bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the detection of underwater metal-containing objects by fusion of ferromagnetic sensors data with vehicle’s navigational data
Authors: Frolov D A , Gromoshinsky D A , Korsakov A M , Yu Smirnova E
Published: August 2019

Currently, the task of developing the Arctic shelf is relevant, because there are proven reserves of minerals – oil and gas. Undoubtedly, researchers and engineers, after installing the appropriate underwater infrastructure, will face the task of maintenance and repair of communications. For this purpose, autonomous unmanned underwater vehicles (AUV) can be used, with e.g. the task of inspecting pipelines. The article describes the processing algorithm for the signal from passive ferromagnetic sensors mounted on an AUV carrier used to search for metal-containing objects at the sea bottom. A scheme for such a measurement is proposed - the installation of two sensors at opposite ends of the carrier. This allows to measure the gradient of magnetic field between the sensors. The characteristic form of such a signal and the dependence of the signal on the motion parameters of the vehicle and external factors are determined. To eliminate false positives, filters are used based on the readings of the position, speed and orientation sensors of the navigation system. Using data on the motion parameters of the device allows to generate a reference signal, which is used to validate the detection of an object using the cross-correlation method. The use of data on orientation angles makes it possible to compensate for the influence of the orientation of the device in the Earth’s magnetic field.
CROSSMAPPER: estimating cross-mapping rates and optimizing experimental design in multi-species sequencing studies
Authors: Hovhannisyan Hrant , Hafez Ahmed , Llorens Carlos , Gabaldón Toni
Published: August 2019

Motivation

Numerous sequencing studies, including transcriptomics of host-pathogen systems, sequencing of hybrid genomes, xenografts, mixed species systems, metagenomics and meta-transcriptomics, involve samples containing genetic material from divergent organisms. A crucial step in these studies is identifying from which organism each sequencing read originated, and the experimental design should be directed to minimize biases caused by cross-mapping of reads to incorrect source genomes. Additionally, pooling of sufficiently different genetic material into a single sequencing library could significantly reduce experimental costs but requires careful planning and assessment of the impact of cross-mapping. Having these applications in mind we designed Crossmapper, the first to our knowledge tool able to assess cross-mapping prior to sequencing, therefore allowing optimization of experimental design.

Results

Using any combination of reference genomes, Crossmapper performs read simulation and back-mapping of those reads to the pool of references, quantifies and reports the cross-mapping rates for each organism. Crossmapper performs these analyses with numerous user-specified parameters, including, among others, read length, read layout, coverage, mapping parameters, genomic or transcriptomic data. Additionally, it outputs the results in highly interactive and publication-ready reports. This allows the user to perform multiple comparisons at once and choose the experimental setup minimizing cross-mapping rates. Moreover, Crossmapper can be used for resource optimization in sequencing facilities by pooling different samples into one sequencing library.

Availability and implementation

Crossmapper is a command line tool implemented in Python 3.6 and available as a conda package, allowing effortless installation. The source code, detailed information and a step-by-step tutorial is available at our GitHub page https://github.com/Gabaldonlab/crossmapper.

Supplementary information

Supplementary data are available at Bioinformatics online.
Impact of aortic stenosis on layer-specific longitudinal strain: relationship with symptoms and outcome
Authors: Ilardi Federica , Marchetta Stella , Martinez Christophe , Sprynger Muriel , Ancion Arnaud , Manganaro Roberta , Sugimoto Tadafumi , Tsugu Toshimitsu , Postolache Adriana , Piette Caroline , Cicenia Marianna , Esposito Giovanni , Galderisi Maurizo , Oury Cécile , Dulgheru Raluca , Lancellotti Patrizio
Published: August 2019

Aims

The present study sought to assess the impact of aortic stenosis (AS) on myocardial function as assessed by layer-specific longitudinal strain (LS) and its relationship with symptoms and outcome.

Methods and results

We compared 211 patients (56% males, mean age 73 ± 12 years) with severe AS and left ventricular ejection fraction (LVEF) ≥50% (114 symptomatic, 97 asymptomatic) with 50 controls matched for age and sex. LS was assessed from endocardium, mid-myocardium, and epicardium by 2D speckle-tracking echocardiography. Despite similar LVEF, multilayer strain values were significantly lower in symptomatic patients, compared to asymptomatic and controls [global LS: 17.9 ± 3.4 vs. 19.1 ± 3.1 vs. 20.7 ± 2.1%; endocardial LS: 20.1 ± 4.9 vs. 21.7 ± 4.2 vs. 23.4 ± 2.5%; epicardial LS: 15.8 ± 3.1 vs. 16.8 ± 2.8 vs. 18.3 ± 1.8%; P < 0.001 for all]. On multivariable logistic regression analysis, endocardial LS was independently associated to symptoms (P = 0.012), together with indexed left atrial volume (P = 0.006) and LV concentric remodelling (P = 0.044). During a mean follow-up of 22 months, 33 patients died of a cardiovascular event. On multivariable Cox-regression analysis, age (P = 0.029), brain natriuretic peptide values (P = 0.003), LV mass index (P = 0.0065), LV end-systolic volume (P = 0.012), and endocardial LS (P = 0.0057) emerged as independently associated with cardiovascular death. The best endocardial LS values associated with outcome was 20.6% (sensitivity 70%, specificity 52%, area under the curve = 0.626, P = 0.022). Endocardial LS (19.1 ± 3.3 vs. 20.7 ± 3.3, P = 0.02) but not epicardial LS (15.2 ± 2.8 vs. 15.9 ± 2.5, P = 0.104) also predicted the outcome in patients who were initially asymptomatic.

