bluuebunny/crossref_metadata_2025 huggingface dataset:
Antifibrotic therapy for fibrotic lung disease beyond idiopathic pulmonary fibrosis
Authors: Collins Bridget F. , Raghu Ganesh
Published: October 2019

Two antifibrotic medications (nintedanib and pirfenidone) were recommended (conditionally) for the treatment of patients with idiopathic pulmonary fibrosis (IPF) in the 2015 IPF evidence-based guidelines. These medications have been shown to reduce the rate of decline in forced vital capacity among patients with IPF over time and are the only two disease-modulating pharmacological agents approved by regulatory agencies and available for clinical use worldwide. With the evolved standard of care for interstitial lung disease evaluation including routine use of high-resolution computed tomography, fibrotic lung diseases other than IPF are increasingly recognised. In addition, it is becoming evident that genetic and pathophysiological mechanisms as well as disease behaviour in patients manifesting other “non-IPF progressive fibrotic interstitial lung diseases” (non-IPF-PF) may be similar to those in patients with IPF. Thus, it is biologically plausible that pharmacological agents with antifibrotic properties may be efficacious in non-IPF-PF. Indeed, studies are underway or planned to assess the safety and efficacy of nintedanib or pirfenidone among patients with several non-IPF fibrotic lung diseases. In this review, we briefly summarise the use of pirfenidone and nintedanib in IPF as well as the rationale and potential for use of these medications in non-IPF-PF that are being investigated in ongoing and upcoming clinical trials.
Treating restless legs syndrome in the context of sleep disordered breathing comorbidity
Authors: Romero-Peralta Sofía , Cano-Pumarega Irene , Garcia-Malo Celia , Agudelo Ramos Lina , García-Borreguero Diego
Published: October 2019

Obstructive sleep apnoea (OSA) and restless legs syndrome (RLS) are two of the most prevalent sleep disorders and can coexist within the same patient. Nonetheless, the recognition of RLS among OSA patients has important clinical implications, since RLS can disrupt sleep despite adequate treatment of sleep disordered breathing and should be treated accordingly. Furthermore, the presence of OSA can also increase the severity of RLS. Therefore, it is important to be able to correctly identify both disorders and treat them effectively. The present article reviews our current knowledge on this comorbidity and discusses potential treatment options for RLS in the context of OSA.
Groundwater and connected ecosystems: an overview of groundwater body status assessment in Croatia
Authors: Brkić Željka , Kuhta Mladen , Larva Ozren , Gottstein Sanja
Published: October 2019

Background

Croatia, as a Member State of the European Union, has to shape its water policy in accordance with the European Union Water Framework Directive. One of the tasks is to determine whether groundwater are susceptible to anthropogenic changes that would result in a significant surface water status reduction as well as terrestrial and aquatic ecosystems that directly depend on the groundwater.

Methods

Quality and quantity data on groundwater and surface water, as well as ecosystems data were collected from multiple sources. Data were analyzed for the selection groundwater associated aquatic and groundwater-dependent ecosystems. Chemical time series data were analyzed and compared with the national guideline limits set by the Croatian water quality standard. The impact of the groundwater abstraction on the groundwater-dependent ecosystem was considered by analyzing the aquifer hydrogeological characteristics, as well as location of the pumping site in relation of the ecosystem, the pumping rate and groundwater level or discharge.

Results

In karst areas of Croatia, groundwater-dependent aquatic ecosystems are predominant; while in the Pannonian area of Croatia, typically, there are groundwater-dependent terrestrial ecosystems. The status of groundwater bodies was defined as good. The analyzed chemical parameters are at acceptable concentration levels. Groundwater abstraction does not adversely affect most ecosystems. However, many springs that are captured for the water supply dry up in the summer. Given that this is also a common phenomenon at springs not captured, it has to be expected that such environments will be inhabited by organisms that have already adjusted to these conditions. Many different bioindicators have been found to indicate a good chemical and quantitative state of groundwater.

Conclusions

To increase the degree of reliability, research monitoring has been proposed. The monitoring should reduce knowledge gaps including an increase of knowledge of the status of the ecosystems, the definition boundary conditions and threshold values of a good quantitative and qualitative status for individual ecosystems. In future prospects, unavoidable focus has to be climate change that may compromise the availability of groundwater resources.
Identifying ‘avoidable harm’ in family practice: a RAND/UCLA Appropriateness Method consensus study
Authors: Carson-Stevens Andrew , Campbell Stephen , Bell Brian G. , Cooper Alison , Armstrong Sarah , Ashcroft Darren , Boyd Matthew , Prosser Evans Huw , Mehta Rajnikant , Sheehan Christina , Sheikh Aziz , Avery Anthony
Published: October 2019

Background

Health care-related harm is an internationally recognized threat to public health. The United Kingdom’s national health services demonstrate that upwards of 90% of health care encounters can be delivered in ambulatory settings. Other countries are transitioning to more family practice-based health care systems, and efforts to understand avoidable harm in these settings is needed.

Methods

We developed 100 scenarios reflecting a range of diseases and informed by the World Health Organization definition of ‘significant harm’. Scenarios included different types of patient safety incidents occurring by commission and omission, demonstrated variation in timeliness of intervention, and conditions where evidence-based guidelines are available or absent. We conducted a two-round RAND / UCLA Appropriateness Method consensus study with a panel of family practitioners in England to define “avoidable harm” within family practice. Panelists rated their perceptions of avoidability for each scenario. We ran a k-means cluster analysis of avoidability ratings.

