bluuebunny/crossref_metadata_2025 huggingface dataset:
The Battle over Syria's Reconstruction
Authors: Hinnebusch Raymond
Published: February 2020

Reconstruction is becoming the new battleground in the Syrian conflict – its continuation by other means. It is instrumentalized by the regime as a way to reconsolidate its control over the country and by rival regional and international powers to shape the internal balance of power and establish spheres of influence in the country. The paper examines the Asad regime's practices, including co‐optation of militia leaders via reconstruction concessions and use of reconstruction to clear strategic areas of opposition‐dominated urban settlements. The paper then surveys how the geopolitical struggle in Syria has produced an asymmetry as regards reconstruction: those powers that lost the geopolitical contest on the ground seek to use geo‐economic superiority to reverse the geopolitical outcome. First the impact of proxy wars and spheres of influence in the country on the security context for reconstruction is examined. Finally, the reconstruction initiatives of the various external parties are assessed, including Russia, Iran and Turkey as well as the spoiler role by which the US seeks to obstruct reconstruction that would spell victory in Syria for its Russian and Iranian rivals.
Europe in a Turbulent World: Four Comments
Authors: Wade Robert H.
Published: February 2020

The way ahead should be to greatly strengthen the doctrine of ‘subsidiarity,’ to protect against the EU taking on tasks it does not need to perform. This may have costs in terms of economic efficiency, due to more policy incoherence; but these costs have to be weighed against the economic gains from more scope for policy experimentation and copying.
Enhancing Europe’s Economic Global Power
Authors: Buti Marco
Published: February 2020

EU bodies and institutions where the EU has a substantial influence should also lead by example and encouraging the use of the euro in their operations namely, debt issuances and international payments. An increase in euro‐denominated debt could represent a natural hedge, as it would lead to a better matching between the foreign exchange position of assets and liabilities.
Salvage surgery for advanced non‐small cell lung cancer after targeted therapy: A case series
Authors: Song Weian , Di Shouyin , Liu Junqiang , Fan Boshi , Zhao Jiahua , Zhou Shaohua , Chen Siyu , Dong Hai , Yue Caiying , Gong Taiqian
Published: February 2020

Background

Tumor recurrence or residual tumor after targeted therapy is common in patients with advanced non‐small cell lung cancer (NSCLC). There is a lack of high‐level evidence on which type of treatment should be employed for these patients and the role of salvage surgery has not been well reported in the literature.

Methods

A retrospective analysis of patients who underwent salvage surgery in our center between January 2016 and June 2019 for advanced NSCLC after targeted therapy was performed.

Results

A total number of nine patients were identified, including five males and four females, with a median age of 56 years (range, 40–65 years), all diagnosed with lung adenocarcinoma stage IIIa–IVb. All patients had received targeted therapy according to individual positive mutation of driver gene(s). Salvage surgery was performed for tumor recurrence or residual tumor after a duration of 2–46 months of targeted therapy. A negative surgical margin was achieved in all cases. Postoperative complication rate was 11.1% (1/9). All patients were alive at the time of this analysis and two patients had disease progression. After a median follow‐up of 17 months (range: 5–44 months), the median event‐free survival and postoperative survival was 14 months (range: 2–44 months) and 17 months (range: 5–44 months) respectively.

Conclusions

Salvage surgery may be a feasible and promising therapeutic option for tumor recurrence or residual tumor in advanced NSCLC in selective patients after targeted therapy.

Key points

Salvage surgery is feasible in selected patients with advanced NSCLC and provides promising survival outcomes after targeted therapy failure.

Salvage surgery provides precise molecular and pathological information which is most important for subsequent therapy.
The Real Winner's Curse
Authors: Fergusson Leopoldo , Querubin Pablo , Ruiz Nelson A. , Vargas Juan F.
Published: February 2020

Traditional theories of democracy suggest that political representation of excluded groups can reduce their incentives to engage in conflict and lead to lower violence. However, this argument ignores the response of established elites when (1) their interests are threatened by the policy stance of new political actors and (2) elites have a comparative advantage in the exercise of violence. Using a regression discontinuity approach, we show that the narrow election of previously excluded left‐wing parties to local executive office in Colombia results in a one standard deviation increase in violent events by right‐wing paramilitaries. We interpret this surge in violence as a reaction of traditional elites to offset the increase in outsiders' access to formal political power. Consistent with this interpretation, we find that violence by left‐wing guerrillas and other actors is unaffected and that violence is not influenced by the victory of right‐wing or other new parties in close elections.
Do Gender Quotas Hurt Less Privileged Groups? Evidence from India
Authors: Karekurve‐Ramachandra Varun , Lee Alexander
Published: February 2020

How do political gender quotas affect representation? We suggest that when gender attitudes are correlated with ethnicity, promoting female politicians may reduce the descriptive representation of traditionally disadvantaged ethnic groups. To assess this idea, we examine the consequences of the implementation of random electoral quotas for women on the representation of caste groups in Delhi. Constituencies reserved for women are less likely than unreserved constituencies to elect members of groups where the status of women is low. In practice, this means they are less likely to elect members of several traditionally underprivileged groups (especially OBC castes) and more likely to elect candidates from the Hindu upper castes. The results highlight the difficulties of balancing descriptive representation on multiple, crosscutting dimensions, and the possible unintended consequences of the type of single‐dimension quotas currently proposed for inclusion in the Indian constitution.
Use of social media for surgical education in Australia and New Zealand
Authors: Larkins Kirsten , Murphy Victoria , Loveday Benjamin P. T.
Published: February 2020

Background

Social media are an increasingly important tool for educators, although their use for surgical education in Australia and New Zealand (ANZ) has not been quantified. This study aimed to determine the social media presence of surgical training institutions in ANZ, quantify the proportion of their social media content that is educational, compare engagement between educational and non‐educational content, and determine perspectives on using social media for education.

