bluuebunny/crossref_metadata_2025 huggingface dataset:
The assessment of quantitative risk to road users from debris flow
Authors: Winter M. G. , Wong J. C. F.
Published: January 2020

Background

A methodology for the quantitative risk assessment (QRA) of the impact of debris flow in a road environment has been developed and applied to two sites that are typically subject to high frequency-low magnitude and low frequency-high magnitude events. The methodology considers the probability of an event of a typical size, and the conditional probabilities of a vehicle being affected, given an event, and of damage (fatality) occurring given that the vehicle is affected. Scenarios covering a vehicle being hit by a debris flow and of a vehicle hitting a debris flow are considered. The computed Personal Individual Risk (PIR) is used to calculate worst case fatality probabilities for commuters and logistics truck drivers. The overall risk to society is expressed both by the annual probability of fatality amongst all road users, the Potential Loss of Life (PLL), and using the F-N diagram and is used to demonstrate the effect of a programme of management and mitigation works on the societal risk at one of the sites. The authors believe that this is the first full, formal quantitative risk assessment for debris flow risk to road users.

Results

The PIR for a single trip through the sites ranges between 1.147E-10 for the low frequency-high magnitude site and 1.583E-09 for the high frequency-low magnitude site. These figures increase to 1.248E-07 and 1.922E-06, respectively, when more frequent travellers are considered. The PLL for the two sites ranges between 2.616E-04 for the low frequency-high magnitude site and 4.083E-03 for the high frequency-low magnitude site. The F-N diagrams illustrate the Broadly Acceptable level of risk at the low frequency-high magnitude site and the partially Unacceptable level of risk at the high frequency-low magnitude site. The risk at the high frequency-low magnitude site is reduced to ALARP levels when management and mitigation measures extant as of October 2014 are considered.

Conclusions

The QRA proves an effective technique for understanding, comparing and articulating the differences in levels of risk and the temporal changes in risk at a given site as a result of landslide risk reduction activities.
Partial portal vein arterialization during living-donor liver transplantation: a case report
Authors: Maruya Yasuhiro , Hidaka Masaaki , Pecquenard Florian , Baubekov Alzhan , Nunoshita Yuki , Ono Shinichiro , Adachi Tomohiko , Takatsuki Mitsuhisa , Tanaka Katsumi , Ito Shinichiro , Kanetaka Kengo , Eguchi Susumu
Published: January 2020

Background

Hepatic artery thrombosis can lead to graft loss associated with severe hepatic infarction or bile duct ischemia. When anatomical hepatic artery reconstruction is impossible in liver transplantation or hepato-pancreatic biliary surgery, portal vein arterialization (PVA) is proposed as a salvage technique. Herein, we report our experience with a case that showed favorable clinical outcomes after partial PVA during living-donor liver transplantation (LDLT) because of difficulties in arterial reconstruction.

Case presentation

A 62-year-old woman with non-B, non-C liver cirrhosis complicated with hepatocellular carcinoma was being prepared for LDLT using an extended left lobe graft. The graft presented with two arteries (left hepatic artery, 2 mm; middle hepatic artery, 2 mm). The first anastomosis was performed using the recipient hepatic artery stumps, but no flow was detected on Doppler control because of thrombus formation. The next attempt was executed using the middle colic artery with a radial artery jump graft and the right gastroepiploic artery, but it led to the same result. Thus, the graft oxygen support by the standard arterial procurement was abandoned, and a shunt was created between the ileocecal artery and the vein to obtain PVA. Arteriography of the superior mesenteric artery showed that the shunt was relatively patent, and the portal vein was apparent. No biliary complication or liver abscess occurred postoperatively, and the patient presented with good liver function and no complications related to portal vein hypertension, nor liver fibrosis 18 months after the LDLT.

Conclusion

Partial PVA with a shunt created between the ileocecal artery and the vein is useful when arterial reconstruction is difficult during LDLT for preventing graft loss caused by severe hepatic infarction or bile duct ischemia.
Evaluation of fluorinated hydroxyapatite nanoparticles as an antibacterial material for catheter coating
Authors: Gyotoku Hiroki , Azuma Yoshinano , Furuzono Tsutomu
Published: January 2020

Background

Catheter-related infection of peritoneal dialysis (PD) is one of the serious factors of peritonitis. However, an antibacterial PD catheter has not been commercially available in Japan yet. From an infection control viewpoint, it is necessary to develop an antibacterial coating material for catheters with a long-term effectiveness.

Methods

Fluorinated hydroxyapatite (F-HAp) nanoparticles were prepared by a wet chemical process. F-HAps with different F substitution contents were prepared by adjusting the feed ratio of F ions versus sites of OH groups in HAp structures. The characterization and evaluation of F-HAps were conducted using several analytical equipment and an antibacterial powder assay.

Results

The F-HAp nanoparticles possessed highly crystalline and dispersibility. The F-HAps were named as F(30)-HAp, F(50)-HAp, and F(100)-HAp and were 24, 52, and 84% of the actual F substitution content, respectively. The nanomaterials showed acidic resistance, i.e., chemical stability, compared to normal HAp. In an antibacterial assay of F(100)-HAp with 50 mg in 0.2 mL of NaCl aqueous solution, four types of causative bacteria of catheter-related infections,Pseudomonas aeruginosa,Staphylococcus aureus,Enterobacter aerogenes, andKlebsiella pneumoniaewere used. The antibacterial activities of F(100)-HAp showed 50–60% against the microorganisms. F ions were gradually released and finally plateaued at 24 weeks.

