bluuebunny/crossref_metadata_2025 huggingface dataset:
Infectious keratitis: isolated microbes and their antibiotic susceptibility pattern during 2004–2014 in Region Örebro County, Sweden
Authors: Sagerfors Susanna , Ejdervik‐Lindblad Birgitta , Söderquist Bo
Published: October 2019

Purpose

To describe predisposing risk factors, causative microorganisms and their antibiotic susceptibility patterns in infectious keratitis during an 11‐year period in Region Örebro County, Sweden.

Methods

This is a descriptive study conducted as a retrospective audit of clinical records. Patients who received treatment for infectious keratitis at any of the three ophthalmological departments within Region Örebro County, Sweden, between 2004 and 2014 were included if they fulfilled the predefined criteria for infectious keratitis. Data regarding culture results, antibiotic susceptibility pattern and risk factors for infectious keratitis were obtained from medical records and microbiological reports.

Results

In total, 398 episodes of infectious keratitis in 392 patients were included, and 285 were culture positive. The most common predisposing risk factor was contact lens wear (45%). Coagulase‐negative staphylococci (39.6%) was the most commonly isolated type of organism. Staphylococcus aureus (15.1%) followed by Moraxella spp. (7.4%) and Pseudomonas aeruginosa (6.7%) were among the most common isolated bacteria not considered to be commensal. Reduced susceptibility to fluoroquinolones was observed in five of 43 S. aureus isolates and in four of nine Streptococcus pneumoniae isolates.

Conclusion

The most common predisposing risk factor for keratitis was contact lens wear. Among the most common microbes, not considered to be exclusively commensals, isolated from the cornea in microbial keratitis were S. aureus, Moraxella spp. and P. aeruginosa. The antibiotic susceptibility patterns showed low proportion of resistance. Empiric treatment of suspected infectious keratitis with topical fluoroquinolones and chloramphenicol might be considered in a setting like ours pending culture results.
Endoscopic activity in asymptomatic patients with an ileal pouch is associated with an increased risk of pouchitis
Authors: Kayal Maia , Plietz Michael , Radcliffe Marlana , Rizvi Anam , Yzet Clara , Tixier Emily , Hirten Robert P. , Cohen Benjamin , Sylla Patricia , Khaitov Sergey , Greenstein Alexander , Colombel Jean‐Frederic , Dubinsky Marla C. , Ungaro Ryan C.
Published: October 2019

Background

The significance of endoscopic activity in asymptomatic ulcerative colitis (UC) patients with an ileal pouch is unknown.

Aim

To investigate the association of endoscopic pouch activity in asymptomatic patients with the subsequent development of pouchitis.

Methods

We analyzed a retrospective cohort of patients with UC or IBD‐unspecified who underwent a total proctocolectomy with ileal pouch anal anastomosis (IPAA). Asymptomatic patients with a Pouchitis Disease Activity Index (PDAI) symptom sub‐score of zero who underwent an index surveillance pouchoscopy were included. Endoscopic pouch body activity was graded as 0: normal, 1: mucosal inflammation, or 2: mucosal breaks (ulcers and/or erosions). The primary outcome was primary acute idiopathic pouchitis defined as PDAI score ≥ 7 with symptoms lasting less than four weeks and responsive to standard antibiotics, not otherwise meeting criteria for secondary pouchitis. The secondary outcome was chronic idiopathic pouchitis defined as PDAI score ≥ 7 with symptoms lasting greater than four weeks despite standard antibiotics. Predictors of pouchitis were analyzed using Kaplan‐Meier and Cox regression methods with hazard ratios (HR) and 95% confidence intervals (CI) reported.

Results

143 asymptomatic pouch patients were included. Index endoscopic pouch body activity was 0 in 86 (60.1%) patients, 1 in 26 (18.2%) and 2 in 31 (21.7%). The median length of follow‐up after index surveillance pouchoscopy was 3.03 [IQR 1.24‐4.60] years. Primary acute idiopathic pouchitis occurred in 44 (31%) patients and chronic idiopathic pouchitis in 12 (8.4%). Grade 2 endoscopic pouch activity was associated with the development of acute pouchitis (HR 2.39, 95% CI 1.23‐4.67), although not chronic pouchitis (HR 1.76, 95% CI 0.53‐5.87). Histologic inflammation in endoscopically normal pouch mucosa was not associated with acute or chronic pouchitis.

Conclusions

Mucosal breaks are present in nearly a quarter of asymptomatic patients with IPAA and are associated with an increased risk of acute pouchitis.
The challenges of diagnosis and management of Gitelman syndrome
Authors: Urwin Stephanie , Willows Jamie , Sayer John A.
Published: October 2019

Gitelman syndrome is an inherited tubulopathy characterized by renal salt wasting from the distal convoluted tubule. Defects in the sodium chloride cotransporter (encoded by SLC12A3) underlie this autosomal recessive condition. This article focuses on the specific challenges of diagnosing and treating Gitelman syndrome, with use of an illustrative case report.

Symptoms relate to decreased serum potassium and magnesium levels, which include muscle weakness, tetany, fatigue and palpitations. Sudden cardiac deaths have been reported. Making a diagnosis may be difficult given its rarity but is important. A knowledge of the serum and urine biochemical picture is vital to distinguish it from a broad differential diagnosis, and application of genetic testing can resolve difficult cases. There is a group of Gitelman syndrome heterozygous carriers that experience symptoms and electrolyte disturbance and these patients should be managed in a similar way, though here genetic investigations become key in securing a difficult diagnosis.