Methods

An online search was conducted in October 2018 to determine the social media presence of surgical training institutions accredited to deliver under‐ and post‐graduate surgical education in ANZ. All their posts on Facebook and Twitter from November 2017 to October 2018 were categorized as educational or non‐educational. Engagement on Twitter was analysed using retweets. An online survey was distributed to each institution to investigate their social media strategy and opinions on the use of social media for surgical education.

Results

Seven out of 37 (19%) surgical training institutions had active social media accounts. Educational content accounted for 677/4615 (14.7%) of their posts. Educational content was retweeted more often than non‐educational content (17.2 versus 5.4, P = 0.002). Seven out of 37 (19%) institutions responded to the survey, with one respondent having a policy for and utilising social media for surgical education.

Conclusions

Social media are being used by a minority of surgical training institutions for educational purposes in ANZ. Social media content is primarily non‐educational although educational posts attract more engagement. Further research is required to assess the efficacy of surgical education on social media.
Exposure to blue LED light before the onset of darkness under a long‐day photoperiod alters melatonin secretion, feeding behaviour and growth in female dairy calves
Authors: Elsabagh Mabrouk , Mon Mamiko , Takao Yui , Shinoda Akiko , Watanabe Takashi , Kushibiki Shiro , Obitsu Taketo , Sugino Toshihisa
Published: February 2020

The effect of blue LED on melatonin secretion, feeding behaviour and growth was addressed in Holstein female dairy calves. In Exp.1, six animals (8 weeks old, 97 ± 4.1 kg BW) were exposed to yellow or blue LED for 2 hr before darkness over 7 days under a long‐day photoperiod (LDPP). In Exp. 2, six animals (8 weeks old, 88.5 ± 4.8 kg BW) were exposed to blue light from a white LED all daytime or a yellow LED for 2 hr before the darkness of LDPP (blue light cut) over 3 weeks. In Exp. 1, blue light mildly suppressed melatonin secretion during the 2‐hr treatment but did not affect the timing of the nightly melatonin rise. However, the rise in nighty melatonin levels was higher with yellow than blue LED. In Exp. 2, white LED completely suppressed melatonin secretion during the 2‐hr treatment, but plasma melatonin concentrations were similar during the darkness. Grass hay intake, rumination time, frequency of water intake and body weight gain were higher in animals exposed to the yellow rather than the white LED. Overall results indicate that exposure to blue light from white LEDs under an LDPP suppresses melatonin secretion and might negatively impact the development of female dairy calves.
What is the appropriate anticoagulation strategy for thrombotic antiphospholipid syndrome?
Authors: Arachchillage Deepa R. J. , Laffan Mike
Published: February 2020

Antiphospholipid syndrome (APS) is an autoimmune prothrombotic disorder mediated by a heterogeneous group of autoantibodies collectively known as antiphospholipid antibodies (aPL). They include lupus anticoagulant (LA), IgG and IgM anticardiolipin antibodies (aCL) and anti‐β2‐glycoprotein I (anti‐β2GPI) antibodies. It has been shown that those patients with all three aPL (triple positive) are at highest risk of both a first thrombotic event and of a recurrence, despite anticoagulation. In response to publication of a meta‐analysis and a randomised controlled trial assessing the safety and efficacy of rivaroxaban versus warfarin in triple‐positive APS with venous and/or arterial thrombosis, the Medicines and Healthcare Products Regulatory Agency (MHRA) and European Medicines Agency (EMA) issued recommendations that direct‐acting oral anticoagulant (DOACs) should not be used for secondary prevention of thrombosis in all APS patients (although they did draw specific attention to the high risk of triple‐positive patients). As there is less evidence for patients with single‐ or dual‐positive patients with APS, this may be an over‐interpretation of the data. In this review, we explore the available evidence on safety and efficacy of DOACs in thrombotic APS, the problem of detecting LA while on DOAC, and provide some practical guidance for managing this problem.
Characterisation and prognostic impact of immunoparesis in relapsed multiple myeloma
Authors: Chakraborty Rajshekhar , Rybicki Lisa , Nakashima Megan O. , Dean Robert M. , Faiman Beth M. , Samaras Christy J. , Rosko Nathaniel , Dysert Hayley , Valent Jason , Anwer Faiz
Published: February 2020

Characterisation and prognostic impact of immunoparesis in relapsed multiple myeloma (MM) is lacking in the current literature. We evaluated 258 patients with relapsed MM, diagnosed from 2008 to 2015, to investigate the prognostic impact of deep immunoparesis on post‐relapse survival. On qualitative immunoparesis assessment, no, partial and full immunoparesis was present in 9%, 30% and 61% of patients, respectively. Quantitative immunoparesis was assessed by computing the average relative difference (ARD) between polyclonal immunoglobulin(s) and corresponding lower normal limit(s), with greater negative values indicating deeper immunoparesis. The median ARD was −39%, with an optimal cut‐off of −50% for overall survival (OS) by recursive partitioning analysis. Deep immunoparesis (ARD ≤–50%) was associated with a higher tumour burden at first relapse compared to none/shallow [ARD >−50%] immunoparesis. The OS (P = 0·007) and progression‐free survival (PFS; P < 0·001) differed significantly between the deep and none/shallow immunoparesis groups. Kaplan–Meier estimates for 3‐year OS were 36% and 46%, and for 2‐year PFS were 17% and 27%, respectively. On multivariable analysis (MVA) for PFS, both qualitative and quantitative immunoparesis retained negative prognostic impact independently. However, only quantitative immunoparesis was independently prognostic for OS on MVA. Depth of immunoparesis in relapsed MM is an important prognostic factor for post‐relapse survival in the era of novel agents and continuous therapy.
Somite boundary determination in normal and clock‐less vertebrate embryos
Authors: Naoki Honda , Matsui Takaaki
Published: February 2020

