bluuebunny/crossref_metadata_2025 huggingface dataset:
Differentiation of developmental plasticity as a major cause of morphological evolution in stag beetles (Coleoptera: Lucanidae)
Authors: Kawano Kazuo
Published: January 2020

Stag beetles show great developmental plasticity (DP) in their external morphology. In intraspecific evolution, DP functions as a stabilizer for morphological change, whereas interspecifically, the evolution of external morphology is primarily a process of differentiation in DP. Greater DP in external morphology has evolved as a species trait through selection for survival in conditions that vary stochastically, rather than a long-term unidirectional trend in conditions. All the interspecific transitions towards larger size, multimodal morphology and adaptive expansion are preceded by an increase in DP. Here, differentiation of DP is more a cause, rather than a result, of species-level evolution. This contrasts with the differentiation of other important traits, such as the morphology of the genitalia, which follow the conventional known process of small effects accumulating to larger effects from an intraspecific stage to an interspecific stage, in which DP plays no significant role. The DP of external morphology, as an emergent property of species, provides the means by which they can survive and subsequently evolve to be better adapted to novel conditions. This contrasting mode of evolution through differentiation of DP should play a crucial role in species survival and the maintenance of biodiversity in the Anthropocene.
Influence of mass on tarsus shape variation: a morphometrical investigation among Rhinocerotidae (Mammalia: Perissodactyla)
Authors: Etienne Cyril , Mallet Christophe , Cornette Raphaël , Houssaye Alexandra
Published: January 2020

Many tetrapod lineages show extreme increases in body mass in their evolutionary history, associated with important osteological changes. The ankle joint, essential for foot movement, is assumed to be particularly affected in this regard. We investigated the morphological adaptations of the astragalus and the calcaneus in Rhinocerotidae, and analysed them in light of a comparative analysis with other Perissodactyla. We performed 3D geometric morphometrics and correlated shape with centroid size of the bone and body mass of the species. Our results show that mass has an influence on bone shape in Rhinocerotidae and in Perissodactyla, but this is not as strong as expected. In heavy animals the astragalus has a flatter trochlea, orientated more proximally, associated with a more upright posture of the limb. The calcaneus is more robust, possibly to sustain the greater tension force exerted by the muscles during plantarflexion. Both bones show wider articular facets, providing greater cohesion and better dissipation of the loading forces. The body plan of the animals also has an influence. Short-legged Teleoceratina have a flatter astragalus than the other rhinocerotids. Paraceratherium has a thinner calcaneus than expected. This study clarifies adaptations to high body weight among Rhinocerotidae and calls for similar investigations in other groups with massive forms.
Ecophylogeography of the disjunct South American xerophytic tree species Prosopis chilensis (Fabaceae)
Authors: Aguilar Dana Lucía , Acosta María Cristina , Baranzelli Matías Cristian , Sérsic Alicia Noemí , Delatorre-Herrera Jose , Verga Anibal , Cosacov Andrea
Published: January 2020

The intraspecific evolutionary history of South American xerophytic plant species has been poorly explored. The tree species Prosopis chilensis has a disjunct distribution in four South American regions: southern Peru, southern Bolivia, central–western Argentina and central Chile. Here, we combined phylogeographical (based on chloroplast and nuclear markers), morphological and climatic data to evaluate the relative contribution of historical demo-stochastic and adaptive processes in differentiating the disjunct areas of distribution. The results obtained with the two molecular markers revealed two closely related phylogroups (Northern and Southern, predominating in Bolivian Chaco and in Argentine Chaco/Monte, respectively), which would have diverged at ~5 Mya, probably associated with transgression of the Paranaense Sea. Bolivia and Argentina have a larger number of exclusive haplotypes/alleles and higher molecular diversity than Chile, suggesting a long-lasting in situ persistence in the former and a relatively recent colonization in the latter, from the Bolivian and Argentinian lineages. The two main lineages differ in morphology and climatic niche, revealing two significant, independent evolutionary units within P. chilensis promoted by local adaptation and geographical isolation.
Applying intersectionality to partnerships between women’s organizations and the criminal justice system in relation to domestic violence
Authors: Day Aviah Sarah , Gill Aisha K
Published: January 2020

The challenges facing domestic violence (DV) survivors has become the subject of a growing body of intersectional analysis; this paper presents a new intersectional framework for analysing DV policy and practice. Examining a partnership between women’s sector organizations and the criminal justice system in London, using interviews with professionals from the bodies, the paper offers an intersectional analysis of the implications, positive and negative, for both policy and practice. The complex interplay between women’s sector organizations and the criminal justice system demonstrate how the intersections of gender, class, ‘race’ and immigration status affect the way DV survivors are able to access and benefit from support, concluding that, to operate more effectively, DV support must consider all forms of oppression and violence affecting the lives of all their users.
Can you see what I see? Assessing brain maturation and injury in preterm and term neonates
Authors: Duerden Emma G , Thompson Deanne K
Published: January 2020

This scientific commentary refers to ‘Modelling brain development to detect white matter injury in term and preterm born neonates’ by O’Muircheartaigh et al. (doi: 10.1093/brain/awz412).
Judicial Activism of Provincial Courts in China: Medical Negligence Law as a Case Study
Authors: Ding Chunyan
Published: January 2020