Conclusion

In patients with severe AS, LS impairment involves all myocardial layers and is more prominent in the advanced phases of the disease, when the symptoms occur. In this setting, the endocardial LS is independently associated with symptoms and patient outcome.
Routine preoperative aortic computed tomography angiography is associated with reduced risk of stroke in coronary artery bypass grafting: a propensity-matched analysis
Authors: Sandner Sigrid E , Nolz Richard , Loewe Christian , Gregorich Mariella , Heinze Georg , Andreas Martin , Kolh Philippe , Zimpfer Daniel , Laufer Guenther
Published: August 2019

OBJECTIVES

The aim of this study was to determine stroke rates in patients who did or did not undergo routine computed tomography angiography (CTA) aortic imaging before isolated coronary artery bypass grafting (CABG).

METHODS

We conducted a retrospective analysis of a prospectively maintained single-centre registry. Between 2009 and 2016, a total of 2320 consecutive patients who underwent isolated CABG at our institution were identified. Propensity score matching was used to create a paired cohort of patients with similar baseline characteristics who did (CTA cohort) or did not (non-CTA cohort) undergo preoperative aortic CTA. The primary end point of the analysis was in-hospital stroke.

RESULTS

In 435 propensity score-matched pairs, stroke occurred in 4 patients (0.92%) in the CTA cohort and in 14 patients (3.22%) in the non-CTA cohort (P = 0.017). Routine preoperative aortic CTA was associated with a significantly reduced risk of in-hospital stroke [relative risk 0.29, 95% confidence interval (CI) 0.09–0.86; P = 0.026; absolute risk reduction 2.3%, 95% CI 0.4–4.2; P = 0.017; number needed to treat = 44, 95% CI 24–242].

CONCLUSIONS

A preoperative screening for atheromatous aortic disease using CTA is associated with reduced risk of stroke after CABG. The routine use of preoperative aortic CTA could be applied so that surgical manipulation of the ascending aorta can be selectively reduced or avoided in patients with atheromatous aortic disease.
Atrial fibrillation diagnosed after stroke and dementia risk: cohort study of first-ever ischaemic stroke patients aged 65 or older
Authors: Krawczyk Michal , Fridman Sebastian , Cheng Yi , Fang Jiming , Saposnik Gustavo , Sposato Luciano A
Published: August 2019

Aims

Atrial fibrillation (AF) is a risk factor for dementia among ischaemic stroke patients in whom the AF was known before the stroke (KAF). Atrial fibrillation detected after stroke (AFDAS) has a different profile compared to KAF, including less frequent cardiovascular comorbidities and lower CHA2-DS2-VASC scores. Currently, it is unknown if AFDAS is also associated with increased dementia risk. We assessed the association between AFDAS and the incident risk of dementia. We also evaluated whether the use of oral anticoagulants (OAC) was associated with lower dementia risk among AFDAS patients.

Methods and results

In this cohort study, we classified 9791 first-ever ischaemic stroke patients from the Ontario Stroke Registry into four groups: (i) No AF, (ii) KAF, (iii) Inpatient AFDAS (diagnosed during admission), and (iv) Outpatient AFDAS (diagnosed after discharge). We used multivariable Cox proportional models to estimate hazard ratios (HR) for the association between AFDAS and incident dementia risk. Dementia was determined through administrative datasets based on previously validated algorithms. In adjusted analyses, the dementia risk was higher for inpatient AFDAS [HR 1.78, 95% confidence interval (CI) 1.51–2.10] and outpatient AFDAS (HR 1.74, 95% CI 1.47–2.05) relative to no AF. Oral anticoagulants use was associated with lower dementia risk among patients with inpatient AFDAS (HR 0.58, 95% CI 0.43–0.79) and outpatient AFDAS (HR 0.60, 95% CI 0.43–0.83).

Conclusion

Atrial fibrillation detected after stroke was independently associated with higher risk of dementia relative to no AF. Among patients with AFDAS, the use of OACs was associated with lower dementia risk.
Barriers and opportunities for prolonging working life across different occupational groups: the SeniorWorkingLife study
Authors: Andersen Lars L , Jensen Per H , Sundstrup Emil
Published: August 2019

Background

Increasing retirement age is a pivotal issue in labour market reforms. This study analyses factors conditioning retirement intentions.

Methods

In SeniorWorkingLife, 11 444 employed workers ≥50 years replied to questions in random order about expected reasons for leaving and potential reasons for staying longer at the labour market. Respondents were stratified based on the Danish version of International Standard Classification of Occupations (ISCO). Representative estimates were produced using the SurveyFreq and SurveyLogistic procedures of SAS combined with model-assisted weights based on national registers.