Conclusions

The retention possibility of the antibacterial effect of F(100)-HAp potentially lasted for 24 weeks based on the F ions release behavior. It is expected that the antibacterial performance can be improved by the precise control of material engineering technology, although the duration of the effect has not yet been satisfactory for a PD catheter.
Round robin comparison study on the form measurement of optical freeform surfaces
Authors: Fortmeier Ines , Schachtschneider Reyko , Ledl Vit , Matousek Ondrej , Siepmann Jens , Harsch Antonia , Beisswanger Rolf , Bitou Youichi , Kondo Yohan , Schulz Michael , Elster Clemens
Published: January 2020

A round robin comparison of freeform form measurements was carried out by the project partners and stakeholders of a European metrology research project. Altogether six measuring instruments were considered: five different (pointwise and areal) optical devices and one tactile device. Three optical freeform surfaces were used for the comparison measurements, where two specimens were measured by five instruments and one specimen by four instruments. In this paper, the evaluation methods and results of this round robin are presented for the three freeform surfaces made from a temperature-stable material, Super Invar®. The freeforms had diameters of 40 mm, 50 mm and 100 mm and best-fit radii of 39.75 mm (convex), 40.9 mm (convex) and 423.5 mm (concave). For comparison, the bilateral pointwise differences between the available measurements were calculated. The root-mean-square values of these differences ranged from 15 nm to 110 nm (neglecting spherical contributions) and provided an insight into the status of typical freeform measurement capabilities for optical surfaces.
Correction to: Preliminary experience with the micro vascular plug for the treatment of pulmonary arteriovenous malformation: case series of four patients
Authors: Duvnjak Stevo , Di Ciesco Carmela Anna , Andersen Poul Erik
Published: January 2020

In the published article (Duvnjak et al. 2018) the statement under the subheading ‘Consent for publication’ is incorrect.
Transsplenic portal vein recanalization and direct intrahepatic portosystemic shunt placement to optimize liver transplantation
Authors: Ahmed Osman , Salaskar Abhijit L. , Zangan Steven , Pillai Anjana , Baker Talia
Published: January 2020

Background

Percutaneous trans-splenic portal vein recanalization (PVR) has been reported for facilitation of transjugular intrahepatic portosystemic shunts (TIPS), however has not been applied to patients undergoing direct intrahepatic portosystemic shunt (DIPS). We report the utilization of trans-splenic-PVR with DIPS creation in a patient with chronic portal and hepatic vein occlusions undergoing liver transplantation evaluation.

Case presentation

A 48-year-old male with decompensated alcoholic cirrhosis complicated by refractory ascites, hepatic encephalopathy, and variceal bleeding underwent CT that demonstrated chronic occlusion of the hepatic veins (HV), extrahepatic portal vein (PV), and superior mesenteric vein (SMV). Due to failed attempts at TIPS at outside institutions, interventional radiology was consulted for portal vein recanalization (PVR) with TIPS to treat the portal hypertension and ascites and also facilitate an end-to-end PV anastomosis at transplantation. After an initial hepatic venogram confirmed chronic HV occlusion, a DIPS with trans-splenic PVR was planned. The splenic vein was accessed under sonographic guidance using a micropuncture set and subsequently upsized to a 6 French sheath over a stiff guidewire. A splenic venogram via this access confirmed occlusion of the PV with drainage of the splenic vein (SV) through gastric varices. The thrombosed PV was then recanalized and angioplastied to restore PV flow via the transsplenic approach. A transjugular liver access kit with a modified 21-gauge needle was advanced into the IVC through the internal jugular vein (IJV) sheath and directed towards the target snare in PV. The needle was used to subsequently puncture the PV through the caudate lobe and facilitate placement of a wire into the SV. The initial portosystemic gradient (PSG) was 20 mmHg. The IJV sheath was advanced through the hepatic parenchymal tract into the main-PV and a stent-graft was placed across the main PV and into the IVC. A portal venogram demonstrated brisk blood flow through the DIPS, resolution of varices and a PSG of 8 mmHg. One month after the procedure, the patient had a significant reduction in ascites and MELD-NA score. Patient is currently listed and awaiting transplantation.

Conclusions

In the setting of chronically occluded portal and hepatic veins, trans-splenic PVR DIPS may serve as an effective bridge to liver transplantation by facilitating an end to end portal vein anastomosis.
Optimization of biogas supply networks considering multiple objectives and auction trading prices of electricity
Authors: Egieya Jafaru Musa , Čuček Lidija , Zirngast Klavdija , Isafiade Adeniyi Jide , Kravanja Zdravko
Published: January 2020

This contribution presents an hourly-based optimization of a biogas supply network to generate electricity, heat and organic fertilizer while considering multiple objectives and auction trading prices of electricity. The optimization model is formulated as a mixed-integer linear programming (MILP) utilizing a four-layer biogas supply chain. The model accounts for biogas plants based on two capacity levels of methane to produce on average 1 ± 0.1 MW and 5 ± 0.2 MW electricity. Three objectives are put forward: i) maximization of economic profit, ii) maximization of economic profit while considering cost/benefits from greenhouse gas (GHG) emissions (economic+GHG profit) and iii) maximization of sustainability profit. The results show that the economic profit accrued on hourly-based auction trading prices is negative (loss), hence, four additional scenarios are put forward: i) a scenario whereby carbon prices are steadily increased to the prevalent eco-costs/eco-benefits of global warming; ii) a scenario whereby all the electricity auction trading prices are multiplied by certain factors to find the profitability breakeven factor, iii) a scenario whereby shorter time periods are applied, and investment cost of biogas storage is reduced showing a relationship between cost, volume of biogas stored and the variations in electricity production and (iv) a scenario whereby the capacity of the biogas plant is varied from 1 MW and 5 MW as it affects economics of the process. The models are applied to an illustrative case study of agricultural biogas plants in Slovenia where a maximum of three biogas plants could be selected. The results hence present the effects of the simultaneous relationship of economic profit, economic+GHG profit and sustainability profit on the supply and its benefit to decision-making.
Case report of gastric teratoma masquerading as neonatal intestinal obstruction
Authors: Chatterjee Rajib , Singh Abhijit , Gharpure Vivek
Published: January 2020

