bluuebunny/crossref_metadata_2025 huggingface dataset:
Single Layers of Attention Suffice to Predict Protein Contacts
Authors: Bhattacharya Nicholas , Thomas Neil , Rao Roshan , Dauparas Justas , Koo Peter K. , Baker David , Song Yun S. , Ovchinnikov Sergey
Published: December 2020

Abstract

The established approach to unsupervised protein contact prediction estimates co-evolving positions using undirected graphical models. This approach trains a Potts model on a Multiple Sequence Alignment, then predicts that the edges with highest weight correspond to contacts in the 3D structure. On the other hand, increasingly large Transformers are being pretrained on protein sequence databases but have demonstrated mixed results for downstream tasks, including contact prediction. This has sparked discussion about the role of scale and attention-based models in unsupervised protein representation learning. We argue that attention is a principled model of protein interactions, grounded in real properties of protein family data. We introduce a simplified attention layer,factored attention, and show that it achieves comparable performance to Potts models, while sharing parameters both within and across families. Further, we extract contacts from the attention maps of a pretrained Transformer and show they perform competitively with the other two approaches. This provides evidence that large-scale pretraining can learn meaningful protein features when presented with unlabeled and unaligned data. We contrast factored attention with the Transformer to indicate that the Transformer leverages hierarchical signal in protein family databases not captured by our single-layer models. This raises the exciting possibility for the development of powerful structured models of protein family databases.1
Listeria monocytogenesMenI encodes a DHNA-CoA thioesterase necessary for menaquinone biosynthesis, cytosolic survival, and virulence
Authors: Smith Hans B. , Li Tin Lok , Liao Man Kit , Chen Grischa Y. , Guo Zhihong , Sauer John-Demian
Published: December 2020

Listeria monocytogenesis a Gram-positive intracellular pathogen that is highly adapted to invade and replicate in the cytosol of eukaryotic cells. Intermediate metabolites in the menaquinone biosynthesis pathway are essential for the cytosolic survival and virulence ofL. monocytogenes, independent of the production of MK and aerobic respiration. Determining which specific intermediate metabolite(s) are essential for cytosolic survival and virulence has been hindered by the lack of an identified DHNA-CoA thioesterase essential for converting DHNA-CoA to DHNA in the MK synthesis pathway. Using the recently identifiedEscherichia coliDHNA-CoA thioesterase as a query, homology sequence analysis revealed a single homolog inL. monocytogenes, LMRG_02730. Genetic deletion of LMRG_02730 resulted in an ablated membrane potential, indicative of a non-functional electron transport chain (ETC) and an inability to aerobically respire. Biochemical kinetic analysis of LMRG_02730 revealed strong activity towards DHNA-CoA, similar to itsE. colihomolog, further demonstrating that LMRG_02730 is a DHNA-CoA thioesterase. Functional analysesin vitro,ex vivo, andin vivousing mutants directly downstream and upstream of LMRG_02730 revealed that DHNA-CoA is sufficient to facilitatein vitrogrowth in minimal media, intracellular replication, and plaque formation in fibroblasts. In contrast, protection against bacteriolysis in the cytosol of macrophages and tissue specific virulencein vivorequires the production of DHNA. Taken together, these data implicate LMRG_02730 (renamed MenI) as a DHNA-CoA thioesterase and suggest that while DHNA protects the bacteria from killing in the macrophage cytosol, DHNA-CoA is necessary for intracellular bacterial replication.
Bumblebees develop more efficient traplines than honey bees
Authors: Buatois Alexis , Dubois Thibault , Lihoreau Mathieu
Published: December 2020

Central place foraging pollinators, such as bees, tend to learn multi-destination routes (traplines) to efficiently visit known feeding locations and return to their nest. To what extent these routing behaviours are shared across species is unknown. Here we ran laboratory experiments to compare trapline formation and efficiency by foragers of two social bee species that differ in their collective foraging strategies: the solo foraging bumblebeeBombus terrestrisand the mass foraging honey beeApis mellifera. In a simple routing task with four artificial flowers, both bumblebees and honey bees developed a stable route, although honey bees were slower and less efficient to do so. In a more complex routing task with six flowers, only bumblebees developed a stable route. Honey bees took a longer time to discover all flowers and never integrated them in a single route. Simulations of a model of trapline formation show that these inter-specific differences can be replicated by adjusting the strength of a single learning parameter. Comparing bumblebees and honey bees in the same experimental conditions thus revealed key differences in their spatial foraging strategies, potentially driven by social constraints.
Provision of health care for prisoners during the COVID-19 pandemic: an ethical analysis of challenges and summary of select best practices
Authors: Brelje Andrea Berkemeier , Pinals Debra A.
Published: December 2020

Purpose

This paper aims to analyze the COVID-19 pandemic response in prisons, focusing on the USA, which imprisons a higher percentage of its population than any other country in the world.

Design/methodology/approach

This paper evaluates the current pandemic response in prisons based on legal and ethical imperatives for providing health care to prisoners.

Findings

Themes of best practices identified include increasing rapid detection of new cases, reducing transmission and advocating for both short- and long-term ethical health care policies. Halting progress now could risk dire consequences and is unacceptable on legal, ethical and public health grounds.

Research limitations/implications

This paper does not involve primary research with prisoners; rather it focuses on reviewing the pandemic response in prisons. Although it may be possible to translate findings in this study to similar environments (e.g. jails and detainment centers), there are unique characteristics pertaining to each that deserve separate, focused analyses.

