bluuebunny/crossref_metadata_2025 huggingface dataset:
Biological responses following one‐stage full‐mouth scaling and root planing with and without azithromycin: Multicenter randomized trial
Authors: Yashima Akihiro , Morozumi Toshiya , Yoshie Hiromasa , Hokari Takahiro , Izumi Yuichi , Akizuki Tatsuya , Mizutani Koji , Takamatsu Hideyuki , Minabe Masato , Miyauchi Satomi , Yoshino Toshiaki , Tanaka Maki , Tanaka Yoshie , Gomi Kazuhiro
Published: July 2019

Background and Objective

Full‐mouth scaling and root planing (FM‐SRP) increases the systemic levels of inflammatory mediators via early inflammation but may be inhibited using an antimicrobial agent. This prospective intervention study evaluates the biological response and clinical effects of FM‐SRP with and without systemically administered azithromycin (AZM).

Materials and Methods

A multicenter parallel randomized controlled and open‐label trial. A central randomization center used computer‐generated tables to allocate treatments. Sixty‐three patients with moderate to severe generalized periodontitis (New American Academy of Periodontology Classification: Stage3 or 4, Grade B) were randomly assigned to receive FM‐SRP with AZM (test group, n = 32) or FM‐SRP without AZM (control group, n = 31). Clinical parameters and body temperature were measured, and subgingival plaque, peripheral blood, and gingival crevicular fluid were collected before and after treatment. Periodontopathic bacteria and IgG titers were measured by gingival crevicular fluid and peripheral blood. High‐sensitivity assays were used to analyze systemic and local inflammatory markers, such as endotoxin, high‐sensitive CRP (hs‐CRP), and six inflammatory cytokines. Follow‐up 6 weeks.

Results

The total number of bacteria and the number of Porphyromonas gingivalis and Prevotella intermedia were significantly lower in the test group after FM‐SRP. IgG titers for P gingivalis significantly decreased after FM‐SRP with AZM, and the body temperature increased significantly after FM‐SRP without AZM. In the control group, serum hs‐CRP, IFN‐γ, IL‐12p70, and IL‐6 were significantly increased one day after treatment, but subsequently decreased below the original numerical value. In the test group, only hs‐CRP showed a significant increase.

Conclusions

FM‐SRP resulted in similar improvements in clinical parameters with and without the use of AZM. Inflammatory mediators showed no difference between the two groups after FM‐SRP treatment. The use of AZM was effective in preventing the elevation of body temperature after FM‐SRP.
Antioxidant supplementation during illness in dogs: effect on oxidative stress and outcome, an exploratory study
Authors: Hagen D. M. , Ekena J. L. , Geesaman B. M. , Viviano K. R.
Published: July 2019

Objectives

To assess whether combination antioxidant supplementation for 30 days in systemically ill dogs alters antioxidant status, degree of lipid peroxidation, clinical score and survival.

Materials and Methods

Forty client‐owned systemically‐ill hospitalised dogs were eligible for inclusion. Dogs were randomised to no supplementation (NS; n=19) or supplementation with N‐acetylcysteine/S‐adenosylmethionine/silybin and vitamin E (AS; n=20) for 30 days. Clinical score and oxidative biomarkers including glutathione, cysteine, vitamin E, selenium and urine isoprostanes/creatinine (F2‐IsoPs/Cr) were determined on days 0 and 30. Glutathione, cysteine, vitamin E and urine F2‐IsoPs/Cr were quantified by high‐performance liquid chromatography, and selenium concentrations determined using atomic absorption spectroscopy.

Results

Thirty‐two dogs completed the study (NS, n=16; AS, n=16). Vitamin E concentrations were significantly greater in the supplemented compared to the non‐supplemented group. No other markers of oxidative stress significantly changed with supplementation. There was no difference in Day 30 clinical scores or survival between the two groups.

Clinical Significance

In this population of systemically‐ill hospitalised dogs, combination antioxidant supplementation did not alter redox state or clinical outcome.
Texture and color characteristics of swell‐dried ready‐to‐eat Zaghloul date snacks: Effect of operative parameters of instant controlled pressure drop process
Authors: Mounir Sabah , Téllez‐Pérez Carmen , Sunooj Kappat V. , Allaf Karim
Published: July 2019

In this work, development of ready‐to‐eat snacks from Zaghloul date using swell‐drying process was studied. Pre‐dried Zaghloul date samples having 12% water content on dry basis were textured by instant controlled pressure drop technique (DIC) at different operative parameters, saturated steam pressure (p) and processing time (t), ranged from 0.2 to 0.6 MPa and from 9 to 35 s, respectively. The effect of these operative parameters on texture, color, and sensory characteristics of swell‐dried (SD) Zaghloul date snacks were determined and optimized through the response surface methodology. Textural (expansion ratio, hardness, springiness, cohesiveness, and chewiness) and color (L*, a*, b*, C*, and ΔE*) characteristics were significantly affected by the operative parameters of DIC. The optimized textural characteristics was identified for SD Zaghloul date at p = 0.6 MPa and t = 22 s with slight yellowness, while the best color properties were observed for texturing conditions of p = 0.2 MPa and t = 22 s. The expansion ratio εr was then 46% higher and the hardness was 262% lower for SD than airflow‐dried date. Instrumental analysis such as texture profile analysis and Hunter's Lab color analyzer could be used to describe the texture and color changes occurred during food drying. Beside these analyses, the expansion ratio could be used to describe the texture as well. Swell‐drying process, an alternative drying process, is defined as DIC‐assisted hot air drying. The thermo‐mechanical effects of DIC are mainly induced by the abrupt pressure drop toward a vacuum after short‐time treatment (9–35 s) by saturated steam pressure (0.2 up to 0.6 MPa). The abrupt pressure drop rate induces an autovaporization of product's water immediately decreasing the product's temperature allowing it to cross the glass transition Tg border. The impact of DIC operative parameters on Zaghloul date could be observed through the expansion ratio, and the textural characteristics (hardness HA, springiness SP, cohesiveness CO, and chewiness CH).
Prevalence, mortality and healthcare utilization among Medicare beneficiaries with Hepatitis C in Haemodialysis units
Authors: Deshpande Rati , Stepanova Maria , Golabi Pegah , Brown Kimberly , Younossi Zobair M.
Published: July 2019

