bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards an integrated perspective of biological conservation and ecological restoration
Authors: McMahen Katie , van Bommel Joanna Klees
Published: February 2020

Biological conservation and ecological restoration differ in their motivations, objectives, and dominant concepts. These differences translate into a dichotomy between the two disciplines in academia, which we illustrate through a review of the scientific literature. Conversely, in practice, conservation and restoration are part of an environmental management continuum and are often used as complementary tools. While we found an increasing transdisciplinary trend in the literature, there is much room for improvement. Optimized implementation of conservation and restoration actions is critical for addressing the increasing pressures of global change and we propose steps to better integrate the two disciplines.
Patellofemoral alignment and geometry and early signs of osteoarthritis are associated in patellofemoral pain population
Authors: Eijkenboom Joost F. A. , van der Heijden Rianne A. , de Kanter Janneke L. M. , Oei Edwin H. , Bierma‐Zeinstra Sita M. A. , van Middelkoop Marienke
Published: February 2020

Background

Patellofemoral pain (PFP) patients show increased prevalence of patellar malalignment. Structural and alignment abnormalities of the patellofemoral joint (PFJ) may play a role in development of PFP and patellofemoral osteoarthritis (PFOA).

Objectives

Evaluating associations of patellofemoral alignment and femoral geometry with bony and cartilaginous abnormalities in PFP patients and healthy control subjects.

Methods

Data from a case‐control study were used (64 PFP subjects, 70 control subjects, 57% female, age 23.2 (6.4)). Alignment and femoral geometry measures in the PFJ were determined using MRI. Structural abnormalities in the PFJ associated with OA (bone marrow lesions, osteophytes, minor cartilage defects and Hoffa‐synovitis), quantified cartilage composition (T1ρ relaxation times) in the PFJ and perfusion within the patellar bone were examined using different MRI techniques. Associations were analyzed using regression analyses, adjusted for potential confounders.

Results

Lateral patellar tilt was negatively associated with presence of osteophytes on both patella (OR 0.91; 95% CI 0.84 to 0.98), anterior femur (OR 0.92; 95% CI 0.84 to 0.99) and minor cartilage defects on patella (OR 0.91; 95% CI 0.84 to 0.99). Patella alta was positively associated with the presence of bone marrow lesions in the patella and minor cartilage defects (OR 48.33; 95% CI 4.27 to 547.30 and OR 17.51; 95% CI 1.17 to 262.57, respectively). Patella alta and medial patellar translation were positively associated with T1ρ relaxation times within trochlear cartilage (β 5.2; 95% CI 0.77 to 9.58, and 0.36; 95% CI 0.08 to 0.64, respectively). None of the alignment and geometry measures were associated with bone perfusion.

Conclusion

Our study implies that associations between patellofemoral alignment and geometry and structural joint abnormalities linked to OA are already present in both PFP patients and healthy control subjects.
Identification of risk factors for recurrent secondary septic peritonitis following initial surgical treatment of secondary septic peritonitis in dogs
Authors: Fink Owen , Buysse Allison , Drobatz Kenneth J. , Bentley Adrienne
Published: February 2020

Objectives

To report the incidence of and risk factors for development of recurrent secondary septic peritonitis (RSSP) in dogs. To report the outcome of dogs treated surgically for RSSP.

Design

Retrospective study.

Setting

University teaching hospital.

Animals

One hundred forty‐nine client‐owned dogs treated surgically for secondary septic peritonitis (SSP).

Interventions

None.

Measurements and Results

The medical records database was searched for dogs that underwent surgery to treat SSP. Of 149 dogs that met the inclusion criteria, 15 (10.1%) dogs developed RSSP following surgery and 134 (89.9%) did not. Dogs with RSSP had significantly lower albumin prior to the first surgery to treat secondary septic peritonitis (SPsx1) (median 18 g/L [1.8 g/dL] vs 22 g/L [2.2 g/dL],P = 0.005) and significantly higher PCV prior to SPsx1 (median 52% vs 45%,P = 0.028). Dogs with septic peritonitis of gastrointestinal (GI) origin were significantly more likely to develop recurrent peritonitis than those with sepsis from a non‐GI source (odds ratio [OR], 4.4, 95% CI: 0.95–20,P = 0.041). Of dogs with sepsis of GI origin, those with sepsis due to a foreign body were significantly more likely to develop RSSP than those with GI sepsis from a non‐foreign body cause (OR, 7.2, 95% CI: 1.6–43,P = 0.0018). Of the 15 dogs in the RSSP group, 8 were euthanized without further treatment. Relaparotomy was performed in the remaining 7 cases; 3 of these (42.9%) survived.