Potassium and magnesium replacement is the cornerstone of treatment, though practically this can be hard for patients to manage and often does not fully relieve symptoms even when serum levels are normalized. Challenges arise due to the lack of randomized controlled trials focussing on treatment of this rare disease; hence, clinicians endorse strategies in line with correction of the underlying pathophysiology such as sodium loading or pharmacological treatments, which seem to help some patients. Focussed dietary advice and knowing the best tolerated preparations of potassium and magnesium medications are useful tools for the physician, as well as an awareness of the specific burdens that this patient group face in order to signpost appropriate support.
White matter repair and treatment strategy after intracerebral hemorrhage
Authors: Jiang Yi‐Bin , Wei Kai‐Yan , Zhang Xu‐Yang , Feng Hua , Hu Rong
Published: October 2019

The predilection site of intracerebral hemorrhage (ICH) is in the basal ganglia, which is rich in white matter (WM) fiber bundles, such as cerebrospinal tract in the internal capsule. ICH induced damage to this area can easily lead to severe neurological dysfunction and affects the prognosis and quality of life of patients. At present, the pathophysiological mechanisms of white matter injury (WMI) after ICH have attracted researchers' attention, but studies on the repair and recovery mechanisms and therapy strategies remain rare. In this review, we mainly summarized the WM recovery and treatment strategies after ICH by updating the WMI‐related content by reviewing the latest researches and proposing the bottleneck of the current research.
Retraction: Receptor tyrosine kinase AXL is correlated with poor prognosis and induces temozolomide resistance in glioblastoma
Authors: Wang Jia , Zuo Jie , Wang Mao‐De , Xie Wan‐Fu , Bai Xiao‐Bin , Ma Xu‐Dong
Published: October 2019

Retraction: Receptor tyrosine kinase AXL is correlated with poor prognosis and induces temozolomide resistance in glioblastoma, CNS Neuroscience & Therapeutics 2019, (https://doi.org/10.1111/cns.13227). The above article published online on 02 October 2019 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal Editor in Chief Jun Chen, and John Wiley & Sons Ltd. The retraction has been agreed due to unreliable data and consequently its misleading results and conclusions.
Epilepsy and lifestyle behaviors related to bone health
Authors: Fernandez Haya , Cooke Martin , Patel Tejal
Published: October 2019

Objective

Adults aged 50 years and older with epilepsy face an increased risk of fracture associated both with age and with the use of antiepileptic drugs. Lifestyle behaviors, such as physical activity and calcium and vitamin D intake, have been found to be beneficial to bone health. The aim of this study is to investigate these osteoprotective behaviors in people aged 50 years and older with and without epilepsy.

Methods

In 2010, the Canadian Community Health Survey (CCHS), a cross‐sectional survey that collects health‐related data nationwide, included a subset of questions related to epilepsy along with the standard items on physical activity, nutrition, and sun exposure. Data on osteoprotective behaviors were extracted and analyzed for adults aged 50 years and older.

Results

There were no significant findings related to calcium and vitamin D intake as measured by food choices and sun exposure survey items. People with epilepsy participated in physical activity significantly less often and for significantly shorter duration than people without epilepsy. Significantly fewer people with epilepsy reported intending to increase exercise in the next 12 months as compared to those without epilepsy.

Significance

Although adults aged 50 years and older with epilepsy face an increased risk of fracture as compared to those without epilepsy, they do not engage in a higher level of osteoprotective behaviors. In fact, adults with epilepsy are less physically active and report less intention to exercise than adults without epilepsy.
Improving phosphorus sustainability of sugarcane production in Brazil
Authors: Soltangheisi Amin , Withers Paul J. A. , Pavinato Paulo Sergio , Cherubin Maurício Roberto , Rossetto Raffaella , Do Carmo Janaina Braga , da Rocha Gustavo Casoni , Martinelli Luiz Antonio
Published: October 2019

Phosphorus (P) use in global food and bioenergy production needs to become more efficient and sustainable to reduce environmental impacts and conserve a finite and critical resource (Carpenter & Bennett, Environmental Research Letters, 2011, 6, 014009; Springmann et al., Nature, 2018, 562, 519). Sugarcane is one crop with a large P footprint because production is centered on P‐fixing soils with low P availability (Roy et al., Nature Plants, 2016, 2, 16043; Withers et al., Scientific Reports, 2018, 8, 2537). As global demand for processed sugar and bioethanol continues to increase, we advocate that improving P efficiency could become a key sustainability goal for the sugarcane industry. Here, we applied the 5R global P stewardship framework (Withers et al., Ambio, 2015, 44, 193) to identify more sustainable options to manage P in Brazilian sugarcane production. We show that current inputs of P fertilizer to the current crop area could be reduced by over 305 Gg, or 63%, over the next three decades by reducing unnecessary P fertilizer use, better utilization of recyclable bioresources and redesigning recommendation systems. Adoption of these 5R options would save the sugarcane industry in Brazil 528 US$ million and help safeguard global food and energy security.
How Imaging Can Help Us Better Understand the Migraine‐Stroke Connection
Authors: Chen Shih‐Pin , Eikermann‐Haerter Katharina
Published: October 2019