Hepatitis C (HCV) is more common among patients with end‐stage renal disease requiring haemodialysis compared to the general population. Thus, we aimed to assess trends in prevalence, health resource utilization and mortality among Medicare beneficiaries with HCV on haemodialysis. This is a retrospective study of outpatient and inpatient claims for Medicare beneficiaries receiving haemodialysis (2005‐2016). A total of 291 663 subjects on haemodialysis were included (67.3 ± 15.2 years, 55% male, 55% white, 49% age‐based eligibility). The prevalence of HCV in subjects on haemodialysis was stable and was significantly higher (mean 4.2% in 2005‐2016,P = 0.50 for the trend) than in subjects not on haemodialysis (<1%). In multivariate analysis, liver cirrhosis (odds ratio = 3.4 (95% CI = 3.3‐3.6)) was an independent predictor of 1‐year mortality among haemodialysis patients. Mean total inpatient payments in dialysis patients with HCV remained stable during 2005 ($73 803) through 2016 ($72 133) (trendP = 0.54) while mean total outpatient payment decreased from 2005 ($53 497) to 2016 ($35 439; trendP = 0.0013). In multivariate analysis, after adjustment for age, gender, race and location, both HCV and cirrhosis remained significant contributors to greater spending [HCV: inpatient +22.1% (+19.2%‐25%), HCV: outpatient +18.4% (+14.6%‐22.2%), cirrhosis: inpatient +59.7% (+56.9%‐62.6%), cirrhosis: outpatient +9.4% (+6.2%‐12.6%)]. In conclusion, HCV‐infected Medicare patients receiving haemodialysis incur greater resource utilization; mortality is higher in patients with cirrhosis only. Although HCV prevalence in Medicare haemodialysis recipients is higher than in patients without haemodialysis, these rates are lower than reported, suggesting potential under‐screening for HCV in this high‐risk population.
A re‐evaluation of the framework for the protection of patents, women’s health in Nigeria and the issue of accessing pharmaceutical innovation in Africa: Designing strategies for medicines
Authors: Mike Jennifer H.
Published: July 2019

The objective of this study is to make a case for Nigerian women to have access essential medicines in light of patent protection of pharmaceuticals. Consequently, this study argues for an improvement of women's access to medicines within the context of patent law and rights, the available flexibilities in the international IP regime of the Trade Related Aspect of Intellectual Property Rights (TRIPS) Agreement and Nigeria's national patent system. Towards this goal, the article makes the point that patent law and its exclusive rights, both the TRIPS Agreement and national law of Nigeria, do not exist in a social welfare vacuum. The legal text of patent law, which confers rights on inventors when enforced, translates to many other things outside the sphere of property rights; indeed, it can be a matter of life and death. It is argued in this regard that patent right could, in effect, interfere with access to medicines and therefore, the right to health and prospects for human development. This study adopts a doctrinal methodology to examine, analyse, and evaluate the issues that have arisen in the context of patent protection of pharmaceuticals and its effect on access medicines. It concludes that while the hindrances to accessibility of essential drugs in Nigeria are multifaceted and demand a multidimensional approach for a lasting solution, the TRIPS flexibilities are significant means for addressing the challenges of affordable access to important health treatments within the context of patent law. However, it is emphasised that utilising the flexibilities will require that Nigeria's patent system is strategically designed to take full advantage of the available exceptions, safeguards, and options.
Age‐dependent heteroblastic development of leaf hairs in Arabidopsis
Authors: Xu Yunmin , Qian Zhiyuan , Zhou Bingying , Wu Gang
Published: July 2019

Higher plants progress through a juvenile and an adult phase of development before they enter the reproductive phase. The transition from the juvenile to the adult phase is referred to as vegetative phase change, and this is signified by the production of trichomes on the abaxial side of leaf blades in Arabidopsis; however, the molecular mechanism underlying this process is poorly understood.

We identified a dominant mutation (gl1‐D) in a forward genetic screen that accelerates abaxial trichome production during shoot development. This phenotype is the result of a G‐to‐A substitution in the 3′ noncoding region in the GLABRA1(GL1) gene.

We show that TOE1, an AP2‐like transcription factor that acts downstream of the miR156‐SPL pathway, represses GL1 expression by directly binding to this site, and that gl1‐D prevents TOE1 binding.

