bluuebunny/crossref_metadata_2025 huggingface dataset:
P085 DOSE ESCALATION (Q4) OF USTEKINUMAB SHOULD BE CONSIDERED FOR CROHN’S DISEASE PATIENTS WHO FAIL STANDARD DOSING
Authors: Yadav Abhijeet , Haider Reza , Akanbi Olalekan , Kudaravalli Praneeth , Tripathi Nishant , Hashim Mahmoud , Abdelsalam Mohammed , Tawfik Soliman Hussein Mohamed Sabry , Elkheshen Ahmed , Patel Vihang , Ali Saad Emhmed , Perry Courtney , Flomenhoft Deborah , Barrett Terrence , Lamb Latoya , Ingram Karen , Mayne Casie , Stufflebeam Amy
Published: January 2020

Background

Ustekinumab, a monoclonal antibody of interleukin-12 and interleukin-23, was approved for the treatment of moderate to severe Crohn’s disease (CD) in 2016. Ustekinumab is approved in CD for a weight-based IV induction dose followed by every 8 weeks of subcutaneous dosing. Response rates by 6 weeks range from 34% (anti-TNF failures) to 56% in bio-naïve patients. The remainder includes patients who partially-respond (PR) or do not respond (NR). Response by week 16 is 55% (anti-TNF failures) and 73% in bio-naïve patients suggestive of a ‘delayed response’ in some. Experience with anti-TNF drugs demonstrates that a subset of patients respond to dose escalation, which prompts the notion of a potential delayed response phenomenon with Ustekinumab.

Aim

Determine the efficacy of dose escalation from standard Q8 dosing to Q4 dosing of Ustekinumab in CD patients, who had PR or NR to standard Q8 dosing.

Methods

A Retrospective observation study of 143 adult patients with CD, on Ustekinumab standard Q8 dosing over a 2 year and 9-month period was conducted. Data was extracted pertaining to demographics, disease, and treatment-related variables (biomarkers, steroid use, interval surgery, ER visits). Patients were further subcategorized as responders, partial responders(PR), and non-responders(NR), based on changes in fecal calprotectin, albumin, CRP, and Physician Global Assessment Disease Severity (1=mild, 2=moderate, 3=severe). Q8 non-responders (NR) and partial responders (PR) were dose-escalated to Q4, and outcome variables were collected. Biomarkers, steroid utilization, interval surgery, and ER visits, and PGA were compared in Q8 partial responder(PR) and non-responders (NR) from the date of starting Ustekinmuab on Q8 dosing to the date of escalation to Q4 dosing, versus the date of escalation Q4 dosing to the end of patient follow up.

Results

30% (n=8) of patients were Q8NR, and 70% (n=19) were Q8PR). In the PR group, biomarkers decreased by up to 21% when these patients were switched to Q4 dosing. 100% of patients saw clinical improvement or remained at mild disease on Q4 dosing. In the NR group, biomarkers decreased by up to 91%. 100% of patients saw clinical improvement or remained at mild disease while on Q4 dosing. In both groups, 50% of patients taking steroids on Q8 dosing were no longer taking steroids or were at a reduced dose at the end of Q4 dosing follow-up. 40% of patients on immunomodulators on Q8 dosing were no longer taking immunomodulators at the end of Q4 dosing follow-up.

Conclusions
Constitutional imaginations of the state: Afterword to the Foreword by Ran Hirschl and Ayelet Shachar
Authors: Finck Michèle
Published: January 2020

This Afterword does not seek to contest Ran Hirschl and Ayelet Shachar’s account of spatial statism. It rather argues that although public power remains in many ways untouched by the ever-changing world states are embedded in, counternarratives can also be identified. Looking toward urban spaces as well as the regulation of data and online spaces, I illustrate that a complementary story of state power can also be told. The challenge is to make sense of the fact that state power is both changing and not changing at the same time.
On the Nonnegativity of Stringy Hodge Numbers
Authors: Olano Sebastián
Published: January 2020

We study the nonnegativity of stringy Hodge numbers of a projective variety with Gorenstein canonical singularities, which was conjectured by Batyrev. We prove that the $(p,1)$-stringy Hodge numbers are nonnegative, and for three-folds we obtain new results about the stringy Hodge diamond, which hold even when the stringy $E$-function is not a polynomial. We also use the Decomposition Theorem and mixed Hodge theory to prove Batyrev’s conjecture for a class of four-folds.
CPlantBox, a whole-plant modelling framework for the simulation of water- and carbon-related processes
Authors: Zhou Xiao-Ran , Schnepf Andrea , Vanderborght Jan , Leitner Daniel , Lacointe André , Vereecken Harry , Lobet Guillaume
Published: January 2020

