bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating the Prevalence of Alcohol Dependence in Europe Using Routine Hospital Discharge Data: An Ecological Study
Authors: Roberts Emmert , Clark Gayle , Hotopf Matthew , Drummond Colin
Published: August 2019

Aims

This study aims to explore the feasibility of using routine hospital discharge data, at the level of countries within Europe, to estimate the general population prevalence of alcohol dependence (AD).

Methods

We utilised the European Core Health Indicators data tool to extract the annual rate of hospital discharges due to any wholly attributable alcohol condition as defined by the ICD-10. For those counties with data available, we systematically searched Medline, EMBASE, PsychINFO and Google for studies reporting an estimate of the prevalence of AD from national cross-sectional surveys. We compared these prevalence estimates with those developed from prediction models based on hospital discharge data.

Results

The rate of hospital discharges due to any condition from the F10 diagnostic category (mental and behavioural disorders due to alcohol) was moderately correlated with AD prevalence (r = 0.56), while the rate due to any condition from the K70 diagnostic category (alcoholic liver disease) was weakly correlated with AD prevalence (r = 0.21). Two-thirds of the estimates from cross-sectional surveys were not significantly different to those generated using the F10 discharge rate prediction model.

Conclusions

Country-level AD prevalence estimates generated using annual F10 hospital discharge rates are likely to provide information of some utility, particularly when limited other sources of information are available or when examining relative trends over time or between regions. There is, however, currently insufficient evidence to make a definitive recommendation to use hospital discharge data to estimate the absolute prevalence of AD per country in Europe.
Newcomb University: A play in one act
Authors: Elga Adam
Published: August 2019

Counter-intuitive consequences of both causal decision theory and evidential decision theory are dramatized. Each of those theories is thereby put under some pressure to supply an error theory to explain away intuitions that seem to favour the other. Because trouble is stirred up for both sides, complacency about Newcomb’s problem is discouraged.
A new cosmological argument from grounding
Authors: Deng Duen-Min
Published: August 2019

This paper presents a new cosmological argument based on considerations about grounding. I argue that, by assuming three plausible principles about grounding, we can construct a cosmological argument for the existence of a unique ungrounded being that ultimately grounds everything else. At the end of the paper I consider two possible objections, and offer my replies to them.
Exploring the Neuropsychological Profile of a Clinically Referred Sample of Children in Mexico
Authors: Giudicessi A , Visconti V D , Zenit Aldana A , Ibarra C
Published: August 2019

Objective

The Wechsler Scale of Intelligence for Children (WISC-IV) is one of the most commonly used intelligence tests for children. A Spanish version of the WISC-IV exists, but a limited amount of published information is available on its utility when assessing pediatric clinical populations. Furthermore, little published research utilizes the WISC-IV in Spanish speaking populations residing outside the US. This study seeks to present the neuropsychological profile of a clinically referred sample of children residing in Mexico.

Participants and Method

The present study included 35 participants (15 females and 20 males, M age of 9.26 years, SD = 1.69). Participants were referred to clinic sites affiliated with the neuropsychology master’s program at Benemérita Universidad Autónoma de Puebla (BUAP). Participants were referred for assessment due to persistent academic/behavior difficulties and were included in this study if they were between the ages of 7 and 12, with no history of a psychiatric disorder. All participants were administered the WISC-IV. Procedures were approved by the ethics committee at BUAP. Informed consent was obtained prior to evaluation.

Results

Descriptive statistics show a Full-Scale IQ average (FSIQ) mean of 75.40 (SD = 12.42). Highest index scores were on Perceptual Reasoning (PRI) (M = 84.94, SD = 16.22) and Processing Speed (PSI) (M = 81.34, SD = 12.96) and lowest index score were on working memory (WMI) (M = 76.97, SD = 14.64) and Verbal Comprehension (VCI) (M = 76.54, SD = 12.42). Independent T-Tests showed no significant differences between genders.

Conclusions

Our results show a low average IQ for the sample but also identifies strengths in certain indices and specific subtests within the WISC-IV that can add rich details in the comprehension of cognitive functioning in this sample. In the future, we plan to continue the growth of our study via the utilization of a control group to compare with the clinical sample.
Effects of Cultural and Educational Variables on a Computerized Continuous Performance Task: the EMBRACED CPT
Authors: Ibanez-Casas I , Jannoo D , Denardis D , De la Cruz F , Santiago S , Lozano-Ruiz A , Daugherty J
Published: August 2019

Objective

The continuous performance tests (CPTs) are the gold standard to assess vigilance or sustained attention. Many studies have shown that educational level is significantly associated with performance on the CPTs. However, very few studies have made comparisons that included cultural factors (Miranda et al, 2008). Given the breadth of educational systems in different parts of the world, it could be expected that the effect of educational level will vary depending on the culture of origin. The aim of this study was to examine the effect of education on performance on a CPT task in 3 ethnically diverse groups (Hispanic, Non-Hispanic and Spanish).