Our work reveals a molecular link between vegetative phase change and abaxial trichome production in Arabidopsis, and answers a long‐standing question of how the vegetative phase change pathway regulates vegetative traits.
Validating the Xerostomia Inventory in a radiation‐induced xerostomia population in German language
Authors: Hohenberger Ralph , Baumann Ingo , Plinkert Peter K. , Brinster Regina , Krisam Johannes , Affolter Annette , Hein Matti , Flechsig Paul , Rathke Hendrik , Oladokun Dare , Lippert Burkard M. , Bulut Olcay Cem
Published: July 2019

Objectives

Though xerostomia is a frequent oral symptom, there is no validated disease‐specific questionnaire in German. The purpose of this study was to translate and validate versions of the Xerostomia Inventory and the Summated Xerostomia Inventory in a German‐speaking population.

Participants and Methods

Thirty‐nine patients including 18 patients suffering from radiation‐induced xerostomia enrolled in this study. Both questionnaires were translated into German language according to international accepted guidelines. For validation, we evaluated reliability, validity, and responsiveness using the COSMIN manual for cross‐cultural adaptation.

Results

Cronbach's α was 0.92 for XI and 0.91 for SXI, showing both high internal consistency. Patients suffering from xerostomia showed significantly higher average scores demonstrating its discriminant validity. Confirmatory factor analysis showed excellent “goodness‐of‐fit” values for SXI and good to moderate values for XI, confirming the assumed factor structures. The Xerostomia Inventory and its summated version both showed excellent test–retest reliability in the non‐xerostomia group (ICC = 0.85 and 0.84).

Conclusions

The XI and SXI in their cross‐cultural adapted versions are the first validated self‐report assessments for xerostomia in German language. They are characterized by practical design and can be easily interpreted by the treating physician.
Long‐term Outcome and Adverse Events of Intrathecal Opioid Therapy for Nonmalignant Pain Syndrome
Authors: Sommer Björn , Karageorgos Nikolaos , AlSharif Mustafa , Stubbe Henning , Hans Franz‐Josef
Published: July 2019

Objective

Intrathecal (IT) opioid pumps are one therapeutic cornerstone of refractory nonmalignant pain syndromes. The aim of this study was to evaluate the efficacy of and surgical and pharmacological complications of IT pumps beyond a time span of 10 years.

Methods

In this retrospective single‐center cohort study, 27 patients (14 female, 13 male, age 64.0 ± 8.9 [median, 1 SD] years) were identified. Pain intensity using the numeric rating scale (NRS), pain and IT pump characteristics, and complications were analyzed. The German Pain Questionnaire was used to investigate the physical and mental health status.

Results

Overall time of IT therapy from first implantation to last follow‐up was 20.4 ± 6.0 years. Time to implantation of the second pump (n = 18) was 10.0 ± 5.3 years, and between the second and third pump (n = 6) 6.5 ± 2.7 years; 2 patients received their fourth pump 6 years later. The NRS score was 9.0 ± 0.9 before implantation, 7.0 ± 1.8 1 year after implantation, and 4.0 ± 2.3 at the last follow‐up. IT drug dose remained stable after 3 years. Opioid intoxications occurred in 3 patients (10%). One patient (3%) underwent revision surgery due to a catheter infection. Drug side effects occurred in 4 patients (14%). Our patient group had pain‐related restrictions in physical activities with menial impact regarding mental and emotional stress.

Conclusion

Even after a time span of over 15 years and several exchanges of pump systems, pain intensity was still reduced. After 3 years, IT drug dose remained unchanged with low side‐effect and complication rates.
Trichoscopy of alopecia areata in children. A retrospective comparative analysis of 50 children and 50 adults
Authors: Waśkiel‐Burnat Anna , Rakowska Adriana , Sikora Mariusz , Olszewska Malgorzata , Rudnicka Lidia
Published: July 2019

Background/Objectives

Trichoscopic findings characteristic of alopecia areata have been established in adults. The objective of the study was to assess trichoscopic findings in children with alopecia areata.

Methods

Retrospective analysis of trichoscopic findings in 50 children (3‐11 years old) and 50 adults (19‐31 years old) with alopecia areata was performed.

Results

Yellow dots were less commonly detected in children compared with adults (26/50, 52% vs 48/50, 96%). Pigtail hairs and empty follicular openings were more commonly observed in children compared with adults (14/50, 28% vs 2/50, 4% and 40/50, 80% vs 16/50, 32%, respectively). No significant difference in the frequency of other trichoscopic features between children and adults was found. Black dots, broken hairs, exclamation mark hairs, and tapered hairs were detected in 20/50 (40%), 27/50 (54%), 22/50 (44%), and 6/50 (12%) children, respectively, and in 26/50 (52%), 27/50 (54%), 20/50 (40%), and 11/50 (22%) adults, respectively. Triangular hairs (short hidden hairs), short vellus hairs, and upright regrowing hairs were observed in 22/50 (44%), 35/50 (70%), and 23/50 (46%) children, respectively, and in 24/50 (48%), 37/50 (74%), and 28/50 (56%) adults, respectively. Pohl‐Pinkus constrictions were present in 2/50 (4%) children and 4/50 (8%) adults.