Results

For ISCO groups 1–4 (seated work) main expected reasons for retiring were freedom to choose and desire for more leisure time, but many would consider staying longer if there were better possibilities for additional senior days, longer vacations and flexible working hours. For ISCO groups 5–9 (physical work), poor physical health and not being capable of doing the job were common expected reasons for retiring, but many would consider staying longer if the work were less physically demanding and there were more senior days. Possibility for pension was a general expected reason for retiring. Expected reasons differed to a less extent between genders than between ISCO groups, e.g. economic factors were more important for men and high work demands more important for women.

Conclusion

Different barriers and opportunities for prolonging working life exist across different occupational groups of the labour market—with most consistent differences between those with seated and physical work. Targeting these specifically seems opportune for policy makers and future interventions.
Utility of catastrophizing, body symptom diagram score and history of opioid use to predict future health care utilization after a primary care visit for musculoskeletal pain
Authors: Rhon Daniel I , Lentz Trevor A , George Steven Z
Published: August 2019

Background

Self-report information about pain and pain beliefs are often collected during initial consultation for musculoskeletal pain. These data may provide utility beyond the initial encounter, helping provide further insight into prognosis and long-term interactions of the patient with the health system.

Objective

The aim of this study was to determine if pain catastrophizing and pain-related body symptoms can predict future health care utilization.

Methods

This was a longitudinal cohort study. Baseline data were collected after receiving initial care for a musculoskeletal disorder in a multidisciplinary clinic within a large military hospital. Subjects completed the Pain Catastrophizing Scale, a region-specific disability measure, numeric pain rating scale and a body symptom diagram. Health care utilization data for 1 year prior and after the visit were extracted from the Military Health System Data Repository. Multivariable regression models appropriate for skewed and count data were developed to predict (i) musculoskeletal-specific medical visits, (ii) 12-month opioid use, (iii) musculoskeletal-specific medical costs and (iv) total medical costs. We investigated whether a pain catastrophizing × body symptom diagram interaction improved prediction, and developed separate models for opioid-naïve individuals and those with a history of opioid use in an exploratory analysis.

Results

Pain catastrophizing but not body symptom diagram was a significant predictor of musculoskeletal visits, musculoskeletal costs and total medical costs. Exploratory analyses suggest these relationships are most robust for patients with a history of opioid use.

Conclusions

Pain catastrophizing can identify risk of high health care utilization and costs, even after controlling for common clinical variables. Addressing pain catastrophizing in the primary care setting may help to mitigate future health care utilization and costs, while improving clinical outcomes. These results provide direction for future validation studies in larger and more traditional primary care settings.
Measurement Invariance and Developmental Trajectories of Multidimensional Self-Perceptions of Aging in Middle-Aged and Older Adults
Authors: Jung Seojung , Cham Heining , Siedlecki Karen L , Jopp Daniela S
Published: August 2019

Objectives

This study examined the measurement invariance and longitudinal trajectories of multidimensional self-perceptions of aging (SPA) and factors that predict between-person variability in the level and change of SPA in middle-aged and older adults.

Method

Data were drawn from the German Ageing Survey spanning four waves, covering a 15-year period. Multidimensional SPA was assessed with the Personal Experience of Aging Scale, consisting of three dimensions, physical decline, social loss, and continuous growth.

Results

The measurement invariance models across age groups (middle-aged versus older adults) and across time showed a good fit after allowing one item to vary at metric and/or scalar levels. Growth curve models showed only minor declining trajectories in two of the three dimensions of SPA, social loss and continuous growth dimensions, toward more negative views. Participants with poor resources in general were more likely to have negative SPA across all three dimensions. The protective effect of having a spouse was observed on only the social dimension of SPA, supporting a domain-specific effect of having a spouse.

Discussion

The study demonstrates the usefulness of a multidimensional understanding of SPA and recognizes the need for identifying different factors that may promote positive perceptions on aging in different dimensions of life.
Life Histories and National Narratives: Remembering Occupied Manchuria in Postwar China
Authors: Dryburgh Marjorie
Published: August 2019

Recent studies of memory work in China have explored productively the uses of national narratives of war and victimhood, at times supported by personal testimony, in service of a ‘public transcript’ of Party-state legitimacy. However, oral histories of education in Japanese-occupied north-east China, collected by Chinese researchers and published in 2005, hint at more complex relations between story, storyteller and imagined audience. Without challenging established judgements on the occupation itself, these personal histories articulate more nuanced and ambivalent social histories of wartime schooling, suggesting that former students were neither passive victims of occupation nor passive consumers of state-sponsored historical narrative.
Western Gunrunners, (Middle-)Eastern Casualties: Unlawfully Trading Arms with States Engulfed in Yemeni Civil War?
Authors: Ferro Luca
Published: August 2019