The interaction between carbon and flows within the vasculature is at the centre of most growth and developmental processes. Understanding how these fluxes influence each other, and how they respond to heterogeneous environmental conditions, is important to answer diverse questions in agricultural and natural ecosystem sciences. However, due to the high complexity of the plant–environment system, specific tools are needed to perform such quantitative analyses. Here, we present CPlantBox, a whole-plant modelling framework based on the root system model CRootBox. CPlantBox is capable of simulating the growth and development of a variety of plant architectures (root and shoot). In addition, the flexibility of CPlantBox enables its coupling with external modelling tools. Here, we connected the model to an existing mechanistic model of water and carbon flows in the plant, PiafMunch. The usefulness of the CPlantBox modelling framework is exemplified in five case studies. Firstly, we illustrate the range of plant structures that can be simulated using CPlantBox. In the second example, we simulated diurnal carbon and water flows, which corroborates published experimental data. In the third case study, we simulated impacts of heterogeneous environment on carbon and water flows. Finally, we showed that our modelling framework can be used to fit phloem pressure and flow speed to (published) experimental data. The CPlantBox modelling framework is open source, highly accessible and flexible. Its aim is to provide a quantitative framework for the understanding of plant–environment interaction.
Cattle adapted to tropical and subtropical environments: social, nutritional, and carcass quality considerations
Authors: Cooke Reinaldo F , Daigle Courtney L , Moriel Philipe , Smith Stephen B , Tedeschi Luis O , Vendramini João M B
Published: January 2020

Beef production needs to increase from 60 million to 130 million tons by 2050 to feed a growing world population, and 70% of this production increase is expected from beef industries located in subtropical and tropical regions of the world. Bos indicus-influenced cattle predominate in these regions but are often managed using practices developed for Bos taurus breeds reared in temperate climates. Hence, a fundamental step to meet the increasing global demand for beef is to develop specific management for B. indicus-influenced cattle in tropical or subtropical environments. Bos taurus and B. indicus are different subspecies, and diverge in social and biological functions due to selection pressure caused by complex evolutionary and domestication processes. Bos indicus cattle display different social responses compared with B. taurus counterparts, which must be taken into account by management planning as these traits directly impact cattle performance and welfare. In tropical and subtropical regions, warm-season perennial C4 grasses are the dominant forages, and their availability has a significant influence on the productivity of beef cattle systems. The resilience of C4 grasses under adverse conditions is one of their most important characteristics, even though these forages have reduced nutritive value compared with forages from temperate climates. Accordingly, nutritional planning in tropical and subtropical conditions must include management to optimize the quantity and quality of C4 forages. Nutritional requirements of cattle raised within these conditions also require special attention, including inherent metabolic compromises to cope with environmental constraints and altered energy requirements due to body composition and heat tolerance. Nutritional interventions to enhance beef production need to be specifically tailored and validated in B. indicus-influenced cattle. As an example, supplementation programs during gestation or early life to elicit fetal programming or metabolic imprinting effects, respectively, yield discrepant outcomes between subspecies. Bos indicus-influenced cattle produce carcasses with less marbling than B. taurus cattle, despite recent genetic and management advances. This outcome is mostly related to reduced intramuscular adipocyte volume in B. indicus breeds, suggesting a lesser need for energy stored intramuscularly as a mechanism to improve thermotolerance in tropical and subtropical climates.
Cattle adapted to tropical and subtropical environments: genetic and reproductive considerations
Authors: Cooke Reinaldo F , Cardoso Rodolfo C , Cerri Ronaldo L A , Lamb G Cliff , Pohler Ky G , Riley David G , Vasconcelos José L M
Published: January 2020

Efforts to understand biological functions and develop management schemes specific to Bos indicus-influenced cattle raised in tropical and subtropical environments are critical to meet the increasing global demand for protein. In the United States, B. indicus breeds are mostly used to generate B. indicus × B. taurus crosses with increased thermal and parasite tolerance, while retaining some productive characteristics of B. taurus cattle. Although crossbreeding represents a proven strategy to improve cattle adaptation almost immediately, research has also attempted to identify B. taurus genetics that can withstand subtropical and tropical climates. Reduced milk production and delayed reproductive maturation appear to be related with tropical adaptation of B. taurus breeds, as a means to conserve energy under stressful conditions and limited nutrition. Moreover, longevity may be the ultimate adaptation response to unfavorable environments, and retention of bulls and heifers from proven cows is the recommended strategy to improve longevity in B. indicus-influenced herds. Besides selection for longevity, other aspects should be considered when planning reproductive management in tropical and subtropical regions. Bos indicus and B. taurus breeds have multiple differences pertaining to reproductive function, including age at puberty, ovarian dynamics, and pregnancy development. Nutritional strategies such as the stair-step regimen, and use of exogenous progesterone (P4) inserts are options to hasten puberty attainment of late-maturing B. indicus-influenced heifers. Yet, limited pharmacological alternatives are available for reproductive management of B. indicus-influenced females in the United States, which rely on GnRH-based protocols not specifically designed to the reproductive function of B. indicus breeds. In contrast, hormonal protocols based on exogenous P4, estradiol esters, and equine chorionic gonadotropin are available for use in B. indicus females in South America. These include protocols tailored to prepubertal heifers, anestrous cows, and cycling nulliparous or parous females, which often yield pregnancy rates of 50% to fixed-time artificial insemination. The global dairy industry also faces similar challenges in increasing demand and production as the beef industry. Selection of cows capable of sustaining optimal milk yield, reproductive success, and health status in hot and humid conditions is essential for optimal dairy production in subtropical and tropical regions.
Influence of feeding thermally peroxidized soybean oil on growth performance, digestibility, gut integrity, and oxidative stress in nursery pigs
Authors: Kerr Brian J , Lindblom Stephanie C , Overholt Martin F
Published: January 2020