By presenting a case study of local judicial activism in medical negligence law reform in recent China, this article examines the active engagement of Chinese provincial courts in bottom-up reform of national laws. Contrary to conventional wisdom that law-making is the least important function of local courts, it finds that provincial courts in China, like the Supreme People’s Court, are actively engaging in law-making, which is an essential part of their functions. It also reveals that the national judiciary is more susceptible to political pressure while the provincial judiciary tends to be less vulnerable to political pressure and more responsive to populist pressure when exercising its law-making power. Therefore, provincial courts may be in a better position to reform national laws in response to urgent social needs, in contrast to the Supreme People’s Court, which encounters political obstacles in pursing top-down law reform. By exploring the dynamic national–local judiciary relationship in the law-making landscape, this article argues that judicial activism of provincial courts in national law reform opens an alternative channel through which populist views can effectively move up to become part of national laws despite China being a non-democratic country.
Rememorying Slavery: Intergenerational Memory and Trauma in Toni Morrison’s Beloved (1987) and Conceição Evaristo’s Ponciá Vicêncio (2003)
Authors: de Souza Sutter Luana
Published: January 2020

This paper looks at parallels in the articulation of memory and trauma between Toni Morrison’s Beloved and the more recent publication Ponciá Vicêncio, written in 2003 by the Afro-Brazilian writer Conceição Evaristo. It examines the novels’ illustration of slavery trauma and the creative investment of descendants of slaves in re-presenting traumatic family history. With this concern, it proposes a comparative reading of Beloved and Ponciá Vicêncio, focusing, first, on their representations of the embodiment of trauma; second, on their respective concepts of rememory and memory-thoughts – or pensamentos-lembranças; and third, on the descendants’ engagement with the revision of narratives of family past, through the characters Denver and Ponciá.
Do ground-glass opacity-dominant features have prognostic significance in node-negative adenocarcinomas with invasive components of similar sizes?
Authors: Han Sung Joon , Jeon Jae Hyun , Jung Woohyun , Seong Yong Won , Cho Sukki , Kim Kwhanmien , Jheon Sanghoon
Published: January 2020

OBJECTIVES

The purpose of this study was to analyse the prognostic significance of the dominant features of ground-glass opacities (GGOs) in part-solid node-negative adenocarcinomas with invasive components of similar sizes.

METHODS

From 2004 to 2017, a total of 544 patients with a diagnosis of part-solid pathological node-negative adenocarcinoma with an invasive component <20 mm in size were selected. The enrolled patients were categorized into 2 groups: a GGO-dominant [50% < GGO (%) < 100%, n = 245] group (group 1) and a solid-dominant [0% < GGO (%) ≤ 50%, n = 299] group (group 2). To analyse the prognostic significance of GGO-dominant features, propensity score matching incorporating variables such as age, sex, preoperative pulmonary function, operation methods and size of the solid component was performed.

RESULTS

Propensity score matching produced 92 patients in each group for the prognostic analysis. The mean size of the solid part was 8.8 mm in the GGO-dominant group and 9.0 mm in the solid-dominant group (P = 0.34); the mean size of the total lesion was 22.2 mm in the GGO-dominant group and 14.9 mm in the solid-dominant group (P < 0.001). The 5-year overall survival rates were 96.7% in group 1 and 96.2% in group 2 (P = 0.52), and the 5-year disease-free survival rates were 96.7% in group 1 and 94.3% in group 2 (P = 0.48).

CONCLUSIONS

Although the total sizes of the GGO-dominant lesions were larger than those of the solid-dominant lesions, the prognosis of patients with GGO-dominant lesions was not significantly different from that of patients with solid-dominant lesions in node-negative adenocarcinomas with a similar invasive component size <20 mm.
Cognitive Sociology, Social Cognition and Coping with Racial Discrimination in International Law
Authors: Hirsch Moshe
Published: January 2020

Cognitive science is the interdisciplinary study of mental processes involved in the acquisition, classification, organization and interpretation of knowledge in the human environment as well as the decision taken on the appropriate action based upon it. The point of departure is that people do not directly sense information; cognitive processes mediate between sensory input from the environment and behaviour. These cognitive processes are influenced by neurological, psychological, socio-cultural and other factors. In recent years, there has been growing scholarly interest in the study of cognitive sociology, focusing on the interactions between culture and cognition. This stream in sociological literature draws upon and complements cognitive psychological literature. The prohibition on discrimination constitutes one of the fundamental rules in international human rights law, but studies reveal that racial discrimination is pervasive and persistent in many states. Non-compliance with this international legal rule is significantly related to cognitive processes through which people acquire and interpret incoming information about other people. Racial groups are socially constructed and deeply ingrained socio-cognitive biases feed and reproduce racially discriminatory behaviour. These biased mental processes, however, are not inevitable and may change over time. Effective struggle against racial discrimination requires that international legal mechanisms also address the socio-cognitive infrastructure that facilitates and sustains racial discrimination. Consequently, this study also discusses some international legal strategies aimed at mitigating cognitive biases and enhancing compliance with treaties prohibiting racial discrimination.
Variation in the microbiome of the spider mite Tetranychus truncatus with sex, instar and endosymbiont infection
Authors: Zhu Yu-Xi , Song Zhang-Rong , Huo Shi-Mei , Yang Kun , Hong Xiao-Yue
Published: January 2020

