bluuebunny/crossref_metadata_2025 huggingface dataset:
1. Introduction
Authors: Child John , Ormerod David
Published: August 2019

This book focuses on substantive criminal law, that is, how offences such as theft and murder are defined. This introductory chapter sets in context criminal offences and defences, first by considering the basis upon which certain conduct is criminalised and other conduct is not. It then outlines the reasons why people commit crimes, which types of people commit them, and whether certain groups are over-represented in criminal statistics. It also discusses the role of evidence in assessing how well criminal offences can be proved in practice; the punishments for committing crimes; the difference between criminal and civil law; the process and procedure to obtain a criminal conviction; sources of the substantive criminal law; the internal structure of offences and defences; principles of the substantive criminal law and the subjects to which it applies; legal reform; and the application of the current law.
3. Mens rea
Authors: Child John , Ormerod David
Published: August 2019

This chapter provides an overview of mens rea, loosely translated as ‘guilty mind’. Whereas the actus reus of an offence focuses on the accused’s conduct, the results of that conduct, and the circumstances in which it takes place (external elements), mens rea focuses on what is going on in the accused’s mind (internal elements). The chapter first considers the elements of criminal liability under mens rea versus actus reus before discussing the legal meaning of central mens rea terms such as ‘intention’, ‘negligence’, ‘dishonesty’, and ‘recklessness’ and how these terms work in the context of a whole offence. It also describes certain offences that require actus reus elements with no corresponding mens rea and vice versa. Finally, it outlines a structure for analysing the mens rea of an offence when applying the law in a problem-type question. Relevant cases are highlighted throughout the chapter.
7. Non-fatal offences against the person
Authors: Child John , Ormerod David
Published: August 2019

This chapter deals with non-fatal offences against the person, a variety of offences designed to criminalise behaviour ranging from the infliction of serious (non-fatal) injuries to potential targeting of any non-consensual contact. The chapter begins by explaining the offences of assault and battery, the actus reus and mens rea of each, and defences. It then considers relevant provisions of the Offences Against the Person Act 1861 with respect to assault occasioning actual bodily harm, wounding or inflicting grievous bodily harm, and wounding or causing grievous bodily harm with intent. The chapter then considers ‘conduct focused’ offences against the person, such as harassment and poisoning. Finally the chapter outlines potential legal reforms concerning modernisation and re-codification, constructive liability, and consent; and the potential application of the offences against the person within a problem question. Relevant cases are highlighted throughout the chapter, with a brief summary of the main facts and judgment.
8. Sexual offences
Authors: Child John , Ormerod David
Published: August 2019

This chapter deals with sexual offences which criminalise the accused’s invasion of the victim’s sexual—as opposed to simply physical—autonomy. Sexual offences are almost entirely codified within a single statute, the Sexual Offences Act 2003 (SOA 2003). The chapter first considers the relevant provisions of the SOA 2003 with respect to rape, assault by penetration, sexual assault, and causing a person to engage in sexual activity without consent. It then turns to sexual offences against children under 13 and children under 16, as well as status-based and relationship-based sexual offences. The final sections of the chapter outline potential options for legal reform and the application of the offences within the SOA 2003 to problem facts. Relevant cases are highlighted throughout the chapter, with brief summaries of the main facts and judgments.
13. Denials of an offence
Authors: Child John , Ormerod David
Published: August 2019

This chapter deals with the rules on denials of an offence, a denial of one or more actus reus or mens rea elements. In particular, it considers three sets of rules relating to the denial of an offence: intoxication, sane automatism, and insanity. As well as discussing how each of these rules can be used by D to avoid liability, the chapter also focuses on how circumstances of ‘prior fault’ can be used by the prosecution to substitute for missing mens rea elements so as to construct liability. It also outlines potential options for legal reform concerning intoxication, sane automatism, and insanity, and concludes by considering how denials of offending based on intoxication, automatism, and insanity should be applied to problem facts. Relevant cases are highlighted throughout the chapter, with brief summaries of the main facts and judgments.
12. The term of copyright
Authors: Torremans Paul
Published: August 2019

This chapter discusses the duration of copyright protection in the UK. The basic rule is that the term of copyright has been harmonized at life of the author plus 70 years in the EU. The basic rule applies to the original category of works (literary, dramatic, musical, and artistic works) and to films. Entrepreneurial works, such as sound recordings and broadcasts, receive 50 years of copyright protection. Performances fixated in a phonogram will in future be protected for 70 years. The term of protection for typographical arrangements is 25 years.
18. Dealing in copyright
Authors: Torremans Paul
Published: August 2019

This chapter discusses the commercial exploitation of copyright, both in a domestic and in a European context. It covers the Crown copyright in the UK; commercial exploitation of copyright in the UK; and exploitation under European law, i.e. friction with the free movement of goods and competition law.
2. Agreement
Authors: Taylor Richard , Taylor Damian
Published: August 2019

Without assuming prior legal knowledge, books in the Directions series introduce and guide readers through key points of law and legal debate. Questions, diagrams and exercises help readers to engage fully with each subject and check their understanding as they progress. A contract requires that the parties reach an Agreement which normally consists of a matching offer and acceptance. This chapter discusses the following: the objective test of agreement; identifying an offer and acceptance; rejection, counter-offers and inquiries; communication of acceptance including the postal rule and the contrasting rule for revocation; mode of acceptance; the death of an offer; and unilateral contracts.
5. Positive terms
Authors: Taylor Richard , Taylor Damian
Published: August 2019