Originality/value

Outbreaks that occur within prisons are likely to spread to the community and vice versa. Analyses based on ethics, law and public health point to the same conclusion: preventing significant outbreaks within prisons will benefit not only prisoners but also the general public. Furthermore, even though the scientific understanding of the pandemic may change with future research, the ethical and legal principles highlighted in this paper will continue to be foundational when considering just care for prisoners.
Application of LC‐HRMS identified marker peptides in an LC‐MS/MS method for detection and quantification of heat‐resistant proteolytic activity in raw milk
Authors: Verhegghe Marijke , De Block Jan , Heyndrickx Marc , Van Coillie Els , Van Poucke Christof , Duquenne Barbara
Published: December 2020

For the dairy industry, it would be useful to be able to determine the heat‐resistant proteolytic activity of the raw milk upon arrival at the plant, preferably before processing (within 24 h of arrival). This would allow producers to choose the most optimal processing of the raw milk and hence its fate, together with a more accurate prediction of shelf‐life. A liquid chromatography‐tandem mass spectrometry (LC‐MS/MS) method for the detection and quantification of Pseudomonas‐derived heat‐resistant proteolytic activity in raw milk based on three new marker peptides, identified using liquid chromatography coupled to high‐resolution mass spectrometry (LC‐HRMS), was developed. This method involved a sample preparation where existing peptides are removed from the milk sample, after which the heat‐resistant protease‐containing fraction is mixed with a casein substrate. After incubation, the increase of the peptide markers is determined using an LC‐MS/MS method. The limit of detection (LOD) and limit of quantification (LOQ) of this method were determined using synthetically produced peptides (with an average LOD between 0.1 and 5 ng/mL and an average LOQ between 0.1 and 10 ng/mL).
The Bougainville referendum through the eyes of the ‘lost generation’: Observations from Siwai
Authors: McKenna Kylie , Ariku Augusta , Ariku Emelda , Sam Lieberth , Siniku Anthony
Published: December 2020

A referendum to decide on Bougainville's future political relationship with Papua New Guinea was held in November 2019. The deferred, non‐binding, referendum is a key milestone contained in the Bougainville Peace Agreement (BPA), which sought to reconcile a violent conflict from 1988 to 1998. Although the Bougainville peace process has been deemed a success and significant milestones have been reached towards implementation of the BPA, the conflict continues to have enduring impacts. Particular concerns have been raised about Bougainville's large youth population, often referred to as the ‘lost generation’. This paper documents observations of the 2019 referendum from the perspective of four university students born during the conflict in Siwai District, South Bougainville, whom participated officially in the referendum as an observer group. While trauma and a disrupted education have contributed to youth unemployment and substance abuse in Bougainville, the paper offers a stark contrast to negative narratives of young Bougainvilleans as lacking capabilities to contribute to social and political life. As Bougainville embarks on yet another period of political uncertainty, the paper calls for greater attention to finding avenues to support these young voices to ensure that their generation is not ‘lost’ forever.
Genetic diagnosis of infantile‐onset epilepsy in the clinic: Application of whole‐exome sequencing following epilepsy gene panel testing
Authors: Kim Soo Yeon , Jang Se Song , Kim Hunmin , Hwang Hee , Choi Ji Eun , Chae Jong‐Hee , Kim Ki Joong , Lim Byung Chan
Published: December 2020

This study aimed to evaluate the clinical utility of whole‐exome sequencing in a group of infantile‐onset epilepsy patients who tested negative for epilepsy using a gene panel test. Whole‐exome sequencing was performed on 59 patients who tested negative on customized epilepsy gene panel testing. We identified eight pathogenic or likely pathogenic sequence variants in eight different genes (FARS2, YWHAG, KCNC1, DYRK1A, SMC1A, PIGA, OGT, and FGF12), one pathogenic structural variant (8.6 Mb‐sized deletion on chromosome X [140 994 419–149 630 805]), and three putative low‐frequency mosaic variants from three different genes (GABBR2, MTOR, and CUX1). Subsequent whole‐exome sequencing revealed an additional 8% of diagnostic yield with genetic confirmation of epilepsy in 55.4% (62/112) of our cohort. Three genes (YWHAG, KCNC1, and FGF12) were identified as epilepsy‐causing genes after the original gene panel was designed. The others were initially linked with mitochondrial encephalopathy or different neurodevelopmental disorders, although an epilepsy phenotype was listed as one of the clinical features. Application of whole‐exome sequencing following epilepsy gene panel testing provided 8% of additional diagnostic yield in an infantile‐onset epilepsy cohort. Whole‐exome sequencing could provide an opportunity to reanalyze newly recognized epilepsy‐linked genes without updating the gene panel design.
Effect of multiple freeze‐thaw cycles on protein and lipid oxidation in rabbit meat
Authors: Wang Zefu , He Zhifei , Zhang Dong , Chen Xiaosi , Li Hongjun
Published: December 2020