Background

Teratomas are rare in neonates. They are embryonic neoplasms containing elements from all the three germ layers. Commonly, they arise in the ovary and testis. Rarely do they arise from the gastrointestinal tract, as in our case. Intestinal obstruction in neonates is usually due to congenital obstructive malformation such as atresia and/or stenosis of the gastrointestinal tract with or without sepsis.

Case presentation

An outborn 5-day neonate, generally well before admission presented with non-bilious vomiting, abdominal distension and a palpable mass extending from the right to left flank across the centre. Bilious aspirates/vomiting usually indicates obstruction distal to the ampulla of Vater. Clear aspirates indicate obstruction proximal to the ampulla which usually present by second day of life.

Possibility of a mass lesion such as a “teratoma” causing gastrointestinal obstruction needs a high index of suspicion. Imaging studies of plain X-ray chest with abdomen enhanced our clinical suspicion which was promptly followed by ultrasonography of the abdomen and thereafter computerized tomography of the abdomen which provided corroborative evidence. Laparotomy on the seventh day of life confirmed the clinical suspicion and imaging evidence of an exogastric mass arising from the postero-inferior wall of the stomach along its greater curvature. Histopathology revealed a mature teratoma.

Conclusion

A high index of clinical suspicion by the paediatrician/neonatologist attending a neonate with abdominal distension suggestive of gastrointestinal obstruction, immediate cardiopulmonary, hemodynamic and circulatory stabilization, followed by prompt and appropriate imaging studies with timely surgical consultation holds the key to quality outcome.
A simplified laparoscopic-assisted gastrostomy technique: a single center experience
Authors: Sheir Hesham M. , Wafa Tamer A. , Elshafey Abdelrahman , Elzohiri Mohamed
Published: January 2020

Background

Although percutaneous endoscopic gastrostomy (PEG) is considered simple and effective, major complications have been reported because of the partly blind placement technique. Laparoscopic gastrostomy was described to overcome most of the problems and the contraindications of PEG. Various modifications have been reported to anchor the stomach to the abdominal wall.

This study aims at highlighting a single center experience using a simplified technique for gastrostomy and evaluates its outcome.

Results

The age of the patients ranged from 7 days to 3 years (mean 11.75 ± 12 months in group A and 16 ± 3 months in group B). The mean body weight at time of gastrostomy was 6.5 ± 4.6 kg in group A and 7.5 ± 2 in group B. The mean operative time was 24.8 ± 4 min in group A and 25 ± 1.6 in group B, ranging from 18 to 31 min. The incidence of gastrostomy-related complications was 20% (three cases) in group A versus 12.5% (one case) among patients included in group B. Yet, this difference was statistically insignificant (p= 0.651). No major complications were reported apart from persistent gastrocutaneous fistula in one out of eight cases followed after removal of the gastrostomy (12.5%). There is no significant difference in the outcome either in neonates or in patients less than 5 kg.

Conclusions

The described simple technique of laparoscopic-assisted gastrostomy is easy, effective, and with a very low incidence of complications. It is also equally safe in neonates and children less than 5 kg.
Electromagnetic characterization of epithermal gold deposits: A case study from the Tuoniuhe gold deposit, Northeast China
Authors: Xu Shan , Xu Fengming , Hu Xiangyun , Zhu Qun , Zhao Yuandong , Liu Shuang
Published: January 2020

A high-resolution electromagnetic study has helped to define the mineralization and alteration system of the Cretaceous volcano-sedimentary hosted epithermal gold (Au) deposit in Tuoniuhe, northeast China. Audio-magnetotelluric (AMT) array data were acquired to map the regional resistivity structure of the Mesozoic volcanic field, whereas an AMT profile and a ground magnetic survey line with denser site spacing were deployed across the deposit to image the alteration and mineralization system. The electrical resistivity model from 2D inversion of the AMT profile data reveals a low-resistivity (approximately [Formula: see text]) cover from the surface to a depth of 0.1 km, which is likely caused by clay and sulfide minerals in the subaerial alteration zone. The magnetic survey and a geologic borehole log assisted in outlining a zone of tonalite and andesite with silicification in the depth interval of 0.1–0.3 km, featuring high resistivity ([Formula: see text]) and high magnetization ([Formula: see text]). This zone is a potential gold target bounded by two channels of moderate resistivity (approximately [Formula: see text]) to its northwest and southeast. The two channels possibly coincide with breccia pipes with fractured stockworks and high permeability to allow gold-bearing fluids to move toward the surface. The 2D and 3D resistivity models reveal regions of low resistivity ([Formula: see text]) at the depth range of 0.5–1.0 km beneath the Cretaceous calderas and the deposit, which might be related to magmatic cryptoexplosion breccia. In the 2D resistivity model, this magmatic cryptoexplosion breccia zone connects to the subaerial alteration zone through the two breccia pipes, indicative of a circulation system of gold-bearing fluids. Given the coincidence of Cretaceous volcanism and the age of mineralization, the Cretaceous magma is inferred to have supplied heat that drove the convective hydrothermal activity and also was a source of magmatic fluids that led to the development of the Tuoniuhe epithermal gold deposit.
Patient Advocacy Approaches to Improving Care for Breast and Cervical Cancer in East and Southern Africa
Authors: Kizub Darya A. , Zujewski JoAnne , Gralow Julie R. , Ndoh Kingsley , Soko Udie , Dvaladze Allison L.
Published: January 2020