According to the United Nations Secretary-General, Yemen today constitutes the worst man-made humanitarian crisis in the world. It is fuelled by extensive third-state involvement, with none of the warring parties championing respect for international human rights and humanitarian law (to put it mildly). Conversely, primary rules of international law already prohibit arms transfers from the moment there is a significant risk that they could be used to commit or facilitate grave breaches, with the recipient’s past and present record of respect for international law qualifying as the crucial factor to predict future transgressions. From that perspective, it appears deeply disingenuous for western states to continue transferring military equipment to members of the multilateral coalition in Yemen while maintaining adherence to the international legal framework. This article thus aims to examine whether the legal framework lives up to its noble goals or rather serves to defend state decisions that primarily serve their economic interests. It is structured as follows: Section 1 starts with an overview of the facts, and the focus and aim of this article. Section 2 then sets out the international legal framework as it applies to the trade in conventional arms with states that are involved in a non-international armed conflict. Section 3 analyses key domestic judgments (in the UK, Canada, Belgium and France) to test the available facts against the legal framework as elaborated. Finally, Section 4 concludes.
Pittsburgh’s Freedom House Ambulance Service: The Origins of Emergency Medical Services and the Politics of Race and Health
Authors: Edwards Matthew L
Published: August 2019

This manuscript explores the history of the Freedom House Enterprises Ambulance Service, a social and medical experiment that trained “unemployable” black citizens during the late 1960s and early 1970s to provide then state of the art prehospital care. Through archives, newspapers, personal correspondence, university memoranda, and the medical literature, this paper explores the comparable, yet different roles of the program’s two leaders, Drs. Peter Safar and Nancy Caroline. Despite its success in demonstrating national standards for paramedic training and equipment, the program ended abruptly in 1975. And though Pittsburgh’s city administration cited economic constraints for its fledgling support of Freedom House, black and majority newspapers and citizens alike understood the city’s diminishing support of the program in racial terms. The paper discusses Safar and Caroline’s well-intentioned efforts in developing this novel program, while confronting the racial, social, and structural constraints on the program and the limits of racial liberalism.
Phylogeography and taxonomic revision of Nelson’s pocket mouse (Chaetodipus nelsoni)
Authors: Neiswenter Sean A , Hafner David J , Light Jessica E , Cepeda Gabriella D , Kinzer Kathleen C , Alexander Lois F , Riddle Brett R
Published: August 2019

Chaetodipus nelsoni occurs on rocky substrates across the Mexican Altiplano. We investigated phylogeographic diversity within the species using morphologic, karyotypic, and molecular data. Data from nuclear (AFLP) and mitochondrial DNA support three distinct genetic groups with minimal substructuring coincident with biogeographic barriers previously identified in the Chihuahuan Desert and drainage basins of the Altiplano. We examined the morphological and karyotypic data in light of the molecular data. The results support recognition of three species within the currently accepted widespread C. nelsoni: 1) C. nelsoni restricted to a distribution centered on the El Salado River Basin; 2) elevation of C. n. collis to species, with two subspecies: one centered on Trans-Pecos Texas, the other on the Mapimí Basin (new subspecies); and 3) recognition of a new species, C. durangae, centered on the Nazas Basin and upper Río Mezquital drainage.
A method for determining sex and chromosome copy number: sex-by-sequencing reveals the first two species of marine mammals with XXY chromosome condition
Authors: Einfeldt Anthony L , Orbach Dara N , Feyrer Laura J
Published: August 2019

Molecular assays of sex determination typically rely on qualitative evaluation of sex-linked markers, which can lead to uncertainty when results contradict morphological identifiers of sex. To investigate whether disagreement between phenotypic and genotypic assays of sex could be underpinned by variation in sex chromosome copy number, we developed a quantitative genetic method to determine sex that is broadly applicable to mammals with XY sex determination. We sequenced a region of the zinc-finger gene ZF, which has fixed genetic differences between the X and Y chromosomes, and screened 173 cetacean specimens for ZFX–ZFY haplotype identity and read depth. Using a subset of 90 male specimens, we demonstrate that haplotype read depth is an accurate estimator of chromosome copy number. We identified three specimens representing two different cetacean species that had external female morphological traits, Y chromosome haplotypes, and ratios of ZFX:ZFY haplotypes that were above the 1:1 value expected for genetic males. These results provide the first evidence of XXY aneuploidy in cetaceans. Investigation of the reproductive tract of one specimen, a True’s beaked whale (Mesoplodon mirus), revealed an intersex phenotype; despite having external characteristics typically diagnostic for the female sex, a penis and testes were present. Our results suggest that intersex phenotypes may be associated with XXY aneuploidy, and that this phenomenon may be underestimated due to it not being detectable by qualitative assays for determining sex.
Landscape use by two opossums is shaped by habitat preferences rather than by competitive interactions
Authors: Cruz Paula , Iezzi María Eugenia , De Angelo Carlos , Varela Diego , Di Bitetti Mario S
Published: August 2019