Results

Panelists reached consensus for 95 out of 100 scenarios. The panel agreed avoidable harm occurs when a patient safety incident could have been probably, or totally, avoided by the timely intervention of a health care professional in family practice (e.g. investigations, treatment) and / or an administrative process (e.g. referrals, alerts in electronic health records, procedures for following up results) in accordance with accepted evidence-based practice and clinical governance. Fifty-four scenarios were deemed avoidable, whilst 31 scenarios were rated unavoidable and reflected outcomes deemed inevitable regardless of family practice intervention. Scenarios with low avoidability ratings (1 s or 2 s) were not represented by the categories that were used to generate scenarios, whereas scenarios with high avoidability ratings (7 s 8 s or 9 s) were represented by these a priori categories.

Discussion

The findings from this RAND/UCLA Appropriateness Method study define the characteristics and conditions that can be used to standardize measurement of outcomes for primary care patient safety.

Conclusion

We have developed a definition of avoidable harm that has potential for researchers and practitioners to apply across primary care settings, and bolster international efforts to design interventions to target avoidable patient safety incidents that cause the most significant harm to patients.
Late delayed radiation-induced cerebral Arteriopathy by high-resolution magnetic resonance imaging: a case report
Authors: Chen Huan , Li Xiuhua , Zhang Xiaoyu , Xu Wenjuan , Mao Fei , Bao Mengxin , Zhu Meijia
Published: October 2019

Background

Radiation therapy can cause cerebral arteriopahty, resulting in ischemic stroke. We document late-delayed cerebral arteriopathy by high-resolution magnetic resonance imaging (HR-MRI) in a middle aged man who had cranial irradiation 19 years earlier.

Case presentation

A 45-year-old man was diagnosed with frontal lobe glioma 19 years ago and was treated with radiation after surgical resection. He was admitted to our hospital with an acute cerebral infarction in November 8, 2017. Traditional MRI examination and HR-MRI (sagittal, reconstruction of coronal and axial) were performed at admission. He was treated with prednisone (30 mg/day) and clinical symptoms disappeared after 3 months by telephone follow-up. Our patient complained of dizziness and blurred vision and traditional MRI examination indicated acute ischemic stroke in temporal lobe and occipital lobe and microbleeds. In order to define the exact mechanism of stroke, blood tests, auto-immune screening and thrombophilia were performed and results were normal. Electrocardiography and echocardiography were negative and cardiogenic cerebral embolism was excluded. In cerebrospinal fluid (CSF) examination, level of albumin and IgG were elevated. HR-MRI showed vessel wall thickening in T1-weighted imaging, narrow lumen in proton density imaging and vessel wall concentric enhancement in contrast-enhanced T1- weighted imaging. Combined with radiotherapy history, the patient was diagnosed with radioactive vasculitis.

Conclusion

Radiation-induced cerebrovascular damages could be a lasting progress, which we cannot ignore. HR-MRI can provide sensitive and accurate diagnostic assessment of radiation-induced arteritis and may be a useful tool for the screening of causes of cryptogenic stroke.
Euthanasia requests in dementia cases; what are experiences and needs of Dutch physicians? A qualitative interview study
Authors: Schuurmans Jaap , Bouwmeester Romy , Crombach Lamar , van Rijssel Tessa , Wingens Lizzy , Georgieva Kristina , O’Shea Nadine , Vos Stephanie , Tilburgs Bram , Engels Yvonne
Published: October 2019

Background

In the Netherlands, in 2002, euthanasia became a legitimate medical act, only allowed when the due care criteria and procedural requirements are met. Legally, an Advanced Euthanasia Directive (AED) can replace direct communication if a patient can no longer express his own wishes. In the past decade, an exponential number of persons with dementia (PWDs) share a euthanasia request with their physician. The impact this on physicians, and the consequent support needs, remained unknown. Our objective was to gain more insight into the experiences and needs of Dutch general practitioners and elderly care physicians when handling a euthanasia request from a person with dementia (PWD).

Methods

We performed a qualitative interview study. Participants were recruited via purposive sampling. The interviews were transcribed verbatim, and analyzed using the conventional thematic content analysis.

Results

Eleven general practitioners (GPs) and elderly care physicians with a variety of experience and different attitudes towards euthanasia for PWD were included. Euthanasia requests appeared to have a major impact on physicians. Difficulties they experienced were related to timing, workload, pressure from and expectations of relatives, society’s negative view of dementia in combination with the ‘right to die’ view, the interpretation of the law and AEDs, ethical considerations, and communication with PWD and relatives. To deal with these difficulties, participants need support from colleagues and other professionals. Although elderly care physicians appreciated moral deliberation and support by chaplains, this was hardly mentioned by GPs.

Conclusions

Euthanasia requests in dementia seem to place an ethically and emotionally heavy burden on Dutch GPs and elderly care physicians. The awareness of, and access to, existing and new support mechanisms needs further exploration.
Plasma peroxiredoxin changes and inflammatory cytokines support the involvement of neuro-inflammation and oxidative stress in Autism Spectrum Disorder
Authors: Abruzzo P. M. , Matté A. , Bolotta A. , Federti E. , Ghezzo A. , Guarnieri T. , Marini M. , Posar A. , Siciliano A. , De Franceschi L. , Visconti P.
Published: October 2019

Background

It has been established that children with Autism Spectrum Disorders (ASD) are affected by oxidative stress, the origin of which is still under investigation. In the present work, we evaluated inflammatory and pro-oxidant soluble signature in non-syndromic ASD and age-matched typically developing (TD) control children.