Vertebrate segments called somites are generated by periodic segmentation of the presomitic mesoderm (PSM). In the most accepted theoretical model for somite segmentation, the clock and wavefront (CW) model, a clock that ticks to determine particular timings and a wavefront that moves posteriorly are presented in the PSM, and somite positions are determined when the clock meets the posteriorly moving wavefront somewhere in the PSM. Over the last two decades, it has been revealed that the molecular mechanism of the clock and wavefront in vertebrates is based on clock genes including Hes family transcription factors and Notch effectors that oscillate within the PSM to determine particular timings and fibroblast growth factor (FGF) gradients, acting as the posteriorly moving wavefront to determine the position of somite segmentation. A clock‐less condition in the CW model was predicted to form no somites; however, irregularly sized somites were still formed in mice and zebrafish, suggesting that this was one of the limitations of the CW model. Recently, we performed interdisciplinary research of experimental and theoretical biological studies and revealed the mechanisms of somite boundary determination in normal and clock‐less conditions by characterization of the FGF/extracellular signal‐regulated kinase (ERK) activity dynamics. Since features of the molecular clock have already been described in‐depth in several reviews, we summarized recent findings regarding the role of FGF/ERK signaling in somite boundary formation and described our current understanding of how FGF/ERK signaling contributes to somitogenesis in normal and clock‐less conditions in this review.
Implementation of the perfect plasticity approximation with biogeochemical compartments in R
Authors: Erickson Adam , Strigul Nikolay
Published: February 2020

Modeling forest ecosystems is a landmark challenge in science, due to the complexity of the processes involved and their importance in predicting future planetary conditions. While there are a number of open‐source forest biogeochemistry models, few papers exist detailing the software development approach used to develop these models. This has left many forest biogeochemistry models large, opaque and/or difficult to use, typically implemented in compiled languages for speed. Here, we present a forest biogeochemistry model from the SORTIE‐PPA class of models, PPA‐SiBGC. Our model is based on the perfect plasticity approximation with simple biogeochemistry compartments and uses empirical vegetation dynamics rather than detailed prognostic processes to drive the estimation of carbon and nitrogen fluxes. This allows our model to be used with traditional forest inventory data, making it widely applicable and simple to parameterize. We detail the conceptual design of the model as well as the software implementation in the R language for statistical computing. Our aim is to provide a useful tool for the biogeochemistry modeling community that demonstrates the importance of vegetation dynamics in biogeochemical models.
Neofusicoccum parvum associated with pomegranate branch canker in Iran
Authors: Golmohammadi Hadi , Arzanlou Mahdi , Rabbani Nasab Hojjatollah
Published: February 2020

Pomegranate (Punica granatum) is native to Iran and neighbouring countries and is negatively affected by a wide range of diseases. Canker and dieback diseases caused by Cytospora punicae and members of the family Botryosphaeriaceae are the main trunk diseases on pomegranate. In summer 2017, progressive dieback of branches on some young pomegranate trees was observed in orchards of the Gorgan Region (Golestan province, Northeast Iran). Fungal colonies with similar colony colour were isolated from symptomatic tissues. The identity of the causal agent was determined as Neofusicoccum parvum, based on a polyphasic taxonomic approach including morphological features of conidiomata and phylogenetic inference based on the ITS‐rDNA region and translation elongation factor 1 alpha (tef1‐α) gene. Koch's postulates were fulfilled using an excised shoot method. This study provides the first report on the occurrence of N. parvum as a cause of branch canker on pomegranate in Iran.
Opinion: Is gene mapping in wild populations useful for understanding and predicting adaptation to global change?
Authors: Gienapp Phillip
Published: February 2020

Changing environmental conditions will inevitably alter selection pressures. Over the long term, populations have to adapt to these altered conditions by evolutionary change to avoid extinction. Quantifying the ‘evolutionary potential’ of populations to predict whether they will be able to adapt fast enough to forecasted changes is crucial to fully assess the threat for biodiversity posed by climate change. Technological advances in sequencing and high‐throughput genotyping have now made genomic studies possible in a wide range of species. Such studies, in theory, allow an unprecedented understanding of the genomics of ecologically relevant traits and thereby a detailed assessment of the population's evolutionary potential. Aimed at a wider audience than only evolutionary geneticists, this paper gives an overview of how gene‐mapping studies have contributed to our understanding and prediction of evolutionary adaptations to climate change, identifies potential reasons why their contribution to understanding adaptation to climate change may remain limited, and highlights approaches to study and predict climate change adaptation that may be more promising, at least in the medium term.
Evaluation of a fully automated von Willebrand factor assay panel for the diagnosis of von Willebrand disease
Authors: Stufano Francesca , Baronciani Luciano , Bucciarelli Paolo , Boscarino Marco , Colpani Paola , Pagliari Maria Teresa , Peyvandi Flora
Published: February 2020

Introduction

von Willebrand disease (VWD) diagnosis starts with first level tests: factor VIII coagulant activity, VWF antigen (VWF:Ag) and platelet‐dependent VWF activity (VWF:RCo, VWF:Ab, VWF:GPIbR or VWF:GPIbM). The VWF collagen binding (VWF:CB) assay measures the binding capacity of von Willebrand factor (VWF) to collagen.

