bluuebunny/crossref_metadata_2025 huggingface dataset:
Robust electromagnet design for pulse forming application
Authors: Dond Shantaram , Choudhary Hitesh , Kolge Tanmay , Sharma Archana , Dey G.K.
Published: January 2019

Purpose

An electromagnet that can produce strong pulsed magnetic fields at kHz frequencies is potentially very favourable to exert a Lorentz force on the metallic workpiece. One of the applications of the pulsed magnetic field is the electromagnetic forming where the design of robust electromagnet is critical. The purpose of this paper is to design a robust electromagnet (coil) for high velocity electromagnetic tube forming operation.

Design/methodology/approach

First of all, an analytical model is developed to design the electromagnet and predict the aluminium tube velocity under the action of the estimated pulsed magnetic field. Next, the finite element-based numerical model is used to test the robustness of the designed coil and validate the analytical model. The coil is fabricated and implemented for free forming of aluminium tube. Experimental results of tube displacement are further compared with numerical and analytical model results.

Findings

The experimental tube displacement results are showing a good match with analytical and numerical results. The designed electromagnet has generated a peak magnetic field around 14 T at 20 µs rise time and deformed the aluminium tube with a peak velocity of 160 m/s. Robustness of the electromagnet under the action of forming stress is insured by numerical stress analysis and experiments.

Practical implications

Though the designed model in this work is for the 2.4 mm aluminium tube forming, it can also be used for different tube materials, tube dimensions and other electromagnetic forming applications with some modifications.

Originality/value

The research results provide powerful theoretical, numerical simulation and experimental support for the robust electromagnet design.
Selective laser sintered mould for orbital cavity reconstruction
Authors: Mandolini Marco , Brunzini Agnese , Germani Michele , Manieri Steve , Mazzoli Alida , Pagnoni Mario
Published: January 2019

Purpose

Orbital fractures are the most commonly encountered midfacial fractures, and usually, the fracture involves the floor and/or the medial wall of the orbit. This paper aims to present an innovative approach for primary and secondary reconstructions of fractured orbital walls through the use of computer-assisted techniques and additive manufacturing.

Design/methodology/approach

First, through the 3D anatomical modelling, the geometry of the implant is shaped to fill the orbital defect and recover the facial symmetry. Subsequently, starting from the modelled implant, a customised mould is designed taking into account medical and technological requirements.

Findings

The selective laser sintered mould is able to model and form several kind of prosthetic materials (e.g. titanium meshes and demineralised bone tissue), resulting in customised implants and allowing accurate orbital cavity reconstructions. The case study proved that this procedure, at the same time, reduces the morbidity on the patients, the duration of surgery and the related costs.

Originality/value

This innovative approach has great potential, as it is an easy and in-office procedure, and it offers several advantages over other existing methods.
Supported Loving – developing a national network to support positive intimate relationships for people with learning disabilities
Authors: Bates Claire
Published: January 2019

Purpose

The purpose of this paper is to outline the work of the Supported Loving Network from its origin in academic research to the practical development of a national Network supporting relationships for people with learning disabilities.

Design/methodology/approach

First, the need for the Network is established through a review of the research literature. The paper goes on to critically discuss the Network’s progress to date including its limitations and difficulties encountered, concluding by considering plans for future growth and development.

Findings

There is evidence that having a national Network is helpful in supporting intimate relationships for people with learning disabilities. The Network is having a positive impact on professionals who support people with learning disabilities by providing a space for discussion, inspiration and to share positive practice. However, an increase in resources would enable Supported Loving to have a wider reach and possibly a greater influence on organisations that provide social care to adults with learning disabilities.

Originality/value

The research indicates that people with learning disabilities are still less likely to have a loving relationship. The level of interest and engagement with Supported Loving implies that the Network is of value to people with learning disabilities and the professionals who work with them.
Diversity and distribution of the bmp gene cluster and its Polybrominated products in the genus Pseudoalteromonas
Authors: Busch Julia , Agarwal Vinayak , Schorn Michelle , Machado Henrique , Moore Bradley S. , Rouse Greg W. , Gram Lone , Jensen Paul R.
Published: January 2019

The production of pentabromopseudilin and related brominated compounds by Pseudoalteromonas spp. has recently been linked to the bmp biosynthetic gene cluster. This study explored the distribution and evolutionary history of this gene cluster in the genus Pseudoalteromonas. A phylogeny of the genus revealed numerous clades that do not contain type strains, suggesting considerable species level diversity has yet to be described. Comparative genomics revealed four distinct versions of the gene cluster distributed among 19 of the 101 Pseudoalteromonas genomes examined. These were largely localized to the least inclusive clades containing the Pseudoalteromonas luteoviolacea and Pseudoalteromonas phenolica type strains and show clear evidence of gene and gene cluster loss in certain lineages. Bmp gene phylogeny is largely congruent with the Pseudoalteromonas species phylogeny, suggesting vertical inheritance within the genus. However, the gene cluster is found in three different genomic environments suggesting either chromosomal rearrangement or multiple acquisition events. Bmp conservation within certain lineages suggests the encoded products are highly relevant to the ecology of these bacteria.
Transition Pathways to Sustainable Agricultural Water Management: A Review of Integrated Modeling Approaches
Authors: Haacker Erin M.K. , Sharda Vaishali , Cano Amanda M. , Hrozencik R. Aaron , Núñez Agustín , Zambreski Zachary , Nozari Soheil , Smith Garvey Engulu B. , Moore Lacey , Sharma Sumit , Gowda Prasanna , Ray Chittaranjan , Schipanski Meagan , Waskom Reagan
Published: January 2019