Without assuming prior legal knowledge, books in the Directions series introduce and guide readers through key points of law and legal debate. Questions, diagrams and exercises help readers to engage fully with each subject and check their understanding as they progress. The terms of the contract give substance to the contractual parties’ obligations. They lay down what each party is expected to do in performance of his obligations, and so it is crucial in any dispute to first establish the terms of the contract before looking to see whether one party has failed to perform his obligations. This chapter focuses on the positive terms of the contract. The discussions cover terms and representations; collateral warranties; implied terms; and conditions, warranties and innominate terms and the significance of the remedies, including termination, attached to each.
9. Duress, undue influence and unconscionable bargains
Authors: Taylor Richard , Taylor Damian
Published: August 2019

Without assuming prior legal knowledge, books in the Directions series introduce and guide readers through key points of law and legal debate. Questions, diagrams and exercises help readers to engage fully with each subject and check their understanding as they progress. This chapter focuses on the principles applicable where a contract is entered into after there have been threats or improper influence brought to bear on one party or where the one-sided nature of the contract suggests that one party has been taken advantage of. The discussions cover duress (duress and pressure, threats against the person, threats against goods and economic duress); undue influence (actual undue influence, presumed undue influence and third-party cases); and unfairness and unconscionable bargains.
12. Specific remedies
Authors: Taylor Richard , Taylor Damian
Published: August 2019

Without assuming prior legal knowledge, books in the Directions series introduce and guide readers through key points of law and legal debate. Questions, diagrams and exercises help readers to engage fully with each subject and check their understanding as they progress. This chapter considers remedies that directly address the issue of providing the innocent party with the performance that was expected. Their use depends on a number of factors, which means that they are not universally available and that the claimant will therefore often be left to his remedy in damages. The discussions cover actions for the price or other agreed sum, the rule in White and Carter v McGregor, affirmation and anticipatory breach. The chapter goes on to discuss specific performance and injunctions and the tests of damages being inadequate, mutuality plus other factors such as personal service contracts and the relevance of the need for supervision.
1. Aims, themes, and structure
Authors: Partington Martin
Published: August 2019

This chapter sets out the basic aims, themes, and structure of this book. The book provides an introductory account of the English legal system, how it has developed in recent years, and how it may develop in future. Part II raises fundamental issues about the social functions of law and the legitimacy of law; and considers the institutional framework within which law is made. Part III looks at the different context in which law is developed and practised. Part IV looks at the delivery and funding of legal services. Part V returns to the theme of transformation and the challenges to be faced.
7. The family justice system
Authors: Partington Martin
Published: August 2019

This chapter discusses the family justice system. It considers the role law plays in regulating the family. The chapter covers the institutional framework of family justice and its transformation. It notes the creation of the Family Court and the pressures on that court. It reviews the remedies which are available in that court, in particular those relating to the protection of children. The chapter briefly considers adoption. It considers other matrimonial matters, in particular the financial effects of divorce. It considers policy relating to child support, and notes changes to ways of dealing with domestic violence. It considers the legal practitioners involved in family law issues and how they seek to deal with family disputes on a less adversarial basis. The effect of changes to legal aid for funding for family law cases is discussed.
5. The Supremacy of EU Law
Authors: Foster Nigel
Published: August 2019

This chapter examines the supremacy of EU law from both the point of view of the Union, as understood by the Court of Justice of the European Union, and the point of view of member states. A consensus seems to be emerging from the national and constitutional courts that EU law supremacy is accepted only insofar as it does not infringe the individual rights protection of the national constitutions, in which case the constitutional courts will exercise their reserved rights over national constitutions to uphold them over inconsistent EU law or to review EU law in light of their own constitutions. The changing position of the UK and the EU is also considered including the Brexit referendum result and possible consequences of that.
7. The Direct Jurisdiction of the Court of Justice
Authors: Foster Nigel
Published: August 2019

This chapter considers the actions commenced before the Court of Justice. These include actions by the European Commission and other member states against a member state (Articles 258–60 TFEU); judicial review of acts of the institutions (Article 263 TFEU); the action against the institutions for a failure to act (Article 265 TFEU); actions for damages (Articles 268 and 340 TFEU); and the right to plead the illegality of an EU regulation (Article 277 TFEU). The chapter also considers interim measures under Articles 278 and 279 TFEU and enforcement actions arising from the Commission enforcement of EU competition law against individuals.
Geographical Variation and Factors Associated With Inflammatory Bowel Disease in a Central Canadian Province
Authors: Torabi Mahmoud , Bernstein Charles N , Yu B Nancy , Wickramasinghe Lahiru , Blanchard James F , Singh Harminder
Published: August 2019

Background

We investigated temporal trends, geographical variation, and geographical risk factors for incidence of inflammatory bowel disease (IBD).

Methods

We used the University of Manitoba IBD Epidemiology Database to identify incident IBD cases diagnosed between 1990 and 2012, which were then geocoded to 296 small geographic areas (SGAs). Sociodemographic characteristics of the SGAs (proportions of immigrants, visible minorities, Indigenous people, and average household income) were obtained from the 2006 Canadian Census. The geographical variation of IBD incidence was modeled using a Bayesian spatial Poisson model. Time trends of IBD incidence were plotted using Joinpoint regression.