Aim

To assess, in previously diagnosed VWD patients, the performance of a fully automated chemiluminescent test panel including VWF:Ag, VWF:GPIbR and VWF:CB assays.

Methods

The patients, historically evaluated using in‐house VWF:Ag and VWF:CB assays and an automated latex enhanced immunoassay VWF:GPIbR method, were re‐evaluated using the VWF test panel HemosIL AcuStar.

Results

The VWF:GPIbR/VWF:Ag and VWF:CB/VWF:Ag obtained by means of AcuStar showed an overall good concordance with the corresponding data obtained at the time of the historical diagnosis. When discrepancies occurred, these were generally due to the lower VWF:CB/VWF:Ag obtained with AcuStar as compared with that obtained with the historical methods and this affected particularly the diagnosis of VWD type 2M. Together, the AcuStar VWF:GPIbR/VWF:Ag and VWF:CB/VWF:Ag were able to distinguish type 1 from types 2A, 2B and 2M, whereas no distinction was possible between type 2A and 2B.

Conclusion

The AcuStar panel offers a good performance in the differential diagnosis between VWD type 1 and 2A/2B patients. A high rate of coincidence with historical diagnosis was obtained for VWD types 3, 2A/2B and 1. Even though in some cases more tests (eg, RIPA/multimeric analysis) are needed to complete an accurate VWD classification, the AcuStar panel is considered a sensitive, rapid and reliable tool to diagnose VWD patients.
Multicentre pharmacokinetic evaluation of rFVIII‐Fc (efmoroctocog alfa) in a real life and comparison with non‐extended half‐life FVIII concentrates
Authors: Pouplard Claire , Sattler Laurent , Ryman Anne , Eschwege Valérie , De Maistre Emmanuel , Flaujac Claire , Szymezak Jean , Grand François , Repesse Yohann , Galinat Hubert , Donnard Magali , Ternisien Catherine , Iorio Alfonso , Chelle Pierre , Jeanpierre Emmanuelle ,   On behalf of the ‘Biology Study Group on Haemorrhagic Diseases’ (Group BIMHO ‐ GFHT)
Published: February 2020

The use of enhanced half‐life (EHL) FVIII has improved the quality of prophylaxis in haemophilia A, but with a benefit that may vary from one patient to another. We analysed the pharmacokinetic data obtained with efmoroctocog alfa (rFVIII‐Fc) in 114 patients and, in 47 cases, compared them to those previously measured with non‐EHL FVIII. The in vivo recovery (IVR) of rFVIII‐Fc measured with one stage clotting assay (OSA) and chromogenic assay (CSA) was 2.2 and 2.8 IU/mL per IU/kg, respectively. The median half‐life (T1/2) of rFVIII‐Fc was 14.5 hours whatever the FVIII:C assay used, but variable and correlated with preinfusion VWF:Ag levels (r = .76). Both IVR and T1/2 were lower in patients under 12 years old (2.4 IU/mL per IU/kg and 11.1 hours, respectively; CSA). PK study of rFVIII‐Fc vs non‐EHL FVIII showed a T1/2 ratio of 1.4 in favour of rFVIII‐Fc, regardless of the patient's age. However the relative increase in T1/2 with rFVIII‐Fc was lower than 30% in one‐third of patients evaluated, particularly when the previous FVIII administered was a BHK‐derived product. This study therefore suggests that analysis of individual PK profile in response to a specific FVIII concentrate is potentially useful before a switch in haemophilia A patients.
Quantitative prediction of the glass‐forming region and luminescence properties in Tm3+‐doped germanate laser glasses
Authors: Qian Guoquan , Tang Guowu , Qian Qi , Xiao Yongbao , Chen Dongdan , Jiang Zhonghong , Yang Zhongmin
Published: February 2020

Germanate laser glasses have received much attention as a promising host materials for mid‐infrared fiber lasers in recent years because of the outstanding infrared transparency, low phonon energy, and high rare earth solubility of such glasses. However, the development of high‐performance germanate laser glasses is usually based on intuition and a trial‐and‐error method, which can involve long experimental periods and high costs, and thus, this approach is highly inefficient. Recently, with proposals for materials genome engineering, the concept of the “glass genome” has grown of interest to us. Herein, the structures of Tm3+‐doped germanate laser glasses (BaO–GeO2 and BaO–La2O3–GeO2) were investigated by Fourier transform infrared spectra (FTIR) and Raman spectra analyses, which revealed that the resulting glass contains similar structural groups to the neighboring congruently melted glassy compounds (NCMGCs) in the composition diagram. What is more, the structure and properties of the resulting laser glasses largely depend on NCMGCs. Then, the glass‐forming region, physical properties, and luminescence properties were calculated via the use of NCMGCs in Tm3+‐doped BaO–GeO2 binary and BaO–La2O3–GeO2 ternary laser glass systems. The calculated results were in good agreement with the experimental results, thus demonstrating that our approach is practical for predicting the glass‐forming region, physical properties, and luminescence properties in Tm3+‐doped BaO–GeO2 binary and BaO–La2O3–GeO2 ternary laser glass systems. This work may provide an effective method to develop Tm3+‐doped germanate laser glasses rapidly and at low cost.
Pulsed field ablation for pulmonary vein isolation in the treatment of atrial fibrillation
Authors: Bradley Christopher J. , Haines David E.
Published: February 2020