Methods

We analyzed leukocyte gene expression of inflammatory cytokines and inflammation/oxidative-stress related molecules in 21 ASD and 20 TD children. Moreover, in another—comparable—group of non-syndromic ASD (N = 22) and TD (N = 21) children, we analyzed for the first time the protein expression of the four members of the antioxidant enzyme family of peroxiredoxins (Prx) in both erythrocyte membranes and in plasma.

Results

The gene expression of IL6 and of HSP70i, a stress protein, was increased in ASD children. Moreover, gene expression of many inflammatory cytokines and inflammation/oxidative stress-related proteins correlated with clinical features, and appeared to be linked by a complex network of inter-correlations involving the Aryl Hydrocarbon Receptor signaling pathway. In addition, when the study of inter-correlations within the expression pattern of these molecules was extended to include the healthy subjects, the intrinsic physiological relationships of the inflammatory/oxidative stress network emerged. Plasma levels of Prx2 and Prx5 were remarkably increased in ASD compared to healthy controls, while no significant differences were found in red cell Prx levels.

Conclusions

Previous findings reported elevated inflammatory cytokines in the plasma of ASD children, without clearly pointing to the presence of neuro-inflammation. On the other hand, the finding of microglia activation in autoptic specimens was clearly suggesting the presence of neuro-inflammation in ASD. Given the role of peroxiredoxins in the protection of brain cells against oxidative stress, the whole of our results, using peripheral data collected in living patients, support the involvement of neuro-inflammation in ASD, and generate a rational for neuro-inflammation as a possible therapeutic target and for plasma Prx5 as a novel indicator of ASD severity.
Limitation of treatment in prehospital care – the experiences of helicopter emergency medical service physicians in a nationwide multicentre survey
Authors: Kangasniemi Heidi , Setälä Piritta , Huhtala Heini , Kämäräinen Antti , Virkkunen Ilkka , Tirkkonen Joonas , Yli-Hankala Arvi , Hoppu Sanna
Published: October 2019

Background

Making ethically sound treatment limitations in prehospital care is a complex topic. Helicopter Emergency Medical Service (HEMS) physicians were surveyed on their experiences with limitations of care orders in the prehospital setting, including situations where they are dispatched to healthcare facilities or nursing homes.

Methods

A nationwide multicentre study was conducted among all HEMS physicians in Finland in 2017 using a questionnaire with closed five-point Likert-scale questions and open questions. The Ethics Committee of the Tampere University Hospital approved the study protocol (R15048).

Results

Fifty-nine (88%) physicians responded. Their median age was 43 (IQR 38–47) and median medical working experience was 15 (IQR 10–20) years. All respondents made limitation of care orders and 39% made them often. Three fourths (75%) of the physicians were often dispatched to healthcare facilities and nursing homes and the majority (93%) regularly met patients who should have already had a valid limitation of care order. Every other physician (49%) had sometimes decided not to implement a medically justifiable limitation of care order because they wanted to avoid conflicts with the patient and/or the next of kin and/or other healthcare staff. Limitation of care order practices varied between the respondents, but neither age nor working experience explained these differences in answers. Most physicians (85%) stated that limitations of care orders are part of their work and 81% did not find them especially burdensome. The most challenging patient groups for treatment limitations were the under-aged patients, the severely disabled patients and the patients in healthcare facilities or residing in nursing homes.

Conclusion

Making limitation of care orders is an important but often invisible part of a HEMS physician’s work. HEMS physicians expressed that patients in long-term care were often without limitations of care orders in situations where an order would have been ethically in accordance with the patient’s best interests.
Persistence of global well-posedness for the 2D Boussinesq equations with fractional dissipation
Authors: Su Xing , Wang Gangwei , Wang Yue
Published: October 2019

In this paper, we study the IBVP for the 2D Boussinesq equations with fractional dissipation in the subcritical case, and prove the persistence of global well-posedness of strong solutions. Moreover, we also prove the long time decay of the solutions, and investigate the existence of the solutions in Sobolev spaces$W^{2,p}({R}^{2})\times W^{1,p}({R}^{2})$W2,p(R2)×W1,p(R2)for some$p>2$p>2.
Associations of PGK1 promoter hypomethylation and PGK1‐mediated PDHK1 phosphorylation with cancer stage and prognosis: a TCGA pan‐cancer analysis
Authors: Shao Fei , Yang Xueying , Wang Wei , Wang Juhong , Guo Wei , Feng Xiaoli , Shi Susheng , Xue Qi , Gao Shugeng , Gao Yibo , Lu Zhimin , He Jie
Published: October 2019

Background

Cancer cells reprogram metabolism for proliferation. Phosphoglycerate kinase 1 (PGK1), as a glycolytic enzyme and newly identified protein kinase, coordinates glycolysis and mitochondrial metabolism. However, the clinical significance of PGK1 expression and function in cancer progression is unclear. Here, we investigated the relationship between the progression and prognosis of multiple cancer types and PGK1 expression and its function in the mitochondrial metabolism regulation.