Migraine and stroke are among the most prevalent and disabling neurological diseases. Epidemiologic studies showed that there is an association between migraine and stroke. Migraineurs, especially those with aura, are more likely to develop subclinical infarct‐like lesions in the brain and are at risk for cryptogenic or cardioembolic stroke. Migrainous headache can be found at the onset of acute ischemic stroke in some patients, and in rare instances, an infarction can be directly attributed to a prolonged migraine aura, ie, migrainous infarction. Importantly, recent studies suggest that in the event of cerebral artery occlusion, even a history of migraine is sufficient to accelerate infarct progression and worsen outcomes. The mechanisms underlying the migraine‐stroke connection are multifactorial, with genetic predisposition, aura‐related electrophysiological mechanisms (cortical spreading depolarization), and cerebral microembolism being the most convincing ones at this point. Here, we provide a comprehensive overview on recent imaging studies that have helped us better understand the complex association between migraine and stroke.
Diagnostic utility of pan‐Trk immunohistochemistry for inflammatory myofibroblastic tumours
Authors: Yamamoto Hidetaka , Nozaki Yui , Kohashi Kenichi , Kinoshita Izumi , Oda Yoshinao
Published: October 2019

Aims

Inflammatory myofibroblastic tumour (IMT) is a spindle cell neoplasm of intermediate malignancy, and the diagnosis is often challenging due to the morphological overlap with other spindle cell neoplasms and reactive lesions. More than half of IMTs have the ALK gene rearrangement, and a minor subset have ROS1, NTRK3 or RET gene rearrangements. We sought to determine the potential diagnostic utility of pan‐Trk immunohistochemistry for IMTs.

Methods and results

We retrospectively examined 40 cases of IMT using immunohistochemistry with a rabbit monoclonal pan‐Trk antibody. Gene rearrangement was confirmed by fluorescence in‐situ hybridisation and/or reverse transcription–polymerase chain reaction. The IMTs were classified as the ALK (n = 29), ROS1 (n = 2), NTRK3 (n = 2), RET (n = 0) and ‘quadruple‐negative’ (n = 7) genotypes by molecular analyses. Both of the ETV6–NTRK3 fusion‐positive cases showed nuclear and cytoplasmic staining for pan‐Trk in the majority of tumour cells. None of the ALK, ROS1 or quadruple‐negative‐type IMTs showed nuclear staining for pan‐Trk, but approximately one‐third of these IMTs showed focal and weak cytoplasmic staining. One exceptional case of a RANBP2–ALK‐positive epithelioid inflammatory myofibroblastic sarcoma (an aggressive variant of IMT) showed moderate cytoplasmic staining for pan‐Trk.

Conclusions

These results suggest that pan‐Trk immunoreactivity with a nuclear and cytoplasmic staining pattern may be useful to identify ETV6–NTRK3‐positive IMTs and may be helpful in selecting patients for Trk‐targeted therapy.
Proximate and phenolic composition of selected native Australian food plants
Authors: Njume Collise , McAinch Andrew J. , Donkor Osaana
Published: October 2019

Edible portions of Leucopogon parviflorus, Arthropodium strictum, Carpobrotus rossii, Rhagodia candolleana, Typha orientalis, Correa alba, Dianella revoluta and Acacia longifolia were collected in 2017 and 2019 from Warrnambool, Victoria Australia, and studied for phenolics and proximate composition. The plant species recorded consistent antioxidant activity with no nutritional alterations. Except for A. longifolia, total phenolic contents (TPC) were higher in 2019 than 2017 (P < 0.05). All the plant species contained Ca, Mg, Na and K. Except for betanin, isolated from R. candolleana (700 mg L−1) and C. rossii (244 mg L−1), higher quantities of polyphenols were extractable in methanol than water (P < 0.05). The plant fatty acid composition was predominantly palmitic, oleic and linoleic acids with A. longifolia containing 44% linoleic acid. While the plant nutrients and fatty acids were fairly stable, TPCs, some of the minerals and polyphenols varied between the years.
Reexamining the demand for HR certification in the United States
Authors: Bayer Jenna E. , Lyons Brian D.
Published: October 2019

Given the addition of new Human Resources (HR) certification offerings by the Society for Human Resource Management and the increase in HR certifications being awarded by the HR Certification Institute, it is necessary to investigate the current rate of demand for HR certification and explore practical implications for those within the field. The current study analyzed over 5,300 HR job announcements and found 20.7% demanded (preferred and/or required) HR certification with more requiring HR certification than before. Additionally, HR certification demand was positively related to salary, experience, education level, and job title with demand reaching 33.7% for managerial HR roles.
Quantitative T‐wave morphology assessment from surface ECG is linked with cardiac events risk in genotype‐positive KCNH2 mutation carriers with normal QTc values
Authors: Cortez Daniel , Zareba Wojciech , McNitt Scott , Polonsky Bronislava , Rosero Spencer Z. , Platonov Pyotr G.
Published: October 2019

Introduction

Long QT syndrome (LQTS) mutation carriers have elevated the risk of cardiac events even in the absence of QTc prolongation; however, mutation penetrance in patients with normal QTc may be reflected in abnormal T‐wave shape, particularly in KCNH2 mutation carriers. We aimed to assess whether the magnitude of a three‐dimensional T‐wave vector (TwVM) will identify KCNH2‐mutation carriers with normal QTc at risk for cardiac events.

Methods

Adult LQT2 patients with QTc < 460 ms in men and <470 ms in women (n = 113, age 42 ± 16 years, 43% male) were compared with genotype‐negative family members (n = 1007). The TwVM was calculated using T‐wave amplitudes in leads V6, II, and V2 as the square root of (TV62 + TII2 + (0.5*TV2)2). Cox regression analysis adjusted for gender and time‐dependent beta‐blocker use was performed to assess cardiac event (CE) risk, defined as syncope, aborted cardiac arrest, implantable cardioverter‐defibrillator therapy, or sudden death.