Results

The incidence of IBD decreased over the study years from 23.6 (per 100,000 population) in 1990 to 16.3 (per 100,000 population) in 2012. For both Crohn’s disease (CD) and ulcerative colitis (UC), the highest incidence was in Winnipeg and the southern and central regions of Manitoba, whereas most of northern Manitoba had lower incidence. There was no effect of sociodemographic characteristics of SGAs, other than the proportion of Indigenous people, which was associated with lower IBD incidence.

Conclusions

Although the incidence of IBD in Manitoba is decreasing over time, we have identified geographic areas with persistently higher IBD incidence that warrant further study for etiologic clues.
Cohomologically Full Rings
Authors: Dao Hailong , De Stefani Alessandro , Ma Linquan
Published: August 2019

Inspired by a question raised by Eisenbud–Mustaţă–Stillman regarding the injectivity of maps from ${\operatorname{Ext}}$ modules to local cohomology modules and the work by the third author with Pham, we introduce a class of rings, which we call cohomologically full rings. This class of rings includes many well-known singularities: Cohen–Macaulay rings, Stanley–Reisner rings, F-pure rings in positive characteristics, and Du Bois singularities in characteristics $0$. We prove many basic properties of cohomologically full rings, including their behavior under flat base change. We show that ideals defining these rings satisfy many desirable properties, in particular they have small cohomological and projective dimension. When $R$ is a standard graded algebra over a field of characteristic $0$, we show under certain conditions that being cohomologically full is equivalent to the intermediate local cohomology modules being generated in degree $0$. Furthermore, we obtain Kodaira-type vanishing and strong bounds on the regularity of cohomologically full graded algebras.
The impact of dietary supplementation of arginine during gestation in a commercial swine herd: II. Offspring performance
Authors: Hines Elizabeth A , Romoser Matthew R , Kiefer Zoë E , Keating Aileen F , Baumgard Lance H , Niemi Jarad , Haberl Benjamin , Williams Noel H , Kerr Brian J , Touchette Kevin J , Ross Jason W
Published: August 2019

Arginine (Arg) is an important amino acid of pig fetal development; however, whether Arg improves postnatal performance is ill-defined. Therefore, the influence of Arg supplementation at different gestational stages on offspring performance was evaluated in a commercial swine herd. Sows (n = 548) were allocated into 4, diet by stage of gestation treatments: Control (n = 143; 0% suppl. Arg), or dietary treatments supplemented with 1% L-Arg (free-base; Ajinomoto Animal Nutrition North America, Inc., Chicago, IL): from 15 to 45 d of gestation (n = 138; Early-Arg); 15 d of gestation to farrowing (n = 139; Full-Arg); and from day 85 of gestation to farrowing (n = 128; Late-Arg). All offspring were individually identified and weighed at birth; at weaning, a subset was selected for evaluation of carcass performance at market. All data were analyzed using birth weight (BiWt) and age as covariates. Wean weights (WW) and prewean (PW) ADG tended to increase (P = 0.06) in progeny from sows supplemented with Arg, as compared to progeny from Control sows. Preplanned contrast comparisons revealed an increased (P = 0.03) BiWt for pigs from sows receiving 1% L-Arg prior to day 45 of gestation (Early-Arg and Full-Arg; 1.38 kg/pig), as compared to pigs from sows not supplemented prior to day 45 of gestation (Control and Late-Arg; 1.34 kg/pig). No difference in BiWt was observed (1.36 kg/pig; P = 0.68) for Arg supplementation after day 85 of gestation (Full-Arg and Late-Arg), as compared to those not receiving Arg supplementation after day 85 (Control and Early-Arg); although WW and PW ADG were greater (P = 0.02), respectively. A 3.6% decrease (P = 0.05) in peak lean accretion ADG occurred when dams received 1% L-Arg prior to day 45 of gestation (Early-Arg and Full-Arg), however, no other significant differences were detected in finishing growth parameters or carcass characteristics (P ≥ 0.1). Pig mortality rates tended (P = 0.07) to decrease in progeny of dams supplemented Arg after day 85 (3.6%) compared to dams not provided additional Arg during late gestation (4.9%). Collectively, these data suggest that Arg provided during late gestation may improve WW and PW ADG, however, finishing performance was not affected. While Arg supplementation provided some moderate production benefits, further investigation is warranted to comprehensively understand the gestational timing and biological role of Arg supplementation during fetal and postnatal development in commercial production systems.
A unique case of congenital transmesocolic hernia with malrotation in a 25-year-old female: a case report
Authors: Danial Aghyad Kudra , Alsaman Muhamad Zakaria Brimo , Zazo Rama , Mazketly Muhammad , Kitaz Mohammad Nour , Alobied Majd , Mahli Nihad
Published: August 2019

Congenital transmesocolic hernia of the transverse colon is a very rare type of internal hernia. In addition, intestinal malrotation is very rare in adults. Most of these patients do not have clear clinical manifestations. Incidence of congenital transmesocolic hernia of the transverse colon along with malrotation is an unusual phenomenon in medical literature and clinical practice. Here, we report a unique case of a 25-year-old woman diagnosed with transmesocolic hernia of the transverse colon and malrotation of the small intestine, without any history of trauma or previous surgery. The patient underwent surgery, where the hernia orifice was closed and Ladd’s procedure was performed.
From Bondage to Precariousness? New Perspectives on Labor and Social History
Authors: De Vito Christian G , Schiel Juliane , van Rossum Matthias
Published: August 2019