Most arthropod-associated bacterial communities play a crucial role in host functional traits, whose structure could be dominated by endosymbionts. The spider mite Tetranychus truncatus is a notorious agricultural pest harboring various endosymbionts, yet the effects of endosymbionts on spider mite microbiota remain largely unknown. Here, using deep sequencing of the 16S rRNA gene, we characterized the microbiota of male and female T. truncatus with different endosymbionts (Wolbachia and Spiroplasma) across different developmental stages. Although the spider mite microbiota composition varied across the different developmental stages, Proteobacteria were the most dominant bacteria harbored in all samples. Positive relationships among related operational taxonomic units dominated the significant coassociation networks among bacteria. Moreover, the spider mites coinfected with Wolbachia and Spiroplasma had a significantly higher daily fecundity and juvenile survival rate than the singly infected or uninfected spider mites. The possible function of spider-mite associated bacteria was discussed. Our results highlight the dynamics of spider mite microbiotas across different life stages, and the potential role of endosymbionts in shaping the microbiota of spider mites and improving host fitness.
Investigating temporal microbial dynamics in the rumen of beef calves raised on two farms during early life
Authors: O'Hara Eóin , Kenny David A , McGovern Emily , Byrne Colin J , McCabe Matthew S , Guan Le Luo , Waters Sinéad M
Published: January 2020

Manipulation of the rumen microorganisms during early life has emerged as a promising strategy for persistent improvement of nutrient utilisation and lowering of enteric methanogenesis. However, limited understanding of the dynamics of rumen microbial colonisation has prevented the identification of the optimum timeframe for such interventions. The present study used DNA amplicon sequencing of the 16S rRNA gene to assess bacterial and archaeal dynamics in the rumen digesta of beef calves raised on two farms from birth through to post-weaning. The colonisation patterns of both communities were influenced by age (P < 0.05) and farm of origin (P < 0.05). The bacterial community exhibited an age-wise progression during the first month of life which appeared to be partly related to diet, and settled by day 21, indicating that this may mark the boundary of a timeframe for intervention. The archaeal community appeared less sensitive to age/diet than bacteria in the first month of life but was more sensitive to farm environment. These data show that ruminal microbial composition during early life is driven by calf age, diet and local environment, and provide important fundamental information concerning the ontogeny of the rumen microbiota from birth.
Engineering of Saccharomyces cerevisiae for efficient fermentation of cellulose
Authors: Oh Eun Joong , Jin Yong-Su
Published: January 2020

Conversion of lignocellulosic biomass to biofuels using microbial fermentation is an attractive option to substitute petroleum-based production economically and sustainably. The substantial efforts to design yeast strains for biomass hydrolysis have led to industrially applicable biological routes. Saccharomyces cerevisiae is a robust microbial platform widely used in biofuel production, based on its amenability to systems and synthetic biology tools. The critical challenges for the efficient microbial conversion of lignocellulosic biomass by engineered S. cerevisiae include heterologous expression of cellulolytic enzymes, co-fermentation of hexose and pentose sugars, and robustness against various stresses. Scientists developed many engineering strategies for cellulolytic S. cerevisiae strains, bringing the application of consolidated bioprocess at an industrial scale. Recent advances in the development and implementation of engineered yeast strains capable of assimilating lignocellulose will be reviewed.
The genetic composition of feeding aggregations of the Atlantic mackerel (Scomber scombrus) in the central north Atlantic: a microsatellite loci approach
Authors: Gíslason Davið , Helyar Sarah J , Óskarsson Guðmundur J , Ólafsdóttir Guðbjörg , Slotte Aril , Jansen Teunis , Jacobsen Jan Arge , Ólafsson Kristinn , Skirnisdottir Sigurlaug , Dahle Geir , Siegstad Helle , Joensen Hóraldur , Curti Kiersten L , Grégoire François , Masse Jacques , Sveinsson Sæmundur , Daníelsdóttir Anna Kristín , Pampoulie Christophe
Published: January 2020

The impacts of climate change on marine ecosystems can be seen in the changing distribution, migration, and abundance of species in the oceans. For some species this changing environment may be beneficial and can support population expansions. In the northeast Atlantic (NEA), the Atlantic mackerel (Scomber scombrus) is undergoing an increase in stock size accompanied by changing summer migration patterns, which have resulted in an expansion further north and north west than previously recorded. This study uses microsatellite loci to confirm the differentiation among NEA and northwest Atlantic (NWA) mackerel spawning populations and to assess the level of structuring within these populations. In addition, to enable population-specific exploitation rates to be factored into fisheries management, we identified the origin of individuals composing the expanding feeding aggregations in the central north Atlantic (Greenland, Iceland, Faroes), with all aggregations tested originating from spawning populations in the NEA. This study showed that microsatellite loci were useful to assess the contribution of NEA and NWA populations to mixed feeding aggregations across the north Atlantic for large pelagic fish stocks but were not powerful enough to evaluate the specific contribution of known stocks within NEA and NWA.
Platypnea–orthodeoxia syndrome after pulmonary wedge resection in a patient with severe scoliosis
Authors: Donghi Stefano Maria , Sedda Giulia , Guarize Juliana , Spaggiari Lorenzo
Published: January 2020