Conclusions

The most common trichoscopic findings of alopecia areata in children are empty follicular openings and short vellus hairs. Pigtail hairs and empty follicular openings are more commonly presented in children compared with adults. In contrast, yellow dots are less commonly observed in children compared with adults. Triangular hairs (short hidden hairs) are new trichoscopic findings of alopecia areata.
Eucalypt seedlings are aided by phosphorus in the face of drought
Authors: Law Simon R.
Published: July 2019

Drought is an increasingly common climatic event that can devastate ecosystems, as well as surrounding agricultural and forestry industries. Few places face this challenge more than Australia, where millennia of droughts linked to geography and climatic drivers, such as El Niño, have shaped the flora and fauna into forms predicated on resilience and economy. How an organism responds to these cyclic challenges is a combination of the inherent tolerance mechanisms encoded in their genome and outside influences, such as the effect of nutrients and symbiotic interactions. In this issue of Physiologia Plantarum, Tariq et al. (2019) describes how the presence of the element phosphorus can bolster the physiological and biochemical response of eucalypt seedlings to severe drought conditions.
From the Book of Mormon to the Circle Seven Koran: Scriptures of American new religions
Authors: Blythe Christopher James
Published: July 2019

This article examines the growing scholarship on scripture in American new religious movements, specifically on exemplary studies on African–American Islam, Mormonism, and Satanism. After reviewing the state of the scholarship, I seek to encourage additional work in this inchoate subfield at the intersection of new religious movements, American religious history, and scriptural studies by offering potential trajectories and publication venues.
The interaction effect of gender and ethnicity in loan approval: A Bayesian estimation with data from a laboratory field experiment
Authors: Gonzales Martínez Rolando , Aguilera‐Lizarazu Gabriela , Rojas‐Hosse Andrea , Aranda Blanco Patricia
Published: July 2019

Microfinance targets women and uses loan provision as a tool for empowerment, which translates into better household nutrition, improved education, and a scale down of domestic violence. However, ethnic discrimination in microfinance may exist in countries with a segregated indigenous population. We assessed this possibility with a field experiment in Bolivia. The controlled laboratory experiment evaluated whether credit officers rejected microloan applications based on the interaction effect of ethnicity and gender of potential borrowers. Point estimates of a Bayesian mixed‐effects logistic regression, estimated with the experimental data, indicate that nonindigenous women have double the chance of loan approval, but indigenous women have only 1.5 times the chance of loan approval when compared with men. While the findings about gender are limited, the evidence for the interaction of gender and ethnicity is more robust and suggests the existence of positive taste‐based discrimination favorable for nonethnic women in Bolivia. We conclude that the affirmative actions towards women promoted by development agencies and microfinance institutions must not overlook ethnicity as an important factor for financial policies of sustainable development. In practice, these policies should be aimed at identifying and reducing both social desirability bias and the structural barriers to financial inclusion that indigenous women may face when trying to obtain access to a loan.
Public response to welfare policy retrenchment: The importance of trust in implementing agencies. The case of early retirement in Sweden 1999–2010
Authors: Stensöta Helena Olofsdotter , Bendz Anna
Published: July 2019

There is a long‐standing argument that citizensapos; trust in the state needs to be recurrently reproduced for policies to endure and that this also includes trust in its separate policy agencies. Such trust is likely to be more important for costlier policies, as, for example, social insurance schemes. The article explores whether short‐term changes in welfare programme generosity affect peopleapos;s trust in the agency implementing the programme. Using the example of early retirement in the encompassing welfare state of Sweden, we study a decade of significant reform (1999–2010), during which the inflow to early retirement diminished greatly, as did citizensapos; trust in the implementing Swedish Social Insurance Agency (SSIA). We conclude that citizensapos; trust is higher when implementation is more generous. Indeed, a third of the drop in citizensapos; trust in the SSIA over the period can be explained by declining levels of generosity in early retirement, with people politically to the left responding with lower trust. Theoretically, we suggest, first, that trust in implementing institutions can function as feedback to policy and, second, that there is a basic relationship between more generous policy outcome and higher trust in encompassing welfare states such as Sweden.
Partisanship, continuity, and change: Politics in Finnish unemployment benefit reforms 1985–2016
Authors: Varjonen Sampo , Kangas Olli , Niemelä Mikko
Published: July 2019

The apparent decline of partisan effects on social policies since the 1980s has encouraged the development of theories that challenge the traditional partisan politics theory. Although the new politics approach pointed to institutional path‐dependence and to the unpopularity of radical retrenchment, recent research has highlighted shifts in electoral landscapes, differences in party systems and institutional contexts, and changing party‐voter linkages. This in‐depth case study contributes to debates on partisan effects by focusing on Finland, whose dualistic unemployment benefit system and institutional and political conditions provide an interesting case to analyse changing partisan effects. The aim is to explain, through qualitative policy analysis, why government partisanship has not had a significant effect on unemployment benefit levels since 1985. The explanations are different for earnings‐related and flat‐rate benefits. For the former, retrenchment efforts have seen a distinct partisan divide, but trade unions have thwarted most cutbacks; thus, although partisanship has not mattered much for policy outcomes, power resources have remained important as inhibitor of cuts. For the latter, parties that in the late 1980s still had differing priorities have since converged on policies emphasizing activation and work incentives. Universal flat‐rate benefits have lacked political support and have been left to stagnate. The study suggests that one single theory is not sufficient to explain developments even in one single welfare policy—there are too many aspects to cover—not to speak of the entire welfare state consisting of an array of different schemes.
A case‐control analysis of hyperhemolysis syndrome in adults and laboratory correlates of complement involvement
Authors: Merrill Samuel A. , Brodsky Robert A. , Lanzkron Sophie M. , Naik Rakhi
Published: July 2019

BACKGROUND

Hyperhemolysis syndrome (HS) is a poorly understood, severe hemolytic anemia provoked by transfusion. Both host and donor RBCs are destroyed in HS; thus, transfusion paradoxically worsens anemia. Risk factors and mechanism of HS are unknown.