Given the phylogenetic proximity and similar morphology of opossums (Didelphis spp.), they are good models to study factors that facilitate or impede coexistence of syntopic species and to better understand how landscape changes affect species distributions and habitat use. For this purpose, we used single-species and two-species occupancy models using records of D. albiventris, considered the dominant species, and D. aurita from a camera-trap survey conducted in an agricultural and conservation landscape in the Atlantic Forest of Argentina. We evaluated which factors determined the probability of species occurrence: habitat preferences or interspecific relationships. We also estimated the overlap in daily activity patterns between species, and evaluated changes in D. aurita activity in response to the occupancy probability of D. albiventris. Didelphis aurita had higher occupancy probabilities in the continuous native forest, whereas D. albiventris had higher occupancy probabilities in fragmented forests with less complex and more open vegetation structure, and greater proximity to buildings. Both opossums were almost absent in pine plantations. Results of the co-occurrence models and the overlap in diel activity suggest that D. aurita is not avoiding D. albiventris. Occurrences of these two opossums most probably reflect different adaptations by each species to different habitats, and competitive interactions seem to play a minor role in shaping their current distributions. Didelphis albiventris may be replacing D. aurita mainly as a result of changing environmental conditions, which become unfavorable to the latter but promote the creation of new habitat for the former.
Genomic and transcriptome identification of fluconazole-resistant genes for Trichosporon asahii
Authors: Xia Zhikuan , Yu Haiying , Wang Congmin , Ding Xiao , Zhang Dequan , Tan Xinyu , Chen Jianghan , Hu Songnian , Yang Rongya
Published: August 2019

Trichosporon asahii infection is difficult to control clinically. This study identified a case with over 15 years of T. asahii infection-related systemic dissemination disease and conducted genome and transcriptome sequencing to identify fluconazole-resistant genes in fluconazole-resistant versus susceptible strains isolated from this patient's facial skin lesions. The data revealed mutations of the ergosterol biosynthetic pathway-related genes in the T. asahii genome of the fluconazole-resistant strain, that is, there were 36 novel mutations of the ERG11 gene, three point mutations (V458L, D457V, and D334S) in the ERG3, and a missense mutation (E349D) in ERG5 in the fluconazole-resistant strain of the T. asahii genome. To ensure that ERG11 is responsible for the fluconazole resistance, we thus simultaneously cultured the strains in vitro and cloned the ERG11 CDS sequences of both fluconazole-susceptible and -resistant strains into the Saccharomyces cerevisiae. These experiments confirmed that these mutations of ERG11 gene affected fluconazole resistance (> 64 μg/ml vs. <8 μg/ml of the MIC value between fluconazole-resistant and -susceptible strains) in Saccharomyces cerevisiae. In addition, expression of ergosterol biosynthesis pathway genes and drug transporter was upregulated in the fluconazole-resistant strain of T. asahii. Collectively, the fluconazole resistance in this female patient was associated with mutations of ERG11, ERG3, and ERG5 and the differential expression of drug transporter and fatty acid metabolic genes.
Global approaches to promoting whole grain consumption
Authors: Toups Kelly E
Published: August 2019

There is wide global consensus that whole grains are an important component of a healthy diet, yet in many countries around the globe populations continue to fall short of recommended intakes for whole grains. This article aims to evaluate whole grain promotional strategies of various stakeholders across 4 countries with diverse culinary and cultural norms: the United States, Singapore, the Philippines, and Denmark. To do this, information was collected on regulations, NGO (nongovernmental organization) activities, and promotional campaigns across each of the target countries. The effort led to the identification of best practices for promoting whole grain consumption in both the public and private spheres.
Decision-making for active living infrastructure in new communities: a qualitative study in England
Authors: Le Gouais A , Foley L , Ogilvie D , Guell C
Published: August 2019

Background

Urban design can influence population levels of physical activity and subsequent health impacts. This qualitative study investigates local level decision-making for ‘active living’ infrastructure (ALI)—walking and cycling infrastructure and open spaces in new communities.

Methods

Thirty-five semi-structured interviews with stakeholders, and limited ethnographic observations, were conducted with local government and private sector stakeholders including urban and transport planners, public health practitioners, elected councillors and developers. Interview transcripts were coded and analysed thematically.

Results

Public health practitioners in local government could act as knowledge brokers and leaders to motivate non-health stakeholders such as urban and transport planners to consider health when designing and building new communities. They needed to engage at the earliest stages and be adequately resourced to build relationships across sectors, supporting non-health outcomes such as tackling congestion, which often had greater political traction. ‘Evidence’ for decision-making identified problems (going beyond health), informed solutions, and also justified decisions post hoc, although case study examples were not always convincing if not considered contextually relevant.

Conclusion

We have developed a conceptual model with three factors needed to bridge the gap between evidence and ALI being built: influential public health practitioners; supportive policies in non-health sectors; and adequate resources.
Extreme morning chronotypes are often familial and not exceedingly rare: the estimated prevalence of advanced sleep phase, familial advanced sleep phase, and advanced sleep–wake phase disorder in a sleep clinic population
Authors: Curtis Brian John , Ashbrook Liza H , Young Terry , Finn Laurel A , Fu Ying-Hui , Ptáček Louis J , Jones Christopher R
Published: August 2019

Study Objectives

Report the first prevalence estimates of advanced sleep phase (ASP), familial advanced sleep phase (FASP), and advanced sleep–wake phase disorder (ASWPD). This can guide clinicians on the utility of screening for extreme chronotypes both for clinical decision-making and to flag prospective participants in the study of the genetics and biology of FASP.