Platypnea–orthodeoxia is a rare syndrome characterized by dyspnoea and arterial desaturation, exacerbated by an upright position and relieved when the subject is recumbent. We report on a unique case of a patient with severe scoliosis who presented with several episodes of arterial desaturation after right pulmonary wedge resection.
Antimicrobial stewardship failure: time for a new model
Authors: O’Sullivan Cathal E
Published: January 2020

There are now 10 years of national antimicrobial consumption data in Ireland. Despite the creation of an ‘antimicrobial stewardship and infection control industrial complex’ over this period, the data demonstrate a 16% increase in consumption nationally. Given the ongoing challenges with carbapenemase-producing Enterobacterales and Clostridioides difficile within the acute hospital system, the data point to the ineffectiveness of the national antimicrobial stewardship programme/model. A different model of antimicrobial stewardship is therefore needed. This new model is one based around the collection and dissemination of physician-specific consumption, together with greater education of clinicians in the management of infections. By shining a light on individual clinician antibiotic prescribing, outlier identification, along with peer to peer (or clinician to clinician) pressure, can be brought to bear on the problem and shift the emphasis from the current ‘policing’ oversight, to self-regulation instead.
The algorithm used for the interpretation of doravirine transmitted drug resistance strongly influences clinical practice and guideline recommendations
Authors: Guerrero-Beltrán Carlos , Martínez-Sanz Javier , Álvarez Marta , Olalla Julián , García-Álvarez Mónica , Iribarren Jose Antonio , Masiá Mar , Montero Marta , García-Bujalance Silvia , Blanco José Ramón , Rivero María , García-Fraile Lucio Jesús , Espinosa Núria , Rodríguez Carmen , Aguilera Antonio , Vidal-Ampurdanes María Carmen , Martínez Marina , Iborra Asunción , Imaz Arkaitz , Gómez-Sirvent Juan Luis , Peraire Joaquim , Portilla Joaquín , Caballero Estrella , Alejos Belén , García Federico , Moreno Santiago ,   on behalf of CoRIS
Published: January 2020

Objectives

We report the results of the reverse transcriptase (RT)/protease (PR) transmitted drug resistance (TDR) prevalence study in 2018, focusing on doravirine resistance-associated mutations and the differences observed when Stanford or French National Agency for AIDS Research (ANRS)/Spanish Network of AIDS Research (RIS)/IAS-USA resistance interpretation algorithms are used to describe clinically relevant resistance.

Methods

We used the WHO 2009 list to investigate the prevalence of NNRTI, NRTI and PI TDR, in treatment-naive HIV-1-infected patients, adding mutations E138A/G/K/Q/R, V106I, V108I, V179L, G190Q, H221Y, F227C/L/V, M230IDR, L234I, P236L and Y318F in RT. The prevalence of doravirine resistance-associated mutations, as described by Soulie et al. in 2019, was evaluated. Clinically relevant TDR was investigated using the latest versions of ANRS, RIS, IAS-USA and Stanford algorithms.

Results

NNRTI mutations were detected in 82 of 606 (13.5%) patients. We found 18 patients (3.0%) with NRTI mutations and 5 patients (0.8%) with PI mutations. We detected 11 patients harbouring doravirine resistance-associated mutations (prevalence of 1.8%). Furthermore, we observed important differences in clinically relevant resistance to doravirine when ANRS/RIS (0.7%), IAS-USA (0.5%) or Stanford algorithms (5.0%) were used. V106I, which was detected in 3.8% of the patients, was the main mutation driving these differences. V106I detection was not associated with any of the clinical, demographic or virological characteristics of the patients.

Conclusions

The prevalence of NRTI and PI TDR remains constant in Spain. Doravirine TDR is very infrequent by RIS/ANRS/IAS-USA algorithms, in contrast with results using the Stanford algorithm. Further genotype–phenotype studies are necessary to elucidate the role of V106I in doravirine resistance.
RP-HPLC Method for the Simultaneous Determination of a Quaternary Mixture of Propyphenazone, Flavoxate HCl and Two of Their Official Impurities with Dissolution Profiling of Their Tablets
Authors: El-Ragehy Nariman A , Ramadan Nesrin K , Ragab Mona T , El-Zeany Badr A
Published: January 2020

Background

Determination of different drugs in the presence of their impurities is now receiving attention from regulatory authorities such as the ICH and the United States Food and Drug Administration (USFDA).

Objective

To develop and validate a reversed-phase (RP)-HPLC method for the simultaneous separation and quantification of a quaternary mixture of propyphenazone, flavoxate HCl, and their official impurities; phenazone and 3-methylflavone-8-carboxylic acid, respectively. Then utilize the validated method as an in vitro methodology to monitor the rate of release of the active ingredients from Cistalgan® tablets.

Methods

RP-HPLC method was applied using Kinetex® coreshell C8 column (250 mm × 4.6 mm I.D., particle size 5 μm) and acetonitrile: phosphate buffer pH 3.50 (42:58, v/v) as the mobile phase with UV detection at 240.0 nm.