Conclusions

There was a 10.1% rate of RSSP following SPsx1. Preoperative albumin was significantly lower and preoperative PCV was significantly higher in dogs that developed recurrence. Dogs with GI sepsis were at increased risk of recurrence and, among dogs with GI sepsis, the presence of a foreign body was an additional risk factor for recurrence.
Gestión del conocimiento en el marco de la innovación en la Facultad de Ciencias Juridicas de la Universidad de Manizales: Auditoria de conocimiento
Authors: González Carreño Camilo , Montoya Escobar Mónica Cecilia
Published: February 2020

El aporte a la optimización de la gestión del conocimiento en el Programa de Derecho de la Facultad de Ciencias Jurídicas de la Universidad de Manizales, emerge como interés primordial en este estudio y puede evidenciarse a través de la formulación de un plan de acción diseñado por los autores, luego de determinar el estado de la gestión del conocimiento de dicho programa mediante la implementación de una metodología de auditoría del conocimiento basada en el enfoque de los procesos clave de la organización. Se desarrolla bajo un enfoque empírico-analítico, cuyo nivel de análisis se identificó en dos momentos: descriptivo y propositivo, este último consistió en el plan de acción como aporte a la planeación estratégica. El plan de acción está compuesto de acciones de mejora ubicadas estratégicamente de acuerdo a los procesos de la gestión del conocimiento: adquisición, difusión y aplicación, pero también enmarcadas en la innovación educativa. El surgimiento de las acciones de mejora se dio a partir de las brechas de conocimiento existentes y detectadas. Su análisis con ánimo propositivo, permitió con este estudio, contribuir a la planificación estratégica del programa con miras a sostener los estándares de calidad misional  con los que se identifica.
Assessment of Muscular Activity and Postural Load During Coffee Harvesting Activities – A Case Study
Authors: Pelaez Sebastián Alberto , Quintana Leonardo Augusto
Published: February 2020

Objective: The goal of this case study was to analyze and evaluate the posture, force and repetitive movement risks associated with manual coffee harvesting activities. Materials and Methods: A self-discomfort report was administered to 28 participants, of whom 4 volunteered for an evaluation of postural load on muscular activity using electromyography and electrogoniometry. Eight upper limb muscles and the kinematics of the wrist and upper arm of the dominant arm were assessed. Results: The results of the self-discomfort report showed a greater demand, from the harvester’s perception, in areas such as the back, lower back, knees and feet during a period of one week of work. The outcomes of the muscular activity assessment showed that the extensor carpi ulnaris (ECR) was the muscle with the highest demand during the assessment. The dynamic activity of the muscle exceeded 20% of the maximum voluntary contraction (MVC), which classifies coffee harvesting as a threatening activity. The postural load on the body segments revealed that wrist deviation was critical due to an abnormal range of the wrists during the activity. Conclusions: It is necessary to improve the working conditions of the coffee harvesters.
Design and Characterization of a Passive Instrumented Hand
Authors: Yousaf Saad N. , Joshi Victoria S. , Britt John E. , Rose Chad G. , O’Malley Marcia K.
Published: February 2020

Although soft robotic assistive gloves have high potential for restoring functional independence for individuals with motor impairment, their lack of rigid components makes it difficult to obtain accurate position sensing to validate their performance. To track soft device motion, standard practice relies on costly optical motion capture techniques, which have reduced accuracy due to limitations in marker occlusion and device deformation. We propose the Instrumented Hand as a low-cost, open-source measurement tool to serve as a standard solution for acquiring joint-level position and torque measurements from magnetoresistive sensors. Shown in a case study, the Instrumented Hand can be used to validate soft wearable devices and evaluate range of motion (ROM) and torque capabilities.
Hydro Energy Harvesting by Using Compliant Surfaces: Preliminary Experimental Assessment
Authors: Arias Francisco J. , Heras Salvador De Las
Published: February 2020

In this work consideration is given for hydro energy harvesting contained in residual water streams. The idea lies in the bifurcation of the stream into two channels separated by a compliant surface or membrane which, albeit with equalized static pressure at both sides, nevertheless with a relative velocity. As a result of the differential dynamic pressure, a steady-state harmonic motion is established which might be transformed into an electrical output. A first experimental assessment of this idea constitutes the core of this presentation.
Fabrication process of integrated inductors on flexible substrate for radio frequency and microwave applications
Authors: Freitas Wilson J. , Piazzetta Maria H. O. , Manera Leandro T. , Gobbi Ângelo L.
Published: February 2020

This paper presents a fabrication process for integrated inductors on a flexible substrate using a simple and cost effective method. Kapton was the choice for the substrate due to its attractive characteristics such as thermal stability and electrical insulation. Metal layers were formed by the deposition of a thin Ni film onto the substrate as a seed for Au electroplating deposition and to improve the adhesion between the metal and the substrate. Au lines were patterned by lift-off and served as a mask for Ni wet etching. SiO2 was selected as the dielectric, also patterned by lift-off and preceded by a Cr e-beam deposition step to enhance adhesion. Inductor structures were formed by a conventional photolithography process. There was no need for substrate modification to improve metal adhesion with the use of an Ni intermediate layer. Using this process, it was possible to fabricate integrated inductors appropriate for radio frequency and microwave circuits on a flexible substrate with values compatible with those from the simulation and the literature.
The effect of vocal tract parameters on aspiration noise discrimination
Authors: Labuschagne Ilse B. , Ciocca Valter
Published: February 2020