Results

Dichotomized by median of 0.30 mV, lower TwVM was associated with elevated CE risk compared to those with high TwVM (HR = 2.95, 95% CI, 1.25‐6.98, P = .014) and also remained significant after including sex and time‐dependent beta‐blocker usage in the Cox regression analysis (HR = 2.64, 95% CI, 1.64‐4.24, P < .001). However, these associations were found only in women but not in men who had low event rates.

Conclusion

T‐wave morphology quantified as repolarization vector magnitude using T‐wave amplitudes retrieved from standard 12‐lead electrocardiogram predicts cardiac events risk in LQT2 women and appears useful for risk stratification of KCNH2‐mutation carriers without QTc prolongation.
Insights into IL‐29: Emerging role in inflammatory autoimmune diseases
Authors: Wang Jia‐Min , Huang An‐Fang , Xu Wang‐Dong , Su Lin‐Chong
Published: October 2019

Interleukin‐29 (IL‐29) is a newly discovered member of type III interferon. It mediates signal transduction via binding to its receptor complex and activates downstream signalling pathways, and therefore induces the generation of inflammatory components. Recent studies reported that expression of IL‐29 is dysregulated in inflammatory autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, osteoarthritis, Sjögren's syndrome, psoriasis and systemic sclerosis. Furthermore, functional analysis revealed that IL‐29 may involve in the pathogenesis of the inflammatory autoimmune disorders. In this review, we will systematically review the current knowledge about IL‐29. The information collected revealed the regulatory role of IL‐29 and may give important implications for its potential in clinical treatment.
A 3‐miRNA signature predicts survival of patients with hypopharyngeal squamous cell carcinoma after post‐operative radiotherapy
Authors: Xu Xinbo , Lu Zhongming , Gross Neil , Li Guojun , Zhang Fenghua , Lei Dapeng , Pan Xinliang
Published: October 2019

Since the prognosis of hypopharyngeal squamous cell carcinoma (HSCC) remains poor, identification of miRNA as a potential prognostic biomarker for HSCC may help improve personalized therapy. In the 2 cohorts with a total of 511 patients with HSCC (discovery: N = 372 and validation: N = 139) after post‐operative radiotherapy, we used miRNA microarray and qRT‐PCR to screen out the significant miRNAs which might predict survival. Associations of miRNAs and the signature score of these miRNAs with survival were performed by Kaplan‐Meier survival analysis and multivariate Cox hazard model. Among 9 candidate, miRNAs, miR‐200a‐3p, miR‐30b‐5p, miR‐3161, miR‐3605‐5p, miR‐378b and miR‐4451 were up‐regulated, while miR‐200c‐3p, miR‐429 and miR‐4701 were down‐regulated after validation. Moreover, the patients with high expression of miR‐200a‐3p, miR‐30b‐5p and miR‐4451 had significantly worse overall survival (OS) and disease‐specific survival (DSS) than did those with low expression (log‐rankP < .05). Patients with a high‐risk score had significant worse OS and DSS than those with low‐risk score. Finally, after adjusting for other important prognostic confounders, patients with high expression of miR‐200a‐3p, miR‐30b‐5p and miR‐4451 had significantly high risk of overall death and death owing to HSCC and patients with a high‐risk score has approximately 2‐fold increased risk in overall death and death owing to HSCC compared with those with a low‐risk score. These findings indicated that the 3‐miRNA‐based signature may be a novel independent prognostic biomarker for patients given surgery and post‐operative radiotherapy, supporting that these miRNAs may jointly predict survival of HSCC.
Analysis of urinary sphingolipids using liquid chromatography‐tandem mass spectrometry in diabetic nephropathy
Authors: Morita Yoshifumi , Kurano Makoto , Sakai Eri , Nishikawa Takako , Nishikawa Masako , Sawabe Motoji , Aoki Junken , Yatomi Yutaka
Published: October 2019

Aims/Introduction

Sphingolipids, such as ceramides and sphingosine, are involved in the pathogenesis of diabetes; however, the modulation of urinary sphingolipids in diabetic nephropathy has not been fully elucidated. Therefore, we aimed to develop a simultaneous measurement system for urinary sphingolipids using liquid chromatography‐tandem mass spectrometry and to elucidate the modulation of urinary sphingolipids in diabetic nephropathy.

Materials and Methods

We established a simultaneous measurement system for the urinary sphingosine, dihydrosphingosine, and six ceramide species (Cer d18:1/16:0, Cer d18:1/18:0, Cer d18:1/18:1, Cer d18:1/20:0, Cer d18:1/22:0 and Cer d18:1/24:0), and we examined the urinary sphingolipids in 64 type 2 diabetes patients and 15 control participants.

Results

The established measurement system for the urinary sphingolipids showed good precision for Cer d18:1/16:0, Cer d18:1/20:0, Cer d18:1/22:0 and Cer d18:1/24:0. We observed that the urinary levels of Cer d18:1/16:0, Cer d18:1/18:0, Cer d18:1/20:0, Cer d18:1/22:0 and Cer d18:1/24:0 were elevated in patients with stage 3 of diabetic nephropathy, and were correlated with urinary biomarkers, such as albumin and N‐acetyl‐β‐d‐glucosaminidase, and sediment score.