Results

The studied components were eluted with average retention times of 2.80, 3.40, 4.20, and 5.90 min for phenazone, flavoxate HCl, 3-methylflavone-8-carboxylic acid, and propyphenazone, respectively within linearity range of 1.00–60.00 µg/mL propyphenazone, 3.00–60.00 µg/mL flavoxate HCl and 0.50–40.00 µg/mL of the specified impurities.

Conclusions

The suggested method could be considered as the first validated analytical method for the simultaneous determination of the studied components and proved to be accurate, precise, sensitive, and robust.

Highlights

The proposed method displays a useful analytical tool for dissolution profiling and clear discrimination of both active ingredients from their impurities along with impurities profiling.
Effect of feeding barley or corn silage with dry-rolled barley, corn, or a blend of barley and corn grain on rumen fermentation, total tract digestibility, and nitrogen balance for finishing beef heifers
Authors: Johnson Jordan A , Sutherland Brittney D , McKinnon John J , McAllister Tim A , Penner Gregory B
Published: January 2020

Five ruminally cannulated heifers were used in an incomplete 6 × 6 Latin square design to determine the effects of cereal silage (barley vs. corn), cereal grain (barley vs. corn vs. a 50:50 blend of barley and corn), and their interaction (S × G) on dry matter intake, ruminal fermentation, total tract digestibility, nitrogen balance, and in situ degradation. Corn silage (CS) or barley silage (BS) was included at 8% of dietary dry matter (DM). Within each silage source, diets contained (DM basis) either dry-rolled barley (BG; 86%), dry-rolled corn (CG; 85%), or an equal blend of barley and corn (BLEND; 85%). Periods were 25 d, with 5 d of dietary transition, 13 d of dietary adaptation, and 7 d of data and sample collection. Samples collected included feed and refusals, total urine and feces, and ruminal fluid. All data were analyzed using the Mixed model of SAS with the fixed effects of silage, grain, and the S × G. Dry matter intake (P ≥ 0.19) and mean ruminal pH (P ≥ 0.096) were not affected by the silage, grain, or S × G. Total short-chain fatty acid concentrations were greater for BLEND than BG or CG (grain, P = 0.003) and for CS (silage, P = 0.009) relative to BS. The molar proportion of acetate was greater for BS-BG and BS-CG (S × G, P < 0.001), while molar proportion of propionate was greater for CS-BG (S × G, P < 0.001) relative to other silage and grain source combinations. Rumen ammonia-N concentration was greater for CG than BG, or BLEND (grain, P < 0.001), and greater for CS compared to BS (silage, P = 0.023). Apparent total tract digestibility of DM, organic matter, neutral detergent fiber, starch, and gross energy were greatest for BG (grain, P ≤ 0.035). Digestible energy content (Mcal/kg) was greater for BG (grain, P = 0.029) than CG and BLEND. Total nitrogen retention (g/d and % of intake) was greatest for CS-BG (S × G, P ≤ 0.033) relative to all other treatments. In situ degradation rates of DM, crude protein, and starch were greater for BG than CG (P ≤ 0.004). The potentially degradable fraction of DM, crude protein, and starch was greater for CG (P ≤ 0.031), while the undegradable fraction was greater for BG (P ≤ 0.046). For silage sources, CS had greater 24 h in situ DM digestibility (P = 0.009) and starch digestibility (24, 48, and 72 h incubations, P ≤ 0.034) relative to BS. Results suggest that while feeding a combination of CS and BG promotes propionate production and greater N retention; few other additive effects were observed.
The constitutive high-affinity Met-binding site in the kringle domain is dispensable for the signalling activity of hepatocyte growth factor
Authors: Umitsu Masataka , Sakai Katsuya , Tamura-Kawakami Keiko , Matsumoto Kunio , Takagi Junichi
Published: January 2020

Activation of a tyrosine kinase receptor Met by hepatocyte growth factor (HGF) requires binding of proteolytically activated, two-chain (tc) HGF, but the biochemical detail of this ligand–receptor interaction specificity remains elusive because biologically inactive single chain (sc) HGF can also bind to Met with high affinity. We found that this proteolysis-independent Met binding can be eliminated by mutagenesis introduced in the kringle domain without losing the ability to bind and activate cellular Met receptor after proteolytic activation, arguing against this site’s involvement in the physiological signalling. This non-signal producing Met–HGF interaction can also be eliminated by addition of a heparin mimetic sucrose octasulphate (SOS). By including SOS in the running buffer, we succeeded in detecting cleavage-dependent tcHGF–Met complex formation by size exclusion chromatography.
Cost-Effectiveness and Quality-Adjusted Survival of Watch and Wait After Complete Response to Chemoradiotherapy for Rectal Cancer
Authors: Miller Jacob A , Wang Hannah , Chang Daniel T , Pollom Erqi L
Published: January 2020

Background

Neoadjuvant chemoradiotherapy (CRT) followed by total mesorectal excision (TME) is the standard treatment for locally advanced rectal cancer. There is interest in deescalating local therapy after a clinical complete response to CRT. We hypothesized that a watch-and-wait (WW) strategy offers comparable cancer-specific survival, superior quality-adjusted survival, and reduced cost compared with upfront TME.

Methods

We developed a decision-analytic model to compare WW, low anterior resection, and abdominoperineal resection for patients achieving a clinical complete response to CRT. Rates of local regrowth, pelvic recurrence, and distant metastasis were derived from series comparing WW with TME after pathologic complete response. Lifetime incremental costs and quality-adjusted life-years (QALY) were calculated between strategies, and sensitivity analyses were performed to study model uncertainty.