PURPOSE

Breast and cervical cancer are the most common cancers among women in East and Southern Africa, where mortality remains high because of late diagnosis and limited access to treatment. We explored local approaches to breast and cervical cancer advocacy to identify the most pressing issues and opportunities for increasing the impact of civil society activities in the region.

METHODS

Focus group discussions were conducted with participants of the 2016 Women’s Empowerment Cancer Advocacy Network (WE CAN) Summit in Nairobi, Kenya. Discussions were audio-recorded, transcribed, coded, and analyzed for emergent themes. Results were presented to participants of 2019 WE CAN summit for cross-validation.

RESULTS

Four focus group discussions were conducted with 50 participants. Thirty-six (70%) identified as advocates, 30 (59%) as cancer survivors, 14 (27%) as nongovernmental organization representatives, 13 (25%) as researchers, 4 (8%) as clinicians, and 6 (8%) as policymakers. Although most participants focused on cancer awareness and screening/early detection, some noted that treatment was often unavailable and advocated for a broader strategy to improving access to care. Challenges to designing and implementing such a strategy included knowledge gaps in addressing late diagnosis and access to care, difficulty collaborating with like-minded organizations, approaching policymakers, and addressing treatment financing. Cancer coalitions, although rare, were crucial to building collaborations with ministries of health, policymakers, and international organizations that advanced breast and cervical cancer care.

CONCLUSION

Participants indicated that they would benefit from additional training about resource-appropriate best practices for improving breast and cervical cancer care and outcomes. Coalition-building and collaborations, including with oncologists and other medical professionals involved in cancer care, were crucial to leveraging limited resources, sharing lessons learned, and developing local solutions to common challenges.
Frequency and Incidence of Carney Complex Manifestations: A Prospective Multicenter Study With a Three-Year Follow-Up
Authors: Espiard Stéphanie , Vantyghem Marie-Christine , Assié Guillaume , Cardot-Bauters Catherine , Raverot Gerald , Brucker-Davis Françoise , Archambeaud-Mouveroux Françoise , Lefebvre Hervé , Nunes Marie-Laure , Tabarin Antoine , Lienhardt Anne , Chabre Olivier , Houang Muriel , Bottineau Muriel , Stroër Sebastian , Groussin Lionel , Guignat Laurence , Cabanes Laure , Feydy Antoine , Bonnet Fidéline , North Marie Odile , Dupin Nicolas , Grabar Sophie , Duboc Denis , Bertherat Jérôme
Published: January 2020

Introduction

Carney Complex (CNC) is a rare multiple endocrine and nonendocrine neoplasia syndrome. Manifestations and genotype-phenotype correlations have been described by retrospective studies, but no prospective study evaluating the occurrence of the different manifestations has been available so far.

Methods

This multicenter national prospective study included patients with CNC, primary pigmented nodular adrenal disease (PPNAD), or a pathogenic PRKAR1A mutation; after a full initial workup, participants were followed for 3 years with annual standardized evaluation.

Results

The cohort included 70 patients (50 female/20 male, mean age 35.4 ± 16.7 years, 81% carrying PRKAR1A mutation). The initial investigations allowed identification of several manifestations. At the end of the 3-year follow-up, the newly diagnosed manifestations of the disease were subclinical acromegaly in 6 patients, bilateral testicular calcifications in 1 patient, and cardiac myxomas in 2 patients. Recurrences of cardiac myxomas were diagnosed in 4 patients during the 3-year follow-up study period. Asymptomatic abnormalities of the corticotroph and somatotroph axis that did not meet criteria of PPNAD and acromegaly were observed in 11.4% and 30% of the patients, respectively. Patients carrying the PRKAR1A c.709-7del6 mutation had a mild phenotype.

Conclusion

This study underlines the importance of a systematic follow-up of the CNC manifestations, especially a biannual screening for cardiac myxoma. By contrast, regular screening for the other manifestations after a first extensive workup could be spread out, leading to a lighter and more acceptable follow-up schedule for patients. These are important results for recommendations for long-term management of CNC patients.
Fibroblast Growth Factor-21, Leptin, and Adiponectin Responses to Acute Cold-Induced Brown Adipose Tissue Activation
Authors: Sun Lijuan , Yan Jianhua , Goh Hui Jen , Govindharajulu Priya , Verma Sanjay , Michael Navin , Sadananthan Suresh Anand , Henry Christiani Jeyakumar , Velan S Sendhil , Leow Melvin Khee-Shing
Published: January 2020

Background

Adipocyte-derived hormones play a role in insulin sensitivity and energy homeostasis. However, the relationship between circulating fibroblast growth factor 21 (FGF21), adipocytokines and cold-induced supraclavicular brown adipose tissue (sBAT) activation is underexplored.

Objective

Our study aimed to investigate the relationships between cold-induced sBAT activity and plasma FGF21 and adipocytokines levels in healthy adults.