Previous research showed that aspiration noise difference limens in moderately breathy /a/ vowels decreased as the spectral slope of the glottal source spectrum became increasingly steep [Kreiman and Gerratt, J. Acoust. Soc. Am. 131(1), 492–500 (2012)]. The current study investigated whether discrimination of aspiration noise levels was affected by differences in spectral shape due to vowel quality (/æ/ and /i/) and speaker identity (three male speakers) when the slope of the glottal source spectrum was fixed. The results showed that discrimination performance was worse overall for /i/ than /æ/, but the result may have resulted from relatively poor performance for the /i/ vowel of one speaker. Acoustic analyses of the stimuli were performed to estimate the association between acoustic properties and the perceptual outcomes. The results showed that both the smoothed cepstral peak prominence and the harmonic energy level between 2 and 5 kHz may account for the observed differences in aspiration noise discrimination among speakers within each vowel, but not for differences between vowel categories. It is possible that the relationship between the aspiration noise discrimination and aforementioned acoustic properties may be modulated by the spectral distribution of energy across frequency.
Biofilm Interactions of Candida albicans and Mitis Group Streptococci in a Titanium-Mucosal Interface Model
Authors: Souza João Gabriel Silva , Bertolini Martinna , Thompson Angela , Barão Valentim Adelino Ricardo , Dongari-Bagtzoglou Anna
Published: February 2020

Our findings provide new insights into the cross-kingdom interaction between
C. albicans
and
Streptococcus
species representative of the mitis group. These microorganisms colonize titanium-based dental implant materials, but little is known about their ability to cause inflammation and damage of the adjacent mucosal tissues. Using an
in vitro
biomaterial-mucosal interface infection model, we showed that mixed biofilms of each species with
C. albicans
enhance tissue damage. One possible mechanism for this effect is the increased fungal hypha-associated virulence gene expression we observed in mixed biofilms with these species. Interestingly, we also found that the interaction of multispecies biofilms with organotypic mucosal surfaces led to the release of growth-suppressing mediators of
Candida
, which may represent a homeostatic defense mechanism of the oral mucosa against fungal overgrowth. Thus, our findings provide novel insights into biofilms on biomaterials that may play an important role in the pathogenesis of mucosal infections around titanium implants.
Bacteria from the Genus
Arcobacter
Are Abundant in Effluent from Wastewater Treatment Plants
Authors: Kristensen Jannie Munk , Nierychlo Marta , Albertsen Mads , Nielsen Per Halkjær
Published: February 2020

The genus
Arcobacter
was unexpectedly abundant in the effluent from 14 Danish wastewater treatment plants treating municipal wastewater, and the species included the human-pathogenic
A. cryaerophilus
and
A. butzleri
. Recent studies have shown that
Arcobacter
is common in wastewater worldwide, so the study indicates that discharge of members of the genus
Arcobacter
may be a global problem, and further studies are needed to quantify the risk and potentially minimize the discharge. The study also shows that culture-based analyses are insufficient for proper effluent quality control, and new standardized culture-independent measurements of effluent quality encompassing most pathogens should be considered.
Hepatitis B Virus: Advances in Prevention, Diagnosis, and Therapy
Authors: Nguyen Mindie H. , Wong Grace , Gane Edward , Kao Jia-Horng , Dusheiko Geoffrey
Published: February 2020

Currently, despite the use of a preventive vaccine for several decades as well as the use of effective and well-tolerated viral suppressive medications since 1998, approximately 250 million people remain infected with the virus that causes hepatitis B worldwide. Hepatitis C virus (HCV) and hepatitis B virus (HBV) are the leading causes of liver cancer and overall mortality globally, surpassing malaria and tuberculosis. Linkage to care is estimated to be very poor both in developing countries and in high-income countries, such as the United States, countries in Western Europe, and Japan.
Epidemiology of β-Lactamase-Producing Pathogens
Authors: Bush Karen , Bradford Patricia A.
Published: February 2020

β-Lactam antibiotics have been widely used as therapeutic agents for the past 70 years, resulting in emergence of an abundance of β-lactam-inactivating β-lactamases. Although penicillinases in
Staphylococcus aureus
challenged the initial uses of penicillin, β-lactamases are most important in Gram-negative bacteria, particularly in enteric and nonfermentative pathogens, where collectively they confer resistance to all β-lactam-containing antibiotics.
GABARAPL2 Is Critical for Growth Restriction of Toxoplasma gondii in HeLa Cells Treated with Gamma Interferon
Authors: Zhang Zhaoxia , Gu Haorong , Li Qi , Zheng Jun , Cao Shinuo , Weng Changjiang , Jia Honglin
Published: February 2020

Gamma interferon (IFN-γ)-induced innate immune responses play important roles in the inhibition of
Toxoplasma gondii
infection. It has been reported that IFN-γ stimulates non-acidification-dependent growth restriction of
T. gondii
in HeLa cells, but the mechanism remains unclear. Here, we found that γ-aminobutyric acid (GABA) receptor-associated protein-like 2 (GABARAPL2) plays a critical role in parasite restriction in IFN-γ-treated HeLa cells.
mSphere of Influence: Combining Host and Pathogen Genetics To Disrupt Chronic Infections
Authors: Olive Andrew J.
Published: February 2020

Andrew J. Olive works in the field of host responses to chronic infections. In this mSphere of Influence article, he reflects on how “Tryptophan biosynthesis protects mycobacteria from CD4 T-cell-mediated killing” (Y. J. Zhang, M. C. Reddy, T. R. Ioerger, A. C. Rothchild, et al., Cell 155:1296–1308, 2013,
https://doi.org/10.1016/j.cell.2013.10.045
) impacted his own work using genetic approaches to dissect the interface between host and pathogen.
Metabolic Reprogramming in the Opportunistic Yeast Candida albicans in Response to Hypoxia
Authors: Burgain Anaïs , Tebbji Faiza , Khemiri Inès , Sellam Adnane
Published: February 2020