Methods

Data on morning or evening sleep schedule preference (chronotype) were collected from 2422 new patients presenting to a North American sleep center over 9.8 years. FASP was determined using a severity criterion that has previously identified dominant circadian mutations in humans. All patients were personally seen and evaluated by one of the authors (C.R.J.).

Results

Our results demonstrate an ASP prevalence of 0.33%, an FASP prevalence of 0.21%, and an ASWPD prevalence of at least 0.04%. Most cases of young-onset ASP were familial.

Conclusions

Among patients presenting to a sleep clinic, conservatively 1 out of every 300 patients will have ASP, 1 out of every 475 will have FASP, and 1 out of every 2500 will have ASWPD. This supports obtaining a routine circadian history and, for those with extreme chronotypes, obtaining a family history of circadian preference. This can optimize treatment for evening sleepiness and early morning awakening and lead to additional circadian gene discovery. We hope these findings will lead to improved treatment options for a wide range of sleep and medical disorders in the future.
MiRNA-target pairs regulate adventitious rooting in Populus: a functional role for miR167a and its target Auxin response factor 8
Authors: Cai Heng , Yang Chunxia , Liu Sian , Qi Haoran , Wu Ling , Xu Li-An , Xu Meng
Published: August 2019

The ability of a plant to form roots from its non-root tissues is ecologically advantageous during rapid adaptation to a changing environment. Although this biological phenomenon has been widely utilized for cuttings in many economically important agronomic and tree species, its genetic and developmental mechanisms have been poorly understood. In this study, we conducted an association analysis of small RNAs, the degradome and the transcriptome of adventitious rooting in poplar softwood cuttings, which revealed that 373 miRNA-target pairs were detected. Of these, 72 significantly differentially expressed targets were screened as likely to modulate adventitious root (AR) development, in conjunction with plant hormone signal transduction. Poplar miR167a and its targets PeARF6s and PeARF8s were subjected to functional verification of their ability to mediate plant growth and hormone signal transduction. Overexpression of miR167a inhibited target transcripts and improved lateral root (LR) development in poplar, while overexpressing PeARF8.1mut increased AR numbers and slightly inhibited LR development. Taken together, these results suggest that miR167a-PeARF8.1 modules play crucial roles in regulating AR and LR development in poplar and improve the adaptation of poplar to more complex environments.
Productivity Losses and Firm Responses to Electricity Shortages: Evidence from Ghana
Authors: Abeberese Ama Baafra , Ackah Charles Godfred , Asuming Patrick Opoku
Published: August 2019

One of the commonly cited obstacles to firms’ operations in developing economies is inadequate access to electricity. This paper explores the impact of electricity outages on firm productivity using arguably exogenous variation in outages, induced by an electricity rationing program, across small and medium-sized Ghanaian manufacturing firms. The results indicate that eliminating outages in this setting could lead to an increase in firm productivity. Further analyses of the strategies firms use to cope with outages show that changing the firm's product mix to favor less electricity-intensive products mitigates the negative impacts of outages on productivity. However, using a generator, a common strategy in many parts of the world, is unable to insulate firms from the negative impacts of outages on productivity.
Association Between Sepsis and Microvascular Brain Injury*
Authors: Ehlenbach William J. , Sonnen Joshua A. , Montine Thomas J. , Larson Eric B.
Published: August 2019

Objectives:

Many survivors of sepsis suffer long-term cognitive impairment, but the mechanisms of this association remain unknown. The objective of this study was to determine whether sepsis is associated with cerebral microinfarcts on brain autopsy.

Design:

Retrospective cohort study.

Setting and Subjects:

Five-hundred twenty-nine participants of the Adult Changes in Thought, a population-based prospective cohort study of older adults carried out in Kaiser Permanente Washington greater than or equal to 65 years old without dementia at study entry and who underwent brain autopsy.

Measurements and Main Results:

Late-life sepsis hospitalization was identified using administrative data. We identified 89 individuals with greater than or equal to 1 sepsis hospitalization during study participation, 80 of whom survived hospitalization and died a median of 169 days after discharge. Thirty percent of participants with one or more sepsis hospitalization had greater than two microinfarcts, compared with 19% participants without (χ2p= 0.02); 20% of those with sepsis hospitalization had greater than two microinfarcts in the cerebral cortex, compared with 10% of those without (χ2p= 0.01). The adjusted relative risk of greater than two microinfarcts was 1.61 (95% CI, 1.01–2.57;p= 0.04); the relative risk for having greater than two microinfarcts in the cerebral cortex was 2.12 (95% CI, 1.12–4.02;p= 0.02). There was no difference in Braak stage for neurofibrillary tangles or consortium to establish a registry for Alzheimer’s disease score for neuritic plaques between, but Lewy bodies were less significantly common in those with sepsis.