Results

The base case 5-year cancer-specific survival was 93.5% (95% confidence interval [CI] = 91.5% to 94.9%) on a WW program compared with 95.9% (95% CI = 93.6% to 97.4%) after upfront TME. WW was dominant relative to low anterior resection, with cost savings of $28 500 (95% CI = $22 200 to $39 000) and incremental QALY of 0.527 (95% CI = 0.138 to 1.125). WW was also dominant relative to abdominoperineal resection, with a cost savings of $32 100 (95% CI = $21 800 to $49 200) and incremental QALY of 0.601 (95% CI = 0.213 to 1.208). WW remained dominant in sensitivity analysis unless the rate of surgical salvage fell to 73.0%.

Conclusions

Using current multi-institutional recurrence estimates, we observed comparable cancer-specific survival, superior quality-adjusted survival, and decreased costs with WW compared with upfront TME. Upfront TME was preferred when surgical salvage rates were low.
Association of Routine Chlamydia trachomatis Screening During Pregnancy and Seroprevalence of Chlamydial Infection in Children, 1991–2015
Authors: Banniettis Natalie , Wisecup Kimberly , Boland Leah , Watanabe Izumi , Hammerschlag Margaret R , Kohlhoff Stephan
Published: January 2020

We performed a seroepidemiologic study of sera from children in Brooklyn, New York, before and after the implementation of prenatal chlamydial screening almost 20% of children aged ≤10 years in the prescreening group had anti-Chlamydia trachomatis immunoglobulin G compared with none in the postscreening group.
Against Abandonment Activist-Humanitarian Responses to LGBT Refugees in Athens and Beirut
Authors: Reda Ali , Proudfoot Philip
Published: January 2020

This article compares lesbian, gay, bisexual and transgender (LGBT) ‘activist-humanitarianism’ in Beirut and Athens. In both locations, ‘out’ or ‘outed’ refugees endure a unique combination of structural and physical violence. In response, LGBT activists and their allies have established grassroots aid and solidarity networks. In Beirut, we examine an LGBT-advocacy non-governmental organization (NGO) that offers legal aid and training to LGBT refugees and Lebanese citizens. In Athens, we consider two self-organized horizontalist support groups. From a comparative ethnographic perspective, we explore how each sought to improve the wellbeing of LGBT refugees. We conclude that, while the structural limitations of ‘neoliberalism’ and ‘NGO-ization’ frustrated the emergence of a fully alternative activist-orientated humanitarianism, the groups nonetheless produced significant but ‘unintended’ impacts on refugee lives. Even if our informants felt much of the organizations’ activities and training sessions were ineffective, they nonetheless harnessed marginal aspects of the projects, such as the provision of space for collective organizing. Through appropriating these spaces for their own means, they went on to build practical solidarity and develop a political critique of their predicaments as refugees.
FIT, a regulatory hub for iron deficiency and stress signaling in roots, and FIT-dependent and -independent gene signatures
Authors: Schwarz Birte , Bauer Petra
Published: January 2020

Iron (Fe) is vital for plant growth. Plants balance the beneficial and toxic effects of this micronutrient, and tightly control Fe uptake and allocation. Here, we review the role of the basic helix–loop–helix (bHLH) transcription factor FIT (FER-LIKE FE DEFICIENCY-INDUCED TRANSCRIPTION FACTOR) in Fe acquisition. FIT is not only essential, it is also a central regulatory hub in root cells to steer and adjust the rate of Fe uptake by the root in a changing environment. FIT regulates a subset of root Fe deficiency (–Fe) response genes. Based on a combination of co-expression network and FIT-dependent transcriptome analyses, we defined a set of FIT-dependent and FIT-independent gene expression signatures and co-expression clusters that encode specific functions in Fe regulation and Fe homeostasis. These gene signatures serve as markers to integrate novel regulatory factors and signals into the –Fe response cascade. FIT forms a complex with bHLH subgroup Ib transcription factors. Furthermore, it interacts with key regulators from different signaling pathways that either activate or inhibit FIT function to adjust Fe acquisition to growth and environmental constraints. Co-expression clusters and FIT protein interactions suggest a connection of –Fe with ABA responses and root cell elongation processes that can be explored in future studies.
Nothing According to Anselm and Michael Ende’s The Neverending Story
Authors: Gallagher Joel R
Published: January 2020

Anselm uniquely examined the concept of nothing in a number of his works. In his analyses, he appeared to argue that the intelligibility of concrete existence was evidence of God’s existence and that the possible ‘existence’ of nothing, or inexistence, was an absurd, unintelligible, impossible reality, as was a theoretical, unintelligible existence. A similar argument was uniquely presented in Michael Ende’s The Neverending Story. This article examines Anselm’s analysis of nothing in conjunction with Ende’s ‘The Nothing’ and illustrates how Ende’s presentation can assist in understanding Anselm’s explanations of nothing and how Anselm’s ideas can offer insights into elements of Ende’s novel.
On the complexity of index sets for finite predicate logic programs which allow function symbols
Authors: Cenzer D , Marek V W , Remmel J B
Published: January 2020