Methods

We performed pan‐cancer analyses of PGK1 mRNA level and DNA methylation in 11,908 tumor tissues and 1582 paired normal tissues across 34 cancer types in The Cancer Genome Atlas datasets. Using specific antibodies against PGK1 S203 and PDHK1 T338 phosphorylation, we performed immunohistochemistry with tissue microarray assay in additional 818 cancer cases with 619 paired normal tissues from five cancer types.

Results

The PGK1 mRNA level was significantly elevated with hypomethylation in promotor regions and associated with advanced TNM stage in 15 and four cancer types, respectively. In breast carcinoma, elevated PGK1 mRNA level and promoter hypomethylation were associated with poor prognosis. Positively correlated PGK1 S203 and PDHK1 T338 phosphorylation levels were significantly associated with short overall survival (OS) in cancers of the breast, liver, lung, stomach, and esophagus and with advanced TNM stage in breast and esophageal cancers. PGK1 pS203 and PDHK1 pT338 were also independent predictors of short OS in liver, lung, and stomach cancer.

Conclusions

The elevated expression, promoter hypomethylation, and phosphorylation of PGK1 and PDHK1 were related with disease progression and short OS in diverse types of cancer. PGK1 and PDHK1 phosphorylation may be potential prognostic biomarkers.
Looking like the locals - gut microbiome changes post-release in an endangered species
Authors: Chong Rowena , Grueber Catherine E. , Fox Samantha , Wise Phil , Barrs Vanessa R. , Hogg Carolyn J. , Belov Katherine
Published: October 2019

Background

Captivity presents extreme lifestyle changes relative to the wild, and evidence of microbiome dysbiosis in captive animals is growing. The gut microbiome plays a crucial role in host health. Whilst captive breeding and subsequent reintroduction to the wild is important for conservation, such efforts often have limited success. Post-release monitoring is essential for assessing translocation success, but changes to the microbiome of released individuals are poorly understood. The Tasmanian devil was previously shown to exhibit loss of microbiome diversity as a result of intense captive management. This current study examines changes in the devil gut microbiome in response to translocation and aims to determine if perturbations from captivity are permanent or reversible.

Methods

Using 16S rRNA amplicon sequencing, we conducted temporal monitoring of the gut microbiome of released devils during two translocation events, captive-to-wild and wild-to-wild. To investigate whether the microbiome of the released devils changed following translocation, we characterized their microbiome at multiple time points during the translocation process over the course of 6–12 months and compared them to the microbiome of wild incumbent devils (resident wild-born devils at the respective release sites).

Results

We showed that the pre-release microbiome was significantly different to the microbiome of wild incumbent animals, but that the microbiomes of animals post-release (as early as 3 to 4 weeks post-release) were similar to wild incumbents. The gut microbiome of released animals showed significant compositional shifts toward the wild incumbent microbiome of both translocation events.

Conclusion

Our results suggest that the devil gut microbiome is dynamic and that loss of microbiome diversity in captivity can be restored following release to the wild. We recommend the broader application of microbiome monitoring in wildlife translocation programs to assess the impacts of translocation on animal microbiomes.
Primary hip arthroplasty for the treatment of alkaptonuric hip arthritis: 3- to 24-year follow-ups
Authors: Pachore Javahir A. , Shah Vikram Indrajit , Upadhyay Sachin , Shah Kalpesh , Sheth Ashish , Kshatriya Amish
Published: October 2019

Background

The objective of this study is to share our experience in total hip replacement for the treatment of ochronotic hip arthritis, in particular to report how to establish the diagnosis and some tips to limit complications.

Method

A cohort comprised of 10 patients (12 hips) with alkaptonuric hip arthritis. There were six men and four women with the mean age of 62.80 ± 7.57 years. All patients had a stiff spine, grossly restricted movements of hip joints, and severely limited daily routine activities. Total hip replacement was performed in all patients. The patients were evaluated at 6, 12, and 24 months after surgery, as well as every 4 years thereafter. Harris hip score was used to assess the functional outcome. The level of significance was set at p < 0.05.

Results

The mean follow-up lasted 16.70 ± 6.82 years (3 to 24 years). At the final available follow-up, nine patients returned to work, ambulate without an orthosis, and achieve complete pain relief. Harris hip score was improved from poor to excellent. One patient died 16 years after surgery due to breast cancer. No complication relating to prosthetic failures was detected.

Conclusion

Total hip replacement gives long-term satisfactory results in patients with alkaptonuric hip arthritis, resulting in comparable function of the hips in patients who undergo primary osteoarthrosis.
Relation between coalbed permeability and in-situ stress magnitude for coalbed methane exploration in Jharia and Raniganj coalfields, India
Authors: Chatterjee Rima , Paul Suman , Pal Prabir Kumar
Published: October 2019