This article pursues two goals. First, it reviews recent literature calling for a revised and extended history of work. Based on that review, it then explores the possibility of a new, empirically based analytical and methodological framework for the study of labor relations and the reinterpretation of contemporary issues, including precariousness, “modern slavery,” social inequality, and dependence. We contend that viewing labor relations as standardly diverse, coexisting, entangled, and overlapping across history provides an alternative organizing principle for the research field and is central to the understanding of larger social processes. To this end, we propose a contextualized, interrelational and transepochal approach to labor relations and labor experiences and discuss the potential of three research strategies: the analysis of the historical semantics of labor relations, the detailed study of coercion, and the historical investigation of the relation between precariousness and flexibility.
The pyrenoidal linker protein EPYC1 phase separates with hybrid Arabidopsis–Chlamydomonas Rubisco through interactions with the algal Rubisco small subunit
Authors: Atkinson Nicky , Velanis Christos N , Wunder Tobias , Clarke David J , Mueller-Cajar Oliver , McCormick Alistair J
Published: August 2019

Pyrenoid linker EPYC1 interacts with specific structures of the Rubisco small subunit. Modified plant Rubisco interacts with EPYC1 to form pyrenoid-like aggregates, a key feature of the algal CO2-concentrating mechanism.
Real-bogus classification for the Zwicky Transient Facility using deep learning
Authors: Duev Dmitry A , Mahabal Ashish , Masci Frank J , Graham Matthew J , Rusholme Ben , Walters Richard , Karmarkar Ishani , Frederick Sara , Kasliwal Mansi M , Rebbapragada Umaa , Ward Charlotte
Published: August 2019

Efficient automated detection of flux-transient, re-occurring flux-variable, and moving objects is increasingly important for large-scale astronomical surveys. We present braai, a convolutional-neural-network, deep-learning real/bogus classifier designed to separate genuine astrophysical events and objects from false positive, or bogus, detections in the data of the Zwicky Transient Facility (ZTF), a new robotic time-domain survey currently in operation at the Palomar Observatory in California, USA. Braai demonstrates a state-of-the-art performance as quantified by its low false negative and false positive rates. We describe the open-source software tools used internally at Caltech to archive and access ZTF’s alerts and light curves (kowalski ), and to label the data (zwickyverse). We also report the initial results of the classifier deployment on the Edge Tensor Processing Units that show comparable performance in terms of accuracy, but in a much more (cost-) efficient manner, which has significant implications for current and future surveys.
The potential of cerebrospinal fluid–based liquid biopsy approaches in CNS tumors
Authors: Mattox Austin K , Yan Hai , Bettegowda Chetan
Published: August 2019

Cerebrospinal fluid (CSF) may be the best hope for minimally invasive diagnosis and treatment monitoring of central nervous system (CNS) malignancies. Discovery/validation of cell-free nucleic acid and protein biomarkers has the potential to revolutionize CNS cancer care, paving the way for presurgical evaluation, earlier detection of recurrence, and the selection of targeted therapies. While detection of mutations, changes in RNA and miRNA expression, epigenetic alterations, and elevations of protein levels have been detected in the CSF of patients with CNS tumors, most of these biomarkers remain unvalidated. In this review, we focus on the molecular changes that have been identified in a variety of CNS tumors and profile the approaches used to detect these alterations in clinical samples. We further emphasize the importance of systemic collection of CSF and the establishment of standardized collection protocols that will lead to better cross-study biomarker validation and hopefully FDA-approved clinical markers.
Delayed Cerebral Infarction is Systematically Associated with a Cerebral Vasospasm of Large Intracranial Arteries
Authors: Brami Jonathan , Chousterman Benjamin , Boulouis Grégoire , Dorze Matthieu Le , Majlath Melinda , Saint-Maurice Jean-Pierre , Civelli Vittorio , Froelich Sébastien , Houdart Emmanuel , Labeyrie Marc-Antoine
Published: August 2019

BACKGROUND

Whether delayed cerebral infarction (DCIn) after aneurysmal subarachnoid hemorrhage (aSAH) is driven by large artery vasospasm is still controversial.

OBJECTIVE

To study the association between DCIn and vasospasm by using quantitative assessment of vasospasm up to distal arteries with time and territorial-based correlation.

METHODS

Clinical and imaging data of 392 patients with aSAH treated at our center between 2012 and 2017 were reviewed. DCIn was defined as any cerebral infarction occurring within 3 to 21 d after ictus and not related to other specific cause. In patients with DCIn, vasospasm was assessed within 24 h around DCIn for each cerebral artery up to the end of the 2nd segments. DCIn and vasospasm analyses were blinded.

RESULTS

DCIn was found in 11% of patients (inter-rater k = 0.90, computed tomography (CT)-scan = 100%, follow-up MRI = 91%). Vasospasm was quantified in 258 artery territories including 66 with and 192 without DCIn (DSA = 93%, computed tomography angiography = 7%). Vasospasm was more severe in DCIn than in non-DCIn territories (60% [55-69] vs 20% [0-50], P < .001). Vasospasm was associated with DCIn in a “dose-dependent” manner (P for trend = .022). Every DCIn territory had a vasospasm ≥ 50%, including 39% only of distal artery segments. Only 9% of non-DCIn territories had vasospasm ≥ vasospasm in DCIn territories.