A critical aspect of cell fitness is the ability to sense and adapt to variations in oxygen levels in their local environment.
Candida albicans
is an opportunistic yeast that is the most prevalent human fungal pathogen. While hypoxia is the predominant condition that
C. albicans
encounters in most of its niches, its impact on fungal metabolism remains unexplored so far. Here, we provided a detailed landscape of the
C. albicans
metabolome that emphasized the importance of many metabolic routes for the adaptation of this yeast to oxygen depletion. The fungal hypoxic metabolome identified in this work provides a framework for future investigations to assess the contribution of relevant metabolic pathways in the fitness of
C. albicans
and other human eukaryotic pathogens with similar colonized human niches. As hypoxia is present at most of the fungal infection foci in the host, hypoxic metabolic pathways are thus an attractive target for antifungal therapy.
The next step in learning from sentinel events in healthcare
Authors: Bos Kelly , Dongelmans Dave A , Greuters Sjoerd , Kamps Gert-Jan , van der Laan Maarten J
Published: February 2020

Objective

The aim of this study was to evaluate the current status of handling and learning from sentinel events (SEs) in Dutch academic hospitals and to develop a basis for the first steps in a joint and transparent approach to improve learning from SEs.

Design

Survey by the Netherlands Federation of University Medical Centres (NFU) as part of the project ‘Quality-based Governance’.

Participants and setting

All eight Dutch University Medical Centres (UMCs).

Results

Three methods are used to identify the root cause of SEs: the Systematic Incident Reconstruction and Evaluation, Prevention and Recovery Information System for Monitoring and Analysis or TRIPOD method. Experts with different backgrounds are involved in the analysis of SEs. UMCs have different policies regarding the selection of recommendations for implementation. Some UMCs implement all recommendations formulated by the analysis team and in some UMCs the head of the involved department selects recommendations for implementation. No predetermined criteria have been established for this selection. Most UMCs confirm that similar SEs reoccur, which might be due to the quality of the analysis of the SEs or the quality of the recommendations.

Conclusion

There is a large variety in handling SEs in Dutch academic hospitals and standards for the selection of recommendations are lacking. A next step to decrease the number of (similar) SEs lies in a joint and transparent approach to objectively assess recommendations and further define strategies for successful implementation. Selecting high-quality recommendations for implementation has the potential to lead to a decrease in the number of (similar) SEs and increase in the quality and safety of Dutch healthcare.
Promoting appropriate utilisation of laboratory tests for inflammation at an academic medical centre
Authors: Bartlett Kristen J , Vo Ann P , Rueckert Justin , Wojewoda Christina , Steckel Elizabeth H , Stinnett-Donnelly Justin , Repp Allen B
Published: February 2020

Erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) are commonly ordered in clinical practice to evaluate for inflammation. CRP is a more sensitive and specific test for detecting acute phase inflammation, and the American Society for Clinical Pathology recommends ordering CRP rather than ESR to detect acute phase inflammation in patients with undiagnosed conditions. We sought to understand CRP and ESR ordering practices and reduce unnecessary use of ESR testing at our academic medical centre. We surveyed physician leaders in clinical areas with high utilisation of ESR testing to understand the drivers of potential overutilisation of these tests. Based on survey responses, we designed an intervention focused on education, clinical decision support within the electronic medical record and quarterly audit and feedback. We evaluated appropriateness of ESR ordering before and after the intervention via structured chart audit. Comparison of monthly rates of ESR tests during the preintervention and postintervention periods was conducted using interrupted time series analysis. Clinical habit and ease of test ordering were identified as key drivers of ESR overuse. Compared with the preintervention period, we observed a 33% reduction in the number of ESR tests per month and a 25% reduction in combined CRP and ESR tests per month during the postintervention period. This reduction corresponded to an annual avoidance of 2633 ESR tests with a corresponding estimated direct cost avoidance of $23 701 annually. Although the rate of ESR testing decreased, there was no significant improvement in the clinical appropriateness of residual ESR test ordering following the intervention. A multifaceted intervention was associated with significant decreases in unnecessary ESR tests and concurrent ESR and CRP tests at our academic medical centre. Despite these reductions, there are continued opportunities to reduce inappropriate ESR testing.
Adult liver transplantation: A UK clinical guideline - part 1: pre-operation
Authors: Millson Charles , Considine Aisling , Cramp Matthew E , Holt Andrew , Hubscher Stefan , Hutchinson John , Jones Kate , Leithead Joanna , Masson Steven , Menon Krish , Mirza Darius , Neuberger James , Prasad Raj , Pratt Anthony , Prentice Wendy , Shepherd Liz , Simpson Ken , Thorburn Doug , Westbrook Rachel , Tripathi Dhiraj
Published: February 2020