Pulsed‐field ablation (PFA) is a promising new ablation modality for the treatment of atrial fibrillation. This energy form employs a train of microsecond duration high amplitude electrical pulses that ablate myocardium by electroporation of the sarcolemmal membrane without measurable tissue heating. The ablation pulse waveform has multiple variable components that can affect ablation efficacy, thus each proprietary system has unique properties that cannot be generalized to other systems. Success with PFA depends upon the proximity of the electrode to the target tissue, but not necessarily upon contact. A unique feature of PFA is tissue specificity. Myocardium is very susceptible to irreversible injury whereas the esophagus, phrenic nerves, pulmonary veins, and coronary arteries are relatively resistant to injury. The tissue specificity of PFA may result in a wide therapeutic range and improved safety profile during atrial fibrillation ablation. Vein isolation can be achieved very rapidly (seconds) promising that PFA may reduce procedure time to 1 hour or less. This attractive new technology promises to be a major advance in the field of atrial fibrillation ablation.
The evolution of gene‐guided management of inherited arrhythmia syndromes: Peering beyond monogenic paradigms towards comprehensive genomic risk scores
Authors: Rowe Matthew K. , Roberts Jason D.
Published: February 2020

Inherited arrhythmia syndromes have traditionally been viewed as monogenic forms of disease whose pathophysiology is driven by a single highly penetrant rare genetic variant. Although an accurate depiction of a proportion of genetic variants, the variable penetrance frequently noted in genotype positive families and the presence of sporadic genotype negative cases have long highlighted a more nuanced truth being operative. Coupled with our more recent recognition that many rare variants implicated in inherited arrhythmia syndromes possess unexpectedly high allele frequencies within the general population, these observations have contributed to the realization that a spectrum of pathogenicity exists among clinically relevant genetic variants. Notably, variable mutation pathogenicity and corresponding variable degrees of penetrance emphasize a limitation of contemporary guidelines, which attempt to dichotomize genetic variants as pathogenic or benign. Recognition of the existence of low and intermediate penetrant variants insufficient to be causative for disease in isolation has served to emphasize the importance of additional genetic, clinical, and environmental factors in the pathogenesis of rare inherited arrhythmia syndromes. Despite being rare, it has also become increasingly evident that common genetic variants play critical roles in both heritable channelopathies and cardiomyopathies and in aggregate may even be the primary drivers in certain instances, such as genotype negative Brugada syndrome. Our growing realization that the genetic substrates of inherited arrhythmia syndromes have intricacies that extend beyond traditionally perceived monogenic paradigms has highlighted a potential value of leveraging more comprehensive genomic risk scores for predicting disease development and arrhythmic risk.
A comparative study of pericardial effusion and pleural effusion after cryoballoon ablation or radiofrequency catheter ablation of atrial fibrillation
Authors: Xiao Fang Yi , Ju Wei Zhu , Chen Hong Wu , Huang Wei Jian , Chen Minglong
Published: February 2020

Introduction

The incidence and clinical outcome of pericardial and pleural effusion after cryoballoon ablation (CBA) or radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) have not been fully investigated.

Methods

A total of 60 patients with paroxysmal AF were treated with either CBA (n = 30) or RFCA (n = 30) groups, with assessment of serum troponin I level, left atrial pulmonary vein computed tomography (CT) angiography and echocardiography within 24 hours before ablation, and serum troponin I level at 12 hours, and chest CT and echocardiography within 24 hours postablation. Repeat chest CT was performed 1 month after the index procedure in patients with pericardial or pleural effusion.

Results

With similarly distributed baseline characteristics, the CBA group relative to the RFCA group had postablation: higher serum troponin I level (13.48 vs 1.84 µg/L, P < .001); similarly high pericardial effusion rates on chest CT (80% vs 93.3%, P > .05), with chest CT yielding significantly higher detection rate than echocardiography; similarly high pleural effusion rates on chest CT (73.3% vs 80%, P > .05); and smaller maximum depths on chest CT cross‐section of pericardial effusion (5.21 ± 3.37 vs 7.13 ± 2.68 mm, P < .05) and pleural effusion bilaterally (left: 4.16 ± 4.90 vs 6.96 ± 5.42 mm; right: 5.04 ± 4.46 vs 7.55 ± 4.95 mm, both P < .05). The effusions self‐resolved within a mean period of 1 month.