The objectives of the current experiments were to evaluate the effect of feeding soybean oil (SO) with different levels of peroxidation on lipid, N, and GE digestibility, gut integrity, oxidative stress, and growth performance in nursery pigs. Treatments consisted diets containing 10% fresh SO (22.5 °C) or thermally processed SO (45 °C for 288 h, 90 °C for 72 h, or 180 °C for 6 h), each with an air infusion of 15 L/min, with postprocessing peroxide values of 7.6, 11.5, 19.1, and 13.4 mEq/kg and p-anisidine values of 1.92, 6.29, 149, and 159, for the 22.5 °C, 45 °C, 90 °C and 180 °C processed SO, respectively. In experiment 1, 64 barrows (7.1 ± 0.9 kg initial BW) were randomly allotted into 2 rooms of 32 pens and individually fed their experimental diets for 21 d, with a fresh fecal sample collected on day 20 for determination of GE and lipid digestibility. In experiment 2, 56 barrows (BW 9.16 ± 1.56 kg) were placed into individual metabolism crates for assessment of GE, lipid, and N digestibility and N retention. Urinary lactulose to mannitol ratio was assessed to evaluate in vivo small intestinal integrity, and urine and plasma were collected to analyze for markers of oxidative stress. Pigs were subsequently euthanized to obtain liver weights and analyze the liver for markers of oxidative stress. In experiment 1, pigs fed the SO thermally processed at 90 °C had reduced ADG (P = 0.01) and ADFI (P = 0.04) compared to pigs fed the other SO treatment groups, with no differences noted among pigs fed the 22.5 °C, 45 °C, and 180 °C SO treatments. No effects of feeding thermally processing SO on dietary GE or lipid digestibility (P > 0.10) were noted in either experiment. In experiment 2, there was no dietary effect of feeding peroxidized SO on the DE:ME ratio, N digestibility, or N retained as a percent of N digested, on the urinary ratio of lactulose to mannitol, on serum, urinary, or liver thiobarbituric acid reactive substances, on plasma protein carbonyls, or on urinary or liver 8-OH-2dG (P > 0.10). In experiment 2, pigs fed the SO thermally processed at 90 °C had the greatest isoprostane concentrations in the serum (P ≤ 0.01) and urine (P ≤ 0.05) compared to pigs fed the unprocessed SO. These results indicate that the change in fatty acid composition and/or the presence of lipid peroxidation products in peroxidized SO may reduce ADG and ADFI in nursery pigs, but appears to have no impact on GE, lipid, or N digestibility, or gut permeability. These data suggest that the presence of lipid peroxidation products may affect certain markers of oxidative stress.
Energy values of triticale or sorghum distillers’ dried grains with solubles and rye fed to broiler chickens
Authors: Adeola Olayiwola , Kong Changsu
Published: January 2020

The current experiments were conducted to determine ileal digestible energy (IDE), metabolizable energy (ME), and nitrogen-corrected ME (MEn) of triticale distillers’ dried grains with solubles (TDDGS), sorghum distillers’ dried grains with solubles (SDDGS), or rye for broiler chickens using the regression method. Five diets including a corn-soybean meal reference diet and four assay diets, prepared by adding TDDGS or SDDGS at 10% or 20% of the diet to partly replace energy-yielding ingredients in the reference diet, were used. Each of the five diets was fed to eight replicate cages of six birds per replicate cage from day 14 to 21 post-hatching. Similarly in experiment 2, corn-soybean reference diet and two assay diets in which rye at 20% or 40% replaced energy-yielding sources in the reference diet and each of the three diets was fed to eight replicate cages of eight birds per replicate cage from day 18 to 23 post-hatching. Excreta samples were collected twice daily from day 18 to 20 in experiment 1 or day 20 to 22 in experiment 2, and ileal digesta were collected on day 21 (experiment 1) or day 23 (experiment 2). The IDE, ME, and MEn (kcal/kg DM) of TDDGS or SDDGS were derived from the regressions of TDDGS-, SDDGS-, or rye-associated, IDE, apparent ME, and apparent MEn intake in kilocalories against the intake of TDDGS, SDDGS, or rye (X, kg DM), respectively. For diets with TDDGS substitution, regression equations were IDE = 12.3 + 3,288X, ME = −3.0 + 2,800X, and MEn = −0.4 + 2,647X. The equations for the SDDGS diets were IDE = −4.8 + 3,247X, ME = −7.6 + 3,210X, and MEn = −7.0 + 3,072X; and those for the rye diets were IDE = 9.5 + 3,002X, ME = 6.3 + 3,053X, and MEn = 4.8 + 2,928X. The IDE contents did not differ between TDDGS and SDDGS whereas the ME and MEn contents were greater (P < 0.05) in the SDDGS than in the TDDGS. In conclusion, the current study provided energy values of the DDGS sources and rye using the regression method. The regression-derived IDE for TDDGS, SDDGS, or rye were 3,288, 3,247, or 3,002 kcal/kg DM, respectively; corresponding ME were 2,800, 3,210, or 3,053 kcal/kg DM. The respective regression-derived MEn for TDDGS, SDDGS, or rye were 2,647, 3,072, or 2,928 kcal/kg DM for broiler chickens.
Variance estimates are similar using pedigree or genomic relationships with or without the use of metafounders or the algorithm for proven and young animals1
Authors: Aldridge Michael N , Vandenplas Jérémie , Bergsma Rob , Calus Mario P L
Published: January 2020