CONCLUSION

The necessary association between severe vasospasm and DCIn in our study brings additional arguments in favor of large artery vasospasm (especially of distal segments) as a major determinant of DCIn and a potential therapeutic target.
Rigid Cranial Fixation for Robot-Assisted Stereoelectroencephalography in Toddlers: Technical Considerations
Authors: Alexander Hepzibha , Fayed Islam , Oluigbo Chima O
Published: August 2019

BACKGROUND

Stereoelectroencephalography (sEEG) using depth electrodes has become a mainstay of pediatric epilepsy surgery. This technique relies on rigid cranial fixation using skull pins, which forms the basis for accurate stereotactic navigation. The use of cranial fixation pins poses the threat of traumatic skull injuries in young children because of inadequate cranial bone thickness.

OBJECTIVE

To describe a rigid cranial fixation technique involving the integrated Gel Head Ring from the DORO QR3 multipurpose skull clamp set (Pro Med Instruments) with superimposed pin fixation in children below the age of 36 mo undergoing sEEG.

METHODS

Patients were placed in the supine position and the head was fixed using a DORO skull clamp with 3 pediatric cranial pins. The head was supported on the integrated Gel Head Ring, and a pin pressure of 20 pounds was applied. The DORO skull clamp set was then attached to the ROSA neurosurgical robot support telescopic arm for stereotactic navigation.

RESULTS

We present an illustrative series of 2 patients below the age of 3 yr with medically refractory epilepsy who underwent sEEG using our modified cranial fixation technique. Head position and reference registration were stable throughout the surgeries. Postoperative volumetric computed tomography scans of the head showed accurate placement of sEEG depth electrodes and did not reveal any fractures or epidural hematoma. No other complications related to cranial fixation were noted.

CONCLUSION

Concurrent use of rigid and nonrigid cranial fixation using the DORO skull clamp set provides safe and effective cranial fixation in infants and toddlers undergoing sEEG.
Occlusion of Extracranial-Intracranial Bypass Anastomosis-Associated Aneurysms Following Contralateral High-Flow Extracranial-Intracranial Bypass in a Patient with Impaired Cerebrovascular Reserve
Authors: Stapleton Christopher J , Theiss Peter , Arnone Gregory D , Shakur Sophia F , Charbel Fady T
Published: August 2019

BACKGROUND AND IMPORTANCE

Extracranial-intracranial (EC-IC) bypass anastomosis-associated aneurysms are rare sequelae of cerebral revascularization surgery. Although treatment paradigms are not well defined, clipping, trapping with revision bypass, and donor vessel ligation represent the most common microsurgical approaches.

CLINICAL PRESENTATION

A 53-yr-old male presented with cognitive decline, left extremity weakness, and left visual field blurriness. Computed tomographic angiography of head/neck demonstrated bilateral cervical internal carotid artery occlusion and magnetic resonance imaging of brain showed a small right parieto-occipital lobe infarct. The patient's symptoms worsened despite aggressive medical management. Therefore, a right superficial temporal artery to middle cerebral artery (STA-MCA) bypass was performed for flow augmentation. Follow-up digital subtraction angiography (DSA) approximately 1 yr after surgery noted 2 new aneurysms adjacent to the patent STA-MCA anastomosis. Perfusion imaging at that time showed persistently reduced blood flow in the left cerebral hemisphere. A left STA-MCA bypass was performed, and intraoperative blood flow measurements showed this to be a high-flow bypass. Follow-up DSA 4 mo later demonstrated involution of the right STA-MCA bypass and occlusion of the anastomosis-associated aneurysms with increased perfusion of the right cerebral hemisphere via collateral blood flow from the patent high-flow left STA-MCA bypass. At 7 mo following left STA-MCA bypass, the patient's neurological examination remained stable and perfusion imaging showed improved blood flow in the left cerebral hemisphere.

CONCLUSION

We present a unique case in which a high-flow left EC-IC bypass with robust contralateral collateral blood flow was associated with subsequent occlusion of a right EC-IC bypass and 2 anastomosis-associated aneurysms in a patient with bilateral impaired cerebrovascular reserve.
19 Dubious Ways to Compute the Marginal Likelihood of a Phylogenetic Tree Topology
Authors: Fourment Mathieu , Magee Andrew F , Whidden Chris , Bilge Arman , Matsen Frederick A , Minin Vladimir N
Published: August 2019

The marginal likelihood of a model is a key quantity for assessing the evidence provided by the data in support of a model. The marginal likelihood is the normalizing constant for the posterior density, obtained by integrating the product of the likelihood and the prior with respect to model parameters. Thus, the computational burden of computing the marginal likelihood scales with the dimension of the parameter space. In phylogenetics, where we work with tree topologies that are high-dimensional models, standard approaches to computing marginal likelihoods are very slow. Here, we study methods to quickly compute the marginal likelihood of a single fixed tree topology. We benchmark the speed and accuracy of 19 different methods to compute the marginal likelihood of phylogenetic topologies on a suite of real data sets under the JC69 model. These methods include several new ones that we develop explicitly to solve this problem, as well as existing algorithms that we apply to phylogenetic models for the first time. Altogether, our results show that the accuracy of these methods varies widely, and that accuracy does not necessarily correlate with computational burden. Our newly developed methods are orders of magnitude faster than standard approaches, and in some cases, their accuracy rivals the best established estimators.
Social norms associated with nonmedical opioid use in rural communities: a systematic review
Authors: Bolinski Rebecca , Ellis Kaitlin , Zahnd Whitney E , Walters Suzan , McLuckie Colleen , Schneider John , Rodriguez Christofer , Ezell Jerel , Friedman Samuel R , Pho Mai , Jenkins Wiley D
Published: August 2019

