bluuebunny/crossref_metadata_2025 huggingface dataset:
Famotidine use and quantitative symptom tracking for COVID-19 in non-hospitalised patients: a case series
Authors: Janowitz Tobias , Gablenz Eva , Pattinson David , Wang Timothy C , Conigliaro Joseph , Tracey Kevin , Tuveson David
Published: June 2020

Objective

Treatment options for non-hospitalised patients with coronavirus disease 2019 (COVID-19) to reduce morbidity, mortality and spread of the disease are an urgent global need. The over-the-counter histamine-2 receptor antagonist famotidine is a putative therapy for COVID-19. We quantitively assessed longitudinal changes in patient reported outcome measures in non-hospitalised patients with COVID-19 who self-administered high-dose famotidine orally.

Design

Patients were enrolled consecutively after signing written informed consent. Data on demographics, COVID-19 diagnosis, famotidine use, drug-related side effects, temperature measurements, oxygen saturations and symptom scores were obtained using questionnaires and telephone interviews. Based on a National Institute of Health (NIH)-endorsed Protocol to research Patient Experience of COVID-19, we collected longitudinal severity scores of five symptoms (cough, shortness of breath, fatigue, headaches and anosmia) and general unwellness on a four-point ordinal scale modelled on performance status scoring. All data are reported at the patient level. Longitudinal combined normalised symptom scores were statistically compared.

Results

Ten consecutive patients with COVID-19 who self-administered high-dose oral famotidine were identified. The most frequently used famotidine regimen was 80 mg three times daily (n=6) for a median of 11 days (range: 5–21 days). Famotidine was well tolerated. All patients reported marked improvements of disease related symptoms after starting famotidine. The combined symptom score improved significantly within 24 hours of starting famotidine and peripheral oxygen saturation (n=2) and device recorded activity (n=1) increased.

Conclusions

The results of this case series suggest that high-dose oral famotidine is well tolerated and associated with improved patient-reported outcomes in non-hospitalised patients with COVID-19.
How to manage healthcare waste and reduce its environmental impact
Authors: West Ellie , Woolridge Anne , Ibarrola Patricia
Published: June 2020

Healthcare waste is likely to increase with a rise in the global population and access to medical care. The main reasons to optimise waste management are the statutory duty of care, to reduce environmental impact, for the health and safety of personnel and to reduce financial costs. Working up the waste hierarchy, the priority must be the initial prevention of waste production. This article provides a guide to managing healthcare waste and ways to try and reduce its environmental impact.
Nursing the recumbent patient
Authors: Haskey Eleanor
Published: June 2020

Background: Recumbency is defined as a patient that is lying down or unable to stand (Lane and Gruthrie 2001). The time that a patient is recumbent is dependent on the underlying cause and their comorbidities; however, there is little evidence describing the best way to nurse the recumbent patient. Some evidence from nursing human patients can be transferred to veterinary patients, whereas other ideas are merely anecdotal. Recumbent patients can present a challenge to the veterinary team as they often have many nursing considerations. It is therefore important to adopt a holistic approach, including regular patient assessment, treatment of the underlying cause and comorbidities, and the administration of frequent nursing interventions to reduce the risk of complications associated with being recumbent.

Aim of the article: To outline key patient assessment areas to consider when treating a recumbent patient.
Practical tips for managing change during the Covid‐19 pandemic
Authors: Orpin Pete , Judson Anna , Davis Ryan
Published: June 2020

The global Covid‐19 pandemic has resulted in monumental changes to our daily lives in an effort to reduce the spread of the disease; in the UK, the veterinary industry has been very actively involved in these events. This article focuses on some key areas of change that veterinary practices have had to accommodate, with tips on how to implement them effectively.
Changing levels of local crime and mental health: a natural experiment using self-reported and service use data in Scotland
Authors: Baranyi Gergő , Cherrie Mark , Curtis Sarah E , Dibben Chris , Pearce Jamie
Published: June 2020

Background

This study contributes robust evidence on the association between mental health and local crime rates by showing how changing exposure to small area-level crime relates to self-reported and administrative data on mental health.

Methods

The study sample comprised 112 251 adults aged 16–60 years, drawn from the Scottish Longitudinal Study, a 5.3% representative sample of Scottish population followed across censuses. Outcomes were individual mental health indicators: self-reported mental illness from the 2011 Census and linked administrative data on antidepressants and antipsychotics prescribed through primary care providers in the National Health Service in 2010/2012. Crime rates at data zone level (500–1000 persons) were matched to the participants’ main place of residence, as defined by general practitioner patient registration duration during 2004/2006, 2007/2009 and 2010/12. Average neighbourhood crime exposure and change in area crime were computed. Covariate-adjusted logistic regressions were conducted, stratified by moving status.

Results

In addition to average crime exposure during follow-up, recent increases in crime (2007/2009–2010/2012) were associated with a higher risk of self-reported mental illness, among ‘stayers’ aged 16–30 years (OR=1.11; 95% CI 1.00 to 1.22), and among ‘movers’ aged 31–45 years (OR=1.07; 95% CI 1.01 to 1.13). Prescribed medications reinforced these findings; worsening crime rates were linked with antidepressant prescriptions among young stayers (OR=1.09; 95% CI 1.04 to 1.14) and with antipsychotic prescriptions among younger middle-aged movers (OR=1.11; 95% CI 1.01 to 1.23).