Conclusions:

Sepsis was specifically associated with moderate to severe vascular brain injury as assessed by microvascular infarcts. This association was stronger for microinfarcts within the cerebral cortex, with those who experienced severe sepsis hospitalization being more than twice as likely to have evidence of moderate to severe cerebral cortical injury in adjusted analyses. Further study to identify mechanisms for the association of sepsis and microinfarcts is needed.
Old Mice Demonstrate Organ Dysfunction as well as Prolonged Inflammation, Immunosuppression, and Weight Loss in a Modified Surgical Sepsis Model*
Authors: Stortz Julie A. , Hollen McKenzie K. , Nacionales Dina C. , Horiguchi Hiroyuki , Ungaro Ricardo , Dirain Marvin L. , Wang Zhongkai , Wu Quran , Wu Kevin K. , Kumar Ashok , Foster Thomas C. , Stewart Brian D. , Ross Julia A. , Segal Marc , Bihorac Azra , Brakenridge Scott , Moore Frederick A. , Wohlgemuth Stephanie E. , Leeuwenburgh Christiaan , Mohr Alicia M. , Moldawer Lyle L. , Efron Philip A.
Published: August 2019

Objectives:

Our goal was to “reverse translate” the human response to surgical sepsis into the mouse by modifying a widely adopted murine intra-abdominal sepsis model to engender a phenotype that conforms to current sepsis definitions and follows the most recent expert recommendations for animal preclinical sepsis research. Furthermore, we aimed to create a model that allows the study of aging on the long-term host response to sepsis.

Design:

Experimental study.

Setting:

Research laboratory.

Subjects:

Young (3–5 mo) and old (18–22 mo) C57BL/6j mice.

Interventions:

Mice received no intervention or were subjected to polymicrobial sepsis with cecal ligation and puncture followed by fluid resuscitation, analgesia, and antibiotics. Subsets of mice received daily chronic stress after cecal ligation and puncture for 14 days. Additionally, modifications were made to ensure that “Minimum Quality Threshold in Pre-Clinical Sepsis Studies” recommendations were followed.

Measurements and Main Results:

Old mice exhibited increased mortality following both cecal ligation and puncture and cecal ligation and puncture + daily chronic stress when compared with young mice. Old mice developed marked hepatic and/or renal dysfunction, supported by elevations in plasma aspartate aminotransferase, blood urea nitrogen, and creatinine, 8 and 24 hours following cecal ligation and puncture. Similar to human sepsis, old mice demonstrated low-grade systemic inflammation 14 days after cecal ligation and puncture + daily chronic stress and evidence of immunosuppression, as determined by increased serum concentrations of multiple pro- and anti-inflammatory cytokines and chemokines when compared with young septic mice. In addition, old mice demonstrated expansion of myeloid-derived suppressor cell populations and sustained weight loss following cecal ligation and puncture + daily chronic stress, again similar to the human condition.

Conclusions:

The results indicate that this murine cecal ligation and puncture + daily chronic stress model of surgical sepsis in old mice adhered to current Minimum Quality Threshold in Pre-Clinical Sepsis Studies guidelines and met Sepsis-3 criteria. In addition, it effectively created a state of persistent inflammation, immunosuppression, and weight loss, thought to be a key aspect of chronic sepsis pathobiology and increasingly more prevalent after human sepsis.
Core Outcome Measures for Research in Critically Ill Patients Receiving Extracorporeal Membrane Oxygenation for Acute Respiratory or Cardiac Failure: An International, Multidisciplinary, Modified Delphi Consensus Study*
Authors: Hodgson Carol L. , Burrell Aidan J. C. , Engeler Daniel M. , Pellegrino Vincent A. , Brodie Daniel , Fan Eddy
Published: August 2019

Objectives:

Research evaluating outcomes in critically ill patients with acute respiratory and cardiac failure supported with extracorporeal membrane oxygenation has increased significantly. The objective was to identify a core set of outcomes that are essential to include in all clinical research evaluating the use of either venoarterial or venovenous extracorporeal membrane oxygenation in critically ill patients, particularly regarding safety and adverse events.

Design:

A three-round modified Delphi process.

Subjects:

Patients, caregivers, multidisciplinary clinicians, researchers, industry partners, and research funders were included.

Setting:

Participants represented key extracorporeal membrane oxygenation organizations, including the Extracorporeal Life Support Organization, the International Extracorporeal Membrane Oxygenation Network, clinicians from high volume extracorporeal membrane oxygenation centers, and extracorporeal membrane oxygenation researchers or former extracorporeal membrane oxygenation patients from five continents.

Interventions:

We used recommended standards for the development of a core outcome set. Outcome measures identified from systematic reviews of the literature and from qualitative studies of survivors were mapped to the domains identified by the Core Outcome Measures in Effectiveness Trials initiative separately for venovenous extracorporeal membrane oxygenation and venoarterial extracorporeal membrane oxygenation.

Measurements and Main Results:

Participant response rates were 40 of 47 (85%), 35 of 37 (95%), and 64 of 69 (93%) for survey rounds 1, 2, and 3, respectively, with participants representing 10 different countries on five continents. After the third round survey, 8 outcome measures met consensus for both venovenous extracorporeal membrane oxygenation and venoarterial extracorporeal membrane oxygenation.