Liver transplantation is a highly successful treatment for all types of liver failure, some non-liver failure indications and liver cancer. Most referrals come from secondary care. This first part of a two-part guideline outlines who to refer, and how that referral should be made, including patient details and additional issues such as those relevant to alcohol and drug misuse. The process of liver transplant assessment involves the confirmation of the diagnosis and non-reversibility, an evaluation of comorbidities and exclusion of contraindications. Finally, those making it onto the waiting list require monitoring and optimising. Underpinning this process is a need for good communication between patient, their carers, secondary care and the liver transplant service, synchronised by the transplant coordinator. Managing expectation and balancing the uncertainty of organ availability against the inevitable progression of underlying liver disease requires sensitivity and honesty from all healthcare providers and the assessment of palliative care needs is an integral part of this process.
Adult liver transplantation: UK clinical guideline - part 2: surgery and post-operation
Authors: Millson Charles , Considine Aisling , Cramp Matthew E , Holt Andrew , Hubscher Stefan , Hutchinson John , Jones Kate , Leithead Joanna , Masson Steven , Menon Krish , Mirza Darius , Neuberger James , Prasad Raj , Pratt Anthony , Prentice Wendy , Shepherd Liz , Simpson Ken , Thorburn Doug , Westbrook Rachel , Tripathi Dhiraj
Published: February 2020

Survival rates for patients following liver transplantation exceed 90% at 12 months and approach 70% at 10 years. Part 1 of this guideline has dealt with all aspects of liver transplantation up to the point of placement on the waiting list. Part 2 explains the organ allocation process, organ donation and organ type and how this influences the choice of recipient. After organ allocation, the transplant surgery and the critical early post-operative period are, of necessity, confined to the liver transplant unit. However, patients will eventually return to their referring secondary care centre with a requirement for ongoing supervision. Part 2 of this guideline concerns three key areas of post liver transplantation care for the non-transplant specialist: (1) overseeing immunosuppression, including interactions and adherence; (2) the transplanted organ and how to initiate investigation of organ dysfunction; and (3) careful oversight of other organ systems, including optimising renal function, cardiovascular health and the psychosocial impact. The crucial significance of this holistic approach becomes more obvious as time passes from the transplant, when patients should expect the responsibility for managing the increasing number of non-liver consequences to lie with primary and secondary care.
Outcomes and adverse factors for endoscopic mucosal resection (EMR) of colorectal polyps in elderly patients
Authors: Skouras Thomas , Bond Ashley , Gaglia Asimina , Bonnett Laura , Jiang Lim Meng , Sarkar Sanchoy
Published: February 2020

Introduction

Endoscopic mucosal resection (EMR) is an invaluable technique, however it is associated with significant risks. In the elderly in particular, the long-term survival benefits of polyp resection with EMR are unknown. The aim of this study was to determine the long-term outcomes in elderly patients who had undergone EMR and to identify any adverse factors.

Method

A retrospective observational study on patients of 75 years of age or greater, who underwent EMR of colorectal polyps, in a single tertiary centre, from 2005 to 2014. Demographics of the patients, including Charlson Comorbidity Index (CCI), endoscopic and histological data, were reviewed to identify potential factors predicting outcomes.

Results

The patients’ median age was 80 years. In total 239 procedures were performed in 206 unique patients. The complication rate was 1.6%. Mean overall survival was 6.7 years with only one patient dying from metastatic colorectal cancer (0.5%) and 49 dying from non-colorectal cancer conditions (24%). Age more than 79 years and CCI more than 2 were independent predictors of significantly shorter survival (p=<0.01). Gender, size of the removed polyps and total number of polyps were not statistically significantly affecting survival. Patients who had more than two colonoscopies were found to have a survival benefit (p=0.02).

Conclusion

EMR of colonic polyps is safe even for elderly patients. However, the decision to proceed to complex endoscopic therapy should be individualised considering the patients’ age and comorbidities. CCI can help to objectively assess the comorbid state of a patient prior to such decisions.
Modes of late mortality in patients with a Fontan circulation
Authors: Poh Chin , Hornung Tim , Celermajer David S , Radford Dorothy J , Justo Robert N , Andrews David , du Plessis Karin , Iyengar Ajay J , Winlaw David , d'Udekem Yves
Published: February 2020

Objectives

The mechanisms of attrition of the Fontan population have been poorly characterised and it is unclear whether some of the deaths are potentially preventable. We analysed the circumstances of late death in patients with a Fontan circulation, with a special focus on identifying lesions amenable to intervention that may have contributed to the decline of their circulation.

Methods

Between 1975 and 2018, a total of 105 patients from a Bi-National Registry died beyond 1 year after Fontan completion, at a median age of 18.6 (IQR 13.8–26.0) years old, 12.7 (IQR 6.0–19.3) years after Fontan completion.

Results

A total of 105 patients died—63 patients (60%) with an atriopulmonary (AP) Fontan, 21 patients (20%) with a lateral tunnel (LT) and 21 patients (20%) with an extracardiac conduit (ECC). 72 patients (69%) were reviewed within 2 years preceding death, with 32% (23/72) deemed to be clinically well. Fontan circulatory failure was the most common cause of death in 42 patients (45%). Other causes of death included sudden death/arrhythmia (19%), perioperative death (12%), neurological complication (7%) and thromboembolism (7%). All patients with an LT or ECC who died from Fontan failure had at least one surgical defect that was amenable to intervention at time of death.

Conclusions

Conventional clinical surveillance has been insensitive in detecting a significant proportion of patients at risk of late death. Fontan circulatory failure contributes to half of the late deaths. Patients with an LT or ECC Fontan who died with a clinical picture of circulation failure may have potentially correctable lesions.
Variability in echocardiography and MRI for detection of cancer therapy cardiotoxicity
Authors: Lambert James , Lamacie Mariana , Thampinathan Babitha , Altaha Mustafa A , Esmaeilzadeh Maryam , Nolan Mark , Fresno Camila Urzua , Somerset Emily , Amir Eitan , Marwick Thomas H , Wintersperger Bernd J , Thavendiranathan Paaladinesh
Published: February 2020

Objectives

To compare variability of echocardiographic and cardiovascular magnetic resonance (CMR) measured left ventricular (LV) function parameters and their relationship to cancer therapeutics-related cardiac dysfunction (CTRCD).