Design

Nineteen healthy participants underwent energy expenditure (EE) and supraclavicular infrared thermography (IRT) within a whole-body calorimeter at baseline and at 2 hours post-cold exposure. 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography/magnetic resonance (PET/MR) imaging scans were performed post-cold exposure. PET sBAT mean standardized uptake value (SUV mean), MR supraclavicular fat fraction (sFF), anterior supraclavicular maximum temperature (Tscv max) and EE change (%) after cold exposure were used to quantify sBAT activity.

Main Outcome Measures

Plasma FGF21, leptin, adiponectin, and tumor necrosis factor alpha (TNFα) at baseline and 2 hours post-cold exposure. Body composition at baseline by dual-energy x-ray absorptiometry (DXA).

Results

Plasma FGF21 and adiponectin levels were significantly reduced after cold exposure in BAT-positive subjects but not in BAT-negative subjects. Leptin concentration was significantly reduced in both BAT-positive and BAT-negative participants after cold exposure. Adiponectin concentration at baseline was positively strongly associated with sBAT PET SUV mean (coefficient, 3269; P = 0.01) and IRT Tscv max (coefficient, 6801; P  = 0.03), and inversely correlated with MR sFF (coefficient, −404; P  = 0.02) after cold exposure in BAT-positive subjects but not in BAT-negative subjects.

Conclusion

Higher adiponectin concentrations at baseline indicate a greater cold-induced sBAT activity, which may be a novel predictor for sBAT activity in healthy BAT-positive adults.

Highlights

A higher adiponectin concentration at baseline was associated with higher cold-induced supraclavicular BAT PET SUV mean and IRT Tscv max, and lower MR supraclavicular FF. Adiponectin levels maybe a novel predictor for cold-induced sBAT activity.
Effect of the Age at Menarche and Menopause Status Interaction on Type 2 Diabetes: The Henan Rural Cohort Study
Authors: Zhang Lulu , Li Yuqian , Dong Xiaokang , Zhou Wen , Wang Chongjian , Mao Zhenxing , Yang Xiu , Fan Mengying , Han Shengna , Li Linlin
Published: January 2020

Purpose

The aims of this study were to evaluate the effect of age at menarche (AM) on type 2 diabetes mellitus (T2DM) and to assess whether the fasting plasma glucose (FPG) and homeostasis model assessment (HOMA) index responses to AM and menopause status interact in Chinese rural adults.

Methods

A cross-sectional, population-based study including 23 138 participants was performed. Logistic regression and multivariable linear regression were performed to investigate the relationship between AM and glucose status. Generalized linear model was used to calculate the interaction term of AM and menopause status on FPG and the HOMA index. Interaction plot was used to interpret the significant interaction effect.

Results

Women in the later menarche age group (≥18 years) had a 17.7% lower risk of T2DM (95% confidence interval [CI]: 0.712-0.951, P = .008), after adjusting for multiple variables. Further adjustment for body mass index (BMI) completely attenuated this association (odds ratio = 0.884, 95% CI: 0.764-1.024, P = .099). A significant interaction effect of AM and menopause status on T2DM (P = .004) was observed. The adverse effects of menopausal status on FPG and HOMA-2 of insulin resistance decreased with increasing menarche age, and the age ranges were limited to <18 and 9 to 19 years, respectively.

Conclusions

Later menarche was associated with a lower risk of T2DM, and the association appears to be mediated by BMI. More importantly, the adverse effect of menopause status on T2DM was decreased along with increasing menarche age.
PROP1-Dependent Retinoic Acid Signaling Regulates Developmental Pituitary Morphogenesis and Hormone Expression
Authors: Cheung Leonard Y M , Camper Sally A
Published: January 2020

Dietary vitamin A is metabolized into bioactive retinoic acid (RA) in vivo and regulates the development of many embryonic tissues. RA signaling is active in the oral ectoderm-derived tissues of the neuroendocrine system, but its role there has not yet been fully explored. We show here that RA signaling is active during pituitary organogenesis and dependent on the pituitary transcription factor Prop1. Prop1-mutant mice show reduced expression of the aldehyde dehydrogenase gene Aldh1a2, which metabolizes the vitamin A–intermediate retinaldehyde into RA. To elucidate the specific function of RA signaling during neuroendocrine development, we studied a conditional deletion of Aldh1a2 and a dominant-negative mouse model of inhibited RA signaling during pituitary organogenesis. These models partially phenocopy Prop1-mutant mice by exhibiting embryonic pituitary dysmorphology and reduced hormone expression, especially thyrotropin. These findings establish the role of RA in embryonic pituitary stem cell progression to differentiated hormone cells and raise the question of gene-by-environment interactions as contributors to pituitary development and disease.
JNK signaling is required for proper tangential migration and laminar allocation of cortical interneurons
Authors: Myers Abigail K. , Cunningham Jessica G. , Smith Skye E. , Snow John P. , Smoot Catherine A. , Tucker Eric S.
Published: January 2020

The precise migration of cortical interneurons is essential for the formation and function of cortical circuits, and disruptions to this key developmental process are implicated in the etiology of complex neurodevelopmental disorders, including schizophrenia, autism and epilepsy. We have recently identified the Jun N-terminal kinase (JNK) pathway as an important mediator of cortical interneuron migration in mice, regulating the proper timing of interneuron arrival into the cortical rudiment. In the current study, we demonstrate a vital role for JNK signaling at later stages of corticogenesis, when interneurons transition from tangential to radial modes of migration. Pharmacological inhibition of JNK signaling in ex vivo slice cultures caused cortical interneurons to rapidly depart from migratory streams and prematurely enter the cortical plate. Similarly, genetic loss of JNK function led to precocious stream departure ex vivo, and stream disruption, morphological changes and abnormal allocation of cortical interneurons in vivo. These data suggest that JNK signaling facilitates the tangential migration and laminar deposition of cortical interneurons, and further implicates the JNK pathway as an important regulator of cortical development.
The Thoracic Spine in the Overhead Athlete
Authors: Ruiz Jeffrey , Feigenbaum Luis , Best Thomas M.
Published: January 2020