Frozen storage is chosen to be the preferred method in meat preservation. However, multiple freeze‐thaw (F‐T) cycles will occur during the transfers or distribution processes under poor cold‐chain conditions. This study investigated the effects of multiple freeze‐thaw (F‐T) cycles on water mobility, microstructure damage, protein oxidation and lipid oxidation in rabbit meat during seven F‐T cycles through 56 days. Scanning electron microscopy results indicated that the increase of F‐T cycles induced the rupture of endomysia and the increase of gaps between fibres. Low‐field nuclear magnetic resonance (LF‐NMR) results showed that the peak area of T21 and T22 decreased with increasing number of repeated F‐T cycles, indicating that immobile water shifted to free water, and free water mobility increased. During repeated freeze‐thaw process, the peroxide value, thiobarbituric acid‐reactive substances, non‐haem iron content and carbonyl groups of rabbit meat gradually increased, whereas haem content, haem iron content and sulfhydryl content of rabbit meat gradually decreased. In addition, the results of Fourier transform infrared, sodium dodecyl sulphate polyacrylamide gel electrophoresis, and intrinsic fluorescence spectroscopy indirectly proved that multiple F‐T cycles could cause α‐helix structure disruption, protein aggregation and degradation, and tryptophan oxidation of rabbit meat myofibrillar protein (MP). Overall, multiple repeated F‐T cycles changed moisture migration, damaged microstructure and promoted lipid and protein oxidation of rabbit meat.
Patients’ experiences of recovery: Beyond the intensive care unit and into the community
Authors: Calkins Kelly , Kako Peninnah , Guttormson Jill
Published: December 2020

Aims

To understand barriers and facilitators of recovery for critical illness survivors’, who are discharged home from the hospital and do not have access to dedicated outpatient care.

Design

Multi‐site descriptive study guided by interpretive phenomenology using semi‐structured interviews.

Methods

Interviews were conducted between December 2017 ‐July 2018. Eighteen participants were included. Data were collected from interview recordings, transcripts, field notes, and a retrospective chart review for sample demographics. Analysis was completed using Interpretive Phenomenological Analysis which provided a unique view of recovery through the survivors’ personal experiences and perception of those experiences.

Results

Participants encountered several barriers to their recovery; however, they were resilient and initiated ways to overcome these barriers and assist with their recovery. Facilitators of recovery experienced by survivors included seeking support from family and friends, lifestyle adaptations, and creative management of their multiple medical needs. Barriers included unmet needs experienced by survivors such as mental health issues, coordination of care, and spiritual needs. These unmet needs left participants feeling unsupported from healthcare providers during their recovery.

Conclusion

This study highlights important barriers and facilitators experienced by critical illness survivors during recovery that need be addressed by healthcare providers. New ways to support critical illness survivors, that can reach a broader population, must be developed and evaluated to support survivors during their recovery in the community.

Impact

This study addressed ICU survivors’ barriers and facilitators to recovery. Participants encountered several barriers to recovery at home, such as physical, cognitive, psychosocial, financial, and transportation barriers, however, these survivors were also resilient and resourceful in the development of strategies to try to manage their recovery at home. These results will help healthcare providers develop interventions to better support ICU survivors in the community.
Completion and Adverse Drug Events of Latent Tuberculosis Infection Treatment in Patients Receiving Dialysis: Predictors and Impacts of Different Regimens in a Prospective Cohort Study
Authors: Lin Shu-Yung , Feng Jia-Yih , Lee Chih-Yuan , Lin Yi-Chih , Chou Yu-Hsiang , Lin Kuan-Yin , Wei Yu-Feng , Lin Shu-Wen , Chang Chin-Hao , Wang Ping-Huai , Shu Chin-Chung , Wang Jann-Yuan , Yu Chong-Jen
Published: December 2020

Although patients with end-stage renal disease receiving maintenance hemodialysis are at high risk for tuberculosis, the optimal treatment regimen for latent tuberculosis infection (LTBI) in this group has scarcely been studied for predictors of completion rate and adverse drug events (ADE). We prospectively enrolled dialysis patients for LTBI intervention from three medical centers in Taiwan.
Genome Sequence of
Frankia
sp. Strain CH37, a Metallophore-Producing, Nitrogen-Fixing Actinobacterium Isolated from the Sea Buckthorn, Hippophae rhamnoides (Elaeagnaceae)
Authors: Mohr Jan Frieder , Weiss Anne , Roy Sébastien , Wichard Thomas
Published: December 2020

We report the genome sequence of
Frankia
sp. strain CH37, a filamentous nitrogen-fixing soil-dwelling Gram-positive bacterium and hyper-producer of metal-complexing organic ligands (metallophores) isolated from the sea buckthorn (
Hippophae rhamnoides
). The 9.7-Mbp sequence, obtained using PacBio technology, harbors 7,766 predicted coding sequences, including gene clusters for metallophore production.
Place of death of children and young adults with a life-limiting condition in England: a retrospective cohort study
Authors: Gibson-Smith Deborah , Jarvis Stuart William , Fraser Lorna K
Published: December 2020

Objective

To assess trends in place of death for children with a life-limiting condition and the factors associated with death at home or hospice rather than hospital.

Design

Observational cohort study using linked routinely collected data.

Setting

England.

Patients

Children aged 0–25 years who died between 2003 and 2017.

Main outcome measures

Place of death: hospital, hospice, home. Multivariable multinomial logistic regression models.

Results

39 349 children died: 73% occurred in hospital, 6% in hospice and 16% at home. In the multivariable models compared with dying in a hospital: neonates were less likely, and those aged 1–10 years more likely, than those aged 28 days to <1 year to die in hospice. Children from all ethnic minority groups were significantly less likely to die in hospice, as were those in the most deprived group (RR 0.8, 95% CI 0.7 to 0.9). Those who died from 2008 were more likely than those who died earlier to die in a hospice.