Conclusions

Our method is useful for the measurement of ceramide in urine specimens, and urinary ceramides might be associated with the pathological condition of diabetic nephropathy, such as renal tubular injury.
Color stability of bulk‐fill and universal composite restorations with dissimilar dentin replacement materials
Authors: Miletic Vesna , Marjanovic Jovana , Veljovic Djordje N. , Stasic Jovana N. , Petrovic Violeta
Published: October 2019

Objective

To determine color changes in bulk‐fill composite and universal composite restorations with dissimilar dentin replacement materials in extracted teeth after staining in red wine.

Materials and Methods

Cylindrical, 4 mm deep, class I cavities were prepared in 140 human molars. Bottom 2 mm was restored with Biodentine (Septodont), everX posterior (GC) or experimental HAP inserts. Each dentin replacement material was covered with a 2‐mm layer of a universal composite Filtek Z250 or Z550 (3M ESPE) or Gradia Posterior (GC). Groups combining top composite layer and the underlying dentin replacement were designated as “composite_dentin replacement.” Filtek Bulk Fill (3M ESPE) and Tetric EvoCeram Bulk Fill (Ivoclar Vivadent) were placed as a single 4‐mm layer. Color measurements were performed using Vita Easyshade 4.0 (Vita Zahnfabrik) initially and after 48‐hours storage in red wine at 37°C.

Results

Color differences (ΔEoo) ranged between 2.1 ± 0.7 (Z250_HAP) and 7.8 ± 1.1 (Z550_everX). EverX resulted in higher ΔEoo of the overlying composite than HAP (P < .001) and Biodentine (P = .006). Generally, ΔEoo was affected more by decreasing lightness (ΔL′) than changes in chroma (ΔC′).

Conclusions

EverX resulted in higher ΔEoo of the restoration than Biodentine and experimental HAP after staining in red wine. No significant differences in ΔEoo may be expected in different composites with the same underlying dentin replacement material. The same was generally true for bulk‐fill and universal composites.

Clinical Significance

Similar extent of color changes may be expected in bulk‐fill and universal composites. Highly translucent everX might exhibit greater color differences irrespective of the capping composite than non‐translucent materials. Clinicians have a wider choice of composite materials to cover a particular dentin replacement material, for example, everX or Biodentine, as similar color differences may be expected in various overlying composite brands.
Are hypohydrated older adults at increased risk of exhaustion?
Authors: Anjo I. , Amaral T. F. , Afonso C. , Borges N. , Santos A. , Moreira P. , Padrão P.
Published: October 2019

Background

Dehydration appears to affect muscle strength and weakness, although its influence on exhaustion remains unclear. The present study aimed to quantify the association between hydration status and exhaustion among older adults.

Methods

A cluster sampling approach was used, representing Portuguese older adults (≥65 years) according to age, sex, education level and region within the Nutrition UP65 cross‐sectional study. A 24‐h urine sample was collected to estimate free water reserve (FWR), which was categorised into tertiles according to sex. Subjects with incomplete 24‐h urine and renal disease were excluded. From a sample size of 1500 subjects, 1143 were eligible. Exhaustion was self‐reported according to the Center for Epidemiologic Studies Depression Scale. A logistic regression model was conducted to evaluate the association between FWR and exhaustion. Odds ratios and the respective 95% confidence intervals were calculated by sex and age.

Results

Free water reserve median (interquartile range) was 0.52 (0.68) L in women and 0.36 (0.77) L in men. Hypohydration affected 11.6% of women and 25.1% of men, whereas exhaustion was reported by 39.3% of women and 25.1% of men. After adjusting for confounders, women ≥80 years classified in the highest tertile of FWR showed a decreased risk of exhaustion (third tertile: odds ratio = 0.38; 95% confidence interval = 0.15–0.96) compared to women in the lowest FWR tertile. No such significant association was observed in women with <80 years and in men.

Conclusions

These results show an association between worse hydration status and exhaustion in older women, highlighting the need to implement further studies clarifying this association.
Highly cited dental articles and their authors: An evaluation of publication and citation characteristics
Authors: Yeung Andy Wai Kan , Ho Yuh‐Shan
Published: October 2019

Aim

In the present study, we aimed to identify and analyze the characteristics of highly cited articles in dentistry.

Methods

All articles belonging to Web of Science category of “dentistry, oral surgery and medicine” published until 2016 were analyzed. The bibliometric data of the highly cited articles were evaluated. The Y‐index was applied to assess authors’ publication potential. Altmetric scores were recorded from Dimensions, a free online database.

Results

There were 3666 highly cited dentistry articles published in dental journals. Half of them were published in seven leading journals in their specialties. The major contributing countries were the USA, Sweden, the UK, and Switzerland. The highly cited articles were written by 3.7 authors on average. Jan Lindhe had the largest number of highly cited articles, whereas David H. Pashley had the highest potential to publish highly cited articles in dentistry.

Conclusions

Highly cited articles were distributed among various dental specialties, and the most productive periods were the late 1990s and the early 2000s. The Y‐index gave dimensional details of the prolific authors. The current analysis was based on data extracted from Web of Science. Results could be different if data were extracted from other databases, such as Google Scholar.
A Framework for Race‐Related Trauma in the Public Education System and Implications on Health for Black Youth
Authors: Henderson Dawn X. , Walker Larry , Barnes Rachelle R. , Lunsford Alexis , Edwards Christen , Clark Christopher
Published: October 2019

BACKGROUND

A combination of increased suicide in the past decade, documented high rates of anxiety and depression, and the preponderance of other behavioral and emotional regulation challenges place black youth at risk for school suspension and involvement in the juvenile justice system. Pointing to deficits in black youth and their families negates how forces of racism, whether unconscious or conscious, can disrupt well‐being.