Conclusions

Both CBA and RFCA were associated with high rates of pericardial and pleural effusion, with RFCA yielding numerically higher incidence and significantly higher effusion extent, and chest CT significantly higher detection rates than echocardiography.
Developing and applying a costing tool for hypertension and related cardiovascular disease: Attributable costs to salt/sodium consumption
Authors: Nilson Eduardo Augusto Fernandes , da Silva Everton N. , Jaime Patrícia C.
Published: February 2020

This paper proposes a costing tool for hypertension and cardiovascular disease by adapting cost‐of‐illness methodologies to estimate the attributable burden of excessive salt intake on cardiovascular disease. The methodology estimates the changes in blood pressure that result from each gram change in salt intake and links diet to the direct and indirect costs of cardiovascular diseases (CVD), such as coronary heart disease, stroke, hypertensive disease, aortic aneurysm, heart failure, pulmonary embolism, and rheumatic heart, using the relative risks of disease and the prevalence of salt consumption in the population. The methodology includes (a) identifying major diseases and conditions related to excessive salt intake and relevant economic cost data available, (b) quantifying the relationship between the prevalence of excessive salt intake and the associated risk of disease morbidity and mortality using population attributable risks (PAR), (c) using PARs to estimate the share of total costs directly attributed to excessive salt intake, and (d) undertaking a sensitivity analysis of key epidemiological and economic parameters. The costing tool has estimated that, in 2013, US$ 102.0 million (95% uncertainty interval—UI: US$ 96.2‐107.8 million) in public hospitalizations could be saved if the average salt intake of Brazilians were reduced to 5 g/d, corresponding to 9.4% (95% UI: 8.9%‐9.9%) of the total hospital costs by CVDs. This methodology of cost of illness associated with salt consumption can be adapted to estimate the burden of other dietary risk factors and support prevention and control policies in Brazil and in other countries.
Association between the methylation of theSTAT1andSOCS3in peripheral blood and gastric cancer
Authors: Han Qian , Zhou Haibo , Xie Wenzhen , Sun Tong , Wei Rongrong , Nie Chuang , Hong Jia , Zhu Lin , Tian Wenjing
Published: February 2020

Background and Aim

DNA methylation is an important epigenetic modification that can promote the development of various cancers. TheSTAT1andSOCS3have been observed to be hypermethylated in tumor tissues and peripheral blood. This study aimed to explore the relationship between the methylation status of theSTAT1andSOCS3in peripheral blood and gastric cancer (GC).

Methods

This hospital‐based case‐control study involved 372 patients with GC and 379 controls. The methylation status of theSTAT1andSOCS3was semiquantitatively determined using the methylation‐sensitive high‐resolution melting method. Logistic regression analysis was used to analyze the relationship between theSTAT1andSOCS3methylation status and GC susceptibility. Moreover, propensity scores were used to control confounding factors.

Results

Compared with negative methylation, the positive methylation ofSOCS3significantly increased the risk of GC (ORa = 1.820, 95% CI: 1.247–2.658,P = 0.002). This trend was also found via stratified analysis, and methylation positivity of theSOCS3significantly increased the risk of GC in the < 60 years group, in the ≥ 60 years group, and in the positiveHelicobacter pyloriinfection group (ORa = 1.654, 95% CI: 1.029–2.660,P = 0.038; ORa = 1.957, 95% CI: 1.136–3.376,P = 0.016; ORa = 2.084, 95% CI: 1.270–3.422,P = 0.004, respectively). Additionally, no significant association was found betweenSTAT1methylation and GC risk (ORa = 0.646, 95% CI: 0.363–1.147,P = 0.135). This study found that the interaction between the methylation status ofSTAT1andSOCS3and environmental factors did not have an impact on GC risk.

Conclusion

SOCS3methylation may serve as a new potential biomarker for GC susceptibility.
Internal Resource Allocation and External Alliance Activity of Diversified Firms
Authors: Cabral Joseph J. , Deng Chaoqun , Kumar M. V. Shyam
Published: February 2020

Prior research suggests that diversified firms are often unable to match resources to the market needs and opportunities of their divisions due to factors such as influence activities. In this research, we propose that when such internal inefficiencies arise, diversified firms may form alliances to access resources externally to support their divisions in their industries and operations. Using a sample of US firms between 1997 and 2006, we find that, on average, diversified firms form more alliances within industries that they currently operate in when compared to single business firms. The alliancing activity in related industries increases when businesses with diverse growth opportunities exist within the same firm, and it decreases with the intensity of internal control and coordination mechanisms. Our study suggests a link between internal resource allocation processes and external alliancing activity, while highlighting that alliances may play an important role in how diversified firms manage the inefficiencies that arise within their boundaries.
The Epworth sleepiness scale: Reliably unreliable in a sleep clinic population
Authors: Lee Jessica Louise , Chung Yewon , Waters Edward , Vedam Hima
Published: February 2020

The Epworth Sleepiness Scale is used frequently to measure excessive daytime sleepiness in research and clinical settings, although there is limited evidence on test–retest reliability, particularly among sleep clinic populations. The objective of this study was to evaluate the reliability of this instrument among adult patients recruited from a public hospital sleep clinic in Sydney, Australia. English‐speaking participants self‐completed the Epworth Sleepiness Scale on two occasions, at the specialist clinic visit and on the night of diagnostic polysomnography. Of the 108 participants included in the study, the majority were male (64%) and the mean age was 51 years. The median retest interval was 64 days. The primary outcome of test–retest reliability as measured using the intraclass correlation coefficient was 0.73 (95% confidence interval, 0.61–0.82). Despite moderate statistical reliability and a low mean difference of 1.1, Bland‐Altman analysis showed an unacceptably wide distribution of between‐score differences. The 95% limits of agreement were −8.5 to +10.6, and an absolute difference in scores of at least 3 was observed in 60 (56%) of the participants. Our results suggest that the Epworth Sleepiness Scale should not be used in clinical settings to make individual‐level comparisons, such as the effect of therapeutic interventions, or to prioritise access to services.
Dental disease in alpacas. Part 1: Prevalence of dental disorders and their mutual relationships
Authors: Proost Kirsten , Pardon Bart , Pollaris Elke , Flahou Thijs , Vlaminck Lieven
Published: February 2020

Background

Dental disease is a troublesome health concern in alpacas. Specifically, the occurrence of tooth root abscesses has been described in veterinary literature. Nevertheless, no objective prevalence data are available for dental disorders in alpacas.