India is among the top five countries in the world in terms of proven coal reserves and coal production. As such, significant potential exists for commercial recovery of coalbed methane (CBM). Two coalfields, Jharia and Raniganj, located in eastern India are currently under development for CBM. This paper describes work done to determine coal seam properties, ambient stress conditions, and effects of depletion at these coalfields that influence CBM production. Coalbed permeability is a parameter that has a major influence on CBM production. Other influences include in-situ stress direction, gas content, and the application of suitable stimulation techniques. A robust methodology is required to determine both initial coalbed permeability and its relation to in-situ horizontal stress magnitudes. Coalbed permeability at the Jharia and Raniganj coalfields was estimated from porosity and known cleat spacing. Initial permeability of major coalbeds was correlated with effective horizontal stress, yielding satisfactory to very good exponential fit using data from Raniganj and Jharia wells. Acoustic televiewer image-logging tool measurements in a single well in the Jharia coalfield were used to infer a maximum horizontal stress orientation between N25°W and N25°E. Reservoir-pressure-dependent permeability models are presented for coalbeds under uniaxial strain condition. The coalbed permeability is dominated by the existing effective horizontal stresses normal to the cleats. Two prospective coal seams from Jharia have been identified through assessment of the response of horizontal stress to the decline of CBM reservoir pressure. Coalbed permeability increases with the drawdown of reservoir pressure and is exponentially related to the change of effective horizontal stress during reservoir depletion. The results of this study are to be used for production history matching for wells in Jharia and to determine optimal horizontal drilling directions for increased CBM production.
Lean management in a liaison psychiatry department: implementation, benefits and pitfalls
Authors: Alexander Lauren , Moore Susan , Salter Nigel , Douglas Leonard
Published: October 2019

Aims and method

To apply process mapping, a component of lean management, to a liaison psychiatry service of an emergency department. Lean management is a strategy that has been adapted to healthcare from business and production industries and aims to improve efficiency of a process. The process consisted of four stages: individual interviews with stakeholders, generation of process maps, allocation of goals and assessment of outcomes.

Results

There was a significant reduction in length of stay of psychiatric patients in the emergency department (median difference: 1 h; P = 0.015). Five of the six goals were met successfully.

Clinical implications

This article demonstrates a management intervention that successfully reduced length of stay in an emergency department. Further to the improvements in tangible (quantitative) outcomes, process mapping improved interpersonal relations between different disciplines. This paper may be used to guide similar quality improvement exercises in other areas of healthcare.
Global Oncology Research and Training Collaborations Led by the National Cancer Institute (NCI)–Designated Cancer Centers: Results From the 2018 NCI/ASCO Global Oncology Survey of NCI-Designated Cancer Centers
Authors: Duncan Kalina , Abudu Rachel , Cira Mishka K. , Pyle Doug H.M.
Published: October 2019

PURPOSE

The National Cancer Institute (NCI)–Designated Cancer Centers (NDCCs) are active in global oncology research and training, leading collaborations that contribute to the evidence to support global cancer control. To better understand global oncology activities led by NDCCs, the National Cancer Institute Center for Global Health (NCI-CGH) collaborated with ASCO to conduct the 2018 NCI/ASCO Global Oncology Survey of NDCCs.

METHODS

The 70 NDCCs received a two-part survey that focused on global oncology programs at NDCCs and non–National Institutes of Health (NIH)–funded global oncology projects with an international collaborator led by the NDCCs. Sixty-five NDCCs responded to the survey, and 57 reported non–NIH-funded global oncology projects. Data were cleaned, coded, and analyzed by NCI-CGH staff.

RESULTS

Thirty NDCCs (43%) report having a global oncology program, and 538 non–NIH-funded global oncology projects were reported. Of the NDCCs with global oncology programs, 17 report that trainees complete rotations outside the United States, and the same number enroll trainees from low- and middle-income countries (LMICs). In addition, 147 (28%) of the non–NIH-funded projects focused on capacity building or training, the second highest category after research. Of the 30 top project collaborator countries, 17 were LMICs. Compared with the NCI-funded international grant portfolio, non–NIH-funded global oncology projects were more likely to focus on prevention (12% NCI-funded v 20% non–NIH-funded); early detection, diagnosis, and prognosis (23% v 30%); and cancer control, survivorship, and outcomes research (13% v 22%).

CONCLUSION

This survey shows that there is a substantial amount of global oncology research and training supported by NDCCs, and much of this is happening in LMICs. Results of the 2018 Global Oncology Survey can be used to foster opportunities for NDCCs to work collaboratively on activities and to share their findings with relevant stakeholders in their LMIC collaborator countries.
No Association of Antenatal Synthetic Glucocorticoid Exposure and Hair Steroid Levels in Children and Adolescents
Authors: Ilg Liesa , Kirschbaum Clemens , Li Shu-Chen , Wimberger Pauline , Nitzsche Katharina , Rosenlöcher Franziska , Alexander Nina
Published: October 2019

Context

Antenatal synthetic glucocorticoid (sGC) treatment constitutes a potent programming factor of the hypothalamic–pituitary–adrenal (HPA) axis. Previous findings from our group revealed long-term changes in cortisol stress reactivity following antenatal sGC therapy. However, the few prior studies exclusively relied on spot measurements of phasic HPA axis activity, which may not adequately capture cortisol output over prolonged periods of time.

Objective

To address this gap, the current study utilized hair steroid concentrations, a valid marker of integrated long-term HPA-axis activity, to investigate endocrine changes in individuals treated with antenatal sGC.

Design, Setting, and Participants

This cross-sectional study comprised 76 term-born children (7–12 years) and 58 adolescents (14–18 years). Cumulated hormonal secretion in scalp hair over a 3-month period was determined for different biomarkers of tonic HPA axis activity by liquid chromatography coupled with tandem mass spectrometry. Hair steroid levels were compared between participants with antenatal sGC therapy (dexamethasone or betamethasone) and different control groups.