Successful intervention in rural opioid misuse requires a better understanding of how local social norms and networks, and employment and medical care access, combine to facilitate or hinder individual use.
Evaluating the Sensitivities and Efficacies of Fungicides with Different Modes of Action Against Phomopsis asparagi
Authors: Shi Niuniu , Ruan Hongchun , Gan Lin , Dai Yuli , Yang Xiujuan , Du Yixin , Chen Furu
Published: August 2019

Asparagus stem blight caused by Phomopsis asparagi is a major hindrance to asparagus production worldwide. Currently, fungicides are used to manage the disease in commercial production, but resistance to common fungicides has emerged in the wild population. In the present study, 132 isolates of P. asparagi collected from different provinces in China were tested for sensitivities to pyraclostrobin, tebuconazole, and fluazinam. We also determined the efficacies of six fungicides against P. asparagi. The frequency distributions of EC50 values of the isolates tested were unimodal, but the curves for pyraclostrobin and tebuconazole had long right-hand tails. The mean EC50 values for pyraclostrobin, tebuconazole, and fluazinam were 0.0426 ± 0.0029, 0.6041 ± 0.0416, and 0.0314 ± 0.0013 μg/ml, respectively. In addition, the EC50 values for pyraclostrobin were very similar with or without salicylhydroxamic acid (SHAM), 20 μg/ml, indicating that SHAM is not needed to determine the sensitivity of P. asparagi to pyraclostrobin when using the mycelial growth inhibition assay. In greenhouse assays, Merivon (42.4% fluxapyroxad plus pyraclostrobin SC), Frown-cide (500 g/liter fluazinam SC), Cabrio (250 g/liter pyraclostrobin EC), and Nativo (75% trifloxystrobin plus tebuconazole WG) showed excellent preventive efficacy against P. asparagi. And these fungicides were more effective before inoculation than when they were applied after inoculation (P < 0.05). Therefore, these fungicides should be applied prior to infection to control stem blight. In field trials, Frown-cide, Merivon, Nativo, and Cabrio also performed good control effects, ranging from 75.2 to 86.0% in 2017 and 75.4 to 87.1% in 2018. We demonstrated that Frown-cide, Merivon, Nativo, and Cabrio had considerable potential to manage asparagus stem blight. In addition, rotations of these fungicides are essential for precluding or delaying the development of resistance and for controlling the disease.
Contemplating Our Maternity Care Crisis in the United States: Reflections of an Obstetrician Anesthesiologist
Authors: Pryde P.G.
Published: August 2019

(Anesth Analg. 2019;128(5):1036–1041)

In this Open Mind article, Dr Pryde discusses his unusual career trajectory, his perspective on the state of obstetric medicine in the United States during the past 30 years, and the ongoing attendant crisis in maternal medicine.
Proceedings From the Society for Advancement of Blood Management Annual Meeting 2017: Management Dilemmas of the Surgical Patient—When Blood Is Not an Option
Authors: Tan G.M. , Guinn G.R. , Frank S.M. , Shander A.
Published: August 2019

(Anesth Analg. 2019;128:144–151)

It is well established that blood loss >500 mL and/or hemoglobin (Hb) <5 g/dL are both associated with increased morbidity and mortality. Fortunately, perioperative bleeding is a known preventable complication, and procedures that are at increased risk of severe blood loss are well recognized (eg, obstetric, cardiothoracic, spine, and cancer surgeries). However, there are cases in which patient blood management (PBM) is complicated by religious or medicolegal issues. Therefore, in this special article, authors discuss PBM approaches in cases where blood transfusion is not an option (religious, inability to find blood matches, or lack of resources due to location).
Video Laryngoscopy: Positives, Negatives, and Defining the Difficult Intubation
Authors: Meitzen S.E. , Benumof J.L.
Published: August 2019

(Anesth Analg. 2019;128(3):399–401. Doi:10.1213/ANE.0000000000004023)

A recent article by Bradley and colleagues argues video laryngoscopy has many advantages compared with conventional laryngoscopy and should be the new standard of care. It also asks whether an intubation should be considered “difficult” if video laryngoscopy is successful but conventional laryngoscopy fails, and highlights the importance of informing future providers of a difficult intubation. However, four critical factors are not addressed in this article: disparities in video laryngoscopy design, limitations in the availability of video laryngoscopy, limited experience with video laryngoscopy, and the impact of the results of preoperative airway evaluation on the success of video laryngoscopy.
Maternal Mortality Ratios in 2852 Chinese Counties, 1996-2015, and Achievement of Millennium Development Goal 5 in China: A Subnational Analysis of the Global Burden of Disease Study in 2016
Authors: Liang J. , Li X. , Kang C. , Wang Y. , Kulikoff X.R. , Coates M.M. , Ng M. , Luo S. , Mu Y. , Wang X. , Zhou R. , Liu X. , Zhang Y. , Zhou Y. , Zhou M. , Li Q. , Liu Z. , Dai L. , Li M. , Zhang Y. , Deng K. , Zeng X. , Deng C. , Yi L. , Zhu J. , Murray C.J.L. , Wang H.
Published: August 2019