Conclusion

Changing neighbourhood crime exposure is related to individual mental health, but associations differ by psychiatric conditions, age and moving status. Crime reduction and prevention, especially in communities with rising crime rates, may benefit public mental health.
Are we all in this together? Longitudinal assessment of cumulative adversities by socioeconomic position in the first 3 weeks of lockdown in the UK
Authors: Wright Liam , Steptoe Andrew , Fancourt Daisy
Published: June 2020

Background

Despite media claims that coronavirus disease 2019 (COVID-19) is uniting societies and countries in shared experience, there has been concern that the pandemic is in fact exposing and widening existing inequalities within societies. Data have shown these differences for cases and fatalities, but data on other types of adversities are lacking. Therefore, this study explored the changing patterns of adversity relating to the COVID-19 pandemic by socioeconomic position (SEP) during the early weeks of lockdown in the UK.

Methods

Data were from 12 527 UK adults in the University College London COVID-19 Social Study (a panel study that involves online weekly data collection from participants during the COVID-19 pandemic). We analysed data collected from 25 March to 14 April 2020. The sample was well-stratified and weighted to population proportions of gender, age, ethnicity, education and country of living. We used Poisson and logit models to assess 10 different types of adverse experiences depending on an index of SEP over time.

Results

There was a clear gradient across the number of adverse events experienced each week by SEP. This was most clearly seen for adversities relating to finances (including loss of employment and cut in income) and basic needs (including access to food and medications) but less for experiences directly relating to the virus. Inequalities were maintained with no reductions in discrepancies between socioeconomic groups over time.

Conclusions

There were clear inequalities in adverse experiences during the COVID-19 pandemic in the early weeks of lockdown in the UK. Results suggest that measures taken to try to reduce such adverse events did not go far enough in tackling inequality.
Mutation inCATIP(C2orf62) causes oligoteratoasthenozoospermia by affecting actin dynamics
Authors: Arafat Maram , Harlev Avi , Har-Vardi Iris , Levitas Eliahu , Priel Tsvia , Gershoni Moran , Searby Charles , Sheffield Val C , Lunenfeld Eitan , Parvari Ruti
Published: June 2020

Background

Oligoteratoasthenozoospermia (OTA) combines deteriorated quantity, morphology and motility of the sperm, resulting in male factor infertility.

Methods

We used whole genome genotyping and exome sequencing to identify the mutation causing OTA in four men in a consanguineous Bedouin family. We expressed the normal and mutated proteins tagged with c-Myc at the carboxy termini by transfection with pCDNA3.1 plasmid constructs to evaluate the effects on protein stability in HEK293 cells and on the kinetics of actin repolymerisation in retinal pigment epithelium cells. Patients’ sperm samples were visualised by transmission electron microscopy to determine axoneme structures and were stained with fluorescent phalloidin to visualise the fibrillar (F)-actin.

Results

A homozygous missense mutation in Ciliogenesis Associated TTC17 Interacting Protein (CATIP): c. T103A, p. Phe35Ile, a gene encoding a protein important in actin organisation and ciliogenesis, was identified as the causative mutation with a LOD score of 3.25. The mutation reduces the protein stability compared with the normal protein. Furthermore, overexpression of the normal protein, but not the mutated protein, inhibits repolymerisation of actin after disruption with cytochalasin D. A high percentage of spermatozoa axonemes from patients have abnormalities, as well as disturbances in the distribution of F-actin.

Conclusion

This is the first report of a recessive mutation inCATIPin humans. The identified mutation may contribute to asthenozoospermia by its involvement in actin polymerisation and on the actin cytoskeleton. A mouse knockout homozygote for CATIP was reported to demonstrate male infertility as the sole phenotype.
Muscle biopsy: what and why and when?
Authors: Walters Jon , Baborie Atik
Published: June 2020

Skeletal muscle biopsy remains an important investigative tool in the diagnosis of a variety of muscle disorders. Traditionally, someone with a limb-girdle muscle weakness, myopathic changes on electrophysiology and raised serum creatine kinase (CK) would have a muscle biopsy. However, we are living through a genetics revolution, and so do all such patients still need a biopsy? When should we undertake a muscle biopsy in patients with a distal, scapuloperoneal or other patterns of muscle weakness? When should patients with myositis, rhabdomyolysis, myalgia, hyperCKaemia or a drug-related myopathy have a muscle biopsy? What does normal muscle histology look like and what changes occur in neurogenic and myopathic disorders? As with Kipling’s six honest serving men, we hope that by addressing these issues we can all become more confident about when to request a muscle biopsy and develop clearer insights into muscle pathology.
Neurotoxicity—CAR T-cell therapy: what the neurologist needs to know
Authors: Neill Lorna , Rees Jeremy , Roddie Claire
Published: June 2020

Chimeric antigen receptor (CAR) T-cell therapy is one of the most innovative therapies for haematological malignancies to emerge in a generation. Clinical studies have shown that a single dose of CAR T-cells can deliver durable clinical remissions for some patients with B﻿-cell cancers where conventional therapies have failed.