Methods

We prospectively recruited 60 participants (age: 49.8±11.6 years), 30 women with human epidermal growth factor receptor 2-positive breast cancer (15 with CTRCD and 15 without CTRCD) and 30 healthy volunteers. Patients were treated with anthracyclines and trastuzumab. Participants underwent three serial CMR (1.5T) and echocardiography studies at ~3-month intervals. Cine-CMR for LV ejection fraction (LVEF), myocardial tagging for global longitudinal strain (GLS) and global circumferential strain (GCS), two-dimensional (2D) echocardiography for strain and LVEF and three-dimensional (3D) echocardiography for LVEF measurements were obtained. Temporal, interobserver and intraobserver variability were calculated as the coefficient of variation and as the SE of the measurement (SEM). Minimal detected difference (MDD) was defined as 2xSEM.

Results

Patients with CTRCD demonstrated larger mean temporal changes in all parameters compared with those without: 2D-LVEF: 4.6% versus 2.8%; 3D-LVEF: 5.2% vs 2.3%; CMR-LVEF: 6.6% versus 2.7%; 2D-GLS: 1.9% versus 0.7%, 2D-GCS: 2.5% versus 2.2%; CMR-GCS: 2.7% versus 1.6%; and CMR-GLS: 2.1% versus 1.4%, with overlap in 95% CI for 2D-LVEF, 2D-GCS, CMR-GLS and CMR-GCS. The respective mean temporal variability/MDD in healthy volunteers were 3.3%/6.5%, 1.8%/3.7%, 2.2%/4.4%, 0.8%/1.5%, 1.9%/3.7%, 1.8%/3.6% and 1.4%/2.8%. Although the mean temporal variability in healthy volunteers was lower than the mean temporal changes in CTRCD, at the individual level, 2D-GLS, 3D-LVEF and CMR-LVEF had the least overlap. 2D-GLS and CMR-LVEF had the lowest interobserver/intraobserver variabilities.

Conclusion

Temporal changes in 3D-LVEF, 2D-GLS and CMR LVEF in patients with CTRCD had the least overlap with the variability in healthy volunteers; however, 2D-GLS appears to be the most suitable for clinical application in individual patients.
On the mechanism of anti-CD39 immune checkpoint therapy
Authors: Allard David , Allard Bertrand , Stagg John
Published: February 2020

With the coming of age of cancer immunotherapy, the search for new therapeutic targets has led to the identification of immunosuppressive adenosine as an important regulator of antitumor immunity. This resulted in the development of selective inhibitors targeting various components of the adenosinergic pathway, including small molecules antagonists targeting the high affinity A2A adenosine receptor and low affinity A2B receptor, therapeutic monoclonal antibodies (mAbs) and small molecules targeting CD73 and therapeutic mAbs targeting CD39. As each regulator of the adenosinergic pathway present non-overlapping biologic functions, a better understanding of the mechanisms of action of each targeted approach should accelerate clinical translation and improve rational design of combination treatments. In this review, we discuss the potential mechanisms-of-action of anti-CD39 cancer therapy and potential toxicities that may emerge from sustained CD39 inhibition. Caution should be taken, however, in extrapolating data from gene-targeted mice to patients treated with blocking anti-CD39 agents. As phase I clinical trials are now underway, further insights into the mechanism of action and potential adverse events associated with anti-CD39 therapy are anticipated in coming years.
Current evidence and future perspectives of immune-checkpoint inhibitors in unresectable malignant pleural mesothelioma
Authors: Hotta Katsuyuki , Fujimoto Nobukazu
Published: February 2020

Platinum-based chemotherapy is commonly used as the standard first-line treatment for unresectable malignant pleural mesothelioma (MPM). However, in recent times, immune-checkpoint inhibitors (ICIs) have led to a paradigm shift. Herein, we review relevant literature and ongoing trials of ICIs used as both first-line and salvage therapies. Specifically, in the Japanese single-arm, phase II trial, the MERIT trial, nivolumab, an antiprogrammed cell death 1 (PD-1) antibody showed favorable efficacy when used as a salvage therapy. Currently, multiple ICI monotherapy or combination therapy trials have been conducted, which could provide further evidence. Among available ICIs, the anti-PD-1 antibody is promising for unresectable MPM, despite the limited efficacy of anti-CTLA4 monotherapy. Ongoing studies will further confirm the potential efficacy of ICIs for MPM, as observed across other malignancies. It is also crucial to identify any clinically useful predictive biomarkers that could reveal ICIs with maximal effects in MPM.
Patellar ligament rupture in a cat treated with autologous fascia lata graft augmentation
Authors: Manca Stefano , Witte Philip Georg
Published: February 2020