STUDY DESIGN AND METHODS

A retrospective case‐control analysis was performed on adults with HS. Patients with HS were matched 1:1 with matched, transfused controls, and HS risk factors were analyzed with multivariable logistic regression. HS samples were analyzed for complement deposition by flow cytometry, and an in vitro model of bystander hemolysis was developed.

RESULTS

Forty‐one patients with 54 episodes of HS were identified in a 26‐year period from 1992 to 2018. Of the HS episodes, only 18.5% were associated with a new alloantibody, and such patients were more tolerant of additional transfusion in the acute episode (p = 0.005). Thirteen percent of episodes were fatal, and HS recurred in 52.6%. Alloimmunization (odds ratio [OR], 17.3), non‐B blood type (OR, 9.8), D antigen (OR, 9.1), and infection (OR, 5.5) were associated with HS on multivariable analysis. Hyperbilirubinemia was predictive of fatal HS (OR, 33.6). Increased complement was observed on RBCs during HS episodes, and the in vitro model of bystander hemolysis recapitulated complement decoration of sickled RBCs.

CONCLUSIONS

HS is associated with significant morbidity, mortality, and recurrence. Risk factors such as known alloimmunization, blood group, and infection predispose to HS. Bystander complement activation may drive HS. These factors may help physicians refine risk‐benefit assessments for transfusion and guide further therapeutic development.
Elicited and pre‐existing anti‐Neu5Gc antibodies differentially affect human endothelial cells transcriptome
Authors: Le Berre Ludmilla , Danger Richard , Mai Hoa L. , Amon Ron , Leviatan Ben‐Arye Shani , Bruneau Sarah , Senage Thomas , Perreault Helene , Teraiya Milan , Nguyen Thi Van Ha , Le Tourneau Thierry , Yu Hai , Chen Xi , Galli Cesare , Roussel Jean‐Christian , Manez Rafael , Costa Cristina , Brouard Sophie , Galinanes Manuel , Harris Kristina M. , Gitelman Stephen , Cozzi Emanuele , Charreau Beatrice , Padler‐Karavani Vered , Soulillou Jean‐Paul
Published: July 2019

Humans cannot synthesize N‐glycolylneuraminic acid (Neu5Gc) but dietary Neu5Gc can be absorbed and deposited on endothelial cells (ECs) and diet‐induced anti‐Neu5Gc antibodies (Abs) develop early in human life. While the interaction of Neu5Gc and diet‐induced anti‐Neu5Gc Abs occurs in all normal individuals, endothelium activation by elicited anti‐Neu5Gc Abs following a challenge with animal‐derived materials, such as following xenotransplantation, had been postulated. Ten primary human EC preparations were cultured with affinity‐purified anti‐Neu5Gc Abs from human sera obtained before or after exposure to Neu5Gc‐glycosylated rabbit IgGs (elicited Abs). RNAs of each EC preparation stimulated in various conditions by purified Abs were exhaustively sequenced. EC transcriptomic patterns induced by elicited anti‐Neu5Gc Abs, compared with pre‐existing ones, were analyzed. qPCR, cytokines/chemokines release, and apoptosis were tested on some EC preparations. The data showed that anti‐Neu5Gc Abs induced 967 differentially expressed (DE) genes. Most DE genes are shared following EC activation by pre‐existing or anti‐human T‐cell globulin (ATG)‐elicited anti‐Neu5Gc Abs. Compared with pre‐existing anti‐Neu5Gc Abs, which are normal component of ECs environment, elicited anti‐Neu5Gc Abs down‐regulated 66 genes, including master genes of EC function. Furthermore, elicited anti‐Neu5Gc Abs combined with complement‐containing serum down‐regulated most transcripts mobilized by serum alone. Both types of anti‐Neu5Gc Abs‐induced a dose‐ and complement‐dependent release of selected cytokines and chemokines. Altogether, these data show that, compared with pre‐existing anti‐Neu5Gc Abs, ATG‐elicited anti‐Neu5Gc Abs specifically modulate genes related to cytokine responses, MAPkinase cascades, chemotaxis, and integrins and do not skew the EC transcriptome toward a pro‐inflammatory profile in vitro.
Preparation of hybrid porcine thymus containing non‐human primate thymic epithelial cells in miniature swine
Authors: Sekijima Mitsuhiro , Sahara Hisashi , Shimizu Akira , Iwanaga Takehiro , Murokawa Takahiro , Ariyoshi Yuichi , Pomposelli Thomas , Khosravi Maharlooei Mohsen , Sykes Megan , Yamada Kazuhiko
Published: July 2019

Background

We have achieved greater than a 6‐month survival of a life‐supporting kidney co‐transplanted with a vascularized thymic graft into non‐human primates (NHPs). Although we have achieved pig‐specific unresponsiveness in vitro, immunosuppression was not able to be fully weaned. Studies in mice and humanized mice suggest that a hybrid pig thymus (Hyb‐thy)‐containing host thymic epithelial cells (TECs) can optimize intra‐thymic selection, achieving xenograft tolerance with improved reconstitution of T‐cell function.

Methods

We have tested the feasibility of the preparation of a Hyb‐thy that contains NHP TECs in the donor thymic grafts. We first prepared the Hyb‐thy in the donor pigs 2‐3 weeks before xeno‐Tx. We performed six cases of Hyb‐thy preparation in six juvenile miniature swine. Two pigs received non‐manipulated cynomolgus monkey thymic cells that were isolated from an excised atrophic thymus via injection into their thymic lobes (Group 1). The remaining four received thymic cells that were isolated from non‐atrophic thymic glands (Groups 2 and 3). Pigs in Group 2 received unmanipulated thymic cells in one thymic lobe, as well as CD2‐positive cell‐depleted TEC‐enriched cells in the contralateral lobe. Pigs in Group 3 received TEC‐enriched cells alone.