A significant complication of CAR therapy is the immune effector cell-associated neurotoxicity syndrome (ICANS). This syndrome presents a continuum from mild tremor to cerebral oedema and in a minority of cases, death. Management of ICANS is mainly supportive, with a focus on seizure prevention and attenuation of the immune system, often using corticosteroids. Parallel investigation to exclude other central nervous system pathologies (infection, disease progression) is critical. In this review, we discuss current paradigms around CAR T-cell therapy, with a focus on appropriate investigation and management of ICANS.
Foraging behaviour of four avian species feeding on the same temporarily available prey
Authors: Houpt N.S.B. , Bose A.P.H. , Warriner T. , Brown N.A.W. , Quinn J.S. , Balshine S.
Published: June 2020

Low tide events provide terrestrial predators with ephemeral, but predictable and abundant sources of prey. Understanding the relationships between tidal cycles, prey availability, and predator abundances is vital to characterizing the ecological relationship between terrestrial predators and their marine prey. Here, we describe the foraging tactics of four common bird species in western North America — Bald Eagles (Haliaeetus leucocephalus (Linnaeus, 1766)), Great Blue Herons (Ardea herodias Linnaeus, 1758), Glaucous-winged Gulls (Larus glaucescens J.F. Naumann, 1840), and Northwestern Crows (Corvus caurinus S.F. Baird, 1858) — feeding on the same transiently accessible fish species, the plainfin midshipman (Porichthys notatus Girard, 1854). We conducted avian predator surveys at breeding beaches of plainfin midshipman across multiple years and sites. Our census data showed that Bald Eagle and Great Blue Heron abundances were higher when the tides were receding than incoming at Ladysmith Harbour, British Columbia, Canada, but the opposite trend was found for total predator abundance at a second site in Dabob Bay, Washington, USA. Glaucous-winged Gull abundance decreased over the course of the plainfin midshipman breeding season (April–July), whereas the abundances of the other three species remained stable. Our data suggest that the foraging activities of birds in the intertidal zones of western North America are linked with the tidal cycles, corresponding to periods of high prey vulnerability.
Testing Ghasemi-Nodehi–Bambi metric parameters with quasi-periodic oscillations
Authors: Ghasemi-Nodehi M. , Lu Youjun , Chen Ju , Yang Chao
Published: June 2020

QPOs are seen as peak features in the X-ray power spectral density of stellar mass black holes and neutron stars, of which frequencies can be measured with high precision. These QPO frequencies are believed to be related to fundamental frequencies of test particles, which are mainly determined by the background metric. We consider the metric introduced in Ghasemi-Nodehi and Bambi (Eur Phys J C 76:290, 2016). The fundamental frequencies in this metric are sensitive to some of the metric parameters but insensitive to other parameters, which means, the differences in fundamental frequencies in this metric and those in the Kerr ones can be significant for small changes of some but not all parameters around the Kerr value. By comparing with the QPO observations of GRO J1655-40, we find that only one parameter of the Ghasemi-Nodehi–Bambi metric can be strongly constrained, but other parameters cannot. We also use nested algorithm to investigate whether better constraints on the Ghasemi-Nodehi–Bambi metric parameters can be obtained from QPO observations of multiple objects by simulations. We find that four parameters can be strongly constrained while other parameters cannot . Our results suggest that QPOs may be important tools for testing the Kerr metric.
Regularized vortex approximation for 2D Euler equations with transport noise
Authors: Coghi Michele , Maurelli Mario
Published: June 2020

We study a mean field approximation for the 2D Euler vorticity equation driven by a transport noise. We prove that the Euler equations can be approximated by interacting point vortices driven by a regularized Biot–Savart kernel and the same common noise. The approximation happens by sending the number of particles [Formula: see text] to infinity and the regularization [Formula: see text] in the Biot–Savart kernel to [Formula: see text], as a suitable function of [Formula: see text].
Randomly switched vector fields sharing a zero on a common invariant face
Authors: Strickler Edouard
Published: June 2020

We consider a Piecewise Deterministic Markov Process given by random switching between finitely many vector fields vanishing at [Formula: see text]. It has been shown recently that the behavior of this process is mainly determined by the signs of Lyapunov exponents. However, results have only been given when all these exponents have the same sign. In this paper, we consider the degenerate case where the process leaves invariant some face and results are stated when the Lyapunov exponents are of opposite signs. Our results enable in particular to close a gap in a discussion on random switching between two Lorenz vector fields by Bakhtin and Hurth, Invariant densities for dynamical systems with random switching, Nonlinearity 25 (2012) 2937–2952.
An Integration of Sentiment Analysis and MCDM Approach for Smartphone Recommendation
Authors: Kumar Gaurav , Parimala N.
Published: June 2020