Overhead athletes are susceptible to many injuries, particularly in the shoulder and lumbar spine. Due to the heterogeneity of these two regional injuries, it is difficult to pinpoint the exact origin. A potential contributing factor that should be thoroughly evaluated is the thoracic spine. It can be challenging to quantify exactly how much thoracic spine mobility or lack thereof plays a role toward injury. Despite this, when examining mechanics of an overhead athlete, if neuromuscular control of the thorax is impaired, adjacent motion segments often take the brunt of the required movements. This article addresses the need to incorporate the thoracic spine when analyzing the entire kinetic chain. Clinical pearls regarding thoracic neuromuscular control and rehabilitation were explored, as well as a review of recent literature. Further investigation of thoracic spine therapeutic interventions should be considered when treating overhead athletes.
Association between Objective Activity Intensity and Heart Rate Variability: Cardiovascular Disease Risk Factor Mediation (CARDIA)
Authors: POPE ZACHARY C. , GABRIEL KELLEY PETTEE , WHITAKER KARA M. , CHEN LIN Y. , SCHREINER PAMELA J. , JACOBS DAVID R. , STERNFELD BARBARA , CARR J. JEFFREY , LLOYD-JONES DONALD M. , PEREIRA MARK A.
Published: January 2020

Purpose

We evaluated the associations between accelerometer-estimated physical activity (PA) intensity and heart rate variability (HRV) and examined mediation of these associations by glycemic control indices and other cardiovascular disease risk factors.

Methods

Data were from 1668 participants (X̅
age = 45.9 ± 3.5 yr, 58.0% female, 39.9% black) who participated in year 20 (2005–2006) of the Coronary Artery Risk Development in Young Adults Fitness Study. The ActiGraph 7164 estimated participants’ mean minutes per day of vigorous-intensity PA (VPA), moderate-intensity PA (MPA), and light-intensity PA (LPA) over 7 d. Three sequential 10-s 12-lead ECG strips were used to derive standard deviation of all normal RR intervals (SDNN) and root mean square of all successive RR intervals (rMSSD) HRV. Mediators representing glycemic control indices included fasting glucose, fasting insulin, and 2-h oral glucose tolerance, with other mediators being traditional cardiovascular disease risk factors. Multiple linear regression assessed independent associations of PA intensity with HRV per 1-SD. Mediation analyses computed the proportion of the PA–HRV association attributable to physiological mediators.

Results

Participants averaged 2.7 ± 6.2 min·d−1, 33.0 ± 22.0 min·d−1, and 360.2 ± 83.8 min·d−1 of VPA, MPA, and LPA, respectively, with mean values for SDNN (32.6 ± 22.4 ms) and rMSSD (34.0 ± 24.8 ms) similar. After adjustment for demographic and lifestyle behaviors, VPA was associated with both HRV metrics (SDNN: std beta = 0.06 [0.03, 0.10]; rMSSD: std beta = 0.08 [0.05, 0.12]) and LPA with rMSSD only (std beta = 0.05 [0.01, 0.08]). Fasting insulin and glucose mediated 11.6% to 20.7% of the association of VPA and LPA with HRV, with triglycerides also potentially mediating these associations (range, 9.6%–13.4%).

Conclusions

Accelerometer-estimated VPA was associated with higher (i.e., improved) HRV. Light-intensity PA also demonstrated a positive association. Mediation analyses suggested these associations may be most attributable to glucose-insulin dynamics.
Cost-effectiveness of oral versus intravenous antibiotics (OVIVA) in patients with bone and joint infection: evidence from a non-inferiority trial
Authors: McMeekin Nicola , Geue Claudia , Briggs Andrew , Rombach Ines , Li Ho Kwong , Bejon Philip , McNally Martin , Atkins Bridget L. , Ferguson Jamie , Scarborough Matthew ,   OVIVA collaborators
Published: January 2020

Background: Bone and joint infections are becoming increasingly common and are usually treated with surgery and a course of intravenous antibiotics. However, there is no evidence to support the superiority of intravenous therapy and there is a growing body of literature showing that oral therapy is effective in treating these infections. Given this lack of evidence the clinical trial ‘Oral Versus Intravenous Antibiotics’ (OVIVA) was designed to assess the clinical and cost-effectiveness of intravenous versus oral antibiotics for the treatment of bone and joint infections, using a non-inferiority design. Clinical results from the trial indicate that oral antibiotics are non-inferior to intravenous antibiotics. The aim of this paper is to evaluate the cost-effectiveness of intravenous compared to oral antibiotics for treating bone and joint infections, using data from OVIVA.

Methods: A cost-utility analysis was carried out, the main economic outcome measure was the quality adjusted life-year, measured using the EQ-5D-3L questionnaire, combined with costs to estimate cost-effectiveness over 12-months follow-up.

Results: Results show that costs were significantly lower in the oral arm compared to the intravenous arm, a difference of £2,740 (95% confidence interval £1,488 to £3,992). Results of four sensitivity analyses were consistent with the base-case results. QALYs were marginally higher in the oral arm, however this difference was not statistically significant; -0.007 (95% confidence interval -0.045 to 0.031).