Agricultural water management (AWM) is an interdisciplinary concern, cutting across traditional domains such as agronomy, climatology, geology, economics, and sociology. Each of these disciplines has developed numerous process‐based and empirical models for AWM. However, models that simulate all major hydrologic, water quality, and crop growth processes in agricultural systems are still lacking. As computers become more powerful, more researchers are choosing to integrate existing models to account for these major processes rather than building new cross‐disciplinary models. Model integration carries the hope that, as in a real system, the sum of the model will be greater than the parts. However, models based upon simplified and unrealistic assumptions of physical or empirical processes can generate misleading results which are not useful for informing policy. In this article, we use literature and case studies from the High Plains Aquifer and Southeastern United States regions to elucidate the challenges and opportunities associated with integrated modeling for AWM and recommend conditions in which to use integrated models. Additionally, we examine the potential contributions of integrated modeling to AWM — the actual practice of conserving water while maximizing productivity. Editor's note: This paper is part of the featured series on Optimizing Ogallala Aquifer Water Use to Sustain Food Systems. See the February 2019 issue for the introduction and background to the series.
Outcome and safety of targeted liver biopsies for indeterminate lesions in patients with chronic liver disease: A single centre experience
Authors: Chen Xiao , Kutaiba Numan , Ngo Brian , Goodwin Mark
Published: January 2019

Introduction

To evaluate the histopathological and safety outcomes of indeterminate lesions in patients at high risk for developing hepatocellular carcinoma (HCC) who underwent ultrasound‐guided biopsies.

Methods

Ultrasound‐guided targeted liver biopsies for indeterminate lesions performed in a 10‐year period at our institution were reviewed retrospectively for lesion characteristics, biopsy techniques, histopathological results and post procedural complications.

Results

A total of 172 biopsies were performed in 152 patients. Most common background liver disease included hepatitis C, hepatitis B, alcoholic and non‐alcoholic steatohepatitis. 65.1% had known cirrhosis at time of biopsy. HCC was the most common histopathological finding accounting for 55.8% of all biopsies, followed by cholangiocarcinoma, dysplastic nodule and metastasis. Rarer lesions including lymphoma, neuroendocrine tumour and angiomyolipoma were also encountered. No mortality, clinically significant bleeding or tumour seeding was detected.

Conclusions

Ultrasound‐guided liver biopsies of indeterminate lesions in patients at high risk of HCC yield important histopathological findings, important for management options including the provision of curative treatments and assisting future novel therapies such as immunotherapy and targeted therapies. The low complication rates confirm its safety and the procedure should not be avoided for fear of complications.
Predictive value of non‐consumption outcome measures in alcohol use disorder treatment
Authors: Kirouac Megan , Witkiewitz Katie
Published: January 2019

Background and Aims

For decades, researchers have called for the systematic inclusion of non‐consumption outcomes, such as alcohol‐related consequences and temptation/craving, in addition to consumption outcomes (e.g. percentage of days abstinent) to evaluate alcohol use disorder (AUD) treatment efficacy. However, Food and Drug Administration (FDA) guidelines for alcohol medications development suggest that non‐consumption outcomes may be insensitive to changes that occur within AUD treatment trial assessment windows, although this has never been directly tested. We aimed to measure the predictive value of diagnostically related, non‐consumption measures of AUD treatment effects.

Methods

Pre‐ to post‐treatment effect sizes were examined. Logistic regression analyses were used to test the predictive value of non‐consumption outcome measures that were administered in the COMBINE (Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence) Study and Project MATCH (Matching Alcoholism Treatment to Client Heterogeneity) in detecting 12‐month outcomes following treatment.

Results

Pre‐ to post‐treatment effect sizes suggested that non‐consumption measures changed during the course of treatment; effect sizes for temptation/craving, self‐efficacy, consequences and consumption variables were mostly medium to large (medium effect sizes were 0.2 < dz < 0.8, large effect sizes were dz > 0.8). The regression results indicated temptation/craving and self‐efficacy predicted 12‐month drinking outcomes in COMBINE and MATCH, and drinking consequences predicted 12‐month drinking outcomes in COMBINE.

Conclusions

Self‐report measures of temptation and alcohol craving can change as a result of alcohol dependence treatment and can predict drinking outcomes.
The prognostic value of positive T wave in lead aVR: A novel marker of adverse cardiac outcomes in peripartum cardiomyopathy
Authors: Ekizler Firdevs Aysenur , Cay Serkan , Kafes Habibe , Ozeke Ozcan , Ozcan Firat , Topaloglu Serkan , Temizhan Ahmet , Aras Dursun
Published: January 2019

Background

Peripartum cardiomyopathy (PPCM) is an uncommon complication of pregnancy. Clinical courses of PPCM are markedly heterogeneous. Positive T waves in lead aVR (TaVR) are shown to be associated with adverse cardiac events in several cardiovascular diseases. We aimed to investigate the prevalence and prognostic role of positive TaVR in patients with PPCM.