Children with cancer (RR 4.4, 95% CI 3.8 to 5.1), neurological (RR 2.0, 95% CI 1.7 to 2.3) or metabolic (RR 3.7, 95% CI 3.0 to 4.6) diagnoses were more likely than those with a congenital diagnosis to die in a hospice.

Similar patterns were seen for clinical/demographic factors associated with home versus hospital deaths.

Conclusions

Most children with a life-limiting condition continue to die in the hospital setting. Further research on preferences for place of death is needed especially in children with conditions other than cancer. Paediatric palliative care services should be funded adequately to enable equal access across all settings, diagnostic groups and geographical regions.
Rectal cancer mimic: a rare case of syphilitic proctitis
Authors: Patil Rajashri Veeresh , Stephenson Iain , Richards Cathy J , Griffin Yvette
Published: December 2020

Syphilitic proctitis is a rare presentation of sexually transmitted infection that poses a diagnostic challenge as it mimics rectal cancer clinically, radiologically and endoscopically. We report a case of a 66-year-old male patient with a background of HIV infection presenting with obstructive bowel symptoms and initial diagnosis of rectal cancer on CT. Sigmoidoscopy and histopathology were non-diagnostic. A diagnosis of secondary syphilis was suspected after obtaining sexual history and diagnostic serology, avoiding planned surgical intervention.
Double trouble: a case of an ataxic young man with coeliac disease and cerebrotendinous xanthomatosis
Authors: Burgess Jordan , Behzad-Noori Diba , Longman Cheryl , Brennan Kathryn
Published: December 2020

We present the case of a 29-year-old south Asian man born of consanguineous marriage, presenting with ataxia, peripheral neuropathy and cognitive impairment. An initial diagnosis of coeliac disease was thought to explain the pertinent clinical features; however, further investigation led to an additional diagnosis of the rare yet treatable autosomal recessive condition, cerebrotendinous xanthomatosis. With both conditions employing highly diverse and overlapping clinical phenotypes, this contributed to a delay in diagnosis. Our report highlights the importance of paying close attention to both the clinical phenotype and family history.
Primary acquired melanosis/melanoma: utility of conjunctival map biopsy
Authors: Soto Hansell , Bowen Randy C , Raval Vishal , Yeaney Gabrielle , Singh Arun
Published: December 2020

Aim

To assess the role of map biopsy in patients with conjunctival primary acquired melanosis (PAM)/melanoma.

Methods

Retrospective case series of 400 conjunctival biopsy samples of 51 unique patients in a tertiary referral centre.

Results

Each patient underwent one diagnostic biopsy and several additional map biopsies (range 2–7) providing a total of 400 samples for the analysis (55 diagnostic biopsies, 345 map biopsies). The median age was 63 years old (range 20–88) with women representing 67% of the cases. Histopathological findings were graded as negative for melanosis/normal (grade 0), melanosis without atypia (grade 1), melanosis with mild atypia (grade 2), melanosis with severe atypia (grade 3) or invasive melanoma (grade 4). Clinicopathologic concordance was observed in the majority of the map biopsies (313, 91%) (positive: clinical+/path+ (57,17%), negative: clinical−/path− (256, 74%)). Three discordant samples (clinical−/path+) represented PAM sine pigmento. The histopathological spectrum of atypia was absent (40, 73%) or limited (11, 20%) in the majority of cases with tendency to cluster as low-grade or high-grade atypia. Map biopsy led to the identification of six patients (11%) with severe atypia, requiring topical mitomycin (MMC). Similarly, in 29 cases, periodic observation without topical MMC was recommended. One case of invasive melanoma transformation occurred in the MMC-treated group.

Conclusions

Map biopsy enhances overall assessment of the anatomic and pathologic extent, impacting use of adjuvant topical chemotherapy. In absence of map biopsy, it would be impossible to diagnose PAM sine pigmento. Additional corroborative work is needed to validate our observations.
Development and validation of a deep learning system to screen vision-threatening conditions in high myopia using optical coherence tomography images
Authors: Li Yonghao , Feng Weibo , Zhao Xiujuan , Liu Bingqian , Zhang Yan , Chi Wei , Lu Mingzhi , Lin Jierong , Wei Yantao , Li Jun , Zhang Qi , Zhu Yi , Chen Chuan , Lu Lin , Zhao Lanqin , Lin Haotian
Published: December 2020

Background/aims

To apply deep learning technology to develop an artificial intelligence (AI) system that can identify vision-threatening conditions in high myopia patients based on optical coherence tomography (OCT) macular images.

Methods

In this cross-sectional, prospective study, a total of 5505 qualified OCT macular images obtained from 1048 high myopia patients admitted to Zhongshan Ophthalmic Centre (ZOC) from 2012 to 2017 were selected for the development of the AI system. The independent test dataset included 412 images obtained from 91 high myopia patients recruited at ZOC from January 2019 to May 2019. We adopted the InceptionResnetV2 architecture to train four independent convolutional neural network (CNN) models to identify the following four vision-threatening conditions in high myopia: retinoschisis, macular hole, retinal detachment and pathological myopic choroidal neovascularisation. Focal Loss was used to address class imbalance, and optimal operating thresholds were determined according to the Youden Index.