METHODS

A framework for race‐related trauma in the public education system illustrates the interplay between macro‐level forces, such as institutional and symbolic racism, and micro level forces of racism such as racial discrimination and violence. Identifying causal links between these forces and adverse academic and health outcomes for black youth can inform interventions and strategies to reduce race‐related trauma.

RESULTS

The framework for race‐related trauma is a multi‐level analysis of racism and recognizes school districts facing economic restraints and school personnel turnover may face significant challenges in designing intervening strategies.

CONCLUSION

The framework guides change effort towards improving school climate and culture through preparing school professionals to meet the diverse needs of youth, strengthening family and community collaboration, and tackling those policies and behaviors that exclude and disconnect black youth.
A bi‐level model to optimize road networks for a mixture of manual and automated driving: An evolutionary local search algorithm
Authors: Madadi Bahman , van Nes Rob , Snelder Maaike , van Arem Bart
Published: October 2019

This paper presents a bi‐level model to optimize automated‐vehicle‐friendly subnetworks in urban road networks and an efficient algorithm to solve the model, which is relevant for the transition period with vehicles of different automation levels. We formulate the problem as a network design problem, define solution requirements, present an effective solution method that meets those requirements, and compare its performance with two other solution algorithms. Numerical examples for network of Delft are presented to demonstrate the concept and solution algorithm performances. Results indicate that our proposed solution outperforms competing ones in all criteria considered. Furthermore, our findings show that the optimal configuration of these subnetworks depends on the level of demand; lower penetration rates of automated vehicles call for less dense subnetworks, and thereby less investments. Nonetheless, a large proportion of benefits are already achievable with low‐density subnetworks. Denser subnetworks can deliver higher benefits with higher penetration rates.
Mycobiont contribution to tundra plant acquisition of permafrost‐derived nitrogen
Authors: Hewitt Rebecca E. , DeVan M. Rae , Lagutina Irina V. , Genet Helene , McGuire A. David , Taylor D. Lee , Mack Michelle C.
Published: October 2019

As Arctic soils warm, thawed permafrost releases nitrogen (N) that could stimulate plant productivity and thus offset soil carbon losses from tundra ecosystems. Although mycorrhizal fungi could facilitate plant access to permafrost‐derived N, their exploration capacity beyond host plant root systems into deep, cold active layer soils adjacent to the permafrost table is unknown.

We characterized root‐associated fungi (RAF) that colonized ericoid (ERM) and ectomycorrhizal (ECM) shrub roots and occurred below the maximum rooting depth in permafrost thaw‐front soil in tussock and shrub tundra communities. We explored the relationships between root and thaw front fungal composition and plant uptake of a 15N tracer applied at the permafrost boundary.

We show that ERM and ECM shrubs associate with RAF at the thaw front providing evidence for potential mycelial connectivity between roots and the permafrost boundary. Among shrubs and tundra communities, RAF connectivity to the thaw boundary was ubiquitous. The occurrence of particular RAF in both roots and thaw front soil was positively correlated with 15N recovered in shrub biomass

Taxon‐specific RAF associations could be a mechanism for the vertical redistribution of deep, permafrost‐derived nutrients, which may alleviate N limitation and stimulate productivity in warming tundra.
Opioid‐sparing effects of 10 kHz spinal cord stimulation: a review of clinical evidence
Authors: Al‐Kaisy Adnan , Van Buyten Jean‐Pierre , Amirdelfan Kasra , Gliner Bradford , Caraway David , Subbaroyan Jeyakumar , Rotte Anand , Kapural Leonardo
Published: October 2019

Chronic pain is a common condition that affects the physical, emotional, and mental well‐being of patients and can significantly diminish their quality of life. Due to growing concerns about the substantial risks of long‐term opioid use, both governmental agencies and professional societies have recommended prioritizing the use of nonpharmacologic treatments, when suitable, in order to reduce or eliminate the need for opioid use. The use of 10 kHz spinal cord stimulation (10 kHz SCS) is one such nonpharmacologic alternative for the treatment of chronic, intractable pain of the trunk and limbs. This review examines published clinical data regarding the efficacy of 10 kHz SCS for decreasing chronic pain in patients and its potential to reduce or eliminate opioid usage. Multiple prospective and retrospective studies in patients with intractable pain demonstrated that 10 kHz SCS treatment provided ≥50% pain relief in >70% patients after at least 1 year of treatment. Pain relief with 10 kHz SCS therapy ranged from 54% to 87% in the studies. More importantly, the mean daily dose of opioids required by patients in these studies was reduced after 10 kHz SCS treatment, and on average over 60% patients in studies either reduced or eliminated opioids at the last follow‐up.
Tempestite facies variability and storm‐depositional processes across a wide ramp: Towards a polygenetic model for hummocky cross‐stratification
Authors: Jelby Mads E. , Grundvåg Sten‐Andreas , Helland‐Hansen William , Olaussen Snorre , Stemmerik Lars
Published: October 2019