A five‐year‐old male domestic shorthair cat has been referred with a two‐week history of lameness affecting the right hind limb. Gait assessment revealed an involuntary flexion of the stifle during the stance phase with excessive hip extension and stifle flexion in the terminal phase of the stride. Physical examination and radiographs have been performed and were consistent with patellar ligament rupture. Surgical correction consisted of primary tendon tenorrhaphy, circumpatellar suture and fascia lata graft augmentation. Eight months following surgery, validated owner questionnaire confirmed an excellent outcome.
Barley (Hordeum vulgare) seedling growth declines with increasing exposure to silver nanoparticles in biosolid-amended soils
Authors: González Linares Mónica , Jia Yu , Sunahara Geoffrey I. , Whalen Joann K.
Published: February 2020

Silver nanoparticles (AgNPs), a component of many consumer products, are considered an environmental risk due to the broad-spectrum toxicity of Ag+ to non-target organisms. Most AgNPs released from consumer products will end up as biosolids in wastewater treatment plants, which are often applied as a fertilizer to agriculture. Land application of biosolids may add AgNPs to the soil–plant system, with unknown consequences. This study investigated the growth of Hordeum vulgare seedlings, Ag bioconcentration and distribution in shoot and root tissues of barley exposed to biosolid-amended Delacour and Organization for Economic Co-operation and Development (OECD) soils spiked with AgNPs (up to 366 mg Ag kg−1 dry soil). In both soils, root and shoot growth declined linearly as the concentration of AgNPs increased. Barley had higher Ag bioconcentration values when grown in the OECD soil than in the Delacour soil. Silver bioavailability was greater in the OECD soil due to its physicochemical properties, such as low calcium concentration and acidic pH, relative to the Delacour soil. Barley seedlings exhibited morphological changes, including smaller shoots and shorter, thick roots after 14 d exposure to AgNPs. We conclude that plant structural responses, particularly changes in root biomass, could be an early diagnostic of seedling exposure to AgNPs in biosolid-amended soils.
Hubble inflation in Randall–Sundrum type II model
Authors: Abedi Habib , Abbassi Amir M. , Bahamonde Sebastian
Published: February 2020

We study a braneworld Randall–Sundrum type II (RSII) model using the Hamilton–Jacobi formalism. We extend the standard inflationary parameters and the flow equations for this braneworld scenario. We investigate the conditions that reduce the infinite number of flow equations into a finite number and confirm that by considering one of the inflationary parameters that vanishes, the Hubble expansion rate gets a polynomial form in both General Relativity (GR) and in the high-energy regime of RSII. We also show that if one sets this inflationary parameter to a constant value, the model features a nonpolynomial form of the Hubble expansion rate. The form of the Hubble parameter in this case is different in GR and RSII. Next, we consider a single-scalar field model with a Hubble expansion rate behaving as [Formula: see text] and show that compared to GR, the RSII model has a smaller tensor-to-scalar ratio and larger spectral index for [Formula: see text]. Therefore, RSII model leads to better predictions than GR.
Determinants of Nonperforming Loans in Emerging Markets: Evidence from the MENA Region
Authors: Jabbouri Imad , Naili Maryem
Published: February 2020

Credit risk has severe impacts on banks’ performance, leading to financial and economic distress. To highlight this interesting issue, this study explores bank-specific and macroeconomic determinants of banks’ credit risk, denoted by the level of nonperforming loans (NPLs). The study includes 98 banks from 10 Middle East and North African (MENA) emerging countries spanning the period between 2003 and 2016. The analysis employs panel data estimation technique. Our results reveal that bank size, capital adequacy ratio, bank operating efficiency, profitability, GDP growth, unemployment, inflation, and public debt represent the main determinants of NPLs in MENA emerging markets. The results of this research have practical implications for bank managers, regulators, investors, and financial analysts. This study provides significant insights on the determinants of NPLs, which will allow bank managers to design credit policies that minimize borrowers’ defaults. The findings of the study are useful to policy makers to establish new and reinforce existing regulations to maintain the steadiness of the banking sector in MENA emerging countries.
Integrated geophysical, sedimentological and geotechnical investigation of submarine landslides in the Gulf of Lions (Western Mediterranean)
Authors: Badhani Shray , Cattaneo Antonio , Collico Stefano , Urgeles Roger , Dennielou Bernard , Leroux Estelle , Colin Florent , Garziglia Sebastien , Rabineau Marina , Droz Laurence
Published: February 2020

The Gulf of Lions presents recurring mass-transport deposits (MTDs) within the Plio-Quaternary sediments, suggesting a long history of mass movements. The two large, surficial MTDs are located on the eastern and western levee of the Rhone canyon over an area exceeding 6000 km
2
and volumes exceeding 100 km
3
. Both MTDs were emplaced 21 ka ago (peak of the Last Glacial Maximum), suggesting a common trigger. Here, we present a multidisciplinary high-resolution geophysical, sedimentological and
in-situ
geotechnical study of the source and deposit areas of both MTDs to characterize distinct expressions of sediment deformation as well as their spatial and chronological distributions. We show the internal structure of mass movements and resulting MTDs with unprecedented details that were previously represented in the conventional seismic data as transparent and chaotic facies. The combination of multidisciplinary approaches shows new insights into the nature of basal surfaces of the slope failures. In particular, we show that the basal surfaces of the failures consist of clay-rich material contrasting with the overlying turbiditic deposits, suggesting that a strong lithological heterogeneity exists within the strata. We suggest that this change in lithology between clay-rich sediments and turbiditic sequences most likely controls the localization of weak layers and landslide basal surfaces.
ShadowPlay2.5D
Authors: Zhao Zhenjie , Ma Xiaojuan
Published: February 2020