Results

In the independent test dataset, the areas under the receiver operating characteristic curves were high for all conditions (0.961 to 0.999). Our AI system achieved sensitivities equal to or even better than those of retina specialists as well as high specificities (greater than 90%). Moreover, our AI system provided a transparent and interpretable diagnosis with heatmaps.

Conclusions

We used OCT macular images for the development of CNN models to identify vision-threatening conditions in high myopia patients. Our models achieved reliable sensitivities and high specificities, comparable to those of retina specialists and may be applied for large-scale high myopia screening and patient follow-up.
Remote Rainfall of Typhoon Khanun (2017): Monsoon Mode and Topographic Mode
Authors: Lin Yi-Hsuan , Wu Chun-Chieh
Published: December 2020

Remote rainfall related to tropical cyclones (TCs) can be attributed to interaction between the northeasterly monsoon and TC circulation (hereafter monsoon mode), and topographic blocking and lifting effects (hereafter topographic mode). Typhoon Khanun (2017) is a case in point affected by both modes. The objective of this study is to understand the key factors leading to uncertainty in the TC-induced remote rainfall. Ensemble simulations are conducted, with the ensemble members related to the monsoon mode classified into subtypes based on the geographic location of the precipitation maxima. The results demonstrate that frontogenesis and terrain-induced uplifting are the main mechanisms leading to the heavy precipitation in northeastern Taiwan, while the orographic lifting and the interaction between the TC circulation and the topographically blocked northeasterlies result in the heavy rainfall in southeastern Taiwan. For the topographic mode, at a larger rainfall threshold, strong relation is found between the inflow angle of the TC circulation and the cumulative frequency of the rainfall, while at a smaller rainfall threshold, rainfall cumulative frequency is related to the ensemble track directions. Sensitivity experiments with TC-related moisture reduced (MR) and the terrain of Taiwan removed (TR) show that the average of the 3-day accumulated rainfall is reduced by 40% and more than 90% over the mountainous area in MR and TR, respectively. Overall, this study highlights the fact that multiple mechanisms contribute to remote rainfall processes in Khanun, particularly the orographic forcing, thus providing better insights into the predictability of TC remote rainfall.
Does the Degree of Platelet Adenosine Diphosphate and Arachidonic Acid Receptor Inhibition Correlate With the Severity of Injury in Non-Brain-Injured Trauma Patients?
Authors: Woodruff Grant , Price Dustin , Sodhi Aparna , Kerwin Andrew , Crandall Marie
Published: December 2020

Background

Direct correlations between platelet adenosine diphosphate (ADP) and arachidonic acid (AA) receptor inhibition have been described in the traumatic brain injury (TBI) population. Our goal was to evaluate the percent inhibition of ADP receptor inhibition (ADPri) and AA receptor inhibition (AAri) receptors in non-TBI patients and correlate injury severity and outcomes.

Methods

We performed a retrospective review of non-TBI patients admitted to our trauma center, who received thromboelastography with platelet mapping prior to blood transfusion. Exclusion criteria included patients younger than 18 years, current antiplatelet therapy, or history of renal failure. Univariate descriptive statistics and bivariate comparisons were performed on patient demographic and outcomes. Multivariable linear regression models were constructed to quantify any association between ADPri and AAri with injury outcomes. High ADP inhibition was defined >20% and high AA inhibition >7%.

Results

117 patients met inclusion criteria. Mean age was 53 years with 61% male. Mean ADPri was 64% and AAri 42%. On bivariate analysis, no statistically significant differences with respect to injury severity measures or outcomes were identified. On multivariable linear regression, AAri was associated with longer hospital length of stay.

Discussion

There was a high degree of platelet dysfunction in this cohort of severely injured patients without TBI. Despite this, the only correlation identified between injury severity and outcomes was AAri correlating with hospital length of stay. Irrespective of injury severity or outcomes, these patients’ results were far from reported “normal” values. Further, research is needed to determine the significance and clinical implications of thromboelastography with platelet mapping use in trauma care.
Why does ethnic partition foster violence? Unpacking the deep historical roots of civil conflicts
Authors: Ito Gaku
Published: December 2020

Recent literature highlights the role of historical events in shaping contemporary political and economic outcomes. This article joins the growing debate by utilizing disaggregated data and mediation analysis to explore the causal mechanisms bridging ethnic partition by modern international borders and the risks of postcolonial civil conflicts in Africa. I argue that split ethnic groups are more likely to experience armed conflicts with the central government during the postcolonial age, and the conflict-escalating effect is particularly acute for large-sized split groups. When coupled with sizable demographic forces, ethnic partition heightens the political salience of the corresponding ethnic cleavage while generating greater information and commitment problems. The empirical results provide considerable support for the theoretical claim: first, ethnic partition increases the likelihood of armed conflicts between politically excluded ethnic groups and incumbent; and second, a major part of the conflict-escalating effect is attributable to the indirect and causal interaction effects induced by contemporary group size. The empirical analysis also reveals that the role of the primary alternative mechanism, political discrimination against split groups, in generating the historical treatment effect remains limited.
Incidental Papillary Thyroid Cancer Identified During Parathyroidectomy
Authors: Crenshaw Megan L. , Goldenberg Dana , Bann Darrin V.
Published: December 2020