Results

Findings from this study provide no evidence for a significant effect of antenatal sGCs on long-term hair steroid concentrations. Participants treated with antenatal sGC exhibited comparable levels of hair cortisol, cortisone, dehydroepiandrosterone, and cortisol/dehydroepiandrosterone ratios compared to those of mothers who had been admitted to hospital for pregnancy complications but had never received sGC therapy and controls from physiological pregnancies.

Conclusion

In conjunction with data from previous studies, it is thus tempting to speculate that sGC may affect the capacity of dynamic changes and flexible adaption of an individual’s HPA axis rather than changes in tonic steroid output.
Ischemic Optic Neuropathy
Authors: Morrow Mark J.
Published: October 2019

PURPOSE OF REVIEW

Vision is often threatened or lost by acute ischemic damage to the optic nerves. Such pathology most often affects the anterior portion of the nerve and is visible on funduscopic examination. Ischemic optic neuropathy is associated with typical vascular risk factors and with one systemic disease in particular: giant cell arteritis (GCA). This article provides an overview of the three major classes of ischemic optic neuropathy, including information on risk factors, differential diagnosis, evaluation, and management.

RECENT FINDINGS

Optical coherence tomography provides precise anatomic imaging in ischemic optic neuropathy, showing neural loss weeks before it is visible on examination. Refinements of optical coherence tomography reveal optic nerve microvasculature and may assist in understanding pathogenesis and verifying diagnosis. New diagnostic algorithms and cranial vascular imaging techniques help define the likelihood of GCA in patients with ischemic optic neuropathy. Finally, intraocular drug and biological agent delivery holds promise for nonarteritic ischemic optic neuropathy, whereas newer immunologic agents may provide effective steroid-sparing treatment for GCA.

It is essential to recognize ischemic optic neuropathy upon presentation, especially to determine the likelihood of GCA and the need for immediate steroid therapy. A broad differential diagnosis should be considered so as not to miss alternative treatable pathology, especially in cases with retrobulbar optic nerve involvement.
Optic Neuritis
Authors: Bennett Jeffrey L.
Published: October 2019

PURPOSE OF REVIEW

This article discusses the clinical presentation, evaluation, and management of the patient with optic neuritis. Initial emphasis is placed on clinical history, examination, diagnostic testing, and medical decision making, while subsequent focus is placed on examining specific inflammatory optic neuropathies. Clinical clues, examination findings, neuroimaging, and laboratory testing that differentiate autoimmune, granulomatous, demyelinating, infectious, and paraneoplastic causes of optic neuritis are assessed, and current treatments are evaluated.

RECENT FINDINGS

Advances in technology and immunology have enhanced our understanding of the pathologies driving inflammatory optic nerve injury. Clinicians are now able to interrogate optic nerve structure and function during inflammatory injury, rapidly identify disease-relevant autoimmune targets, and deliver timely therapeutics to improve visual outcomes.

Optic neuritis is a common clinical manifestation of central nervous system inflammation. Depending on the etiology, visual prognosis and the risk for recurrent injury may vary. Rapid and accurate diagnosis of optic neuritis may be critical for limiting vision loss, future neurologic disability, and organ damage. This article will aid neurologists in formulating a systematic approach to patients with optic neuritis.
Higher Cortical Visual Disorders
Authors: Prasad Sashank , Dinkin Marc
Published: October 2019

PURPOSE OF REVIEW

This article reviews the disorders that result from disruption of extrastriate regions of the cerebral cortex responsible for higher visual processing. For each disorder, a historical perspective is offered and relevant neuroscientific studies are reviewed.

RECENT FINDINGS

Careful analysis of the consequences of lesions that disrupt visual functions such as facial recognition and written language processing has improved understanding of the role of key regions in these networks. In addition, modern imaging techniques have built upon prior lesion studies to further elucidate the functions of these cortical areas. For example, functional MRI (fMRI) has identified and characterized the response properties of ventral regions that contribute to object recognition and dorsal regions that subserve motion perception and visuospatial attention. Newer network-based functional imaging studies have shed light on the mechanisms behind various causes of spontaneous visual hallucinations.

Understanding the regions and neural networks responsible for higher-order visual function helps the practicing neurologist to diagnose and manage associated disorders of visual processing and to identify and treat responsible underlying disease.
Sacrificing Citizenship
Authors: Chaudhary Zahid R.
Published: October 2019

This article analyzes the discourse concerning the assimilation of Muslim minorities in the United States and suggests that calls for assimilation are solicitations for a form of self-renunciation and sacrifice. Yet such solicitations occur against the economic and political background of neoliberalism, in which all citizens are asked to make sacrifices for the sake of economic health. How does one read, then, the discourse of Muslim assimilation in light of the psychological, political, and economic realities of neoliberalism? The article explores the transformation of the so-called Jewish question into the contemporary concern with the “Muslim problem.” Drawing on Theodor Adorno and Max Horkheimer’s reflections on the affinities between capitalism and fascism (especially their reading of Odysseus), as well as Sigmund Freud’s reflections on narcissism and group psychology, the article analyzes the figure of the sacrificial victim in the context of neoliberalism’s authoritarian tendencies and argues that sacrificial figuration allows us to think past the polarizations (West/rest; Trump supporters/Muslims) of our contemporary historical moment.
The Visual Frequency of Black Life
Authors: Campt Tina M.
Published: October 2019