Methods

A total of 82 patients (mean age 29.1 ± 6.3 years) with the diagnosis of PPCM were enrolled. Presentation electrocardiogram (ECG) was investigated for presence of a positive TaVR. The median follow‐up duration was 67.0 months. The primary endpoint was defined as composite cardiac events, including cardiac death, arrhythmic events, or persistent left ventricular systolic dysfunction.

Results

Patients with positive T wave in lead aVR showed higher rates for persistent left ventricular systolic dysfunction, arrhythmic events, and cardiac death compared to patients without it. In multivariate logistic regression analysis, after adjusting for other confounding factors, the presence of positive TaVR was found to be as an independent and strong predictor of primary composite endpoint (odds ratio 6.21, 95% CI 1.45–26.51; p = 0.014). In Kaplan–Meier survival analysis, both primary and secondary endpoints occurred more frequently in the positive TaVR group. Using the cut‐off level of 0.25 mV, T‐wave amplitude in lead aVR predicted primary endpoint with a sensitivity of 100% and specificity of 100%.

Conclusion

Positive T wave in lead aVR, as a simple and feasible electrocardiographic marker, seems to be a novel predictor of adverse cardiovascular outcomes in patients with PPCM.
Effect of cinnamon essential oil on the microbiological and physiochemical characters of fresh Italian style sausage during storage
Authors: Zhang Xin , Wang Huhu , Li Xuan , Sun Yangying , Pan Daodong , Wang Ying , Cao Jinxuan
Published: January 2019

In order to study the effect of cinnamon essential oil (CEO) on the microbiological and physiochemical characters of fresh Italian style sausage, CEO (0%, 0.1%, and 0.5%, v/w) was added into ground meat, cased, and stored at 4°C. Lipid oxidation, instrument color, total viable aerobic counts, Enterobacteriaceae, biogenic amines, and total volatile basic nitrogen (TVB‐N) were investigated during 10 days (day). Results showed that CEO treatments had lower thiobarbituric acid reactive substances (TBARS), b* value, aerobic and Enterobacteriaceae counts, biogenic amine contents, and TVB‐N and higher a* values at 4, 6, 8, and 10 days compared to the control, whereas 0.5% CEO treatment had better effect than 0.1% CEO. CEO improved color shelf‐life by inhibiting lipid oxidation and prevented the increase in biogenic amines and TVB‐N by reducing microbial counts of fresh sausage during storage. This study suggested that CEO could be applied in the food industry to improve the shelf‐life of meat products.
Use of the IDEAL framework in the urological literature: where are we in 2018?
Authors: Tradewell Michael B. , Albersheim Jacob , Dahm Philipp
Published: January 2019

Objectives

To assess uptake and application of the IDEAL principles in original surgical procedure‐ or device‐related clinical research studies, as well as its reported relevance as characterized by secondary publications, editorials and reviews.

Materials and Methods

IDEAL (Idea, Development, Exploration, Assessment, Long‐term study) is a framework that provides stage‐specific guidance for surgical innovation and represented a major advance towards raising evidential standards. We performed a comprehensive literature search of all urology‐related publications citing one or more of seven key publications on IDEAL in The Lancet and BMJ using multiple databases up to 31 December 2017.

Results

We identified a total of 150 urology‐related manuscripts citing IDEAL, of which 83 (55.3%) were original research and 67 (44.7%) were secondary publications. Among the original research articles, 40 (48.2%) did not explicitly apply IDEAL principles or were not surgical innovation studies. The IDEAL phases of the 43 (51.8%) remaining original research studies were IDEAL, in nine (20.9%), 27 (62.8%), four (9.3%), 0 (0%), and three publications (7.0%), respectively. Across IDEAL stages, 30 (75.0%) studies were prospective, 29 (85.3%) reported ethical oversight, and 39 (90.7%) captured treatment‐related harms. None of the studies collected information on physician experience.

Conclusions

The IDEAL framework has found widespread adoption in the urology literature as witnessed by a large number of original manuscripts and secondary publications citing IDEAL; however, its application is largely limited to the early stages of surgical innovation, frequently with inappropriate and incomplete implementation. Further efforts are needed to guide investigators in the optimal use of the IDEAL framework as it relates to surgical innovation in urology.
Feasibility of robot‐assisted prostatectomy performed at ultra‐low pneumoperitoneum pressure of 6 mmHg and comparison of clinical outcomes vs standard pressure of 15 mmHg
Authors: Ferroni Matthew C. , Abaza Ronney
Published: January 2019

Objectives

To evaluate the feasibility of performing robot‐assisted laparoscopic prostatectomy (RALP) at an ultra‐low pressure of 6 mmHg and to assess the potential impact on its clinical outcomes, as compared to those of a historical cohort of patients in which RALP was performed at a pressure of 15 mmHg.

Patients and Methods

We evaluated 600 consecutive RALP procedures, performed by a single surgeon, including 300 procedures performed at 6 mmHg and the previous 300 performed at 15 mmHg. We compared preoperative patient characteristics and outcomes including pain scores, morphine equivalents, length of stay (LOS) and complications. After implementing the adjustment to 6 mmHg, we began allowing same‐day discharge in patients meeting established criteria.