With an increase in the number of animals genotyped there has been a shift from using pedigree relationship matrices (A) to genomic ones. As the use of genomic relationship matrices (G) has increased, new methods to build or approximate G have developed. We investigated whether the way variance components are estimated should reflect these changes. We estimated variance components for maternal sow traits by solving with restricted maximum likelihood, with four methods of calculating the inverse of the relationship matrix. These methods included using just the inverse of A (A−1), combining A−1 and the direct inverse of G (HDIRECT−1), including metafounders (HMETA−1), or combining A−1 with an approximated inverse of G using the algorithm for proven and young animals (HAPY−1). There was a tendency for higher additive genetic variances and lower permanent environmental variances estimated with A−1 compared with the three H−1 methods, which supports that G−1 is better than A−1 at separating genetic and permanent environmental components, due to a better definition of the actual relationships between animals. There were limited or no differences in variance estimates between HDIRECT−1, HMETA−1, and HAPY−1. Importantly, there was limited differences in variance components, repeatability or heritability estimates between methods. Heritabilities ranged between <0.01 to 0.04 for stayability after second cycle, and farrowing rate, between 0.08 and 0.15 for litter weight variation, maximum cycle number, total number born, total number still born, and prolonged interval between weaning and first insemination, and between 0.39 and 0.44 for litter birth weight and gestation length. The limited differences in heritabilities suggest that there would be very limited changes to estimated breeding values or ranking of animals across models using the different sets of variance components. It is suggested that variance estimates continue to be made using A−1, however including G−1 is possibly more appropriate if refining the model, for traits that fit a permanent environmental effect.
Dietary vitamin A affects growth performance, intestinal development, and functions in weaned piglets by affecting intestinal stem cells
Authors: Wang Zhaobin , Li Jia , Wang Yu , Wang Lei , Yin Yuebang , Yin Lanmei , Yang Huansheng , Yin Yulong
Published: January 2020

Vitamin A (VA) is an important nutrient for weaning piglets. It plays a significant role in the normal formation, development, and maintenance of epithelial cells. Previous studies have shown that VA supplements could improve the host’s intestinal barrier function. Therefore, we hypothesized that VA supplements can affect intestinal function in weaned piglets by regulating intestinal stem cells. Thirty-two 21-d-old weaned [(Yorkshire × Landrace) × Duroc] piglets with an average weight of 8.34 ± 0.13 kg were randomly divided into 4 treatment groups, with 1) 2 mg/kg (control), 2) 4 mg/kg, 3) 8 mg/kg, and 4) 16 mg/kg doses of VA, respectively. The experiment lasted for 14 d. Weaned piglets were given ad libitum access to food and water during the test. The ADG (linear, P = 0.020) and G:F (linear, P = 0.005) of the piglets were found to increase significantly from days 8 to 14. The Lgr5+ gene expression (P = 0.012) in the jejunum mucosa of the 16 mg/kg VA group was increased. The jejunum villus height (P = 0.027) and villi surface area (P = 0.035) were significantly increased in the 4 mg/kg VA treatment group. The crypt depth increased significantly in the 4 and 8 mg/kg VA treatment groups (quadratic, P = 0.043), and the ratios of villus height to crypt depth significantly increased in the 16 mg/kg VA group (quadratic, P = 0.015). The maltase (P = 0.032), sucrose (P = 0.041), and alkaline phosphatase activity (linear, P = 0.024) were significantly increased when further supplemented with 4 mg/kg VA. Slc2a2 mRNA abundance was significantly increased in the 2 mg/kg VA group (linear, P = 0.024). Moreover, the budding rates, buddings number per organoid, and Chromogranin A and Muc2 expression of piglet intestinal organoids were significantly reduced (P < 0.05) by VA and its metabolites (retinoic acid). Compared with the control group, the expression of Spp1 and Trop2 increased. These results indicated that VA may increase the stemness of intestinal stem cell in vitro. This study suggested that VA could affect growth performance and intestinal function by regulating intestinal stem cells in the jejunum of weaned piglets.
Chromium Levels in Tobacco, Filter and Ash of Illicit Brands Cigarettes Marketed in Brazil
Authors: Lisboa Thalles Pedrosa , Mimura Aparecida Maria Simões , da Silva Julio Cesar Jose , de Sousa Rafael Arromba
Published: January 2020

Smoking is a public health problem and an important source of exposure to toxic metals. This work describes an efficient analytical method comparable to the ones based on atomic emission techniques for the determination of chromium in different constituent parts of cigarette samples (tobacco, filters and ashes) using electrothermal vaporization–atomic absorption spectrometry. The method was evaluated using 12 samples, and the results showed recovery values between 83 and 107%. The accuracy was also evaluated using a reference sample of tomato leaves (NIST SRM 1573a), which proved the efficiency of the method. The limits of detection of the developed method were 20.4, 75.8 and 80.7 ng g−1 for tobacco, filter and cigarette ash samples, respectively. The average chromium values found for the analyzed samples were in the range of 0.96 to 3.85 and from 0.32 to 0.80 μg/cigarette for tobacco and ashes, respectively. For most pre-burn and post-burn filter samples, the values of chromium concentration remained below limits of detection. The developed method presented adequate results about precision and accuracy, demonstrating its applicability in the determination of chromium in cigarette samples.
Cardiac herniation after extrapleural pneumonectomy
Authors: Nishizawa Natsumasa , Osaki Toshihiro , Fukuichi Yukiko , Yasuda Manabu
Published: January 2020