The hydrodynamic mechanisms responsible for the genesis and facies variability of shallow‐marine sandstone storm deposits (tempestites) have been intensely debated, with particular focus on hummocky cross‐stratification. Despite being ubiquitously utilized as diagnostic elements of high‐energy storm events, the full formative process spectrum of tempestites and hummocky cross‐stratification is still to be determined. In this study, detailed sedimentological investigations of more than 950 discrete tempestites within the Lower Cretaceous Rurikfjellet Formation on Spitsbergen, Svalbard, shed new light on the formation and environmental significance of hummocky cross‐stratification, and provide a reference for evaluation of tempestite facies models. Three generic types of tempestites are recognized, representing deposition from: (i) relatively steady and (ii) highly unsteady storm‐wave‐generated oscillatory flows or oscillatory‐dominated combined‐flows; and (iii) various storm‐wave‐modified hyperpycnal flows (including waxing–waning flows) generated directly from plunging rivers. A low‐gradient ramp physiography enhanced both distally progressive deceleration of the hyperpycnal flows and the spatial extent and relative magnitude of wave‐added turbulence. Sandstone beds display a wide range of simple and complex configurations of hummocky cross‐stratification. Features include ripple cross‐lamination and ‘compound’ stratification, soft‐sediment deformation structures, local shifts to quasi‐planar lamination, double draping, metre‐scale channelized bed architectures, gravel‐rich intervals, inverse‐to‐normal grading, and vertical alternation of sedimentary structures. A polygenetic model is presented to account for the various configurations of hummocky cross‐stratification that may commonly be produced during storms by wave oscillations, hyperpycnal flows and downwelling flows. Inherent storm‐wave unsteadiness probably facilitates the generation of a wide range of hummocky cross‐stratification configurations due to: (i) changes in near‐bed oscillatory shear stresses related to passing wave groups or tidal water‐level variations; (ii) multidirectional combined‐flows related to polymodal and time‐varying orientations of wave oscillations; and (iii) syndepositional liquefaction related to cyclic wave stress. Previous proximal–distal tempestite facies models may only be applicable to relatively high‐gradient shelves, and new models are necessary for low‐gradient settings.
The impact of recurrent cytomegalovirus infection on long‐term survival in solid organ transplant recipients
Authors: Gardiner Bradley J. , Chow Jennifer K. , Brilleman Samuel L. , Peleg Anton Y. , Snydman David R.
Published: October 2019

Background

Cytomegalovirus (CMV) remains a significant contributor to morbidity and mortality following solid organ transplantation (SOT). While recurrent infection occurs in up to 30% of patients, its impact on mortality is unclear. The aim of this study was to explore the relationship between recurrent CMV infection and long‐term survival in SOT recipients.

Methods

We performed a retrospective cohort study of SOT recipients who completed treatment for an episode of CMV infection. Patients were followed until death, loss to follow‐up or 10 years following CMV treatment completion. Univariable and multivariable hazard ratios (HR) were calculated, treating relapse and rejection following CMV as time‐varying.

Results

About 79 kidney, 52 heart, 34 liver, and 5 liver‐kidney transplant recipients were included. About 62/170 died, at a median of 3.8 years (IQR 0.8‐6.6 years). Median follow‐up among the 108 survivors was 7.4 years (IQR 3.7‐10 years). Recurrent CMV infection occurred in 49/170 (29%), 67% within 6 months of treatment completion. Mortality among those who relapsed was 39% (19/49) vs 36% (43/121) in those who remained relapse‐free (unadjusted HR 1.59, 95% CI 0.92‐2.75, P = .10). After adjusting for age and transplanted organ, findings were similar (HR 1.68, 95% CI 0.93‐3.04, P = .09).

Conclusions

Mortality following CMV remains high even in the valganciclovir era. Although our findings suggest a possible increased risk of death among patients with recurrent CMV, these did not reach statistical significance. The complex nature of these patients, multiple potential confounders, and limited statistical power made detection of small effects difficult. Larger prospective studies evaluating the clinical impact of strategies to reduce recurrence are needed.
Las cláusulas abusivas en el contrato de seguro: El camino emprendido para consolidar su debida identificación e interpretación en el ordenamiento jurídico colombiano
Authors: Montenegro Molina Nathalia Andrea , Coronado Sabogal Diego Alejandro
Published: October 2019

Bajo la categorización del contrato de seguro como un contrato de adhesión o tipo, se ha desatado un extenso análisis jurídico alrededor del equilibrio y desequilibrio contractual, la dinámica negocial y la posición económica de cada una de las partes, pues debido a su particular naturaleza y desarrollo de comercialización masiva, han sido el contexto propicio para la inserción de las denominadas cláusulas abusivas.

 Motivados por este contexto, el ensayo ausculta los elementos que influyen en la identificación y posterior declaración de una cláusula como abusiva, al igual que explora su interpretación en el contrato de seguro en Colombia. Lo anterior, bajo el entendido que la normativa vigente y, en gran parte, la jurisprudencia, han acogido una postura clásica sobre la posición dominante que ostenta el asegurador, desconociendo situaciones en donde es precisamente la parte contraria quien impone condiciones por sus caracteristicas económicas.

 En consecuencia, para llevar a cabo el mencionado examen propositivo, los autores realizan una breve reseña histórica sobre el surgimiento de lo que se ha considerado como cláusulas abusivas alrededor del mundo, así como la descripción del marco regulatorio vigente sobre las mismas en la República de Colombia. Posteriormente, se ocupa el texto de dilucidar la evolución de la jurisprudencia nacional hacia la construcción del concepto de cláusulas abusivas, los criterios de identificación de las mismas y su alcance en los pronunciamientos relacionados con el contrato de seguro.
La obligación de dar aviso oportuno del siniestro a la aseguradora en el seguro de responsabilidad civil
Authors: Álvarez Pérez Andrés Orión
Published: October 2019

Establecen los diferentes ordenamientos jurídicos objeto de análisis comparativo, en términos generales, la obligación del asegurado de dar aviso oportuno a la aseguradora sobre la ocurrencia del siniestro. A renglón seguido, se establece la forma en que la Compañía puede deducir los perjuicios que se le causen por el incumplimiento de dicha obligación, carga o deber, en cada caso particular.