Results

All 300 consecutive RALP procedures were completed at 6 mmHg with no pressure adjustments for the entirety of the case. There were no significant differences in patient or pathological features between groups. Body mass index was 19.5–44.3 kg/m2 in the 6 mmHg group. The mean operating time was 10.5‐min longer and mean estimated blood loss 20‐mL higher at 6 mmHg, with no blood transfusions in either group. The mean LOS was shorter in the 6‐mmHg group (0.57 vs 1.00 days; P < 0.001), with 43.3% of patients in the 6‐mmHg group discharged home the day of surgery. There were no differences in morphine equivalents or maximum pain scores in the first 4 h after surgery, but there was a small improvement (18%) in pain scores at 5–12 h postoperatively (3.2 vs 3.9; P < 0.001). The 30‐day complication rate was 8.7% vs 4.0%, with 30‐day hospital readmissions of 5.7% vs 1.0% for the 15 vs 6 mmHg groups.

Conclusion

Robot‐assisted laparoscopic prostatectomy at a pneumoperitoneum pressure of 6 mmHg was uniformly feasible without increasing complications. Ultra‐low pneumoperitoneum may confer a pain benefit, which may contribute to safe same‐day discharge.
Habitat amount hypothesis and passive sampling explain mammal species composition in Amazonian river islands
Authors: Rabelo Rafael M. , Aragón Susan , Bicca‐Marques Júlio César , Nelson Bruce W.
Published: January 2019

Nested structures of species assemblages have been frequently associated with patch size and isolation, leading to the conclusion that colonization–extinction dynamics drives nestedness. The ‘passive sampling’ model states that the regional abundance of species randomly determines their occurrence in patches. The ‘habitat amount hypothesis’ also challenges patch size and isolation effects, arguing that they occur because of a ‘sample area effect’. Here, we (a) ask whether the structure of the mammal assemblages of fluvial islands shows a nested pattern, (b) test whether species’ regional abundance predicts species’ occurrence on islands, and (c) ask whether habitat amount in the landscape and matrix resistance to biological flow predict the islands’ species composition. We quantified nestedness and tested its significance using null models. We used a regression model to analyze whether a species’ relative regional abundance predicts its incidence on islands. We accessed islands’ species composition by an NMDS ordination and used multiple regression to evaluate how species composition responds to habitat amount and matrix resistance. The degree of nestedness did not differ from that expected by the passive sampling hypothesis. Likewise, species’ regional abundance predicted its occurrence on islands. Habitat amount successfully predicted the species composition on islands, whereas matrix resistance did not. We suggest the application of habitat amount hypothesis for predicting species composition in other patchy systems. Although the island biogeography perspective has dominated the literature, we suggest that the passive sampling perspective is more appropriate for explaining the assemblages’ structure in this and other non‐equilibrium patch systems.

Abstract in Portuguese is available with online material.
Semaphorin 4A as a biomarker of multiple sclerosis and neuromyelitis optica spectrum disorder
Authors: Okuno Tatsusada , Ishikura Teruyuki , Kinoshita Makoto , Nakatsuji Yuji , Kumanogoh Atsushi , Mochizuki Hideki
Published: January 2019

Selecting appropriate treatment from the early stage of the disease is important for a better prognosis for patients with multiple sclerosis (MS). Although various disease‐modifying drugs have been approved for MS, there is no appropriate biomarker to predict treatment responsiveness. We have recently identified serum semaphorin 4A (Sema4A) as a biomarker for predicting the treatment efficacy of interferon‐β therapy. One‐third of patients with MS show high serum Sema4A levels. These patients tend to have a higher Expanded Disability Status Scale score, and possess immune characteristics of Th17‐skewing condition. Interestingly, these patients do not respond effectively to interferon‐β therapy. However, retrospective analysis of our MS cohort showed that those with high serum Sema4A levels show a favorable response to fingolimod (FTY) therapy. Efficacy of FTY was observed even in patients who later switched to FTY due to recurrent attacks under interferon‐β therapy. Our observations suggest that FTY could be a better candidate for managing the disease activity of MS patients with high Sema4A levels. Considering the fact that the efficacy of other various disease‐modifying drugs still remains elusive among MS patients with varying Sema4A profile, further investigation is required to clarify the role of serum Sema4A as a biomarker in making an appropriate decision regarding various disease‐modifying drug choices. For patients with neuromyelitis optica spectrum disorder, we found that a certain proportion of patients show high levels of serum Sema4A. In the present review, we discuss the current advances in the field of MS research focusing on the role of Sema4A, and further present the clinical features of neuromyelitis optica spectrum disorder patients with high Sema4A levels.
Difficulties and challenges in the development of precision medicine
Authors: Liu Xiaoqin , Luo Xin , Jiang Chunyang , Zhao Hui
Published: January 2019

The rapid development of precision medicine is introducing a new era of significance in medicine. However, attaining precision medicine is an ambitious goal that is bound to encounter some challenges. Here, we have put forward some difficulties or questions that should be addressed by the progress in this field. The proposed issues include the long road to precision medicine for all types of diseases as the unknown domains of the human genome hinder the development of precision medicine. The challenges in the acquisition and analysis of large amounts of omics data, including difficulties in the establishment of a library of biological samples and large‐scale data analysis, as well as the challenges of informed consent and medical ethics in precision medicine, must be overcome to attain the goals of precision medicine. To date, precision medicine programs have accomplished many preliminary achievements and will help to drive a dramatic revolution in clinical practices for the medical community. Through these advances, the diagnosis and treatment of many diseases will achieve many breakthroughs. This project is just beginning and requires a great deal of time and money. Precision medicine also requires extensive collaboration. Ultimately, these difficulties can be overcome. We should realize that precision medicine is good for patients, but there is still a long way to go.
Effectiveness of a skin care programme for the prevention of contact dermatitis in healthcare workers (the Healthy Hands Project): A single‐centre, cluster randomized controlled trial
Authors: Soltanipoor Maryam , Kezic Sanja , Sluiter Judith K. , de Wit Fleur , Bosma Angela L. , van Asperen Ruth , Rustemeyer Thomas
Published: January 2019

Background

Healthcare workers (HCWs) are at risk of developing hand dermatitis (HD). Guidelines recommend moisturizers to prevent HD, but in practice their effectiveness has been poorly investigated.

