

Conclusions

ICU-acquired weakness but not diaphragm dysfunction was associated with a poor 2-year survival of critically ill patients.
Nationwide survey on training and device utilization during tracheal intubation in French intensive care units
Authors:   The Intubation Practices Survey Group, Martin M. , Decamps P. , Seguin A. , Garret C. , Crosby L. , Zambon O. , Miailhe A. F. , Canet E. , Reignier J. , Lascarrou J. B.
Published: January 2020

Background

Intubation is a lifesaving procedure that is often performed in intensive care unit (ICU) patients, but leads to serious adverse events in 20–40% of cases. Recent trials aimed to provide guidance about which medications, devices, and modalities maximize patient safety. Videolaryngoscopes are being offered in an increasing range of options and used in broadening indications (from difficult to unremarkable intubation). The objective of this study was to describe intubation practices and device availability in French ICUs.

Materials and methods

We conducted an online nationwide survey by emailing an anonymous 26-item questionnaire to physicians in French ICUs. A single questionnaire was sent to either the head or the intubation expert at each ICU.

Results

Of 257 ICUs, 180 (70%) returned the completed questionnaire. The results showed that 43% of intubators were not fully proficient in intubation; among them, 18.8% had no intubation training or had received only basic training (lectures and observation at the bedside). Among the participating ICUs, 94.4% had a difficult intubation trolley, 74.5% an intubation protocol, 92.2% a capnography device (used routinely to check tube position in 69.3% of ICUs having the device), 91.6% a laryngeal mask, 97.2% front-of-neck access capabilities, and 76.6% a videolaryngoscope. In case of difficult intubation, 85.6% of ICUs used a bougie (154/180) and 7.8% switched to a videolaryngoscope (14/180). Use of a videolaryngoscope was reserved for difficult intubation in 84% of ICUs (154/180). Having a videolaryngoscope was significantly associated with having an intubation protocol (P = 0.043) and using capnography (P = 0.02). Airtraq®was the most often used videolaryngoscope (39.3%), followed by McGrath®Mac (36.9%) then by Glidescope®(14.5%).

Conclusion

Nearly half the intubators in French ICUs are not fully proficient with OTI. Access to modern training methods such as simulation is inadequate. Most ICUs own a videolaryngoscope, but reserve it for difficult intubations.
How do world and European standard populations impact burden of disease studies? A case study of disability-adjusted life years (DALYs) in Scotland
Authors: Wyper Grant M. A. , Grant Ian , Fletcher Eilidh , McCartney Gerry , Fischbacher Colin , Stockton Diane L.
Published: January 2020

Background

Disability-Adjusted Life Years (DALYs) are an established method for quantifying population health needs and guiding prioritisation decisions. Global Burden of Disease (GBD) estimates aim to ensure comparability between countries and over time by using age-standardised rates (ASR) to account for differences in the age structure of different populations. Different standard populations are used for this purpose but it is not widely appreciated that the choice of standard may affect not only the resulting rates but also the rankings of causes of DALYs. We aimed to evaluate the impact of the choice of standard, using the example of Scotland.

Methods

DALY estimates were derived from the 2016 Scottish Burden of Disease (SBoD) study for an abridged list of 68 causes of disease/injury, representing a three-year annual average across 2014–16. Crude DALY rates were calculated using Scottish national population estimates. DALY ASRs standardised using the GBD World Standard Population (GBD WSP) were compared to those using the 2013 European Standard Population (ESP2013). Differences in ASR and in rank order within the cause list were summarised for all-cause and for each individual cause.

Results

The ranking of causes by DALYs were similar using crude rates or ASR (ESP2013). All-cause DALY rates using ASR (GBD WSP) were around 26% lower. Overall 58 out of 68 causes had a lower ASR using GBD WSP compared with ESP2013, with the largest falls occurring for leading causes of mortality observed in older ages. Gains in ASR were much smaller in absolute scale and largely affected causes that operated early in life. These differences were associated with a substantial change to the ranking of causes when GBD WSP was used compared with ESP2013.

Conclusion

Disease rankings based on DALY ASRs are strongly influenced by the choice of standard population. While GBD WSP offers international comparability, within-country analyses based on DALY ASRs should reflect local age structures. For European countries, including Scotland, ESP2013 may better guide local priority setting by avoiding large disparities occurring between crude and age-standardised results sets, which could potentially confuse non-technical audiences.
Is the soil seed bank a reliable source for passive restoration of bush-cleared semi-arid rangelands of South Africa?
Authors: Mndela Mthunzi , Madakadze Casper Ignacio , Nherera-Chokuda Florence , Dube Sikhalazo
Published: January 2020

Background

Bush clearing of encroached rangelands is crucial for restoration of herbaceous cover and diversity. Regeneration after bush clearing depends largely on the soil seed bank (SSB) size and composition. To assess the potential of the SSB to facilitate post-clearing herbaceous restoration, we examined the SSB density, composition and diversity and similarity between SSB and aboveground vegetation (AGV).

Methods

The study was conducted in semi-arid rangelands of Maseding and Kgomokgomo in North-West Province of South Africa. In each rangeland, all woody plants in three 1250 m2plots were cut using saws and loppers, with the stumps treated with picloram. Paired observations were conducted in cleared and uncleared microsites. Soil samples were collected at three depths (0–10, 10–20 and 20–30 cm) in each microsite in April (pre-treatment), August, October and December 2016 and in April and August 2017. SSB was assessed using seedling emergence method, whereas pre- and post-clearing surveys of AGV were conducted in February 2016 and 2017, respectively.

Results

Cleared microsites had significantly (p< 0.01) higher seed bank densities (1872 and 693 seeds m-2at Maseding and Kgomokgomo, respectively) relative to uncleared microsites in August 2017, with grasses accounting for higher densities than other plant functional groups in the upper 0–10 cm. Pioneer grasses (Aristida congestasubsp. barbicollis,Brachiaria eruciformisandTragus berteronianus) and invasive forbs (Bidens pilosaandSchkuhria pinnata) dominated the SSB in cleared microsites at Maseding, whereas succulents (Portulacaspp.) and pioneer grasses (T. berteronianusandUrochloa mosambicensis) were abundant at Kgomokgomo in August 2017. SSB and AGV were dissimilar until December 2016; thereafter, similarity increased significantly (p< 0.05) in cleared microsites (Sørensen’s coefficient = 0.60 to 0.66 at Maseding and 0.43 to 0.52 at Kgomokgomo) compared to uncleared microsites. Species diversity was highest in August 2016 and April 2017 at Maseding, but it did not differ between two microsites (p> 0.05). At Kgomokgomo, SSB was more diverse in cleared than uncleared microsites in April and August 2017.

Conclusion

High seed bank densities in the upper soil layer in cleared microsites would promote passive restoration, but regeneration is likely to be initiated by early successional species. However, close monitoring and eradication of invasive forbs and succulents is necessary following bush clearing. The tendency of SSB resembling AGV over time in cleared microsites signifies that seed production from AGV is important for passive restoration following bush clearing.