How do we engage a contemporary visual archive of blackness that is saturated by the proliferation and mass circulation of images of violence, antiblackness, and premature death? This article explores the labor required by visual enactments of black precarity in the work of filmmaker and cinematographer Arthur Jafa. The labor of black precarity—specifically, the work required to cultivate, maintain, or articulate our relationship to black precarity—is the effort required to position oneself in proximity to, or in a place of discomfort and, for some, potential complicity with, black precarity. The article stages an encounter with the affective registers of refusal enacted in a genre of black visuality defined as still-moving-images. Still-moving-images hover between still and moving images and require the affective labor of feeling with or through them. The article concludes by expanding the discussion of Jafa’s still-moving-images into a broader enunciation of the author’s theory of hapticity, a term that articulates the labor of feeling across difference and suffering as an effortful practice of exertion and struggle to remain in relation to or in contact or connection with another.
How to Make Dense and Flat Perovskite Layers for >20% Efficient Solar Cells: Oriented, Crystalline Perovskite Intermediates and Their Thermal Conversion
Authors: Ozaki Masashi , Nakaike Yumi , Shimazaki Ai , Jung Mina , Maruyama Naoki , Yakumaru Shinya , Rafieh Alwani Imanah , Ekanayake Piyasiri , Saito Takashi , Shimakawa Yuichi , Sasamori Takahiro , Murata Yasujiro , Murdey Richard , Wakamiya Atsushi
Published: October 2019

CH3NH3PbI3 (MAPbI3) perovskite layers can be obtained by thermal annealing thin films of the intermediate dimethyl sulfoxide (DMSO) intercalated complex, MA2Pb3I8·2DMSO. In the present work, the formation, structure, and thermal transformation of the intermediate complex in both bulk and thin film form is examined in detail. The grain size and orientation of the intermediate crystallites in the solvent-intercalated thin film material is shown to directly influence the flatness of the annealed perovskite layer. Flat-lying orientation of the small needle-like intermediate crystallites is found to yield dense and flat perovskite layers. Optimized spin coating and annealing processes are developed for the formation and thermal conversion, respectively, of the intermediate film. Based on these methods, MAPbI3 perovskite solar cells with high power conversion efficiency (maximum ∼20.3%) were obtained with high reproducibility.
Estabilidade Financeira e Estrutura de Mercado: Evidências Internacionais
Authors: Silva Marcos Soares da , Divino José Angelo
Published: October 2019

Embora a teoria econômica apresente proposições ambíguas sobre a relação entre estrutura de mercado e estabilidade do sistema bancário, alguns modelos, como o de competição-fragilidade desenvolvido por Allen e Gale (2004), sugerem que o aumento da competição leve as instituições bancárias a tomarem maiores riscos. Por conseguinte, propõe-se que mercados financeiros mais concentrados apresentam maior estabilidade do sistema bancário. Para verificar essa hipótese, foi estimado um painel dinâmico de 41 países no período 1987-2007. O modelo econométrico incluiu variáveis de controle para nível de renda e características do mercado financeiro, do ambiente econômico e da regulação macroprudencial. Foram utilizadas as seguintes bases de dados: “A new database on financial development and structure” e “Bank regulation and supervision”, do Banco Mundial; e “Systemic banking crises: a new database”, do Fundo Monetário Internacional. Os resultados obtidos corroboram a tese de que uma maior concentração de mercado favorece a estabilidade do setor bancário.
Estimação e Previsão de Volatilidade em Períodos de Crise: Um Estudo Comparando Modelos GARCH e Modelos Aditivos Semi-Paramétricos
Authors: Santos Douglas Gomes dos , Ziegelmann Flávio Augusto
Published: October 2019

Neste artigo, comparamos os modelos aditivos semi-paramétricos e os modelos GARCH quanto à capacidade de estimar e prever volatilidade em períodos de crise. Nossos estudos de Monte Carlo indicam uma melhor performance dos modelos GARCH quando suas formas funcionais não diferem da especificada no Processo Gerador de Dados (PGD). Contudo, na medida em que diferem do PGD, obtemos resultados que sugerem a superioridade dos modelos aditivos. Adicionalmente, efetuamos uma aplicação empírica em três períodos de alta volatilidade da série de retornos do IBOVESPA, onde ambas as classes de modelos obtêm resultados similares.
O Impacto da Política Fiscal nos Spreads dos Países Emergentes
Authors: Rocha Katia , Moreira Ajax
Published: October 2019

O risco país ou spread soberano afeta diretamente a capacidade de investimento das empresas e dos governos, sendo um importante elemento na composição dos juros domésticos e no crescimento econômico. Este estudo analisa o impacto da política fiscal na determinação do spread soberano de 23 países emergentes entre 1995-2008. Os resultados indicam que menores spreads estão associados a uma política de austeridade fiscal, entendida como o acúmulo do superávit primário para uma trajetória sustentável da relação dívida/PIB. Um aumento de 1% no superávit primário diminui em média os spreads em 50 pontos base. O estudo corrobora o argumento de que a austeridade fiscal é fator relevante na determinação dos spreads soberanos além de contribuir como política pública de mitigação de choques externos.
Determinantes dos Custos de Transação no Mercado de Ações no Brasil
Authors: Sanvicente Antonio Zoratto
Published: October 2019