Results

All thymus‐injected pigs received tacrolimus and rapamycin until endpoint (POD16). We detected cynomolgus monkey TEC networks in pig thymus from Groups 1 and 3, while pigs in Group 2 rejected the thymic cells. We demonstrated the preparation of Hyb‐thy in pigs using tacrolimus plus rapamycin therapy.

Conclusions

Our results suggest that the enrichment of TEC from the excised NHP thymus facilitated NHP TEC engraftment in pig thymus.
Seroepidemiology and genotyping of hepatitis E virus in Singapore reveal rise in number of cases and similarity of human strains to those detected in pig livers
Authors: Wong Chui Ching , Thean Su Ming , Ng Youming , Kang Joanne Su Lin , Ng Tong Yong , Chau Man Ling , Koh Tse Hsien , Chan Kwai Peng
Published: July 2019

Hepatitis E virus (HEV) causes 20 million infections worldwide yearly, of which only about 3.3 million are symptomatic. In developed Asian countries, HEV strains detected in human sera and in food sources were genetically similar, suggesting that indigenous HEV infections may be largely food‐borne. To assess the burden of hepatitis E in Singapore, we performed a seroepidemiologic study of the infection. Additionally, we carried out HEV genotyping on archived, residual HEV IgM‐positive serum samples collected between 2014 and 2016 (n = 449), and on pig liver samples (n = 36) purchased from wet markets and supermarkets. Our study shows a rise in hepatitis E incidence (IgM) from 1.7 to 4.1 cases per 100,000 resident population from 2012 to 2016 and an increase in hepatitis E IgG positivity rate among residents from 14% in 2007 to 35% in 2016. Other findings also suggest the epidemiology of hepatitis E in Singapore has shifted, from it being mainly a disease imported from the Indian subcontinent, to one that is now increasingly prevalent in our resident population. Genotypes obtained from 143 human samples identified the majority to be genotype 3 (n = 121), 21 to be genotype 1 and one to be genotype 4. Further phylogenetic analyses suggest genotype 3a to be the cause of indigenous infections in residents, which showed genetic similarity to the genotype 3a strains detected in pig livers. This link between the strains in the majority of human samples and those in pig livers consumed by the public suggests a possible food‐borne route of HEV infection in Singapore.
Evaluation of Perceptions of Secondary School Students About the Concept of “Music” by Metaphors
Authors: Çelenk Koray
Published: July 2019

Metaphor is associated with expressions such as symbolic expression, connotation and simile. Metaphor is the use of similes to liken, compare and explain something with another. The concepts have been tried to be analyzed through metaphors in many studies. Although studies on the analysis of metaphors in different branches and branches of studies are frequently encountered, studies on analysis through metaphors in music and music education are less common than other areas of education. This study aims to analyze the opinions of secondary school students about music concept by means of metaphors, and to determine the students’ perceptions regarding music and music lesson through metaphors and to give a different and effective direction to music education. The study group consisted of 1003 students attending at the 5th, 6th, 7th and 8th grades at nine secondary schools selected from Erzurum, Turkey in 2017-2018 academic year by Random Sampling method. The study was carried out by the Descriptive Research Model. In this study, Phenomenology, one of the qualitative research methods, was used and the data were processed by the Content Analysis method. The data obtained were digitized and analyzed by coding in SPSS packet program. As a result of this research, it was determined that secondary school students had a high interest and affection towards music and music lesson and their music preferences were pop music. In addition, 68 kinds of metaphors and 13 kinds of conceptual categories related to music were obtained from 1003 participants. It was found that the most frequently repeated metaphors were “Friend” and “Love”, and generally the students' perceptions were positive towards the concept of music and music lesson, and the metaphors produced differed according to gender, class and music preference variables.
Alert Correlation for Detecting Cyber-Manufacturing Attacks and Intrusions
Authors: Wu Mingtao , Moon Young B.
Published: July 2019

Cyber-manufacturing system (CMS) is a vision of smart factories where manufacturing processes are fully integrated with computational components. In CMS, an effective intrusion detection system (IDS) is essential in protecting manufacturing operations from cyber-physical attacks. Current IDS analyses data from cyber and physical domains but produces reports separately for cyber domain and physical domain. To utilize connections between cyber and physical alerts, this paper presents a cyber-physical alert correlation method. To evaluate the method, four case studies have been developed and carried out on a CMS testbed. The experimental results demonstrate that the method can effectively reduce the number of false alerts, improve the detection accuracy, and identify root causes.
Challenges in the Fabrication of Microstructured Polymer Optics
Authors: Roeder M. , Schilling P. , Fritz K.-P. , Guenther T. , Zimmermann A.
Published: July 2019

The fabrication of microstructured polymer optics enables a multitude of new options in the design of technical optics. However, challenges arise along the varying process chains of mold insert fabrication, integration into molding tools, replication by means of injection compression molding and metrology. In order to study the effects, diffractive optical elements (DOE) and microlens arrays (MLA) are fabricated using two different process chains. DOEs are fabricated using a laser direct writing (LDW) based mold insert fabrication. The MLA mold insert is produced using ultra-precision milling (UP-milling). Both optical parts are replicated using injection compression molding. The occurring effects are discussed and the results show, that with complete process control high quality microstructured polymer optical parts can be produced and characterized.
Superhuman AI for multiplayer poker
Authors: Brown Noam , Sandholm Tuomas
Published: July 2019

AI now masters six-player poker

Computer programs have shown superiority over humans in two-player games such as chess, Go, and heads-up, no-limit Texas hold'em poker. However, poker games usually include six players—a much trickier challenge for artificial intelligence than the two-player variant. Brown and Sandholm developed a program, dubbed Pluribus, that learned how to play six-player no-limit Texas hold'em by playing against five copies of itself (see the Perspective by Blair and Saffidine). When pitted against five elite professional poker players, or with five copies of Pluribus playing against one professional, the computer performed significantly better than humans over the course of 10,000 hands of poker.