Conclusions:

This study identified core outcomes to assess in all research evaluating the use of extracorporeal membrane oxygenation, including adverse events specific to this intervention, permitting standardization of outcome reporting for the first time. Identifying appropriate measurement instruments to evaluate these outcomes is an important next step to enable synthesis of extracorporeal membrane oxygenation research.
Impact of Therapeutic Drug Monitoring of Antiretroviral Drugs in Routine Clinical Management of People Living With HIV: A Narrative Review
Authors: Cattaneo Dario , Baldelli Sara , Cozzi Valeria , Clementi Emilio , Marriott Deborah J. E. , Gervasoni Cristina ,   on behalf of the IATDMCT Anti-Infective Committee
Published: August 2019

Background:

The treatment of HIV infection has evolved significantly since the advent of highly active antiretroviral therapy. As a result, a response rate of 90%–95% now represents a realistically achievable target. Given this background, it is difficult to imagine the additional benefits that therapeutic drug monitoring (TDM) could provide in the management of HIV infection.

Methods:

This article is not intended to provide a systematic literature review on TDM of antiretroviral agents; rather, the authors aim to discuss the potential added value of TDM in the optimal management of people living with HIV (PLWH) in selected real-life clinical scenarios based on data collected over 10 years by their TDM service.

Results:

Some clinical situations, in which the selection of the optimal antiretroviral therapy is challenging, have been identified. These include poorly compliant patients, suboptimal antiretroviral therapies (in terms of both efficacy and toxicity), polypharmacy with a high risk of drug–drug interactions, and different patient populations, such as pregnant women.

Conclusions:

The transformation of HIV infection from a near-universally fatal illness to a lifelong chronic disease has resulted in an HIV population that is growing and aging, placing new and increasing demands on public programs and health services. Increasingly, the management of comorbidities, polypharmacy, and drug–drug interaction, and their impact on antiretroviral therapy will have to be undertaken. These clinical settings represent some of the new frontiers for the use of TDM with the goal of achieving optimal prescription and outcome for PLWH.
Graves’ hyperthyroidism in pregnancy
Authors: Nguyen Caroline T. , Mestman Jorge H.
Published: August 2019

Purpose of review

Graves’ hyperthyroidism is associated with significant obstetric, maternal, fetal, and neonatal complications. Early diagnosis and an understanding of the management of Graves’ hyperthyroidism in pregnancy can help to prevent these complications. Antithyroid drugs (ATD) should be avoided in early pregnancy, given their association with congenital malformations.

Recent findings

TSH-receptor antibodies (TRAb) are integral in the management of Graves’ hyperthyroidism in pregnancy and in the preconception period. TRAb are indicative of the current activity of Graves’ hyperthyroidism and the likelihood of relapse. Furthermore, TRAb predicts the risk of fetal and neonatal hyperthyroidism.

The incidence of congenital malformations is roughly the same for propylthiouracil (PTU) and methimazole (MMZ). Exposure to both ATDs in early pregnancy has been associated with increased incidence of congenital malformations compared with exposure to either ATD alone.

The goal of the physician is maintaining euthyroidism throughout pregnancy and delivery of a healthy, euthyroid baby. An understanding of the natural progression of Graves’ hyperthyroidism in pregnancy and the proper utilization of TRAb enables the physician to minimize the risks associated with Graves’ hyperthyroidism and side effects of ATDs unique to pregnancy. The physician should prioritize preconception counseling in women with Graves’ hyperthyroidism in order to avoid hyperthyroidism and having to use ATDs in pregnancy.
Use of multiple free flaps in head and neck reconstruction
Authors: Hsieh Tsung-yen , Bewley Arnaud
Published: August 2019

Purpose of review

To review the recent literature on the use of multiple flaps in head and neck reconstruction with attention to form, function, outcomes, and complications.

Recent findings

Multiple free flap reconstructions are technically feasible with high flap survival rates, tolerable complication rates, and overall adequate functional and aesthetic outcomes, given the large extent of the defects and the high surgical complexity of these cases.

Multiple free flap reconstructions should be considered in cases of large defects involving multiple functional regions and tissue types, which most often arises following resection of advanced malignancies. As there is mortality benefit with clear surgical margins and eradication of malignant lymph nodes, larger resections should be pursued if necessary, followed by a multiple flap reconstruction.
Oculocardiac Reflex: An Underrecognized But Important Association With Orbital Trap Door Fractures
Authors: Mehmood Noormah , Hasan Ali
Published: August 2019

Blowout fractures of the floor of the orbit can serve as a “trap door” for extraocular muscles. Presentation of inferior orbital muscle entrapment classically involves an upward gaze restriction. Diplopia and exophthalmos can also be present. Rarely, orbital fractures can result in an oculocardiac reflex, which is a triad of bradycardia, syncope, and nausea. The purpose of this study was to describe a patient who had orbital floor fracture with symptoms highly suggestive for oculocardiac reflex after a traumatic injury. Although entrapment of extraocular muscles does require early intervention to prevent ischemia and tissue necrosis, the presence of oculocardiac reflex warrants emergent evaluation and management by an ophthalmologist due to the risk of developing arrhythmias. Frequently, there may be none or very subtle clinical findings present, and abnormal motility may be the only apparent clinical sign, which can be difficult to assess in very young and uncooperative children; therefore, a high index of suspicion must be maintained for early identification and management as well as a reduction of complications.