Current treatment guidelines recommend surgical excision of papillary thyroid carcinoma. However, the precise surgical treatment, including thyroid lobectomy, total thyroidectomy, and the need for neck dissection, is dictated by disease extent and tumor cytology. Incidental papillary thyroid carcinoma discovered during another surgery therefore presents a surgical conundrum due to lack of information. Surgeons must consider short- and long-term surgical morbidities, as well as individual patient factors, when deciding how to treat an unexpected thyroid carcinoma.
Radiation-associated angiosarcoma of the breast: analysis of diagnostic tools in a registry-based population
Authors: Salminen Samuli Henri , Sampo Mika M , Böhling Tom O , Salo Juho , Tarkkanen Maija , Blomqvist Carl P , Hukkinen Katja
Published: December 2020

Background

Radiation-associated angiosarcoma of the breast (RAASB) is a serious late consequence caused by breast cancer treatment. Initial symptoms are often inconspicuous, thus contributing to diagnostic delay. Most previous studies of the diagnostic aspects of RAASB are case reports.

Purpose

To perform a complete review of the imaging findings and biopsy methods in a nationwide RAASB cohort.

Material and Methods

RAASB patients were identified from a national cancer registry and additional patients were included from our hospital. All available information from imaging (mammogram [MGR], ultrasound [US], magnetic resonance imaging [MRI], and computed tomography [CT]) and biopsies was reviewed. The sensitivity of imaging and biopsy methods for detection of RAASB was calculated.

Results

Fifty-eight patients with RAASB were found. Fourteen MGR, 30 US, 24 MRI, and 25 CT studies were available for evaluation. The sensitivity of MGR, US, MRI, and CT for detection of RAASB was 43%, 50%, 92%, and 84%, respectively. Superior sensitivity was demonstrated for punch biopsy (84%) and incisional biopsy (93%) compared to fine-needle aspiration cytology (0%) and core needle biopsy (18%).

Conclusion

MRI and CT have comparable sensitivity for detection of RAASB, while MGR and US are unreliable. However, negative findings in MRI or CT must be interpreted with caution. Punch biopsy and incisional biopsy are the preferred biopsy methods.
Design and biomechanical study of slide-poking external fixator for hip fracture
Authors: Chen Hua-Biao , Wu Hong-Bo , Chen Min , Huang Yu-Liang
Published: December 2020

Background

Femoral head collapse and coxa vara lead to internal fixator failure in elderly patients with hip fracture. External fixator application is an optimal choice; however, the existing methods have many disadvantages.

Methods

Type 31-A1.3 hip fracture models were developed in nine pairs of 1-year-old fresh bovine corpse femur specimens. Each left femur specimen was fixed by a dynamic hip screw (control group), and each right femur specimen was fixed by the slide-poking external fixator (experimental group). Vertical loading and torsion tests were then performed in both groups.

Results

In the vertical loading experiment, a 1000-N load was implemented. The mean vertical downward displacement of the femoral head in the experimental and control groups was 1.49322 ± 0.116280 and 2.13656 ± 0.166374 mm, respectively. In the torsion experiment, when the torsion was increased to 10.0 Nm, the mean torsion angle in the experimental and control groups was 7.9733° ± 1.65704° and 15.4889° ± 0.73228°, respectively. The slide-poking external fixator was significantly more resistant to compression and rotation than the dynamic hip screw.

Conclusion

The slide-poking external fixator for hip fractures that was designed and developed in this study can provide sufficient stability to resist compression and rotation in hip fractures.
Predicting forming limit diagrams for AZ31 magnesium alloy and 7050 aluminum alloy by numerical simulation
Authors: Xue Fengmei , Yan Yu , Kang Jincheng
Published: December 2020

Forming limit diagram (FLD) is the most intuitive method to evaluate and analyze the forming performance of sheet metal, which is widely used in production. To examine the formability of AZ31 magnesium alloy and 7050 aluminum alloy, the simplified bulging models based on the Nakazima experiment are established by ABAQUS finite element (FE) software, and the maximum punch force criterion is adopted as the instability criterion. The forming limit diagrams of 7050 high-strength aluminum alloy at room temperature and AZ31 magnesium alloy at warm working conditions are obtained by extracting the in-plane strain of the adjacent element of the maximum strain element at the moment of instability. Compared with experimental observation shows that the Nakazima virtual model established in this paper can accurately predict FLD. In addition, the influences of lubrication conditions and virtual punching speeds on the bulging process of AZ31 and AA7050 sheet metals are also investigated. The results show that the better the lubrication environment, or the lower the punching speed, the better the formability of the sheet, and reducing the punching speed has a more significant improvement effect on the formability of AZ31 sheets.
Biomechanical effects of reconstruction of the posterior structures after laminectomy with an individualized poly-ether-ether-ketone (PEEK) artificial lamina
Authors: Liu Liang , Ma Hong-yun , Yuan Qi-ling , Zhao Xiao-ming , Lou Xiao-xiao , Zhang Yin-gang
Published: December 2020

Background

Laminectomy is a traditional method for treating lumbar diseases; however, the destruction of the posterior structures may cause postoperative symptoms. An individualized poly-ether-ether-ketone (PEEK) artificial lamina was designed to reconstruct the posterior structures after laminectomy. This study aimed to explore the biomechanical effects of reconstruction of the posterior structures with an individualized PEEK artificial lamina using validated finite element models.

Objective

To examine the biomechanical effects of individualized PEEK artificial lamina on postlaminectomy lumbar.