(Lancet. 2019;393:241–252)

Mortality for both mother and child have been falling at impressive rates in China over the past 2 decades. Nationwide, maternal mortality dropped from 111.0 per 100,000 livebirths in 1990 to 21.8 per 100,000 livebirths in 2015. However, child mortality has varied substantially among counties and maternal mortality might also vary widely among counties. Identifying counties experiencing less progress could help guide the Chinese government in allocating extra resources as needed to meet the Millennium Development Goal 5 (MDG 5) of decreasing the maternal mortality rate by 75% between 1990 and 2015. This study aimed to estimate the maternal mortality ratio in 2852 counties in China between 1996 and 2015 and determine the effects of key factors such as economic development and maternal education on maternal mortality.
Perinatal Outcome in Births After a Previous Cesarean Section at High Trial of Labor Rates
Authors: Lehmann S. , Baghestan E. , Børdahl P.E. , Irgens L.M. , Rasmussen S.
Published: August 2019

(Acta Obstet Gynecol Scand. 2019;98:117–126)

National guidelines in Norway state that all cesarean deliveries should be medically indicated, with the final decision regarding delivery mode being made by the obstetrician after discussion with the patient. Trial of labor after cesarean (TOLAC) has been associated with a higher risk of adverse perinatal outcomes when compared to a planned repeat cesarean delivery (CD). Previous studies regarding TOLAC outcomes have used populations with relatively low TOLAC rates or have taken place at centers with a policy that allows repeat CD by maternal request. Norway, however, had a 70% TOLAC rate between 1989 and 2009, and a rate of successful vaginal delivery after cesarean (VBAC) of 53%. Because obstetric practice in Norway is significantly different from those institutions where previous data regarding perinatal outcomes after TOLAC were obtained, this study was undertaken to compare perinatal outcomes in TOLAC and non-TOLAC births after previous CD in Norway between 1989 and 2009.
The Frequency of Intrapartum Cesarean Section Use With the WHO Partograph Versus Zhang’s Guidelines in the Labor Progression Study (LAPS): A Multicenter, Cluster-randomized Controlled Trial
Authors: Bernitz S. , Dalbye R. , Zhang J. , Eggebø T.M. , Frøslie K.F. , Olsen I.C. , Blix E. , Øian P.
Published: August 2019

(Lancet. 2019;393:340–348)

As the rate of cesarean section has been increasing worldwide, there have been efforts to encourage clinicians to avoid medically unnecessary cesarean deliveries. Labor dystocia is the most common indication for intrapartum cesarean section (ICS). Adequate labor progression has been assessed for decades using tools based on Friedman’s work from >60 years ago, including the 1994 World Health Organization (WHO) partograph. However, there have been significant changes in labor management since Freidman reported his work and the patient population has also changed, with higher mean body mass index (BMI) and maternal age. Therefore, in 2010 Zhang and colleagues studied labor progression using a contemporary cohort of parturients. They found labor progressed more slowly than Freidman’s findings, especially in early labor before 6 cm dilation. They provided a guideline that allows for a longer period of time before diagnosing labor dystocia and proceeding with cesarean section in early labor. This study aimed to compare the rate of ICS when the WHO partograph versus Zhang’s contemporary guideline was used to assess labor progression and diagnose labor dystocia.
Pregnant Women and the Ebola Crisis
Authors: Haddad L.B. , Jamieson D.J. , Rasmussen S.A.
Published: August 2019

(N Engl J Med. 2018;379:2492–2493)

Knowledge of the effects of Ebola virus disease (EVD) in pregnant women remains severely limited, despite recent occurence of some of the largest Ebola outbreaks to date—the West Africa Ebola outbreak of 2014-2016 included 28,000 cases and claimed 11,000 lives, and in 2018, the 10th EVD outbreak since 1976 was reported in the Democratic Republic of Congo. Surveillance systems in place at those times did not record pregnancy status, which in turn complicated case-investigation and contact-tracing efforts. In fact, monitoring outcomes of pregnant women and newborns was completed primarily through anecdotal reports. Therefore, in order to establish evidence-based recommendations for the care of Ebola-infected pregnant women, the author of the current perspective article believes that documentation of pregnancy status, via urine testing or, at minimum, self-reporting, is needed for all women of reproductive age who present at Ebola treatment units or hospitals. Not only would these assessments ensure proper obstetrical care in emergency settings, but they would also strengthen national maternal and neonatal mortality surveillance systems and increase knowledge of the overall effects of outbreaks on health care systems.
Contribution of Hypertension to Severe Maternal Morbidity
Authors: Hitti J. , Sienas L. , Walker S. , Benedetti T.J. , Easterling T.
Published: August 2019

(Am J Obstet Gynecol. 2018;219(4):405.e1–405.e7.)

In the United States, maternal morbidity and mortality are growing public health concerns, with severe maternal morbidity (SMM) affecting >50,000 women in 2014. SMM includes renal failure, shock, sepsis, blood transfusion, and peripartum hysterectomy. Hypertensive disorders of pregnancy are strongly associated with maternal morbidity and mortality and are often responsive to intervention. The primary objective of this study was to evaluate the association between preeclampsia with severe features and SMM at a regional perinatal referral center. They hypothesized that parturients with preeclampsia would have a higher rate of SMM than normotensive women. In addition, the proportions of SMM on admission were compared to those that developed during hospitalization.
Novel Application of Exhaled Carbon Monoxide Monitors: Smoking Cessation in Orthopaedic Trauma Patients
Authors: Matuszewski Paul E. , Comadoll Shea M. , Costales Timothy , Zerhusen Timothy , Coale Max , O'Toole Robert V.
Published: August 2019

Objectives:

To determine whether an in-office exhaled carbon monoxide (CO) monitor can increase interest in smoking cessation among the orthopaedic trauma population.