An immersive experience brought about by virtual reality can potentially enhance the appreciation of classical Chinese poetry, which is difficult to describe clearly in everyday language or ordinary media. However, making 3-dimensional illustrations for a 360-degree display in virtual reality is usually a labor-intensive and time-consuming procedure and hard to master for non-professional media creators, such as teachers. Motivated by the homology theory of classical Chinese poetry and painting, we propose an image-based approach of building 2.5-dimensional immersive stories to visualize classical Chinese poetry. Specifically, using Chinese shadow play as a metaphor, we have designed and implemented
ShadowPlay2.5D
, a sketch-based authoring tool to help novices create 360-degree videos of classical Chinese poetry easily. To ensure coverage of the diverse themes in Chinese poetry and preserve the sense of culture, we build a Chinese ink-painting style image repository of essential poetic elements identified via crowdsourcing. To facilitate construction of 2.5-dimensional scenes, we design features that support puppet-like animation, instancing, and camera organization in a 3-dimensional environment. Through two user studies, we show that
ShadowPlay2.5D
can help novices make a short 360-degree video in about 10--15 minutes, and the 2.5D stylized illustrations created can bring about a better immersive experience for poetry appreciation.
The Effects of VR Environments on the Acceptance, Experience, and Expectations of Cultural Heritage Learning
Authors: Ch’ng Eugene , Li Yue , Cai Shengdan , Leow Fui-Theng
Published: February 2020

This article attempts to understand how present Virtual Reality (VR) environments can contribute to enhancing the communication of cultural heritage by providing an experience of the past that is acceptable for the younger generation and how museums and cultural institutions should adopt and use such technologies. Aspects of acceptance, experience, and expectation of VR with the underlying values are not well understood but are important for the sustainability of the communication of cultural heritage as a bequest to future generations. We conducted a combined quantitative--qualitative study on the participants who have various prior experience with gaming and VR, and different levels of knowledge on the history presented within the virtual environment. This study investigates how participants accept and are stimulated in terms of personal experience and their expectations and ideas for the future of museums if VR is used for enhancing the learning of cultural heritage. Prior gaming and VR experience were investigated to see whether they do indeed influence the preference for using VR for learning cultural heritage. We demonstrated that particular age groups and background are especially agreeable to virtual reality as environments for learning and experiencing cultural heritage, regardless of their knowledge of the historical context of the virtually reconstructed site. Our findings also revealed important behaviours in our demographics group with regards to user preferred length of time and the believability of the virtual environment and how it influences aspects of their experience such as the exploration of the heritage site, familiarity, and meaning making. The study has implications for the use of VR for enhancing the experience of cultural heritage in museums and cultural institutions.
On the Power of Border of Depth-3 Arithmetic Circuits
Authors: Kumar Mrinal
Published: February 2020

We show that over the field of complex numbers,
every
homogeneous polynomial of degree
d
can be approximated (in the border complexity sense) by a depth-3 arithmetic circuit of top fan-in at most 2. This is quite surprising, since there exist homogeneous polynomials
P
on
n
variables of degree 2, such that any depth-3 arithmetic circuit computing
P
must have top fan-in at least Ω (
n
).

As an application, we get a new tradeoff between the top fan-in and formal degree in an approximate analog of the celebrated depth reduction result of Gupta, Kamath, Kayal, and Saptharishi [7, 10]. Formally, we show that if a degree
d
homogeneous polynomial
P
can be computed by an arithmetic circuit of size
s
≥
d
, then for every
t
≤
d
,
P
is in the border of a depth-3 circuit of top fan-in

s

O(
t
)

and formal degree

s

O(
d/t
)

. To the best of our knowledge, the upper bound on the top fan-in in the original proof of Reference [7] is always at least
s

Ω
(√d)

, regardless of the formal degree.
Translational and Rotational Arrow Cues (TRAC) Navigation Method for Manual Alignment Tasks
Authors: Usevitch David E. , Sperry Adam J. , Abbott Jake J.
Published: February 2020

Many tasks in image-guided surgery require a clinician to manually position an instrument in space, with respect to a patient, with five or six degrees of freedom (DOF). Displaying the current and desired pose of the object on a 2D display such as a computer monitor is straightforward. However, providing guidance to accurately and rapidly navigate the object in 5-DOF or 6-DOF is challenging. Guidance is typically accomplished by showing distinct orthogonal viewpoints of the workspace, requiring simultaneous alignment in all views. Although such methods are commonly used, they can be quite unintuitive, and it can take a long time to perform an accurate 5-DOF or 6-DOF alignment task. In this article, we describe a method of visually communicating navigation instructions using translational and rotational arrow cues (TRAC) defined in an object-centric frame, while displaying a single principal view that approximates the human’s egocentric view of the physical object. The target pose of the object is provided but typically is used only for the initial gross alignment. During the accurate-alignment stage, the user follows the unambiguous arrow commands. In a series of human-subject studies, we show that the TRAC method outperforms two common orthogonal-view methods—the triplanar display, and a sight-alignment method that closely approximates the Acrobot Navigation System—in terms of time to complete 5-DOF and 6-DOF navigation tasks. We also find that subjects can achieve 1 mm and 1° accuracy using the TRAC method with a median completion time of less than 20 seconds.