Hypothesis/objectives

To determine the prevalence of dental disorders in alpaca herds in Belgium and the Netherlands. To study the associations between the different dental disorders encountered in alpacas.

Animals

A total of 228 alpacas (Vicugna pacos) originating from 25 farms.

Methods

This is a cross‐sectional study. Dental disorders were diagnosed by dental examination of sedated animals using a dental mirror or a portable rigid oroscope.

Results

At the animal level, 82% (n = 187) had dental disorders of which 74.6, 41.7, and 3.9% were cheek teeth, incisor disorders, and canine disorders, respectively. At the level of the cheek teeth, diastemata (43.1%) were most common, followed by wear abnormalities (WA; 39.6%) and periodontal disease (PD; 33.3%). A significant association was detected between the presence of diastemata and PD (odds ratio [OR], 13.1; 95% confidence interval [CI], 6.6‐27.7; P < .001). Pulp exposure was significantly associated with the presence of diastemata (OR, 11.8; 95% CI, 3.8‐51.5; P < .001), PD (OR, 8.2; 95% CI, 3.1‐25.3; P < .001) and WA (OR, 2.9; 95% CI, 1.2‐7.4; P = .002).

Conclusion and Clinical Importance

Dental disorders are highly prevalent in alpacas in Belgium and the Netherlands. Several dental disorders in alpacas had significant associations. To prevent the development of advanced stages of dental disease, routine dental examinations are advised to allow early detection and prompt treatment.
Modified Pedicle Subtraction Osteotomy for Osteoporotic Vertebral Compression Fractures
Authors: Kim Sung‐Kyu , Chung Jae‐Yoon , Park Yong‐Jin , Choi Seung‐Won , Seo Hyoung‐Yeon
Published: February 2020

Objective

To evaluate the cases of osteoporotic compression fracture with kyphotic deformity treated with modified pedicle subtraction osteotomy and analyze the usefulness of this osteotomy.

Methods

Twenty patients (nine men, 11 women; mean age, 66.4 years; mean follow‐up duration, 39.6 months) who underwent modified pedicle subtraction osteotomy at our hospital between November 2003 and July 2012 with a minimum follow‐up period of 2 years were included. All cases were injuries induced by a fall incurred while standing or lifting heavy objects without high‐energy trauma. The mean bone mineral density‐dual energy x‐ray absorptiometry (BMD‐DEXA) was 0.673 g/cm2 (0.571–0.740 g/cm2), which was ‐2SD below normal, indicating severe osteoporosis. The indications for surgery included gait disturbance due to severe pain with pseudarthrosis, increased kyphotic angle, and progressive neurological symptoms. We evaluated Japanese Orthopaedic Association scores, Oswestry Disability Index scores, bone union, change in kyphotic angle, estimated blood loss, complications, and the patient's overall clinical satisfaction.

Results

The collapsed vertebrae were thoracic (T9, 11, 12) in 13 cases and lumbar (L1) in seven cases. The mean pre‐ and post‐operative kyphotic angles were 26.2 ± 9.9 degrees and 8.3 ± 8.1 degrees, showing an 18.3‐degree correction. Plain radiography at the last follow‐up showed a mean angle of 17.9 ± 12.6 degrees, indicating a 9.5‐degree correction loss. The overall correction was 8.2 degrees. Bony union was achieved at the last follow‐up in all cases. Clinical outcomes showed improvement in mean Japanese Orthopaedic Association score from 13.2 to 21.7 and mean Oswestry Disability Index score from 40.3 to 13.6. Overall clinical patient satisfaction showed 12 excellent results, five moderate results, and three poor results. Mean operation time was 4.2 h (range, 4–6 h). The overall mean estimated blood loss (EBL) was 1098 mL (range, 750–1370 mL). The mean hospital stay was 3.6 weeks (range, 2–6 weeks). There was one case of cauda equina syndrome at 2 days postoperatively, and two cases of screw loosening. There were no cases of distal junctional kyphosis, but there were two cases of proximal junctional kyphosis.

Conclusions

Despite limited correction of kyphotic angle, our modified pedicle subtraction osteotomy technique resulted in satisfactory outcomes in our patients, who had persistent severe back pain, increased kyphotic angle with pseudarthrosis, and progressive neurologic deficits. Nevertheless, this procedure requires careful follow‐up and strict surgical indications because of the risk of neurological damage and technical problems.
Characterization of a novel HLA‐DRB1*03 allele, DRB1*03:171
Authors: González‐Escribano María Francisca , Balas Antonio , Muñoz‐García Raquel , Ortiz‐Aljaro Pilar , Vicario José Luis
Published: February 2020

DRB1*03:171 was described in a Caucasian Spanish family.
Birthplace of the São Francisco Craton, Brazil: Evidence from 3.60 to 3.64 Ga Gneisses of the Mairi Gneiss Complex
Authors: Oliveira Elson P. , McNaughton Neal J. , Zincone Stefano A. , Talavera Cristina
Published: February 2020