Science
, this issue p.
885
; see also p.
864
Complete Genome Sequence of
Thalassococcus
sp. Strain S3, a Marine
Roseobacter
Clade Member Capable of Degrading Carbazole
Authors: Vejarano Felipe , Suzuki-Minakuchi Chiho , Ohtsubo Yoshiyuki , Tsuda Masataka , Okada Kazunori , Nojiri Hideaki
Published: July 2019

We determined the complete genome sequence of
Thalassococcus
sp. strain S3, a marine carbazole degrader isolated from Tokyo Bay in Japan that carries genes for aerobic anoxygenic phototrophy. Strain S3 has a 4.7-Mb chromosome that harbors the carbazole-degradative gene cluster and three (96-, 63-, and 46-kb) plasmids.
Draft Genome Sequence of Bradyrhizobium elkanii Strain SEMIA 938, Used in Commercial Inoculants for
Lupinus
spp. in Brazil
Authors: Hungria Mariangela , Delamuta Jakeline Renata Marçon , Ribeiro Renan Augusto , Nogueira Marco Antonio
Published: July 2019

Due to its high capacity for nitrogen fixation, strain SEMIA 938 is used in commercial inoculants for lupins in Brazil. Its genome was estimated at 8,780,064 bp and indicates that it belongs to the
Bradyrhizobium elkanii
species, while the analysis of nodulation genes classifies the strain in the symbiovar sojae.
The rise of pinnacle reefs: Islands of diversity in seas of despair
Authors: McLaughlin Patrick I. , Bancroft Alyssa M. , Brett Carlton E. , Emsbo Poul
Published: July 2019

Pinnacle reef tracts are geomorphic features of carbonate systems that originated in the early Silurian and display an episodic distribution into the Cenozoic. Detailed study of Silurian pinnacle reefs of the United States midcontinent demonstrates repeated motifs, but most enigmatic is the coincidence of carbonate carbon isotope (δ13Ccarb) excursions and reef pulses. Silurian δ13Ccarb excursions were associated with environmental changes and extinctions, and reefs appear to mark a resurgence of conditions favorable to biomineralizers following those extinction events. Previous workers in the region identified six discrete reef origination events in the United States midcontinent during the Silurian. Our reevaluation of outcrops and cores, conodont collections, and the generation of considerable new chemostratigraphic data across the region are clarifying the age relations of these events and their relationships to perturbations of the global carbon cycle.
Hydrodynamic role of groundwater in bolide impact: Evidence from the Kentland structure, Indiana, USA
Authors: Gutschick† Raymond C.
Published: July 2019

The extremely important role of groundwater has been largely overlooked in studies of meteorite and comet impact processes. Beyond the radius of plasma generation, impacts can produce massive shattering in saturated porous rocks. Fluid pressure rise reduces rock strength and facilitates hydrofracture, to produce intraformational monomict breccias, faulting, and generation of mobile polymict breccia slurries. Decompression of a deep “transient” crater accounts for complex central uplift and gravitational collapse of tremendous slide blocks that in turn cause injection and ejection of fluidized breccia. As pore fluid pressures equilibrate, frictional strength increases, and the structural form is locked into stability. Evidence is reported here for Kentland, Indiana, where quarry rocks display relatively low pressure-temperature (elastic to ductile transition, 100 kb–100 °C) impact phases of the model of D. Stöffler. Breccias include monomict, polymict, mixed polymict-fault, and conventional fault types. The monomict breccias are associated with aquifer beds and formed by pervasive shockwave transmission on impact. Polymict breccias are derived from all rock types and formed from late stage injection-ejection pseudoviscous slurries. These processes can apply to similar impacts like Wells Creek, Flynn Creek, Decaturville, Sierra Madre, and many others.
Screening for early onset neonatal sepsis: NICE guidance-based practice versus projected application of the Kaiser Permanente sepsis risk calculator in the UK population
Authors: Goel Nitin , Shrestha Sudeep , Smith Rhian , Mehta Akshay , Ketty Malini , Muxworthy Helen , Abelian Artur , Kirupaalar Vickness , Saeed Shakir , Jain Shikha , Asokkumar Amar , Natti Murali , Barnard Ian , Pitchaikani Prem Kumar , Banerjee Sujoy
Published: July 2019

Objective

To compare management recommendations of the National Institute for Health and Care Excellence (NICE) guidelines with the Kaiser Permanente sepsis risk calculator (SRC) for risk of early onset neonatal sepsis (EONS).

Design

Multicentre prospective observational projection study.

Setting

Eight maternity hospitals in Wales, UK.

Patients

All live births ≥34 weeks gestation over a 3-month period (February–April 2018).

Methods

Demographics, maternal and infant risk factors, infant’s clinical status, antibiotic usage and blood culture results from first 72 hours of birth were collected. Infants were managed using NICE recommendations and decisions compared with that projected by SRC.