Cardiac herniation is a fatal complication in patients undergoing pneumonectomy with pericardial resection. A 53-year-old man underwent right-sided extrapleural pneumonectomy for malignant pleural mesothelioma. He underwent right-sided pericardial resection and reconstruction with an expanded polytetrafluoroethylene sheet. Routine chest radiography performed 18 h postoperatively revealed cardiac herniation into the right-sided thoracic cavity. The patient was immediately transferred to the operating room, and the defect was repaired. He died of tumor progression. However, cardiac herniation did not recur over 2 years postoperatively.
Primary mesenteric vein thrombosis: a case series
Authors: Marconato Roberto , Nezi Giulia , Capovilla Giovanni , Moletta Lucia , Baldan Nicola , Canton Silvio Alen , Spirch Saverio , Salvador Renato , Merigliano Stefano
Published: January 2020

Mesenteric vein thrombosis (MVT) is a rare condition, often misdiagnosed due to its vague and misleading clinical presentation. It can cause intestinal infarction, peritonitis, and consequently necessitate bowel resection. CT scanning with intravenous contrast enhancement is the gold standard for its diagnosis. Radiologists have an important role in defining the extent of thrombosis and identifying any signs of intestinal infarction influencing the decision whether or not to operate. In patients with no clinical signs of peritonitis or radiological evidence of intestinal infarction, the treatment can be exclusively medical, based on full anticoagulation (initially with low molecular weight heparin, followed by vitamin K antagonists or direct acting oral-anticoagulants). The duration of medical treatment depends on radiological evidence of resolution of thrombosis and the identification of pro-coagulant risk factors.
Adam and Evel: Did Satan Sleep with Eve in the Greek and Latin Lives of Adam and Eve?
Authors: Cousland J R C
Published: January 2020

A variety of ancient Jewish and Christian sources refer to a sexual liaison between Satan and Eve, a union that resulted in the birth of Cain. This article assembles these texts, and then considers whether the Greek and Latin Lives of Adam and Eve are also aware of this union, and whether these texts have been influenced by the tradition of the Watchers sleeping with the daughters of men. While scholars have been divided on these issues for the last century, this article determines that the Greek Life does not allude or refer to any sexual liaison. The Latin Vita (perhaps in dependence on a different archetype) could allow for the notion, but it is only Latin P that uses language pointing to a literal sexual union. These findings suggest that the Greek and Latin lives did not originally contain a sexual seduction of Eve by the devil. It was only latterly that the narratives were influenced by the Watchers’ narrative or attempts to account for Cain’s maleficent nature.
Humanidades Digitales en Filipinas: proyectos, dificultades y oportunidades de la colaboración Norte-Sur
Authors: Ortuño Casanova Rocío , Sarmiento Anna
Published: January 2020

Situated within the debate that has taken place in the recent years on how Digital Humanities can break down barriers between countries of the Global North and South (Intersectionality in Digital Humanities Conference, 2016), and how materials in minority langauges can have presence in the network for the generation of new knowledge (Thieberger, 2017; Rodríguez-Ortega and Cruces Rodríguez, 2018), the objective of this article is to explain how (and if) digitalization and Digital Humanities can facilitate research in the Philippines, as well as make it visible, and how this can be facilitated by cooperation projects, citing the example of the project Philperiodicals, carried out by the University of Antwerp and the University of the Philippies. What opportunities and difficulties were encountered upon proposing a project with such characteristics? What problems (ethical, at times) do we encounter when subsidizing projects in the South from the North? We shall address these questions based on the current status of digitalization and Digital Humanities in the country. Lastly, we offer a series of good practices concluded from debates and experiences from the project Philperiodicals, in the hopes that our previous difficulties and discussions may be of use for the development of similar projects in what has been called the Global South.
Stenotrophomonas Bacteremia Antibiotic Susceptibility and Prognostic Determinants: Mayo Clinic 10-Year Experience
Authors: Hamdi Ahmed M , Fida Madiha , Abu Saleh Omar M , Beam Elena
Published: January 2020

Background

Stenotrophomonas maltophilia is a gram-negative, opportunistic infection that is usually hospital-acquired and associated with high morbidity and mortality. The reported increase in S. maltophilia infections is presumed to be due to an increase in the population at risk.

Methods

We retrospectively reviewed 10-year data for S. maltophilia bacteremia in hospitalized adults at our institution to determine the population at risk, sources of infection, common complications, antimicrobial susceptibility profiles, and clinical outcome trends over the past decade.

Results

Among the 98 patients analyzed, the most common source of infection was catheter-related (62, 63.3%). Most isolates (61, 65%) were resistant to ceftazidime; fewer were resistant to trimethoprim-sulfamethoxazole (TMP-SMX; 2, 2.1%) and levofloxacin (22, 23.4%). All-cause in-hospital mortality was 29.6% (29 patients). The highest mortality, 53.8%, was observed in pulmonary sources of bacteremia.