Today, smartphones are being used to manage almost all aspects of our lives, ranging from personal to professional. Different users have different requirements and preferences while selecting a smartphone. There is ‘no one-size fits all’ remedy when it comes to smartphones. Additionally, the availability of a wide variety of smartphones in the market makes it difficult for the user to select the best one. The use of only product ratings to choose the best smartphone is not sufficient because the interpretation of such ratings can be quite vague and ambiguous. In this paper, reviews of products are incorporated into the decision-making process in order to select the best product for a recommendation. The top five different brands of smartphones are considered for a case study. The proposed system, then, analyses the customer reviews of these smartphones from two online platforms, Flipkart and Amazon, using sentiment analysis techniques. Next, it uses a hybrid MCDM approach, where characteristics of AHP and TOPSIS methods are combined to evaluate the best smartphones from a list of five alternatives and recommend the best product. The result shows that brand1 smartphone is considered to be the best smartphone among five smartphones based on four important decision criteria. The result of the proposed system is also validated by manually annotated customer reviews of the smartphone by experts. It shows that recommendation of the best product by the proposed system matches the experts’ ranking. Thus, the proposed system can be a useful decision support tool for the best smartphone recommendation.
Adaptive lasso with weights based on normalized filtering scores in molecular big data
Authors: Patil Abhijeet R. , Park Byung-Kwon , Kim Sangjin
Published: June 2020

The molecular big data are highly correlated, and numerous genes are not related. The various classification methods performance mainly rely on the selection of significant genes. Sparse regularized regression (SRR) models using the least absolute shrinkage and selection operator (lasso) and adaptive lasso (alasso) are popularly used for gene selection and classification. Nevertheless, it becomes challenging when the genes are highly correlated. Here, we propose a modified adaptive lasso with weights using the ranking-based feature selection (RFS) methods capable of dealing with the highly correlated gene expression data. Firstly, an RFS methods such as Fisher’s score (FS), Chi-square (CS), and information gain (IG) are employed to ignore the unimportant genes and the top significant genes are chosen through sure independence screening (SIS) criteria. The scores of the ranked genes are normalized and assigned as proposed weights to the alasso method to obtain the most significant genes that were proven to be biologically related to the cancer type and helped in attaining higher classification performance. With the synthetic data and real application of microarray data, we demonstrated that the proposed alasso method with RFS methods is a better approach than the other known methods such as alasso with filtering such as ridge and marginal maximum likelihood estimation (MMLE), lasso and alasso without filtering. The metrics of accuracy, area under the receiver operating characteristics curve (AUROC), and geometric mean (GM-mean) are used for evaluating the performance of the models.
Analogous BMS symmetry in QED and quantum anomaly in Dirac and Weyl semimetals
Authors: Addazi Andrea , Marcianò Antonino
Published: June 2020

We show that the asymptotic infinite dimensional enlarged gauge symmetries constructed for QED are anomalous in Weyl semimetals. This symmetry is particularly important in particle physics for its analogy with the Bondi–Metzner–Sachs (BMS) symmetries in gravity, as well as for its connection with QED soft IR theorems. This leads to observable effects, because of the induction of a new current in the material, which carries a memory of the BMS symmetry precursor.
Robust Unsupervised Cross-modal Hashing for Multimedia Retrieval
Authors: Cheng Miaomiao , Jing Liping , Ng Michael K.
Published: June 2020

With the quick development of social websites, there are more opportunities to have different media types (such as text, image, video, etc.) describing the same topic from large-scale heterogeneous data sources. To efficiently identify the inter-media correlations for multimedia retrieval, unsupervised cross-modal hashing (UCMH) has gained increased interest due to the significant reduction in computation and storage. However, most UCMH methods assume that the data from different modalities are well paired. As a result, existing UCMH methods may not achieve satisfactory performance when partially paired data are given only. In this article, we propose a new-type of UCMH method called robust unsupervised cross-modal hashing (
RUCMH
). The major contribution lies in jointly learning modal-specific hash function, exploring the correlations among modalities with partial or even without any pairwise correspondence, and preserving the information of original features as much as possible. The learning process can be modeled via a joint minimization problem, and the corresponding optimization algorithm is presented. A series of experiments is conducted on four real-world datasets (Wiki, MIRFlickr, NUS-WIDE, and MS-COCO). The results demonstrate that RUCMH can significantly outperform the state-of-the-art unsupervised cross-modal hashing methods, especially for the partially paired case, which validates the effectiveness of RUCMH.
Point-of-Care Devices to Detect Zika and Other Emerging Viruses
Authors: de Puig Helena , Bosch Irene , Collins James J. , Gehrke Lee
Published: June 2020

Rapid diagnostic tests (point-of-care devices) are critical components of informed patient care and public health monitoring (surveillance applications). We propose that among the many rapid diagnostics platforms that have been tested or are in development, lateral flow immunoassays and synthetic biology–based diagnostics (including CRISPR-based diagnostics) represent the best overall options given their ease of use, scalability for manufacturing, sensitivity, and specificity. This review describes the identification of lateral flow immunoassay monoclonal antibody pairs that detect and distinguish between closely related pathogens and that are used in combination with functionalized multicolored nanoparticles and computational methods to deconvolute data. We also highlight the promise of synthetic biology–based diagnostic tests, which use synthetic genetic circuits that activate upon recognition of a pathogen-associated nucleic acid sequence, and discuss how the combined or parallel use of lateral flow immunoassays and synthetic biology tools may represent the future of scalable rapid diagnostics.
Physiological Modeling and Simulation—Validation, Credibility, and Application
Authors: Pruett W. Andrew , Clemmer John S. , Hester Robert L.
Published: June 2020