Main outcome measure

Proportion of infants recommended for antibiotics on either tool.

Results

Of 4992 eligible infants, complete data were available for 3593 (71.9%). Of these, 576 (16%) were started on antibiotics as per NICE recommendations compared with 156 (4.3%) projected by the SRC, a relative reduction of 74%. Of the 426 infants avoiding antibiotics, SRC assigned 314 (54.6%) to normal care only. There were seven positive blood cultures—three infants were recommended antibiotics by both, three were not identified in the asymptomatic stage by either; one was a contaminant. No EONS-related readmission was reported.

Conclusion

The judicious adoption of SRC in UK clinical practice for screening and management of EONS could potentially reduce interventions and antibiotic usage in three out of four term or near-term infants and promote earlier discharge from hospital in >50%. We did not identify any EONS case missed by SRC when compared with NICE. These results have significant implications for healthcare resources.
An enigmatic triad of acute pancreatitis, diabetic ketoacidosis and hypertriglyceridaemia: who is the culprit?
Authors: Mathuram Thiyagarajan Umasankar , Ponnuswamy Amirthavarshini , Chung Alex
Published: July 2019

Acute pancreatitis(AP) is one of the common causes of acute abdomen and known to be associated with high morbidity and mortality in severe cases. Though most common causes of AP are cholelithiasis and alcoholism, it has also been reported in association with diabetic ketoacidosis (DKA). Triad of AP, hypertriglyceridaemia (HTG) and DKA is rare co-association and here the causal factor of AP is still not fully established. We report a case of AP in a DKA patient with recent diagnosis of hyperlipidaemia and diabetes. Usually AP has been associated with severe HTG; interestingly, our patient showed only moderate raise in triglycerides but still suffered AP during DKA. Hence, it raises question about the real culprit in this enigmatic triad.
Haemophagocytic lymphohistiocytosis complicating visceral leishmaniasis in the UK: a case for detailed travel history, a high index of suspicion and timely diagnostics
Authors: Johnson Sarah May , Gilmour Kimberly , Samarasinghe Sujith , Bamford Alasdair
Published: July 2019

A 4-month-old male infant presented acutely unwell with fever. He was initially treated for sepsis but failed to improve with IV broad spectrum antibiotics. Haemophagocytic lymphohistiocytosis (HLH) was diagnosed due to his fever, pancytopenia, splenomegaly, hypertriglyceridaemia, hypofibrinogenaemia and significant hyperferritinaemia. An array of differentials for HLH including both immunological and infectious causes were considered and excluded. He had travelled to Madrid, and hence visceral leishmaniasis (VL) was suspected, but was not confirmed on the initial bone marrow aspirate (BMA) microscopy or culture. He improved with empirical treatment with dexamethasone and liposomal amphotericin B. VL was later confirmed on BMA PCR. He made a good recovery and remained well at 12 month follow-up. Non-endemic countries need rapid and sensitive VL diagnostics. A thorough travel history and high clinical index of suspicion are necessary to avoid the pitfall of treatment with intense immunosuppression recommended in treatment guidelines for HLH.
Autoimmune hepatitis following Epstein-Barr virus infection: a diagnostic dilemma
Authors: Peng Haoran , Lim Tanna , Nam Jae , Lee Jin
Published: July 2019

Epstein-Barr virus (EBV) infections frequently affect the liver and cause hepatitis. EBV is a well-known trigger of certain autoimmune diseases. There are few case reports showing the evidence of autoimmune hepatitis (AIH) following EBV infection. However, the diagnosis of AIH is very challenging in the setting of an acute infection. Here, we demonstrate a case of AIH following EBV infection in a patient ultimately recovered after receiving treatment for AIH.
Late perioperative native coronary artery spasm following bypass grafting in a patient with anomalous aortic origin of the coronary artery
Authors: Zohourian Hajir , Bhandari Rohit K , Atanasoski McCormack Violeta
Published: July 2019

Native right coronary artery (RCA) spasm is a less frequent early complication of perioperative coronary artery bypass grafting. Late presentation at 6 days postoperation is scarce and its relationship with an anomalous coronary artery is unknown. The optimal management and prevention remains controversial. In the case presented, the patient’s anomalous left coronary artery originating from the right coronary cusp underwent ligation at its proximal segment at the time of bypass grafting. This ligation was preformed to prevent competitive flow. Six days postoperation, a refractory spasm of dominant native RCA occurred. The spasm resulted in right ventricular failure. Administration of intracoronary verapamil had a longer sustained vasodilatory effect and resolution of coronary spasm when compared with intracoronary nitroglycerine injection. An intra-aortic balloon pump, inotropic agents and low-dose nitroglycerine were used to maintain adequate haemodynamic support. Right ventricular systolic function recovery was noted within 2 days postintervention.
An unusual cause of gastrointestinal bleed in patients with liver cirrhosis
Authors: Kulkarni Anand V , Sharma Manoj Kumar , Jamwal Kapil Dev , Arora Asit
Published: July 2019

Acute upper gastrointestinal (UGI) bleeding in cirrhosis has been classically linked to variceal rupture, although peptic ulcer and portal hypertensive gastropathy-related bleed are not uncommon. Gastrointestinal stromal tumour (GIST) is the most common mesenchymal tumour and may also present as UGI bleed; however, there are no reports of GIST presenting as UGI bleed in patients with cirrhosis. Here, we report three cases of GIST who had presented with UGI bleed and were successfully managed with surgical excision and are tolerating imatinib without recurrence.