Conclusions

Although TMP-SMX continues to have reliable activity in our cohort, we noted resistance to TMP-SMX in patients with recent TMP-SMX exposure, including a case with developing resistance to TMP-SMX while on therapy.
Minimal Compared With Standard Monitoring During Sofosbuvir-Based Hepatitis C Treatment: A Randomized Controlled Trial
Authors: Davis J S , Young M , Marshall C , Tate-Baker J , Madison M , Sharma S , Silva C , Jones T , Davies J
Published: January 2020

Background

Oral direct-acting antiviral agents (DAAs) for hepatitis C virus (HCV) became government subsidized in Australia in March 2016, bringing the interferon era to a close. The ideal monitoring schedule for patients receiving DAAs is unclear.

Methods

This study is a randomized controlled trial comparing standard with minimal monitoring in adults receiving sofosbuvir-based therapy for HCV genotypes 1 or 3. Exclusion criteria were cirrhosis or predicted poor adherence. Standard monitoring included blood tests and face-to-face clinic visits at treatment weeks 4 and 12 and 12 weeks after treatment completion. Minimal monitoring included a phone call at weeks 4 and 12 and one set of blood tests plus a clinic visit 12 weeks after treatment completion. The coprimary outcomes were as follows: (1) proportion of participants with sustained virological response; (2) staff time spent on patient support; and (3) patient satisfaction on a 10-point Likert scale.

Results

Thirty-six patients were randomized to standard monitoring and 38 to minimal monitoring. Sustained virological response at 12 weeks after the end of treatment was documented in 32 of 36 (89%) in the standard versus 37 of 38 (97%) in the minimal monitoring group. Staff time was nonsignificantly longer in the standard group (median 69 [interquartile range {IQR}, 54–80] versus 52 [IQR, 40–75] minutes). Patient satisfaction scores were not different (mean 9.8 of 10 standard versus 9.6 of 10 minimal group). There was no difference in adverse events or unplanned hospital visits; mean per-patient blood test costs were higher in the standard monitoring group ($432 versus $123, P < .001).

Conclusions

On-treatment monitoring with blood tests and clinic visits may not be necessary during sofosbuvir-based HCV treatment in selected patients.
Optimizing Screening for HIV
Authors: Chaillon Antoine , Hoenigl Martin , Freitas Lorri , Feldman Haruna , Tilghman Winston , Wang Lawrence , Smith Davey , Little Susan , Mehta Sanjay R
Published: January 2020

Background

The HIV epidemic is unevenly distributed throughout the United States, even within neighborhoods. This study evaluated how effectively current testing approaches reached persons at risk for HIV infection across San Diego (SD) County, California.

Methods

HIV case and testing data, sexually transmitted infection (STI) and socio-demographic data for SD County were collected from the SD Health and Human Services Agency and the ‘Early Test’ community-based HIV screening program between 1998 and 2016. Relationships between HIV diagnoses, HIV prevalence, and STI diagnoses with screening at zip code level were evaluated.

Results

Overall, 379,074 HIV tests were performed. The numbers of HIV tests performed on persons residing in a zip code or region overall strongly correlated with prevalent HIV cases (R2=0.714), new HIV diagnoses (R2=0.798), and STI diagnoses (R2=0.768 [chlamydia],0.836 [gonorrhea], 0.655 [syphilis]) in those regions. Zip codes with the highest HIV prevalence had the highest number of tests per resident and fewest number of tests per diagnosis. Even though most screening tests occurred at fixed venues located in high prevalence areas, screening of residents from lower prevalence areas was mostly proportional to the prevalence of HIV and rates of new HIV and STI diagnoses in those locales.

Conclusion

This study supported the ability of a small number of standalone testing centers to reach at-risk populations dispersed across SD County. These methods can also be used to highlight geographic areas, or demographic segments that may benefit from more intensive screening.
Surrounded
Authors: Lischer Richard
Published: January 2020

This chapter describes Martin Luther King, Jr.’s religious environment. Twenty-one-year-old King characterized his religious environment as a “universe,” a socially constructed world that shaped his identity and outlook on life. The moral and physical center of that universe was the sanctuary of Ebenezer Baptist Church in Atlanta where his father presided from the pulpit and the son had been baptized. The sanctuary dictated the boundaries within which African-American Christians, including Martin Luther King, Jr., sorted out the relationship of suffering and hope. Throughout his career, King carried the sanctuary with him as a state of mind and soul; he also repeatedly returned to it like a grateful soldier home from the front.
The art of touch
Authors: Johnson Julian
Published: January 2020

This chapter explores the way Debussy’s piano music ‘writes’ the body of the pianist, particularly in the late Études, by rewriting the historical body enshrined in pianistic technique and repertoire. Michel Serres’ discussion of Bonnard and Merleau-Ponty on Cézanne are used to explore the idea of art’s presentation of immersive aesthetic experience and of a music that has to do less with representation than a logic of touch and bodily movement. Susan Sontag’s call for an erotics of art (1964) is the starting point for exploring this music as fundamentally erotic (shaped by the body and by desire). The topic of the ‘chevelure’ from Baudelaire to the music of Dutilleux provides a focus for exploring how this repertoire foregrounds itself as an erotic body.
The Surprising Advance of Gun Control Politics after Parkland
Authors: Young Sophia
Published: January 2020