We study the recognition problem in the metaprogramming of finite normal predicate logic programs. That is, let $\mathcal{L}$ be a computable first-order predicate language with infinitely many constant symbols and infinitely many $n$-ary predicate symbols and $n$-ary functions symbols for all $n \geq 1$. Then we can effectively list all the finite normal predicate logic programs $Q_0,Q_1,\ldots $ over $\mathcal{L}$. Given some property $\mathcal{P}$ of finite normal predicate logic programs over $\mathcal{L}$, we define the index set $I_{\mathcal{P}}$ to be the set of indices $e$ such that $Q_e$ has property $\mathcal{P}$. We classify the complexity of the index set $I_{\mathcal{P}}$ within the arithmetic hierarchy for various natural properties of finite predicate logic programs. For example, we determine the complexity of the index sets relative to all finite predicate logic programs and relative to certain special classes of finite predicate logic programs of properties such as (i) having no stable models, (ii) having no recursive stable models, (iii) having at least one stable model, (iv) having at least one recursive stable model, (v) having exactly $c$ stable models for any given positive integer $c$, (vi) having exactly $c$ recursive stable models for any given positive integer $c$, (vii) having only finitely many stable models, (viii) having only finitely many recursive stable models, (ix) having infinitely many stable models and (x) having infinitely many recursive stable models.
Dementia in an Aging World
Authors: Fritze Thomas , Fink Anne , Doblhammer Gabriele
Published: January 2020

Both developed and developing countries are facing economic and social challenges posed by an aging population. Dementia is one of the most common diseases in old age and has major consequences for society. In 2013, an estimated 44.4 million people worldwide suffered from dementia, and this number is expected to increase to 135.5 million by 2050. The current worldwide costs of dementia have been estimated at $604 billion, primarily due to the high demand for care. There is no known cure for dementia; however, positive developments with respect to lifestyle and recognizing risk factors in young and middle ages might have positive long-term effects on the risk of dementia in old age. Prevention and adequate medical treatment of these risk factors might help postpone dementia into higher ages. In addition, assistive technologies may help to mitigate the family and caregiver burden.
Shaping the Development and Use of Intelligent Assistive Technologies in Dementia
Authors: Hildt Elisabeth
Published: January 2020

This chapter aims to offer some general thoughts on the development and use of intelligent assistive technologies in dementia. Based on an analysis of ethical principles and concepts, guidelines, recommendations, and codes of conduct in the field broadly construed, the text argues for an approach that takes the user perspective, in particular the users’ abilities, wishes, and goals, more clearly into consideration in intelligent assistive technology development and use. Although the reflections may have implications for caregivers, family members, and others involved in the care of persons with dementia, they are not so much intended to guide individual, patient-directed decision making as to address future directions for technology development and use in a more general way.
Epilogue
Authors: Wangmo Tenzin , Ienca Marcello
Published: January 2020

Alzheimer’s disease (AD) and other dementias afflict millions of older adults worldwide. The global prevalence of dementia is placing a high financial and caregiving burden on both individual families and the healthcare systems. The silent global epidemic of dementia calls for urgent measures to alleviate this global burden and for improving the delivery of effective care services for patients in need and their families. Achieving this goal will require a coordinated multilevel effort involving (a) advances in basic science aimed at cracking the pathological conundrum of AD and casting light on its etiology, (b) generating innovative pharmacological solutions aimed at mitigating—and possibly reversing—its symptoms, and (c) developing technological solutions that can assist people with dementia and their families, improve their quality of life, and facilitate and ameliorate the delivery of healthcare services. This book shows, however, that the future of dementia care in the digital era will be dependent not only on technology development but also on fundamental ethical considerations, unavoidable societal discussions, well-calibrated regulatory interventions, and adaptive governance frameworks.
Postoperative care
Authors: Masip Nuria
Published: January 2020

After surgery, and before being transferred to the ward, patients will be recovered in a specially designated area: the recovery area or post-anaesthetic care unit (PACU). In recovery, there are some postoperative problems that we need to be familiar with managing: postoperative nausea and vomiting (PONV), emergence delirium (it is important to recognize it, and be able to differentiate it from agitation) and pain. Those patients who need postoperative critical care will be admitted to a high-dependency unit (HDU) or paediatric intensive care unit (PICU), depending on their required level of care. Each time the patient is transferred to a different area, a thorough handover between the giving and receiving team is paramount. This chapter provides the reader with the means to manage common recovery problems, and an understanding of patient postoperative dependency levels.
Advanced vascular access
Authors: Craig Richard
Published: January 2020

In this chapter, the use of ultrasound to facilitate cannulation of a vessel is described in detail, including commentaries on equipment, preparation, scanning, and needling technique. Equipment and techniques for the insertion of short-term non-tunnelled central lines, long-term central venous access devices, arterial lines, and intraosseous needles are presented.
General surgery and urology
Authors: Raj Naveen
Published: January 2020

This chapter covers the range from common day-case procedures (e.g. circumcision) to major emergency cases (e.g. trachea-oesophageal fistula). Its aim is to explain the various pathologies and their subsequent surgical management. The reader will find a thorough and concise perioperative management plan covering everything from preoperative assessment to pain management. The practicalities of anaesthetizing neonates are discussed. The implications and management of laparoscopic methods in children are also covered.
Ophthalmology surgery
Authors: Hunt Anne
Published: January 2020