Records of Earth's primitive crust are scarce. Eoarchean (older than 3.6 Ga) banded mafic to felsic gneisses have been discovered in the São Francisco Craton, Brazil, pushing back by over 100 million years the oldest gneisses known to date in South America (3.5 Ga). Zircon U‐Pb data yield rock ages from 3,598 to 3,642 Ma with a few ca. 3.65–3.69 Ga grains suggesting even older rocks in the area. Zircon grains show significantly negative to nearly chondritic initial εHf values and two‐stage model ages from 3.82 to 4.33 Ga, which may indicate the existence of a recycled Hadean to early Eoarchean crust in the region. The felsic gneisses are chemically similar to the low‐pressure Tonalite‐Trondhjemite‐Granodiorite association whereas the mafic gneisses have geochemical signatures that resemble within‐plate basaltic andesite to andesite of Iceland (icelandites). The results are relevant to constrain the composition of Earth's first continental crust.
Kidney function of Japanese children undergoing kidney transplant with preemptive therapy for cytomegalovirus infection
Authors: Gotoh Yoshimitsu , Shishido Seiichiro , Hamasaki Yuko , Watarai Yoshihiko , Hattori Motoshi , Miura Kenichiro , Ishizuka Kiyonobu , Fujita Naoya , Saito Kazuhide , Nakagawa Yuki , Hotta Kiyohiko , Hataya Hiroshi , Hamada Riku , Sato Hiroyuki , Kitayama Hirotsugu , Ishikura Kenji , Honda Masataka , Uemura Osamu
Published: February 2020

Background

Cytomegalovirus (CMV) infection is one of the major factors that affect morbidity and mortality in kidney transplant (KTx) patients. The rate of CMV seropositivity in children before KTx is lower than that in adults; therefore, pediatric KTx patients have a higher risk of CMV infection. In Japanese pediatric KTx patients, preemptive therapy for CMV infection is a main conventional therapy. This study investigated whether this preemptive treatment would affect kidney function at 2 years post‐KTx.

Methods

A total of 163 patients, that is approximately half of the Japanese pediatric KTx patients nationwide, were recruited to participate in our study. We compared the values of the sequential estimated glomerular filtration rate (eGFR) at two years post‐KTx and other influencing factors in CMV viremia, CMV disease, and no‐infection groups.

Results

Cytomegalovirus infection after KTx occurred in 75 patients (46.0%), 38.7% of whom developed CMV disease. The sequential eGFR values post‐KTx did not differ significantly between the three groups. CMV infection was not significantly correlated with other factors, other infections (including Epstein‐Barr [EB] virus infection), acute rejection (AR), or adverse events. Only prolonged duration of total hospitalization was significantly associated with CMV infection (P = .002). In the multivariate analysis, younger age, CMV infection, and adverse effects were independently significantly related to prolonged total hospitalization.

Conclusion

Preemptive therapy for CMV infection evidenced by viremia and disease did not significantly influence kidney function in Japanese pediatric KTx patients at two years after the operation.
Morphotypes or distinct species? A multilocus assessment of two East Asian scimitar babblers (Aves, Timaliidae)
Authors: Dai Chuanyin , Dong Feng , Yang Xiaojun
Published: February 2020

In birds, widespread species complexes often exhibit dramatic plumage differences across their distribution, which can give rise to discordance between morphotypes and phylogroups. Accurate identification of species diversity may require an integrated approach in which multilocus genetic data are used for inference and further corroborated by ecological, morphometric or behavioural data. Pomatorhinus gravivox and P. swinhoei, which were formerly considered component races of P. erythrogenys, were recently split using a delimitation system that mainly relied on the quantification of differences in phenotypic traits. We therefore carried out a reassessment of this taxonomic recommendation by conducting phylogenetic and population genetic analyses with multilocus genetic data. A deep mitochondrial split with a Kimura 2‐parameter distance of 0.061 was observed, mainly corresponding to the two morphologically defined species. However, one individual from P. swinhoei harboured a haplotype of P. gravivox. Individual‐based analyses of nuclear loci identified two distinct clusters that were exactly congruent with the two species. BPP delimitation also provided support for the separation. These congruencies support the notion that these two taxa are best regarded as two separate species. The presence of the P. gravivox mitochondrial haplotype in P. swinhoei was most likely a result of hybridization, due to the clear separation of nuclear loci. The speciation might be attributed to paleoclimatic changes but requires further evaluation due to the likelihood of ecological speciation. This study was in accordance with the results inferred from the quantitative system but highlighted the importance of sampling various data, especially in contact zones, in the study of taxonomy and speciation history.
Study of the Influence of Geometric Parameters in an Innovative Scraped Surface Heat Exchanger With Helical Ribbon
Authors: Ali Sirine , Baccar Mounir
Published: February 2020

This work aims to characterize the hydrodynamic and thermal behaviors in an innovative scraped surface heat exchanger (SSHE) equipped with helical ribbon by means of the numerical simulation approach. In this study, the conservation equations of continuity, momentum, and energy in the laminar, steady-state and isothermal conditions are resolved using a specific computational fluid dynamics (CFD) code based on the 3D finite volume method. The effects of the gap between the exchanger wall and the tip of the ribbon, the ribbon width, and the number of turns in the ribbon on the hydrodynamic and thermal behaviors are studied. Varying the gap values leads to reveal an optimum value giving the highest heat transfer coefficient. Moreover, numerical results have shown that increasing the ribbon width improves the heat transfer. Furthermore, the influence of the number of turns is carried out for Reynolds number ratios (Rer/Rea) inferior and superior to 1. Results revealed that increasing the number of turns avoids the back-mixing phenomenon and thus improves the heat transfer. In this study, the establishment of correlation is determined with the introduction of dimensionless and geometrical groups to predict the heat transfer coefficient in SSHE.