Methods

A finite element (FE) model of L3-5 was developed based on computed tomography images. Four surgical models (laminectomy, artificial lamina alone, ligament reconstruction, and osseointegration) were constructed, representing different stages of L4 artificial lamina implantation. The range of motion (ROM), intradiscal pressure (IDP), stresses in the annulus fibrosus at the surgical level and cephalad adjacent level, and stresses in the artificial lamina and screws were measured.

Results

The ROM, IDP, and stresses in the annulus fibrosus of the different artificial lamina models decreased compared to those of the laminectomy model at both surgical and adjacent levels for all motion patterns, most notably in the osseointegration model. In addition, the results of the stresses in the implants showed that the artificial lamina could enhance the lumbar isthmus and disperse the abnormally concentrated stresses after laminectomy.

Conclusion

The application of a PEEK artificial lamina has the potential to stabilize the postlaminectomy lumbar spine and prevent adjacent segment disease (ASD) and iatrogenic lumbar deformities, resulting in a reduction in the incidence of post-lumbar surgery syndrome.
Breastmilk Substitutes Marketing Violations and Associated Factors in Rio de Janeiro, Brazil
Authors: de Oliveira Maria Inês Couto , Boccolini Cristiano Siqueira , Fonseca Sally Enilce de Oliveira
Published: December 2020

Background

Aiming to protect breastfeeding, the World Health Organization released the International Code of Marketing of Breastmilk Substitutes in 1981, which was adopted by the vast majority of the 118 member countries, including Brazil. The Brazilian Code regulates the marketing of infant formulas, baby bottles, teats, pacifiers, milk, and processed complementary food.

Research aims

(1) To determine if retail stores had violated the Brazilian Code and (2) to analyze factors associated with these violations.

Methods

This cross-sectional study included all drugstores, supermarkets, and department stores in the Southern Zone of Rio de Janeiro City, Brazil. Trained health professionals observed retail stores for marketed products and violations of the Brazilian Code and then interviewed their managers. Factors associated with the retail stores violating the Brazilian Code (outcome) were analyzed, employing a logistic regression model with 95% Confidence Interval.

Results

Of the retail stores ( N = 349) evaluated, 62.8% violated the Brazilian Code, ranging from 1 to 37 violations per retail store. The most common promotion strategies were price discounts and special displays. Retail stores being part of a chain store (aOR = 4.59) and their manager receiving visits from industry business representatives (aOR = 2.14) were associated with the presence of violations.

Conclusions

The prevalence of Brazilian Code violations was high, especially in chain stores. The association between regular visits by industry representatives and violations suggests an indirect influence of manufacturers on the promotion of human milk substitutes. We recommend strengthening compliance with the Brazilian Code through calling on governmental surveillance agencies and civil society mobilization.
Community Change Concepts and Health Policy Implications
Authors: Ortiz Mario R.
Published: December 2020

Nursing knowledge is housed in its paradigms, philosophies, models, and theories. This knowledge must be utilized to demark nursing’s unique contributions within healthcare, regardless of the setting. The purpose of this paper is to explore the ways in which Parse’s community model may serve as a way to think about health policies and the unique ways policies may connect to nursing knowledge. Within this paper, there is a discussion about health policy, Parse’s humanbecoming paradigm, and policy development reflected upon with change concepts within the humanbecoming community model. This exploration is important because “disciplinary knowledge is the foundation for transforming health policy and health care delivery systems” (American Academy of Nursing, 2020, para. 1).
Dispensing with the theory (and philosophy) of affordances
Authors: Mota Sergio
Published: December 2020

This article will contest the claim made by many ecological psychologists that affordances are invariantly the objects of perception. First of all, the lack of agreement concerning what affordances actually are, what their true nature is, is considerable. Second, the metaphysico-ontological debate has obscured the important misunderstanding consisting in conceiving of affordances as ecological objects or entities of any kind. Third, an appropriate analysis of the notion of affordance will show that this concept is not primarily devoted to perception, and believing that it is has unnecessarily impoverished what we (can) see in our environment. From a Wittgensteinian and an ethnomethodological approach, to make sense of the relation between ourselves and our environments we should use only those concepts available to us, and the internal relation between our everyday concepts and the way we invoke them in practice will be shown. No theory of meaning is needed here.
CWL: A conditional weighted likelihood method to account for the delayed joint toxicity–efficacy outcomes for phase I/II clinical trials
Authors: Zhang Yifei , Zang Yong
Published: December 2020

The delayed outcome issue is common in early phase dose-finding clinical trials. This problem becomes more intractable in phase I/II clinical trials because both toxicity and efficacy responses are subject to the delayed outcome issue. The existing methods applying for the phase I trials cannot be used directly for the phase I/II trial due to a lack of capability to model the joint toxicity–efficacy distribution. In this paper, we propose a conditional weighted likelihood (CWL) method to circumvent this issue. The key idea of the CWL method is to decompose the joint probability into the product of marginal and conditional probabilities and then weight each probability based on each patient’s actual follow-up time. The CWL method makes no parametric model assumption on either the dose–response curve or the toxicity–efficacy correlation and therefore can be applied to any existing phase I/II trial design. Numerical trial applications show that the proposed CWL method yields desirable operating characteristics.
A study on the personal data processing and the UCPD focused on Italy, Germany and the UK
Authors: Nišević Maja
Published: December 2020