Objectives

To assess whether an intervention aimed at improving skin care leads to a reduction in HD severity.

Methods

In this 1‐year randomized controlled trial, 9 wards (285 HCWs) were allocated to an intervention group (IG), and 10 wards (216 HCWs) were allocated to the control group (CG). The intervention included provision of cream dispensers with electronic monitoring of use, regularly communicated to the HCWs. The primary and secondary outcomes were change from baseline in Hand Eczema Severity Index (HECSI) score (ΔHECSI) and change in natural moisturizing factor (NMF) level (ΔNMF).

Results

At 12 months, the rates of loss to follow‐up were 41% and 39% in the IG and the CG, respectively. The HECSI score was reduced in the IG by −6.2 points (95%CI: −7.7 to −4.7) and in the CG by −4.2 points (95%CI: −6.0 to −2.4). There was no significant difference in ΔHECSI or ΔNMF between the groups. Relative improvement in the HECSI score was significantly higher in the IG than in the CG (56% vs 44%). In a subgroup of HCWs with mild HD, the IG showed a larger HECSI score decrease than the CG (P < 0.001).

Conclusion

Although there was no significant effect on the primary outcomes, the intervention showed overall positive effects on the HECSI score.
Non‐medical use of pharmaceutical opioids with and without other illicit substances in Australia: Prevalence and correlates
Authors: Chan Gary Chung Kai , Leung Janni , Hall Wayne
Published: January 2019

Introduction and Aims

To estimate the prevalence of non‐medical use of pharmaceutical opioids and examine the socio‐demographic, psychological, health and behavioural correlates and type of opioids used.

Design and Methods

Data from the Australian National Drug Strategy Household Survey 2016 was used. The sample consisted of. 23 448 participants aged over 14 years (54% female). The key measure was opioid use status in the past year. Based on participants’ responses to questions about their substance use in the past 12 months, they were grouped into four opioid use status: (i) No illicit substance use (ISU) and no non‐medical use of pharmaceutical opioids (NMUPO); (ii) ISU but no NMUPO; (iii) NMUPO but no ISU; and (iv) NMUPO and ISU.

Results

The prevalence non‐medical pharmaceutical opioid use was 3.56%. Two‐thirds of them engaged in NMUPO but no ISU; one‐third engaged in NMUPO and ISU. Younger people were more likely to use pharmaceutical opioids in addition to other illicit drugs, while older people were more likely to only use pharmaceutical opioids. Alcohol risk and daily smoking were associated with using pharmaceutical opioids and other illicit drugs, but not with pharmaceutical opioids only. Those who reported only using pharmaceutical opioids were more likely to use over‐the‐counter codeine products.

Discussion and Conclusions

Over 700 000 Australian used pharmaceutical opioids for non‐medical purpose. Among users, two‐thirds used only opioids and one‐third used opioids in addition to other illicit drugs. Profile of these two types of users were substantially different. Future prevention efforts targeting different type of opioids users may need to be optimised based on their profiles.
Engaging people who inject drugs in hepatitis C virus testing and prevention through community‐based outreach, in Sydney, Australia
Authors: Coupland Heidi , White Bethany , Bates Anna , Park Ju Nyeong , Iversen Jenny , Maher Lisa
Published: January 2019

Introduction and Aims

Increasing treatment uptake among people who inject drugs (PWID) with chronic hepatitis C virus (HCV) infection is integral to eliminating viral hepatitis. This study explored the role of community‐based outreach in engaging and retaining Australian PWID in the testing component of the HCV care cascade.

Design and Methods

Semi‐structured interviews were conducted with 28 PWID, including new initiates to injecting and those from culturally and linguistically diverse (CALD) backgrounds, who acquired HCV infection while enrolled in a community‐based prospective observational study of hepatitis C vaccine preparedness in Sydney. Participants were interviewed at diagnosis and 12 months later. Transcripts were thematically analysed using constant comparative techniques.

Results

Community‐based outreach was effective in engaging newly infected participants in HCV monitoring and decision‐making about seeking interferon‐based treatment. Key factors in the acceptability of outreach were privacy and discretion, and opportunities to build trust with non‐judgmental staff. Retaining participants in the HCV cascade of care required more than a one‐off session of post‐test counselling. Ongoing discussions with staff enabled paced and tailored delivery of information about HCV prevention, testing and treatment. Increased understanding of the role of HCV ribonucleic acid viremia in determining the need for treatment, and access to this testing, was pivotal in making HCV monitoring salient for participants.