Este artigo aplica a estimativa de custos de transação de Lesmond (20055) no mercado brasileiro de ações, apoiada num modelo de variável dependente limitada. O objetivo é testar hipóteses sobre fatores determinantes dos custos de transação no mercado secundário (liquidez, volatilidade, tamanho, governança corporativa diferenciada, participação em programa de ADRs), bem como o impacto da crise de 2008. Utilizam-se dados diários do período de 1999 a 2009, em média com mais de 250 ações por ano. É observado que o custo total médio de transação sofreu redução substancial e continuada em cada ano do período, indo de 2,95% em 1999 a 1,22% em 2009. É verificado que a volatilidade da ação e a participação em níveis de governança corporativa diferenciada são as variáveis explicativas mais importantes.
Fator País e Estrutura Dinâmica de Capital nas Empresas da América Latina
Authors: Bogéa Sobrinho Leonel Rodrigues , Sheng Hsia Hua , Lora Mayra Ivanoff
Published: October 2019

Desenvolvemos modelos de ajuste parcial e de duration para testar a relevância de fatores específicos de países na determinação da estrutura de capital de empresas listadas nas bolsas de valores brasileira, chilena e mexicana. Utilizamos dados em painel, em um período que se estende do quarto trimestre de 1996 ao segundo trimestre de 2010, abrangendo 4403 observações relacionadas a 139 empresas diferentes. Os resultados obtidos sugerem que: a dinâmica da estrutura de capital varia por país; idiossincrasias locais são determinantes-chave dos níveis de alavancagem das empresas brasileiras, chilenas e mexicanas; e outros fatores além de características específicas das empresas influenciam os processos de decisão de financiamento dos gestores latino americanos.
Arbitragem com Fundamentos Latentes em um Modelo Fatorial de Efeitos Mistos
Authors: Gonçalves Andrei Salem , Iquiapaza Robert Aldo , Bressan Aureliano Angel
Published: October 2019

Neste artigo, propomos um modelo de fator único com efeitos mistos para dados em painel de modo a criar uma carteira de arbitragem que identifica diferenças de fundamentos latentes ao nível da firma. Com base neste modelo, é possível verificar que, embora as características que afetam os retornos são variáveis desconhecidas, é possível identificar a força da combinação destes fundamentos latentes para cada empresa, seguindo uma abordagem simples com dados históricos. Como resultado, uma estratégia de arbitragem que comprou as ações com os melhores fundamentos (carteira de fundamentos fortes) e vendeu as ações com os piores fundamentos (carteira com fundamentos fracos) apresentou retornos ajustados ao risco significativos no mercado dos EUA para o período entre julho de 1986 e junho de 2008. Para assegurar a robustez, realizamos análises subperíodo, sazonais e ajustamos para os custos de negociação, reforçando as evidências empíricas de que, usando uma regra simples investimento, que identificou esses fundamentos latentes na estrutura de retornos passados, a estratégia apresenta resultados positivos.
Evolução e Diversificação do Risco Global: uma Abordagem com Modelo Cópula-DCC-GARCH
Authors: Righi Marcelo Brutti , Ceretta Paulo Sergio
Published: October 2019

No presente artigo é estimado um portfólio dinâmico composto pelos mercados norte-americano, alemão, britânico, brasileiro, honconguês e australiano, considerando o período de setembro de 20001 a setembro de 2011. Para tanto, é obtida por meio de um modelo Copula-DCC-GARCH a matriz de covariância condicional dos retornos diários. Os resultados permitem concluir que houve mudanças relevantes na composição do portfólio, ocasionadas por modificações na volatilidade e dependência entre os mercados. Mais além, a abordagem dinâmica reduziu significativamente o risco do portfólio se comparada com a abordagem estática tradicional, especialmente em períodos de turbulência.
Carteiras de Variância Mínima no Brasil
Authors: Rubesam Alexandre , Beltrame André Lomonaco
Published: October 2019

Neste trabalho, investigamos carteiras de variância mínima no mercado de ações brasileiro, utilizando diferentes modelos de estimação da matriz de covariância, desde a simples matriz de covariância amostral até modelos GARCH multivariados. Comparamos os resultados das carteiras de variância mínima com os seguintes benchmarks: (i) o índice IBOVESPA, (ii) uma carteira igualmente ponderada, (iii) uma carteira formada através da maximização da razão de Sharpe e (iv) uma carteira formada através da maximização da média geométrica dos retornos. Os resultados mostram que as carteiras de variância mínima apresentam retornos maiores e volatilidades menores do que todos os benchmarks. Também avaliamos o desempenho de carteiras de variância mínima com alavancagem, do tipo 130/30, com resultados análogos. A carteira de variância mínima concentra os investimentos em um número pequeno de ações, com βs baixos em relação ao IBOVESPA, sendo facilmente replicáveis por investidores individuais ou institucionais.
Dicas para Escrever uma Avaliação de Artigo
Authors: Ferson Wayne , Matsusaka John
Published: October 2019

Como pesquisadores acadêmicos nós gastamos uma quantidade substancial de tempo avaliando artigos para periódicos científicos. Embora não seja tão importante quanto publicar nossa própria pesquisa, a qualidade de nosso trabalho como avaliadores é importante, tanto para nossa profissão quanto para nosso sucesso como acadêmicos. Esta nota apresenta algumas sugestões para escrever um bom parecer de avaliação.