Design:

Prospective.

Setting:

Level I trauma center.

Patients:

One hundred twenty-four orthopaedic trauma patients.

Intervention:

In-office measurement of exhaled CO.

Main Outcome Measures:

Stage of change, Likert scale score on willingness to quit today, patient's request for referral to a quitline, and increase in readiness to quit.

Results:

The use of an exhaled CO monitor increased willingness to quit in 71% of participants still smoking and increased willingness to quit on average by 0.8 points on a 10-point Likert scale (P < 0.001). Fifteen percent of patients modified their stage of change toward quitting. Forty percent of patients after exhaled CO monitor requested referral to a quitline, compared with 4% presurvey (P < 0.001). Anecdotally, most participants were very interested in the monitoring device and its reading, expressing concern with the result. The value of exhaled CO was not associated with any measured outcomes.

Conclusions:

The use of an exhaled CO monitor increased willingness to quit smoking in 71% of patients, but the effect size was relatively small (0.8 points on a 10-point Likert scale). However, use of the CO monitor resulted in a large increase (40% vs. 4%) in referral to the national Quitline. Use of the Quitline typically increases the chance of smoking cessation by 10 times the baseline rate, suggesting that this finding might be clinically important.

Level of Evidence:

Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Brain metastases from esophageal cancer
Authors: Stavrinou Pantelis , Plambeck Lars , Proescholdt Martin , Ghadimi Markus , Goldbrunner Roland , Grau Stefan
Published: August 2019

Brain metastases deriving from esophageal cancer are very rare with scarce data available concerning these patients’ outcome. We, therefore, evaluated outcome after surgical resection followed by radiotherapy of brain metastasis from esophageal cancer.

A retrospective analysis was conducted on consecutive patients undergoing resection of brain metastasis from esophageal cancer in 2 neuro-oncological centers between 2008 and 2018. Clinical and demographic data were retrieved from electronic patient charts. Post-treatment survival was calculated using Kaplan–Meier estimates.

Twenty-five patients were identified. Treatment for primary disease comprised neo-adjuvant radio-chemotherapy followed by surgery (64.0%), surgery and adjuvant radio-chemotherapy (8.0%), radio-chemotherapy only (24.0%), and 1 patient receiving esophageal stenting only. Median time interval since initial diagnosis was 16 (range 0–110) months. All but 1 brain lesion were neurologically symptomatic and median Karnofsky performance score improved postoperatively from 70 to 80. After resection of brain metastases patients received whole-brain (n = 13 (52.0%)) or local fractionated (n = 9 (36.0%)) radiotherapy. In 2 patients adjuvant treatment was impeded by clinical deterioration; 1 patient refused radiotherapy. By the time of analysis 22 patients had died. Median survival after brain metastasis was 6 (95% CI 0.5–11.6) months.

Survival after resection of metastasis from esophageal cancer is poor compared to other tumor entities. Nevertheless, resection of symptomatic brain metastases may improve clinical status in the context of a palliative concept.
Ochronotic arthritis and ochronotic Achilles tendon rupture in alkaptonuria
Authors: Jiang Lifeng , Cao Le , Fang Jinghua , Yu Xinning , Dai Xuesong , Miao Xudong
Published: August 2019

Introduction:

Alkaptonuria (AKU) is a rare disease caused by deficiency of homogentisate 1,2-dioxygenase which results in deposition of homogentisic acid (HGA). Ochronotic arthritis, the deposition of excess oxidized HGA in the connective tissues, causes pigmentation and degeneration of the joint tissues ultimately resulting in chronic inflammation and osteoarthritis. The ochronotic arthritis has similar clinical features with osteoarthritis. There is currently no specific treatment for AKU and management is usually symptomatic. In severe cases, total joint arthroplasty is the major treatment approaches. It is rarely reported in China.

Patient concerns:

Here we reported a case of a patient with bilateral knee pain for more than 1 year. He complained of a 20-year history of chronic, nonspecific low back pain and stiffness. His urine was black since he was a child. Six years after the knee surgery, his Achilles tendon ruptured.

Diagnosis:

Specific radiographic and magnetic resonance imaging manifestations were observed. Darkly pigmented full-thickness cartilage and subchondral bone were found during the operation. Histological investigation also manifested dark stains in meniscus and synovial tissues. Black-denatured tendon tissue was also found during the operation. The patient was diagnosed as AKU.

Interventions:

Total knee arthroplasty and Achilles tendon repair were operated separately after the disease was diagnosed.

Outcomes:

The patient recovered very well after the second surgery. He returned to full activities, described no knee pain, and presented to the clinic walking without any aid. Physical examination revealed 0 to 20 of plantar flexion and 0 to 15 of dorsiflexion of the ankle.

Conclusions:

Ochronosis is a very rare disease in Asia. This paper supplies new information for study of this disease. The mechanism is still unknown right now. Further studies will be necessary.