The 1999 Columbine high school massacre marked the start of an era of recurrent US mass shootings in settings once considered safe. In the aftermath of each horrific event, gun safety advocates tried to persuade state and national politicians to adopt new regulations but with little success—until recently. This chapter compares the political aftereffects of six major mass shootings to illuminate why the 2018 Parkland high school shooting led to more political change in favor of gun regulations than the previous events. Despite an unfavorable partisan climate, the Parkland shooting spurred teenage activists adept with social media tools to take advantage of the political opportunity structure created by prior grassroots resistance organizing. In response, politicians—especially Democrats—have embraced the gun safety cause as never before.
Choosing for Changing Selves
Authors: Pettigrew Richard
Published: January 2020

What we value, like, endorse, want, and prefer changes over the course of our lives. Sometimes this is a result of decisions we make—such as when we choose to become a parent or move to a new country—and sometimes it is caused by forces beyond our control—such as when our political views change as we grow older. This poses a problem for any theory of how we ought to make decisions. Which values and preferences should we appeal to when we are making our decisions? Our current values? Our past ones? Our future ones? Or some amalgamation of all of them? But if that, which amalgamation? This book presents a theory of rational decision-making for people whose values have changed in the past and might change again in the future. It begins with expected utility theory, the orthodox theory of rational choice, and raises the problem of choosing for changing selves in that context. It then offers a new decision theory that avoids the problem. In the process, the book considers a host of related problems: Is it rational to give less weight to your far future preferences than to those in your near future? Can we have moral obligations to pursue the goals of our past selves? Do we know enough about our future preferences to make rational decisions that are sufficiently sensitive to them? How should we combine competing sets of values into a single set?
Neural networks and Keras
Authors: Trappenberg Thomas P.
Published: January 2020

This chapter discusses the basic operation of an artificial neural network which is the major paradigm of deep learning. The name derives from an analogy to a biological brain. The discussion begins by outlining the basic operations of neurons in the brain and how these operations are abstracted by simple neuron models. It then builds networks of artificial neurons that constitute much of the recent success of AI. The focus of this chapter is on using such techniques, with subsequent consideration of their theoretical embedding.
From Islands to Archipelagos
Authors: Riquet Johannes
Published: January 2020

The texts examined in Chapter 4 explore islands in geo(morpho)logical space-time. The chapter begins by discussing how the relational poetics of Darwin’s and Wallace’s writings ask readers to reimagine planetary space as a discontinuous multiplicity of shifting islands. The notion of a geopoetic resonance between the material energies of the physical world and the poetic energies of language guides the analyses of three literary responses to Darwin, Wallace, and their successors. H. G. Wells’s The Island of Doctor Moreau (1896) and ‘Aepyornis Island’ (1894) figure islands as beleaguered territories haunted by the spectre of human extinction. However, their geopoetic descriptions of volcanism and coral suspend these evolutionary narratives. A century later, Amitav Ghosh’s The Hungry Tide explores the radical poetic implications of Darwin and Wallace’s archipelagic thinking. In the novel, the human element intersects with other living forms, physical geography, and textual spaces to form a mutable landscape shaped by conflicts.
The Chorus of Drama in the Fourth Century BCE
Authors: Jackson Lucy C. M. M.
Published: January 2020

The Chorus of Drama in the Fourth Century BCE seeks to upend conventional thinking about the development of drama from the fifth to the fourth centuries. Set in the context of a theatre industry extending far beyond the confines of the City Dionysia and the city of Athens, the identity of choral performers and the significance of their contribution to the shape and meaning of drama in the later Classical period (c.400–323) as a whole is an intriguing and under-explored area of enquiry. Drawing together the fourth-century historical, material, dramatic, literary, and philosophical sources that attest to the activity and quality of dramatic choruses, the book provides a new way of talking and thinking about the choruses of drama after the deaths of Euripides and Sophocles. Having considered the positive evidence for dramatic choral activity, the book provides a radical rethinking of two oft-cited yet ill-understood phenomena that have traditionally supported the idea that the chorus of drama ‘declined’ in the fourth century: the inscription of χοροῦ μέλος‎ in papyri and manuscripts in place of fully written-out choral odes, and Aristotle’s invocation of embolima (Poetics 1456a25–32). The book goes on to explore how influential fourth-century authors such as Plato, Demosthenes, and Xenophon, as well as artistic representations of choruses on fourth-century monuments, have had an important role in shaping later scholars’ understanding of the dramatic chorus throughout the Classical period. The book’s conclusions, too, have implications for the broader story we wish to tell about Attic drama, and its most enigmatic and fundamental element, the chorus.
Economists at Armistice
Authors: Bollard Alan
Published: January 2020

1946 brought the Armistice and a new economic task: the focus of the economists had to move from the problems of wartime rationing and finance to a new world of economic reconstruction, post-war stabilization, economic growth, and debt reduction. In addition the Cold War brought a new tactic: strategic deterrence. In this year Japan commemorated the anniversary of the death of Takashi Korekiyo, H. H. Kung gathered his wealth and prepared to flee the Chinese Communist forces, Maynard Keynes helped establish the International Monetary Fund, only to die exhausted, and Hjalmar Schacht defended himself from accusations of Nazism and regained his freedom.
Good Work for Animals
Authors: Cochrane Alasdair
Published: January 2020