Manipulation with Big Data Analytics allows commercial exploitation of individuals based on unfair commercial practices. Consequently, the concepts of consumer protection are essential in the data-driven economy and a central issue for effective safety for individuals in the Big Data Age. Although the fields of consumer protection and data protection in the European Union (EU) have developed separately, there is an unambiguous relationship between them. While the GDPR plays a crucial role in an individual’s data protection in a case of personal data processing, Directive 2005/29/EC (UCPD) plays an essential role in regulating an individual’s protection from the unfair commercial practice when it comes to personal data processing. A vital aspect of the UCPD is the enforcement of issues related to consumer privacy. However, a much-debated question is whether the UCPD is fully effective or not when it comes to personal data processing. This paper examines case law examples on WhatsApp and Facebook in Italy, Germany and the United Kingdom. This paper also aims to come to a conclusion on the issue of the applicability of the rules on unfair commercial practice when it comes to data processing.
Increasing Career Advancement Opportunities Through Sponsorship: An Identity-Based Model With Illustrative Application to Cross-Race Mentorship of African Americans
Authors: Randel Amy E. , Galvin Benjamin M. , Gibson Cristina B. , Batts Sharifa I.
Published: December 2020

The sponsorship function of mentoring has vast potential to increase career advancement for African American protégés in cross-race mentoring relationships but is not well understood. We conceptualize the processes, practices, and challenges involved in cross-race sponsorship of African American protégés through an identity perspective. We provide a theory regarding how identity processes are involved at different stages of cross-race sponsorship involving African American protégés, as well as for their mentors, by drawing on identity, diversity, and mentoring research. This work is suggestive of opportunities for improvement in the sponsorship function of mentoring in order to increase career advancement for African American protégés and provides theoretical contributions to research on identity, diversity, and career advancement.
Activated Clotting Time (ACT) for Monitoring of Low-Dose Heparin: Performance Characteristics in Healthy Adults and Critically Ill Patients
Authors: Wehner Johannes E. , Boehne Martin , David Sascha , Brand Korbinian , Tiede Andreas , Bikker Rolf
Published: December 2020

Dose adjustment of unfractionated heparin (UFH) anticoagulation is an important factor to reduce hemorrhagic events. High doses of heparin can be monitored by Activated Clotting Time (ACT). Because of limited information about the monitoring of low-dose heparin we assessed monitoring by ACT, aPTT and anti-Xa. Blood samples from healthy volunteers (n = 54) were treated ex vivo with increasing UFH doses (0-0.4 IU/ml). Samples from ICU-patients (n = 60), were drawn during continuous UFH infusion. Simultaneous ACT measurements were performed using iSTAT and Hemochron. In UFH treated blood, iSTAT and Hemochron showed a significant change of ACT at ≥0.075 IU/ml and ≥0.1 IU/ml UFH, respectively. In ICU-patients no relationship between ACT and either UFH dose, aPTT and anti-Xa was observed. Hemochron was affected by antithrombin and platelet count. iSTAT was sensitive to CRP and hematocrit. A moderate correlation was identified between UFH dose and aPTT (R2 = 0.196) or anti-Xa (R2 = 0.162). In heparin-spiked blood, ACT is sensitive to heparin at levels of ≥0.1 IU/ml heparin. In ICU-patients, ACT did not correlate with UFH dose or other established methods. Both systems were differently influenced by certain parameters.
Inhibition of IL-13: A New Pathway for Atopic Dermatitis
Authors: Ratnarajah Kayadri , Le Michelle , Muntyanu Anastasiya , Mathieu Steve , Nigen Simon , Litvinov Ivan V. , Jack Carolyn S. , Netchiporouk Elena
Published: December 2020

Dupilumab, a monoclonal antibody against the common receptor of interleukin (IL)-4 and IL-13, was the first biologic therapy approved in Canada for treatment of moderate-to-severe atopic dermatitis (AD). While it is considered safe and effective, dupilumab is not universally effective and 8%-38% of patients develop conjunctivitis, while some patients develop head and neck dermatitis. Thus, new therapeutic options are warranted. While both IL-4 and IL-13 play important roles in the pathogenesis of AD, it has been recently demonstrated that IL-13 is the primary upregulated cytokine in AD skin biopsy samples. A placebo-controlled phase 2b clinical trial evaluating the efficacy and safety of lebrikizumab, an IL-13 inhibitor, in AD demonstrated that, at 16 weeks, Eczema Area and Severity Index (EASI) 75 and Investigator’s Global Assessment (IGA) 0/1 were achieved by 60.6% and 44.6% of patients taking lebrikizumab at its highest dose (vs 24.3% and 15.3% of patients taking placebo, respectively). Moreover, treatment with lebrikizumab was associated with rapid improvement of pruritus and low rates of conjunctivitis (1.4%-3.8%). Another IL-13 monoclonal antibody, tralokinumab, was evaluated for safety and efficacy in moderate-to-severe AD. By week 12, among adults receiving 300 mg tralokinumab, 42.5% achieved EASI-75 and 26.7% achieved IGA 0/1 score (vs 15.5% and 11.8% in the placebo group, respectively). Both lebrikizumab and tralokinumab demonstrated acceptable safety profiles in AD (and non-AD) trials with adverse events often being comparable between treatment and control groups. Thus, IL-13 inhibitors may provide a safe and effective treatment alternative for patients with moderate-to-severe AD.