In this review, we discuss the science of model validation as it applies to physiological modeling. There is widespread disagreement and ambiguity about what constitutes model validity. In areas in which models affect real-world decision-making, including within the clinic, in regulatory science, or in the design and engineering of novel therapeutics, this question is of critical importance. Without an answer, it impairs the usefulness of models and casts a shadow over model credibility in all domains. To address this question, we examine the use of nonmathematical models in physiological research, in medical practice, and in engineering to see how models in other domains are used and accepted. We reflect on historic physiological models and how they have been presented to the scientific community. Finally, we look at various validation frameworks that have been proposed as potential solutions during the past decade.
Forecasting Stock Market Volatility: A Combination Approach
Authors: Dai Zhifeng , Zhou Huiting , Dong Xiaodi , Kang Jie
Published: June 2020

We find that combining two important predictors, stock market implied volatility and oil volatility, can improve the predictability of stock return volatility. We also document that the stock market implied volatility provides far more significant predictability than the oil volatility and other nonoil macroeconomic and financial variables. The empirical results show the “kitchen sink” combination approach that using two predictors jointly performs better than not only the univariate regression models which use oil volatility or stock market implied volatility separately but also convex combination of the individual forecasts. This improvement of predictability is also remarkable when we consider the business cycle. Furthermore, the robust test based on different lag lengths and different macroinformation shows that our forecasting strategy is efficient.
Maximum Principle of Discrete Stochastic Control System Driven by Both Fractional Noise and White Noise
Authors: Han Yuecai , Li Zheng
Published: June 2020

In this paper, we investigate the necessary optimality conditions of the discrete stochastic optimal control problems driven by both fractional noise and white noise. Here, the admissible control region is not necessarily convex. The corresponding variational inequalities are obtained by applying the classical variation method and Malliavin calculus. We also apply the stochastic maximum principle to a linear-quadratic optimal control problem to illustrate the main result.
Determinants of Anemia in Pregnancy: Findings from the Ethiopian Health and Demographic Survey
Authors: Woldegebriel Ataklti Gebretsadik , Gebregziabiher Gebrehiwot Gebremedhin , Aregay Desta Abraham , Fenta Ajemu Kiros , Berhe Asfawosen Aregay , Woldearegay Tewolde Wubayehu , Mamo Bezabih Nega
Published: June 2020

In Ethiopia, anemia during pregnancy is a major public health problem and affects both the mother’s and their child’s health. There is a scarcity of community-based evidence on determinants of anemia among pregnant women in the country. Therefore, this study aimed to assess the determinants of anemia among pregnant women in Ethiopia. Method. This study was based on the 2016 Ethiopian Demographic Health Survey (EDHS) that used a two-stage stratified cluster sampling technique. A cross-sectional study was conducted among 3080 pregnant women. Data analysis was done using STATA v.14. Variables with P value <0.05 in the bivariate analysis were candidates for the multivariable analysis to identify independent determinants of anemia among pregnant mothers. Odds ratios (OR) were calculated at 95% confidence interval (CI). Results. The overall prevalence of anemia among pregnant women was 41% of which 20% were moderately anemic, 18%, mildly anemic, and 3%, severely anemic. The following were significantly associated with anemia during pregnancy: an age of 30–39 years, receiving no education (AOR = 2.19; 95% CI 1.45, 2.49), belonging to the poorest wealth quintile (AOR = 1.29; 95% CI 1.22, 1.60), being a Muslim (AOR = 1.59; 95% CI 1.69, 2.65), number of house members being 4–6 (AOR = 1.44; 95% CI 1.05, 1.97), number of under-five children being two (AOR = 1.47; 95% CI 1.10, 1.97), head of the household being a female (AOR = 2.02; 95% CI 1.61, 2.54), current pregnancy wanted later (AOR = 1.75; 95% CI 1.23, 1.63), no terminated pregnancy (AOR = 1.49; 95% CI 1.15, 1.93), and an age of 13–17 years at the first sexual intercourse (AOR = 1.97; 95% CI 1.291, 3.00). Conclusions. The study revealed that more than one-third of the pregnant women in Ethiopia were found anemic. Its prevalence varied among regions in which the highest (62.7%) and the lowest (11.9%) were from Somali and Addis Ababa, respectively. Hence, efforts should be made by concerned bodies to intervene in terms of the identified risk factors.
The Clinical Significance of High Antimicrobial Resistance in Community-Acquired Urinary Tract Infections
Authors: Zavala-Cerna Maria G. , Segura-Cobos Midrori , Gonzalez Ricardo , Zavala-Trujillo Isidro G. , Navarro-Perez Silvia F. , Rueda-Cruz Jose A. , Satoscoy-Tovar Fernando A.
Published: June 2020