This chapter explores whether there can be ‘good work’ for animals. In other words, it asks whether certain forms of work can not only be harmless, but also promote the well-being of non-human animals. It argues that in some circumstances good work for animals is possible. In so doing, it surveys four of the most common proposed elements of good work for humans—self-realization, pleasure, autonomy, and self-respect—to see if and how they might apply to animals. In so doing, it argues that good work for animals has a three-fold basis: it provides pleasure, including through affording opportunities to use and develop skills; it allows for the exercise of animals’ agency; and it provides a context in which animals can be esteemed as valuable workers and members of the communities in which they labour.
Enargeia and Bodily Mimesis
Authors: Huitink Luuk
Published: January 2020

This chapter analyses the ancient rhetorical concept of enargeia (‘visual vividness’) against the background of recent cognitively inflected research into embodied aspects of reading. While enargeia has usually been interpreted as involving the transference of mental images from author to reader by means of elaborate verbal descriptions (ekphrasis), this chapter shows that this approach leaves many aspects of enargeia unaccounted for—not least a notable focus on narrative descriptions of bodily movements in ancient sources that discuss the concept. The chapter argues that an enactivist account of vision and imagination and embodied theories of language comprehension help us better to understand what ancient critics mean by enargeia. In particular, they give cognitive substance to the claim made by various ancient critics that readers’ quasi-visual responses to texts entailed taking an internal view of represented scenes and could even prompt readers to imaginatively ‘project’ themselves into the bodies of described characters. Imagining bodily actions always to some extent cuts through an inner–outer dichotomy, as it achieves its power and vividness through the reader’s awareness of motor processes, both in others’ bodies and in one’s own. The chapter shows that ancient critics were drawn especially to narrative renditions of goal-directed, transitive movements of the kind which, on an enactivist account, are formative of our experience of agency, and to representations of not necessarily voluntary movements of ‘swaying’ bodies.
Agriculture in India
Authors: Dev S. Mahendra , Mishra Srijit , Pandey Vijay Laxmi
Published: January 2020

Mahendra Dev, Srijit Mishra, and Vijaylaxmi Pandey contextualize Indian agriculture by an evaluation of its performance, with a focus on the roles, challenges and opportunities for small holders. They observe a turn-around over 2004/5–2010/1 compared to the immediate post-reforms period, which had witnessed stagnation in comparison to the pre-reforms period. Public policy initiatives on investment, research, extension and credit and a set of good monsoons were among the reasons for improvement. But livelihood sustainability of smallholder farmers is a matter of concern. Even so, there are opportunities to reduce costs and risks and use low external input sustainable agriculture without compromising on production. There were sharp peaks in agricultural prices that contributed to inflation. But after prices moderated with export prices, there was severe small farmer distress. The supply response has to keep up with demand growth without excessive inflation even as the population dependent on agriculture shrinks.
New Sources of Dynamism in the Industry
Authors: Prasad Bandi Ram
Published: January 2020

Bandi Ram Prasad places the canvas of Indian industry in relation to the financial sector. Reforms gave much needed impetus to industries with opportunities to pursue growth, diversification and global expansion even as policy support, changing dynamics of global manufacturing, and financial reforms emerged as new sources of dynamism. The rapid expansion of India’s financial sector in terms of reach of institutions, products, domestic and foreign financial flows have had significant impact on financing of the Indian industry- from the corporate sector in the conventional economy to the new infrastructure projects to the start-ups, though concerns continue to exist in terms of inadequate financial flows to small businesses and SMEs that have greater potential for employment generation in the context of bank NPAs. The focus on finance raises interesting issues such as risks from volatilities arising from global geopolitics and the scope for domestic policy to evolve alternatives to ensure sustained financial flows to industry.
The Financial Sector in India
Authors: Chakrabarti Rajesh
Published: January 2020

Rajesh Chakrabarti gives an overview of the financial sector in India. For him a financial system is akin to the circulatory system in the human body, tapping and transporting savings throughout the economy, with markets and banks being the two competing and complementary arteries. The Indian financial system ranks slightly below the median in World Economic Forum rankings but has virtually re-booted since the still ongoing liberalization started in 1991. The four pillars of a financial system—laws, technology, creditors’ rights and corporate governance—have all undergone and are still undergoing major transformations. Financial access and inclusion remain key challenges despite serious efforts and experimentation. The banking system is stable, public-sector dominated, fragmented and heavily regulated. Financial markets have witnessed a sea-change but still have limited liquidity. The corporate bond market—key for much-needed infrastructure financing—remains seriously underdeveloped. The regulatory system is fragmented, rule-based and generally speaking quite conservative. Globalization of the financial system has been steadily increasing with time and while not the most innovation-friendly in the world, it has succeeded in providing stability and averting crises in an increasingly turbulent global financial environment. Aadhaar and big-data based fintech has the potential for inclusive innovations. The chapter’s focus on the institutional and legal base brings out the deep seated transformational changes taking place that perhaps need more time to fructify in increasing domestic savings, allocating them better while reducing the cost of credit, improving its availability and encouraging entrepreneurship.