Conclusions: Treating patients with bone and joint infections for the first six weeks of therapy with oral antibiotics is both less costly and does not result in detectable differences in quality of life compared to treatment with intravenous antibiotics. Adopting a practice of treating bone and joint infections with oral antibiotics early in the course of therapy could potentially save the UK National Health Service over £17 million annually.
Prospective Investigation of Markers of Elevated Delirium Risk (PRIMED Risk) study protocol: a prospective, observational cohort study investigating blood and cerebrospinal fluid biomarkers for delirium and cognitive dysfunction in older patients
Authors: Whitby Jonathan , Bampoe Sohail , Fullerton James N , Smaje Ashley , Hornby Joanna , Hajdu Bence , Schofield Nick , Stafford Ronnie , Zetterberg Henrik , McAuley Daniel F , Passmore Peter , Cunningham Emma , Whittle John , Walker David , Davis Daniel
Published: January 2020

Background: Delirium is a common post-operative complication, particularly in older adults undergoing major or emergency procedures. It is associated with increased length of intensive care and hospital stay, post-operative mortality and subsequent dementia risk. Current methods of predicting delirium incidence, duration and severity have limitations. Investigation of blood and cerebrospinal fluid (CSF) biomarkers linked to delirium may improve understanding of the underlying pathophysiology, particularly with regard to the extent this is shared or distinct with underlying dementia. Together, these have the potential for development of better risk stratification tools and perioperative interventions.

Methods: 200 patients over the age of 70 scheduled for surgery with routine spinal anaesthetic will be recruited from UK hospitals. Their cognitive and functional baseline status will be assessed pre-operatively by telephone. Time-matched CSF and blood samples will be taken at the time of surgery and analysed for known biomarkers of neurodegeneration and neuroinflammation. Patients will be assessed daily for delirium until hospital discharge and will have regular cognitive follow-up for two years. Primary outcomes will be change in modified Telephone Interview for Cognitive Status (TICS-m) score at 12 months and rate of change of TICS-m score. Delirium severity, duration and biomarker levels will be treated as exposures in a random effects linear regression models. PRIMED Risk has received regulatory approvals from Health Research Authority and London – South East Research Ethics Committee.

Discussion: The main anticipated output from this study will be the quantification of biomarkers of acute and chronic contributors to cognitive impairment after surgery. In addition, we aim to develop better risk prediction models for adverse cognitive outcomes.
Efficiently Evaluating Targeting Policies: Improving on Champion vs. Challenger Experiments
Authors: Simester Duncan , Timoshenko Artem , Zoumpoulis Spyros I.
Published: January 2020

Champion versus challenger field experiments are widely used to compare the performance of different targeting policies. These experiments randomly assign customers to receive marketing actions recommended by either the existing (champion) policy or the new (challenger) policy, and then compare the aggregate outcomes. We recommend an alternative experimental design and propose an alternative estimation approach to improve the evaluation of targeting policies. The recommended experimental design randomly assigns customers to marketing actions. This allows evaluation of any targeting policy without requiring an additional experiment, including policies designed after the experiment is implemented. The proposed estimation approach identifies customers for whom different policies recommend the same action and recognizes that for these customers there is no difference in performance. This allows for a more precise comparison of the policies. We illustrate the advantages of the experimental design and estimation approach using data from an actual field experiment. We also demonstrate that the grouping of customers, which is the foundation of our estimation approach, can help to improve the training of new targeting policies.

This paper was accepted by Matthew Shum, marketing.
O consumo cultural-digital das famílias brasileiras
Authors: Maia Alves Elder Patrick , Gontyjo do Couto Bruno
Published: January 2020

Este trabalho tem como objeto a expansão do consumo cultural-digital das famílias brasileiras nos últimos dez anos. Tal expansão implicou diretamente a elevação de seus gastos orçamentários com cultura. De acordo com o IBGE, em 2009, as famílias brasileiras dispenderam em média 5% do seu orçamento mensal com bens culturais. Caso os serviços de telefonia e comunicação fossem adicionados à rubrica cultura, essa mesma média de gastos saltaria para 8,6%. Em face do aumento da produção, distribuição e consumo dos serviços culturais-digitais (séries, filmes, músicas, games, etc.) por meio dos dispositivos digitais móveis, notadamente os smartphones, sustentamos que a metodologia de cálculo e aferição do IBGE exige uma revisão. Para sustentar tal necessidade, demonstramos que os mercados culturais passam por uma profunda mudança: a digitalização do simbólico.
Desenvolvimento turístico e gestão participativa em sítios históricos urbanos: uma contribuição teórico-conceitual sobre o cenário brasileiro
Authors: Erminia Riscado Júlia
Published: January 2020

Cada vez mais próximo a setores empresariais, o turismo tem se tornado alvo de recorrentes críticas por se distanciar de setores sociais na elaboração e no acompanhamento de políticas públicas e/ou programas de recuperação de sítios históricos, especialmente em áreas urbanas. Com base neste nesse cenário, o presente artigo tem como objetivo observar as transformações ocorridas nos sítios históricos urbanos brasileiros a partir de uma análise teórico-conceitual. Para tal, serão apresentados debates bibliográficos sobre as noções de gestão participativa e de turismo. Em ambos os casos pretende-se traçar um diálogo com a questão dos processos de refuncionalização nas cidades contemporâneas. Posteriormente, analisaremos o planejamento do turismo no Brasil e as perspectivas adotadas que interferem de modo determinante na elaboração de estratégias e de medidas para o desenvolvimento do setor na atualidade. Espera-se, com isso, contribuir para a reflexão acerca dos caminhos e possibilidades na introdução de mecanismos participativos na gestão de sítios históricos urbanos.
O controle das emoções na escrita acadêmica e seu impacto na relação do indivíduo com o trabalho intelectual
Authors: Ribeiro de Almeida Rezende Camila , Fayet Sallas Ana Luisa
Published: January 2020