Background. Urinary tract infections (UTIs) affect up to 150 million individuals annually worldwide, mainly due to Escherichia coli (E. coli) and Klebsiella. The emergence and spread of multidrug-resistant (MDR) bacteria are increasing, representing one of the biggest threats for human health. The objective of our study was to describe antimicrobial patterns of resistance and identify risk factors associated with MDR uropathogens. Methods. We conducted a cross-sectional study in 296 patients with community-acquired UTI who underwent clinical and microbiologic analysis, and clinical associations to MDR uropathogens were investigated. Findings. Microbiological analysis included E. coli (55%), ESBL-E. coli (26%), Enterococcus (6%), Klebsiella (5%), and others (8%). Higher frequencies of MDR bacteria were found among ESBL-E. coli, with resistance to ampicillin (100%), ceftriaxone (96%), gentamicin (57%), ciprofloxacin (89%), and TMP/SMX (53%). However, they were sensitive to fosfomycin (6.6%), nitrofurantoin (1.3%), and carbapenems (0%). Fosfomycin MIC90 for ESBL-E. coli was 5.78 μg/mL. The only clinical variable with significant association to ESBL producers was the presence of comorbidities: hypertension and type 2 diabetes mellitus with an OR (95%CI) of 2.51.3−4.9p<0.01 and 2.81.2−6.7p<0.05, respectively. Conclusions. In the majority of cases, resistance rates to commonly prescribed antimicrobials in UTIs were high, except for fosfomycin, nitrofurantoin, and carbapenems. To provide appropriate treatment, both the identification of risk factors and the uropathogen would be important. An active surveillance in UTIs in the community is required since the proportion of ESBL producers is increasing.
Efficacy of CTPV for Diagnostic and Therapeutic Assessment: Comparison with Endoscopy in Cirrhotic Patients with Gastroesophageal Varices
Authors: Cui Zijin , Yang Haiqing , Jin Xiaoxu , Jiang Huiqing , Qi Wei , Feng Wenfeng , Feng Zhijie
Published: June 2020

Background and Aims. Computed tomography portal venography (CTPV) shows potential in detecting varices that need treatment and their drainage pathways. However, its agreement with endoscopy requires further study. We investigated the feasibility of CTPV as an alternative tool to endoscopy in screening gastroesophageal varices (GEVs) and developed a CTPV-based model to provide a less invasive assessment of endotherapy for cirrhotic patients with GEVs. Methods. The study included 33 cirrhotic patients with a recent history of variceal hemorrhage. The presence, grade, and classification of GEVs on endoscopy and CTPV were compared (kappa test). Twenty-four patients were treated endoscopically, including 12 for esophageal varices (EVs), 8 for gastric varices (GVs), and 4 for GEVs. Treatment efficacies were assessed with the newly developed CTPV-based method at 1 week and 1 month after treatment. Efficiency evaluated by CTPV and endoscopy was compared by Fisher’s exact test to determine whether CTPV is efficient in the assessment of endotherapy efficacy. Results. For the screening and grading/classification of EVs and GVs, substantial agreement (EV kappa: 0.63 and 0.68; GV kappa: 0.62 and 0.75, respectively) was noted between endoscopy and CTPV. The therapeutic efficacy of EVs was higher when assessed by CTPV than when evaluated by endoscopy (37.50% vs. 12.50% at 1 week postoperation, P=0.22; 62.50% vs. 25.00% at 1 month postoperation, P=0.07), but without statistical significance. The same trend was also found in the assessment of therapeutic efficacy for GVs (25.00% vs. 16.67% at 1 week postoperation, P=1; 58.33% vs. 41.67% at 1 month postoperation, P=0.68). Conclusion. CTPV is comparable to endoscopy in the detection of GEVs and in the evaluation of endotherapy efficacy, which suggests that it could be a less invasive alternative for endoscopy in cirrhotic patients with GEVs needing treatment.
Fractional Flow Reserve following Percutaneous Coronary Intervention
Authors: Thakur Udit , Khav Nancy , Comella Andrea , Michail Michael , Ihdayhid Abdul R. , Poon Eric , Nicholls Stephen J. , Ko Brian , Brown Adam J.
Published: June 2020

Fractional flow reserve (FFR) is routinely used to determine lesion severity prior to percutaneous coronary intervention (PCI). However, there is an increasing recognition that FFR may also be useful following PCI to identify mechanisms leading to restenosis and the need for repeat revascularization. Post-PCI FFR is associated with the presence and severity of stent under-expansion and may help identify peri-stent-related complications. FFR pullback may also unmask other functionally significant lesions within the target vessel that were not appreciable on angiography. Recent studies have confirmed the prognostic utility of performing routine post-PCI FFR and suggest possible interventional targets that would improve stent durability. In this review, we detail the theoretical basis underlying post-PCI FFR, provide practical tips to facilitate measurement, and discuss the growing evidence supporting its use.
Geographic Variations in Cutaneous Melanoma Distribution in the Russian Federation
Authors: Muntyanu Anastasiya , Savin Evgeny , Ghazawi Feras M. , Alakel Akram , Zubarev Andrei , Litvinov Ivan V.
Published: June 2020