Discussion and Conclusions

Outreach is an effective strategy for engaging new initiates to injecting and CALD PWID in HCV testing and decision‐making about treatment. Findings highlight the need to increase availability and access to HCV ribonucleic acid testing for PWID.
Importance of inpatient hypoglycaemia: impact, prediction and prevention
Authors: Ruan Y. , Tan G. D. , Lumb A. , Rea R. D.
Published: January 2019

Hypoglycaemia is a key barrier to achieving euglycaemic control in people who are hospitalized. Inpatient hypoglycaemia has been linked to adverse clinical outcomes, including mortality and longer stay in hospital. A number of studies have applied mathematical tools and statistical models to predict inpatient hypoglycaemia and identify factors that may result in hypoglycaemic events. Several different approaches have been tested to prevent inpatient hypoglycaemia. These can be categorized as human intervention, computerized methods or application of medical devices. In this review we provide an overview of the epidemiology of inpatient hypoglycaemia and its impact on patients and hospitals. We also discuss the existing methodology used to predict inpatient hypoglycaemia and the limited number of trials performed to prevent inpatient hypoglycaemia. The review highlights the urgent need for evidence‐based methods to reduce inpatient hypoglycaemia.
Modelling the physical states, element stoichiometries and residence times of topsoil organic matter
Authors: Tipping E. , Rowe E. C.
Published: January 2019

Soil organic matter (SOM) is a major ecosystem component, central to soil fertility, carbon balance and other soil functions. To advance SOM modelling, we devised a steady‐state model of topsoil SOM, with explicit descriptions of physical states and properties, and used it to simulate SOM concentration, carbon:nitrogen:phosphorus (C:N:P) stoichiometry, bulk density and radiocarbon content. The model classifies SOM by element stoichiometry (αSOM is poor in N and P, βSOM is rich), mean residence times (1–2000 years) and physical state (free, occluded, adsorbed, hypoxic). The most stable SOM is either βSOM preferentially adsorbed by mineral matter, or αSOM in strongly hypoxic zones. Soil properties were simulated for random combinations of plant litter input (amount and C:N:P stoichiometry), mineral sorption capacity, propensity for hypoxia, and bulk density of non‐adsorbed αSOM. To optimize model parameters, outputs from 5000 simulations were used to construct bivariate relations among soil variables, which were compared with those found in data for 835 survey sites, covering all common land uses. The bivariate relations, and patterns of data scatter, were reproduced, and also variations in soil radiocarbon with soil type, suggesting that apparent scatter in measured data might reflect SOM diversity. The temporal acquisition by soil of ‘bomb 14C’ could also be simulated. The steady‐state model is the basis for a dynamic version, suitable for simulating changes in SOM through time. It provides insight into the possible manipulation of soil organic carbon (SOC) sequestration; for example, increasing litter inputs might only increase moderately‐stable SOC pools, whereas encouraging the creation of βSOM by adsorption to mineral matter from deeper soil could lead to long‐term stabilization.

Highlights

Models of SOM should include explicit descriptions of physical states and properties.

Our new topsoil SOM model is constrained by C:N:P stoichiometry, SO14C, and physical fractionation data.

Simulated soil properties, randomly generated, account for measured trends and patterns of scatter in SOM data.

SOM properties depend upon litter input, interactions with mineral matter, hypoxia, and bulk density.
Real‐time effects of interictal spikes on hippocampus and amygdala functional connectivity in unilateral temporal lobe epilepsy: An EEG‐fMRI study
Authors: Tong Xin , An Dongmei , Xiao Fenglai , Lei Du , Niu Running , Li Wei , Ren Jiechuan , Liu Wenyu , Tang Yingying , Zhang Le , Zhou Baiwan , Gong Qiyong , Zhou Dong
Published: January 2019

Objective

To explore the real‐time effects of interictal epileptiform discharges (IEDs) on hippocampus and amygdala functional connectivity (FC) in unilateral temporal lobe epilepsy (TLE).

Methods

Patients with unilateral TLE were recruited and underwent simultaneous electroencephalography–functional magnetic resonance imaging (EEG‐fMRI) scanning. Simultaneous EEG was used to define the prespike (10 s before spike) and postspike (10 s after spike) periods. Dynamic FC analysis was applied using the left/right hippocampus and amygdala separately as a seed region to map the network alterations after IED occurrence.

Results

A total of 261 IED events (133 left, 128 right) from 21 patients with unilateral TLE (10 left, 11 right) were analyzed. Left IEDs had a greater influence on the hippocampus‐seeded networks, whereas right IEDs affected the amygdala‐seeded networks more. Left IEDs disconnected the ipsilateral hippocampus and the default mode network, which might be related to cognitive impairment in TLE. The reward‐emotion network (more of the prefrontal‐limbic system) and visual network also showed FC changes after left IEDs. The reward‐emotion network (more of the reward system) was coactivated after right IEDs, indicating a possible mechanism of forced normalization.