O trabalho intelectual é fomentado por meio da escrita acadêmica, que é tanto permeada por questões subjetivas – distintas e singulares para cada indivíduo – quanto por questões socialmente compartilhadas – imaginários coletivos de significação e interpretações do campo acadêmico que a constrói. No atual contexto brasileiro, o aumento da cobrança por produtividade tem intensificado o status da escrita como moeda de troca e afetado a relação entre trabalho e emoções na produção intelectual. Em resposta a esse panorama social, algumas universidades têm buscado saídas para lidar com a problemática da produtividade acadêmica. Assim, este artigo busca compartilhar um estudo de caso feito na Universidade Federal do Paraná (UFPR), que, em 2016, inaugurou o Centro de Assessoria de Publicação Acadêmica (CAPA), o primeiro writing center brasileiro. Por meio da observação participante como assessora de escrita acadêmica de diferentes estudantes de pós-graduação nesse centro e de respostas coletadas por meio de questionários aplicados nas assessorias, buscamos refletir sobre o controle das emoções na escrita acadêmica e seu impacto na relação do indivíduo com o trabalho intelectual. O embasamento teórico é apoiado nas intersecções entre a sociologia das emoções, do corpo e da arte, o que permite compreender como a regulação da escrita no meio acadêmico opera tanto no âmbito estético/gramatical quanto no controle da emotividade do indivíduo no texto, sedimentando e perpetuando as dicotomias corpo/mente, arte/ciência, emoção/razão, e influenciando, assim, as construções epistemológicas.
INTERSEÇÕES - REVISTA DE ESTUDOS INTERDISCIPLINARES
Authors: Revista de Estudos Interdisciplinares Interseções
Published: January 2020

Interseções: revista de estudos interdisciplinares é uma publicação organizada pelo Programa de Pós-Graduação em Ciências Sociais (PPCIS) da Universidade do Estado do Rio de Janeiro (UERJ). Seu objetivo é divulgar estudos baseados na interdisciplinaridade das ciências humanas, considerada indispensável para a reflexão sobre a realidade sociocultural dinâmica, cambiante e complexa do mundo contemporâneo.
Tinha um lamento no meio do caminho: A sobreposição de valores em interações argumentativas jurídicas
Authors: Damasceno-Morais Rubens
Published: January 2020

O presente artigo utiliza-se de dados do espaço jurídico, mais precisamente recortes de um julgamento em Segunda Instância de um processo de danos morais, para empreender uma análise da sobreposição de valores (morais e monetários) ao longo de uma deliberação oral, em situação de interação verbal conflituosa. O objetivo precípuo do presente trabalho é descrever como a argumentação constrói-se numa situação argumentativa (PLANTIN, 2008). Intenta-se, ainda, fazer a descrição de fenômenos macrodiscursivos e interacionais do discurso e do contradiscurso da argumentação interacional (CARIZZO, PLANTIN) apresentada para análise. O aporte teórico partirá da Sociologia das interações verbais, passando por estudos clássicos sobre a polidez linguística (BROWN E LEVINSON, GOFFMAN, GRICE) e algumas releituras contemporâneas (KERBRAT-ORECCHIONI, TRAVERSO, AMOSSY). Incluirá ainda leituras de filósofos da área jurídica e retórica (PERELMAN) e de juristas que se preocupam com a atuação de magistrados e como esses lidam com suas emoções (GARAPON, DUPRET, POSNER). A análise nos mostrará que a sobreposição de valores (Valor 1 → Valor 2), em um julgamento de danos morais, é menos incomum do que se possa imaginar.
Os (des)encontros entre a polidez linguística e a Comunicação Não Violenta (CNV)
Authors: Paiva Geórgia Maria Feitosa e
Published: January 2020

O comportamento linguístico figura como um produto de toda uma elaboração racional/emocional que ocorre durante a interação, mas, eventualmente, “acidentes” na interação ocorrem devido ao comprometimento da interpretação dos sujeitos sobre: as intenções comunicativas; o conhecimento mútuo sobre estado emocional em que se encontram, e o contexto. Partindo de uma investigação bibliográfica com base nos estudos de Grice (1975), Goffman (1967), Brown e Levinson (1987), Leech (1983; 2014), Culpeper (1996; 2011), entre outros, propõe-se, neste artigo, relacionar o modelo teórico de polidez linguística desenvolvido por Brown e Levinson (1987) às técnicas de Comunicação Não Violenta (CNV) de Rosenberg (2003). O exame demonstrou que a CNV pode adotar parte das estratégias de polidez propostas por Brown e Levinson (1987), compartilhando a hipótese da instauração de uma interação harmônica, porém, ao refletir sobre as motivações que subjazem determinadas estratégias e dos efeitos que podem gerar ao violar a liberdade dos sujeitos, observa-se que algumas estratégias podem provocar “acidentes” na interação, especialmente quando se espera uma linha mais empática de seus participantes. Conclui-se que o modelo de polidez desenvolvido pelos linguistas pode, até certo ponto, levar a realização de práticas violentas, afetando o estabelecimento de laços afetivos entre os sujeitos.