Background: Cutaneous melanoma (CM) incidence has been increasing around the world. The goal of this study is to describe geographic trends in incidence and mortality of CM in Russia between 2001 and 2017. Methods: To achieve this we used geo-informatic technique (mapping) and descriptive statistical analysis. Additionally, we studied the associations between ethnicity, geographic latitude/longitude, and CM incidence/mortality rates. We retrospectively analyzed the data from the Moscow Oncology Research Institute, Ministry of Health of the Russian Federation, for the period of the study. Routine methods of descriptive epidemiology were used to study incidence and mortality rates by age groups, years, and jurisdictions (i.e., Federal Districts and Federal Subjects of Russia). Results: In total, 141,597 patients were diagnosed with melanoma in Russia over the period 2001–2017, of whom 62% were women. The overall age-standardized incidence and mortality rates were 4.27/100,000 and 1.62/100,000, respectively. Geographic mapping revealed north-to-south and east-to-west gradients. As the study was fully descriptive, retrospective, and based on official statistical reports, detailed characteristics of clinical forms, anatomic sites, Breslow depth, and treatments could not be analyzed. Conclusions: This study outlined the burden of melanoma in the Russian Federation, and the trends were similar to those observed in countries with similar latitudes and skin phenotype. The importance of the skin color gradient and recreational/cultural practices were some of the most important risk factors highlighted in this study for the development of melanoma in Russia.
Alexa, What Are You? Exploring Primary School Children’s Ontological Perceptions of Digital Voice Assistants in Open Interactions
Authors: Festerling Janik , Siraj Iram
Published: June 2020

Today’s children grow up in an environment that is increasingly characterized by digital voice assistants (DVAs), such as Alexa, Siri, or the Google Assistant. This paper argues that any attempt to investigate children’s interactions with, and perceptions of, DVAs should be based on the theoretical grounds of an ontological framework that considers children’s genuine understanding of what it means to be human and what it means to be a machine. Based on focus groups and a gamified data collection design, our empirical inquiry applied qualitative methods to explore primary school children’s (n =27, age range: 6–10 years, average age: 8.6 years) open interactions with DVAs. In particular, our focus was on how DVAs were embedded in children’s general ontological belief system, and how children interpreted certain aspects of DVAs’ interactive capabilities as being genuinely humanoid or non-humanoid. On the one hand, our findings suggest that children’s interactions with DVAs might be more an end in itself than a means to an end, meaning that children primarily interact with DVAs for the sake of engaging excitement instead of using the devices’ utilitarian functionalities. On the other hand, we found that children in our sample held firm ontological beliefs about the distinct nature of humans and machines, whilst interpreting certain aspects of DVAs’ interactive capabilities as being genuinely humanoid (e.g., non-responsiveness, delayed responses, inaccuracy) and non-humanoid (e.g., permanent responsiveness, promptness, accuracy, limited conversational capacities, lack of common sense, standardized responses) at the same time.
Nietzsche e a Proto-Genealogia de Aurora:
Authors: Barbosa Lucas Romanowski
Published: June 2020

Este artigo tem como objetivo apresentar uma perspectiva a respeito da obra Genealogia da Moral (1887), de Nietzsche, a partir de uma outra anterior, a saber, Aurora (1881). É possível perceber que ambas obras discutem acerca da moral – ou sobre preconceitos morais. A partir de duas discussões que são largamente desenvolvidas em Aurora – a moralidade do costume e os sentimentos morais – apresentaremos os pontos de encontro sobre as reflexões desta obra e o quanto já nela, seis anos antes, havia percepções fundamentais para a elaboração da obra de 1887. Alguns outros pontos de encontro também serão apresentados, como por exemplo, alguns termos ou frases que são praticamente repetidos em ambas.
Study Design and Rationale of EXPLORER-HCM
Authors: Ho Carolyn Y. , Olivotto Iacopo , Jacoby Daniel , Lester Steven J. , Roe Matthew , Wang Andrew , Waldman Cynthia Burstein , Zhang David , Sehnert Amy J. , Heitner Stephen B.
Published: June 2020

Background:

Obstructive hypertrophic cardiomyopathy (oHCM) is characterized by unexplained left ventricular (LV) hypertrophy associated with dynamic LV outflow tract obstruction. Current medical therapies are nonspecific and have limited efficacy in relieving symptoms. Mavacamten is a first-in-class targeted inhibitor of cardiac myosin, which has been shown to reduce LV outflow tract obstruction, improve exercise capacity, and relieve symptoms of oHCM in the PIONEER-HCM phase 2 study.

Methods:

EXPLORER-HCM is a multicenter, phase 3, randomized, double-blind, placebo-controlled trial to investigate the efficacy and safety of mavacamten in treating symptomatic oHCM. Eligible adults with oHCM and New York Heart Association Functional Class II or III are randomized 1:1 to receive once-daily, oral mavacamten, or matching placebo for 30 weeks. The primary composite functional end point is clinical response at week 30 compared to baseline defined as either (1) an increase in peak oxygen consumption ≥1.5 mL/kg/min and reduction of at least one New York Heart Association class; or (2) an improvement of ≥3.0 mL/kg/min in peak oxygen consumption with no worsening of New York Heart Association class. Secondary end points include change in postexercise LV outflow tract gradient, New York Heart Association class, peak oxygen consumption, and patient-reported outcomes assessed by the Kansas City Cardiomyopathy Questionnaire and a novel HCM-specific instrument. Exploratory end points aim to characterize the effect of mavacamten on multiple aspects of oHCM pathophysiology.