Significance

This study directly linked the disrupted functional networks in TLE to epileptic activities and offered a unique tool for future research to investigate mechanisms of comorbidities in TLE.
Age‐Dependent Increasing Risk Aversion and the Equity Premium Puzzle
Authors: DaSilva Amadeu , Farka Mira , Giannikos Christos
Published: January 2019

We introduce a new preference structure—age‐dependent increasing risk aversion (IRA)—in a three‐period overlapping generations model with borrowing constraints, and examine the behavior of equity premium in this framework. We find that IRA preferences generate results that are more consistent with U.S. data for the equity premium, level of savings and portfolio shares, without assuming unreasonable levels of risk aversion. We find that the relative difference between the two risk aversions (how much more risk‐averse old agents are relative to the middle‐aged) matters more than the average risk aversion in the economy (how much more risk‐averse both cohorts are). Our findings are robust with respect to a number of model generalizations.
Hyperactive and anxiolytic‐like behaviors result from loss of COUP‐TFI/Nr2f1 in the mouse cortex
Authors: Contesse Thomas , Ayrault Marion , Mantegazza Massimo , Studer Michèle , Deschaux Olivier
Published: January 2019

The nuclear receptor COUP TFI (also known as Nr2f1) plays major roles in specifying distinct neuronal subtypes during patterning of the neocortical motor and somatosensory cortex, as well as in regulating the longitudinal growth of the hippocampus during development. In humans, mutations in the NR2F1 gene lead to a global developmental delay and intellectual disabilities. While more than 30% of patients show behavioral features of autism spectrum disorder, 16% of haploinsufficient children show signs of hyperactivity and impulsivity. Loss of COUP‐TFI in the cortical mouse primordium results in altered area organization and serotonin distribution, abnormal coordination of voluntary movements and learning and memory deficits. Here, we asked whether absence of COUP‐TFI affects locomotor activity, anxiety, as well as depression. Mice mutant for COUP‐TFI have normal motor coordination, but significant traits of hyperactivity, which does not seem to respond to N‐Methyl‐D‐aspartate (NMDA) antagonists. However, no changes in anxiety, despite increased locomotor performances, were observed in the open field task. On the contrary, elevated plus maze and dark‐light test explorations indicate a decreased anxiety‐like behavior in COUP‐TFI mutant mice. Finally, significantly reduced immobility in the forced swim test and no changes in anhedonia in the sucrose preference task suggest no particular depressive behaviors in mutant mice. Taken together, our study shows that loss of COUP‐TFI leads to increased locomotor activity but less anxiety and contributes in further deciphering the pathophysiology of patients haploinsufficient for NR2F1.
FROM NEAR AND FAR: AESTHETIC DISTANCE IN THE REPRESENTATION OF HEIMAT BY LENA CHRIST AND CLARA VIEBIG
Authors: Bland Caroline
Published: January 2019

Lena Christ (1881–1920) and Clara Viebig (1860–1952) depicted the German Catholic peasantry in border regions remote from Berlin: Upper Bavaria in Christ's Mathias Bichler (1914) and Die Rumplhanni (1917) and the Eifel in Viebig's Heimat (1914). Both authors made much of their authentic presentation of peasant life and it is still this aspect which is emphasised in the reception of their work. The irresistible force of modernity in the growing cities, coupled with the upheaval of the Great War, appeared to have provoked fresh longing for rural traditions and simplicity. By linking the writing of Viebig and Christ to the contemporaneous interest of visual artists in the landscape, peasantry, and tradition, this article will demonstrate how authenticity and the rural Heimat became a focus of aesthetic enquiry at this time.
ESCAPING FROM HEIMAT AND LONGING FOR HEIMAT IN WILHELMINE VON HILLERN'S DIE GEIER‐WALLY
Authors: Scharnowski Susanne
Published: January 2019

While Wilhelmine von Hillern's novel and its film adaptations still figure amongst the best‐known examples of the genres ‘Heimatroman’ and ‘Heimatfilm’ respectively, so far no detailed study has been done of the portrayal of Heimat in the novel, even though Heimat is frequently and explicitly thematised. An analysis of the novel reveals a surprisingly bleak image of the village and the village community, of the paternal household and the father. The heroine of the novel, Wally, courageous and with a great desire for independence, experiences both the village and the paternal home solely as restrictions, as a suppression of her determination and individuality. This unrelievedly gloomy portrayal of village life is in fact more reminiscent of the anti‐Heimat literature of the 1970s than of the Heimat literature of the late nineteenth century. Here, high mountains and glaciers serve as a counter‐world to the strangely unhomely Heimat and as a place to escape to. The novel resists the notion of Heimat as a bond to village origins with a more modern, urbanised perspective, in which Heimat is presented as an indeterminate and ultimately unfulfillable yearning rather than as a bond to place and traditions. In this perspective – clearly depicted as modern and urban – the focus is not on rural life and the village community, but rather on the sublime Alpine wilderness.
GENDER, MIGRATION, AND MAGICAL NATURALISM IN EDGAR REITZ'S DIE ANDERE HEIMAT (2013)
Authors: Palfreyman Rachel
Published: January 2019