Se pretende entonces hacer un análisis crítico de la norma, profundizando más en el caso Colombiano, pero trayendo la normatividad de países como España, México, Bolivia, Argentina, y Brasil, para hacer una propuesta final, dadas las verdaderas implicaciones actuariales, presupuestales, de cálculo de prima, de asunción del riesgo, y demás circunstancias que analizaremos al respecto, para que la norma en realidad tenga fuerza coercitiva y vinculante, y objetivamente genere la atención y el cumplimiento en cabeza de los asegurados.
La responsabilidad plena de perjuicios y el sistema general de riesgos laborales. Precedente judicial de la Corte Suprema de Justicia 2019
Authors: Ponce Bravo Germán Ernesto
Published: October 2019

El elemento que diferencia el seguro de riesgos laborales del resto de seguros es la intervención del riesgo. A mayor intervención del riesgo, menor la siniestralidad esperada. Una de las herramientas de intervención del riesgo es el sistema de seguridad y salud en el trabajo, que además es uno los principales criterios adoptados por la Corte Suprema de Justicia, en el año 2019, para deducir la culpa del empleador no solo por el incumplimiento de las normas de seguridad y salud en el trabajo. La reflexión es que la distancia que media entre la responsabilidad objetiva y subjetiva es cada vez más difusa.
El seguro de desgravamen hipotecario: aspectos esenciales y función social
Authors: Claros Soria Nora Andreina
Published: October 2019

La aparición de los seguros lleva implícita una función social traducida en la transferencia del riesgo a una entidad especializada, para que, ante una eventual afectación al patrimonio, a la integridad, a la salud o a la vida de una persona, se pueda otorgar al contratante o asegurado o a quien, revista la calidad de beneficiario, la prestación convenida. De esta forma el asegurado no deberá asumir con su propio patrimonio, los daños o el costo implicados en la ocurrencia del riesgo.

 

Muchos asegurados y en si los directos afectados, al contratar un Seguro de Desgravamen Hipotecario no prestan verdadera atención, ni otorgan la debida importancia a esta modalidad de seguro, que no tiene otra finalidad más que la protección del beneficiario real de la cobertura que otorga el seguro. El beneficiario debe ser entendido no como la entidad financiera que genera la fuente de repago del crédito otorgado, sino como la familia, que indistintamente de perder o ver disminuido en sus capacidades, a quien fungía como cabeza del ingreso económico del hogar, pueda quedarse tranquila y con el bien hipotecado liberado, frente al deceso ocurrido o la incapacidad presentada, en el titular del crédito.
Los epígrafes en los Escolios de Nicolás Gómez Dávila: hacia una lectura intertextual
Authors: Molina Peláez Tomás Felipe
Published: October 2019

El análisis parcial de los epígrafes en los Escolios a un texto implícito de Gómez Dávila ha sido desarrollado por algunos comentaristas de la obra. Sin embargo, hasta el momento ningún artículo se ha dedicado al estudio sistemático de su significado y su relación con los Escolios y el hors du texte al que aluden, una tarea a la que se aboca el presente artículo. El primer resultado de este análisis consiste en resaltar una serie de aspectos esenciales para la comprensión del pensamiento del colombiano. El segundo resultado revela la importancia de la intertextualidad: los epígrafes necesitan de un hors du texte y de los escolios mismos para ser interpretados; al mismo tiempo, los escolios necesitan de los epígrafes y de un hors du texte para ser comprendidos. En otras palabras, ninguno de los dos es autónomo: su significado solo se encuentra en la intertextualidad.
A Modest Refutation of Manifestationalism
Authors: Gava Alessio
Published: October 2019

En su reciente artículo “A modest defense of manifestationalism” (2015), Asay y Bordner defienden la posición de una famosa crítica presentada por Rosen (1994), según la cual, aunque el manifestacionalismo puede ser más compatible con el espíritu del empirismo que otras vertientes bastante conocidas, tales como el empirismo constructivo, no logra, sin embargo, interpretar de manera efectiva la ciencia. Los dos autores consideran que, en realidad, el argumento de Rosen falla. Según ellos, el manifestacionalismo puede de hecho representar una tesis legítima acerca de la naturaleza de la investigación científica. En este trabajo mostraré que las críticas de Asay y Bordner a Rosen en realidad no dan en el blanco. Además, reposan sobre una interpretación del objetivo de la ciencia que puede servir para los propósitos de los autores, pero que no es aceptable. Quizás el empirismo constructivo todavía sea el mejor compromiso encontrado hasta la fecha entre un empirismo riguroso y el reconocimiento de la racionalidad de la ciencia.
Analysis of spherical isotropic noise fields with an A-Format tetrahedral microphone
Authors: Perez-Lopez Andres , Stefanakis Nikolaos
Published: October 2019

Several applications in spatial audio signal processing benefit from the knowledge of the diffuseness of the sound field. In this paper, several experiments are performed to determine the response of a tetrahedral microphone array under a spherically isotropic sound field. The data were gathered with numerical simulations and real recordings using a spherical loudspeaker array. The signal analysis, performed in the microphone signal and spherical harmonic domains, reveals the characteristic coherence curves of spherical isotropic noise as a function of the frequency.