This chapter describes anaesthesia for paediatric ophthalmic cases. Management is generally straightforward, but is not without its problems and complications. Most procedures are day cases, but they may involve children who are unable to comply with tests when awake, children having multiple procedures, or syndromes associated with their ophthalmic condition. Ages range from the neonate to teenagers and involve procedures such as examination under anaesthesia (EUA), squint surgery, cataract surgery (and its complications), nasolacrimal surgery, oculoplastic surgery, and glaucoma surgery. The side effects of ocular drops are discussed, as are the risks of surgery in and around the eye, e.g. the oculocardiac reflex. Also covered are emergencies such as ‘the penetrating eye injury’ scenario.
Mysterious Cause of Respiratory Failure and Multilobar Atelectasis in a 17-Month-Old Male
Authors: Davis Gerrit W , Lockett Casey J , Charny Grigory
Published: January 2020

A 17-month-old male presented to a community hospital emergency department in respiratory distress suggestive of reactive airway exacerbation or pneumonia. He rapidly deteriorated into fulminant respiratory failure with multilobar atelectasis. He was managed with continuous albuterol, intravenous antibiotics, corticosteroids, intubation, and vasopressors. He was then transported to a tertiary Children’s Hospital. The patient was extubated 20 hours after presentation and again developed respiratory failure while in the pediatric intensive care unit. During preparation for extracorporeal membrane oxygenation, he quickly stabilized following reintubation and bronchodilator therapy. He was extubated approximately 24 hours later, and subsequently discharged after a 9-day hospitalization. Outpatient investigation after discharge revealed dysphagia, milk allergy, and eosinophilic esophagitis. In this case, it is highly probable that aspiration secondary to dysphagia and eosinophilic esophagitis led to respiratory failure. This case demonstrates the possible rapid decompensation from aspiration due to insidious inflammation of the esophagus and dysphagia in an otherwise anatomically normal toddler.
Non-linear matter power spectrum without screening dynamics modelling in f(R) gravity
Authors: Ruan Cheng-Zong , Zhang Tong-Jie , Hu Bin
Published: January 2020

Halo model is a physically intuitive method for modelling the non-linear power spectrum, especially for the alternatives to the standard ΛCDM models. In this paper, we examine the Sheth–Tormen barrier formula adopted in the previous CHAM method. As an example, we model the ellipsoidal collapse of top-hat dark matter haloes in f(R) gravity. A good agreement between Sheth–Tormen formula and our result is achieved. The relative difference in the ellipsoidal collapse barrier is less than or equal to $1.6{{\ \rm per\ cent}}$. Furthermore, we verify that, for F4 and F5 cases of Hu–Sawicki f(R) gravity, the screening mechanism does not play a crucial role in the non-linear power spectrum modelling up to k ∼ 1 h Mpc−1. We compare two versions of modified gravity modelling, namely with/without screening. We find that by treating the effective Newton constant as constant number, Geff = 4/3GN is acceptable. The scale dependence of the gravitational coupling is subrelevant. The resulting spectra in F4 and F5, are in $0.1{{\ \rm per\ cent}}$ agreement with the previous CHAM results. The published code is accelerated significantly. Finally, we compare our halo model prediction with N-body simulation. We find that the general spectrum profile agrees, qualitatively. However, via the halo model approach, there exists a systematic underestimation of the matter power spectrum in the comoving wavenumber range between 0.3 and 3 h Mpc−1. These scales are overlapping with the transition scales from two-halo term dominated regimes to those of one-halo term dominated regimes.
Stellar atmospheric parameters of FGK-type stars from high-resolution optical and near-infrared CARMENES spectra
Authors: Marfil E , Tabernero H M , Montes D , Caballero J A , Soto M G , González Hernández J I , Kaminski A , Nagel E , Jeffers S V , Reiners A , Ribas I , Quirrenbach A , Amado P J
Published: January 2020

With the purpose of assessing classic spectroscopic methods on high-resolution and high signal-to-noise ratio spectra in the near-infrared wavelength region, we selected a sample of 65 F-, G-, and K-type stars observed with CARMENES, the new, ultra-stable, double-channel spectrograph at the 3.5 m Calar Alto telescope. We computed their stellar atmospheric parameters (Teff, log g, ξ, and [Fe/H]) by means of the stepar code, a python implementation of the equivalent width method that employs the 2017 version of the moog code and a grid of MARCS model atmospheres. We compiled four Fe i and Fe ii line lists suited to metal-rich dwarfs, metal-poor dwarfs, metal-rich giants, and metal-poor giants that cover the wavelength range from 5300 to 17 100 Å, thus substantially increasing the number of identified Fe i and Fe ii lines up to 653 and 23, respectively. We examined the impact of the near-infrared Fe i and Fe ii lines upon our parameter determinations after an exhaustive literature search, placing special emphasis on the 14 Gaia benchmark stars contained in our sample. Even though our parameter determinations remain in good agreement with the literature values, the increase in the number of Fe i and Fe ii lines when the near-infrared region is taken into account reveals a deeper Teff scale that might stem from a higher sensitivity of the near-infrared lines to Teff.