Conclusions:

EXPLORER-HCM is a phase 3 trial in oHCM testing a first-in-class, targeted strategy of myosin inhibition to improve symptom burden and exercise capacity through reducing LV outflow tract obstruction. Results of this trial will provide evidence to support the first disease-specific treatment for HCM.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03470545.
The syntax, semantics and pragmatics of ‘optional’ wh-in situ in Greek
Authors: Vlachos Christos , Chiou Michalis
Published: June 2020

Building on the relevant literature, this paper provides an up-to-now missing overarching approach to ‘optional’ wh-in situ questions in Greek, by arguing that some properties of wh-in situ are computed at the interface between syntax and semantics, other properties relate to the syntax-pragmatics interface, and yet others are derived at the interface between PF and pragmatics. Wh-in situ is not semantically (hence, syntactically) equivalent to wh-fronting, with the latter being the default strategy of Greek on empirical grounds. Wh-in situ assumes distinct syntax and semantics, while its pragmatics is computed partly by the way it is associated to the discourse, and partly by intonation.
Changing alignments in the Greek of southern Italy
Authors: Ledgeway Adam , Schifano Norma , Silvestri Giuseppina
Published: June 2020

This article investigates a peculiar pattern of subject case-marking in the Greek of southern Italy. Recent fieldwork with native speakers, coupled with the consultation of some written sources, reveals that, alongside prototypical nominative subjects, Italo-Greek also licenses accusative subjects, despite displaying a predominantly nominative-accusative alignment. Far from being random replacements within a highly attrited grammar, the distribution of these accusative subjects obeys specific structural principles, revealing similarities with historical attestations of the so-called “extended accusative” in early Indo-European. On the basis of these data, Italo-Greek is argued to be undergoing a progressive shift towards an active-stative alignment, a claim supported by additional evidence from auxiliary selection, adverb agreement and sentential word order.
CITES and the African Elephant
Authors: Chakanyuka Tatenda Leopold
Published: June 2020

This article focuses on the impact of the ban of international trade of the ivory of the African elephant under the Convention on International Trade in Endangered Species. This species is overpopulated in some countries and threatened in other countries. Overall, its current population and the level of decline suggest a species that is endangered. The population disparities have created misunderstandings in terms of how to address the issues. Controversy has surrounded the two instances of legal sales of ivory, and the continuing ban on ivory trade from 1989 has contributed to animosity between pro-ban Western ‘conservationists’ and anti-ban African countries, with accusations of ‘ecological imperialism’ being levelled at some of the protagonists. The article observes that the vast global ivory market has largely been sustained by countries that have failed to effectively enact laws and/or enforce them, as well as failing to deal with corruption and illegal markets within their jurisdictions. It is argued that identifying such culprit countries and their role in promoting elephant poaching and ivory trade, and identifying the reasons behind the poaching and illegal trade, is crucial in reducing the incidence of poaching. The article argues that with a better understanding of the illegal trade, CITES can take deliberate steps to assist countries involved in the ivory trade where they need that support.
Environmental Sustainability and Regulation in Rivers State, Nigeria
Authors: Worika Ibibia Lucky , Etemire Uzuazo
Published: June 2020

Over the years, the overall quality of the environment in Rivers State, in the Niger Delta of Nigeria, has taken a significant downturn, which has attracted both national and international attention. This situation, among other things, raises questions about the quality of environmental laws and institutions in the state, with respect to their capacity to promote environmental sustainability. This article seeks to unravel this question. The analysis, with specific reference to certain standards, broadly reveals that on the whole, the current status and quality of environmental laws and institutions in Rivers State are largely incapable of ensuring environmental sustainability in the state, in terms of securing a healthy environment conducive to human wellbeing and development. Against this backdrop, recommendations are made regarding extensive law review/revision, the faithful implementation of improved laws, and the proper allocation and employment of adequate material and human resources with a view to strengthening the environmental regulatory system of Rivers State.
Advocacy engagement
Authors: Nzomo Peggy , Fehrmann Paul
Published: June 2020

The current research sought to identify what skills, knowledge, and behaviours (SKBs) in advocacy engagement are closely associated with information literacy skills. The paper examines what role information literacy (IL) skills play in making one an effective advocate by drawing on everyday life situations that involve advocacy such as self-advocacy, social advocacy, patient advocacy, parent advocacy, and policy advocacy. A rapid scoping review was completed using articles published within the last ten years (2008–2019). The articles were retrieved from Academic Search Complete, a multidisciplinary database. The aim of our initial review was to identify what skills, knowledge and behaviours are deemed essential for everyday life situations that involve advocacy. Charting of the literature was then used to map the skills, knowledge and behaviours mentioned in relation to advocacy to information literacy skills. Results showed how the knowledge component in advocacy engagement is closely associated with various IL skills such as finding information, evaluation of information and sharing information. Implications of the study point towards the importance of emphasising IL instruction in broader contexts beyond higher education and/ or academic libraries. The study shows that IL skills are important in the public realm and in primary (elementary) and secondary (high) school contexts as well. Therefore, public librarians and school librarians should be just as engaged in equipping their patrons/clientele with IL skills that may be needed for different types of advocacy such as self-advocacy, parent advocacy and patient advocacy. The study also has implications for humanitarian research and research that involves situations of information poverty as these contexts will often involve advocacy work as well.