A gendered understanding of the concept of Heimat exposes difficulties with gender representation in Heimat film and writing in both the traditional and critical modes. Women can be so closely aligned with the construction or even embodiment of the Heimat that their own access to it is in doubt. Reitz's Heimat (1984) was criticised as well as celebrated for its representation of the maternal Heimat constructed by Maria seemingly for the benefit of her menfolk who are able to transcend the Heimat at will and then return, while she remains stuck in the Heimat realm. Reitz's ‘Vormärz’ prequel Die andere Heimat (2013) on the face of it presents another narrative of a mother and her sons with a fraternal and mirrored gender pattern of Heimat production, as well as dealing with the complexities of leaving and remaining in the Heimat. In engaging both with current debates on the intersection of Heimat discourse and migration, and with the birth of the Heimat movement, this essay ‘bookends’ the core period addressed in this special number, as it looks forwards and backwards to historical and conceptual concerns that anchor the discussions of Heimat texts from 1871–1933.
Elevated pre‐existing lymphocytic infiltrates in tumour stroma predict poor prognosis in resectable urothelial carcinoma of the bladder
Authors: Wang Bo , Xie Shujie , Bi Junming , Liu Zhuowei , Zeng Hong , Huang Hao , Xue Miaoxin , He Zhihua , Yang Meihua , Yu Hao , Huang Jian , Lin Tianxin
Published: January 2019

Aims

Lymphocytic infiltrates are predominantly distributed in the tumour stroma, and represents the tumour‐related immune response. The aim of this study was to elucidate the prognostic value of stromal lymphocytic infiltrates (SLI) in resectable urothelial carcinoma of the bladder (UCB).

Methods and results

The prognostic significance of SLI in UCB was assessed in a discovery cohort (n = 226; 60 deaths) and in a validation cohort (n = 417; 103 deaths). SLI was categorised into intense (≥50% SLI) and non‐intense (<50% SLI). A multivariable Cox model was used to analyse the associations of SLI score with overall survival (OS) and disease‐free survival. Immunofluorescence staining was used to examine the composition and phenotypes of SLI. The median follow‐up times were 58.1 and 64.9 months in the discovery and validation cohorts, respectively. SLI was intense in 38.1% of patients in the discovery cohort and in 20.9% of patients in the validation cohort (P < 0.001). SLI score had independent prognostic value for OS [hazard ratio (HR) 2.132; P = 0.016] and disease‐specific survival (DSS) (HR 1.952; P = 0.04) in the discovery cohort, which was confirmed in the validation cohort (OS: HR 1.636; P = 0.023; DSS: HR 1.627; P = 0.029). SLI score was positively associated with histological grade, tumour stage and lymph node status in both cohorts. Moreover, in the stroma, SLI displayed a broad spectrum of inhibitory immune cells, by expressing several major immune checkpoint molecules, i.e. programmed cell death protein 1, programmed death‐ligand 1, indoleamine 2,3‐dioxygenase, and T‐cell immunoglobulin and mucin domain 3.

Conclusion

Intense pre‐existing SLI was validated as a reliable marker of poorer prognosis for survival in UCB patients, which may add to the prognostic significance of the TNM classification.
OBVIOUSLY STRATEGY‐PROOF IMPLEMENTATION OF TOP TRADING CYCLES
Authors: Troyan Peter
Published: January 2019

Although there is a rich theoretical literature extolling the virtues of the top trading cycles (TTCs) mechanism, it is rarely used in practice. Anecdotal evidence suggests that one possible explanation is that TTC is difficult for participants to understand. This article formalizes this intuition by asking whether it is possible to implement TTC in an obviously strategy‐proof (OSP) way. I identify an acyclicity condition that is both necessary and sufficient for OSP implementation of TTC. The condition is unlikely to hold in most applications, which may explain why TTC is rarely used, despite its many appealing theoretical properties.
IF WE CONFESS OUR SINS
Authors: Silva Francisco
Published: January 2019

I consider a scenario where a social planner suspects that a crime has been committed. There are many suspects and at most one of them is guilty. I characterize the optimal mechanism for the social planner under different assumptions with respect to her commitment power. I find that the optimal mechanism is a “confession inducing mechanism”: Before an investigation, each agent can confess to being guilty in exchange for a reduced punishment. I find that these mechanisms do better than the traditional trial mechanism because of information externalities: When an agent credibly confesses his guilt, he reveals everyone else's innocence.
Towards a circulating marker of hepato‐visceral fat excess: S100A4 in adolescent girls with polycystic ovary syndrome — Evidence from randomized clinical trials
Authors: Malpique Rita , Sánchez‐Infantes David , Garcia‐Beltran Cristina , Taxerås Siri D. , López‐Bermejo Abel , de Zegher Francis , Ibáñez Lourdes
Published: January 2019

S100A4 is a marker of subcutaneous adipose tissue dysfunction. Polycystic ovary syndrome (PCOS) is often driven by hepato‐visceral adiposity. PCOS phenotypes are normalized more by reduction of central fat with spironolactone/pioglitazone/metformin (SPIOMET) than by oral contraceptive (OC) treatment. We studied whether circulating S100A4 concentrations are high in adolescents with PCOS and, if so, whether they normalize more with OC or SPIOMET. Assessments included circulating S100A4, endocrine markers, body composition, abdominal fat partitioning in controls (n = 12) and girls with PCOS (n = 51; age 15.8 y; body mass index [BMI] 24.5 kg/m2), and 1‐year changes in girls with PCOS randomized for OC (n = 27) or SPIOMET (n = 24) treatment. Mean S100A4 concentrations were 71% higher (P < 0.001) in girls with PCOS than in controls and associated with hepato‐visceral adiposity (r = 0.47; P = 0.001); S100A4 concentrations decreased more (P < 0.01) with SPIOMET, those decreases associating to hepato‐visceral fat loss (r = 0.50; P < 0.0001). S100A4 may become a circulating marker of hepato‐visceral fat excess in adolescents with PCOS.