Participants and Method

This study includes 57 participants in the EMBRACED project: 12 Hispanic Americans, 26 non-Hispanics Americans, and 19 Spaniards (8.3%, 30% and 57% with high education respectively). Educational level was defined as high (university degree and above) or low (less than a university degree). The EMBRACED CPT is computerized and demands the participant to touch the iPad screen each time a target is presented. In 3 blocks of 100 stimuli each, the number of hits, omissions, and commissions is recorded.

Results

A mixed between-within subjects analysis of variance was conducted to compare scores in the three blocks of the CPT in relation to the three cultural groups and by education levels. Results showed no interaction effects between cultural groups and education, and no main effects of education for any of the studied variables. However, there was a significant main effect for cultural group for hits (F = 4.676, P = .014) and omissions (F = 5.614, p = .006).

Conclusions

The overall results for education in this study were not significant and would need further study. The variability in cultural group revealed a consistent effect across all studied variables. The non-Hispanics scored higher in hits and the Spaniards had more omissions. These results justify the need for cultural adaptation of neuropsychological measures.

References

Miranda, M. C., Sinnes, E. G., Pompeia, S., & Francisco Amodeo Bueno, O. (2008). A comparative study of performance in the Conners' Continuous Performance Test between Brazilian and North American children. Journal of Attention Disorders, 11(5), 588-598.
Normative Data for the Halstead Category Test in a Spanish-Speaking Adult Population Living in the U.S./México Border Region
Authors: Morlett Paredes A , Carrasco J , Cherner M , Umlauf A , Rivera Mindt M , Suarez P , Artiola i Fortuny L , Franklin D R , Heaton R K , Marquine M J
Published: August 2019

Objective

To provide norms applicable to Spanish-speakers living in the US- Mexico border region for the Halstead Category Test, a test of executive function.

Participants and Method

Healthy Spanish-speakers (n = 252) were recruited from the US–Mexico border regions (Age: M = 37.3, SD = 10.2, range 19-60; Education: M = 10.7, SD = 4.3, range 0-20; 58% female). Participants completed the Category Test as part of a larger neuropsychological test battery. Relationships between demographic variables and raw error scores were assessed using Spearman and Wilcoxon Rank-sum tests. Demographically corrected T-scores for the Category Test were normed using fractional polynomial equations accounting for age, education, and sex. For comparison, T-scores were also computed for the Spanish-speaking normative sample using published norms for English-speaking non-Hispanic Whites and African Americans, which were also adjusted for age, education and sex. Impairment rates based on -1SD (T < 40) were calculated using both, published and current, norms.

Results

Older age was significantly associated with higher number of errors (Spearman ρ = 0.32, p < .001) and higher education was associated with lower number of errors (Spearman ρ = -0.52, p < .001), with no other significant demographic effects. Applying non-Hispanic norms resulted in overestimation of impairment rates in the Spanish-speaking sample (impairment rate: 48% with White norms and 27% with African American norms). This pattern was evident across levels of education except in participants with 13+ years of education, where rates of impairment using African American norms were comparable to those based on the newly developed norms.

Conclusions

The present study is the first to develop norms for the Category test in a sample of Spanish-speakers in the US-Mexico border region. These norms will provide tools for the assessment of executive function in this population. Research concerning generalizability of norms to other Spanish-speaking populations is needed.
Head to Head Clinical Comparison of Two Confrontation Naming Measures in Spanish Speaking People with Epilepsy
Authors: Smith J A D , Bailey K C , Chavarria V
Published: August 2019

Objective

The incidence of epilepsy in Hispanic, adult Spanish-speaking people with epilepsy (PWE) residing in the United States is nearly twice that of non-Hispanic US adults. Neuropsychologists are asked to discern if test findings reveal lateralization or localization regarding known epileptiform activity. Given the high stakes nature of surgical procedures (e.g., partial temporal lobectomy), it is imperative that intervention approaches are guided by valid and reliable neuropsychological measures. Identifying these measures is especially challenging in this underserved group, where test options are limited. The purpose of the present investigation was to compare the clinical utility of two confrontation naming measures, the Pontón-Satz Modified Boston Naming Test (MBNT) and the Vocabulario Sobre Dibujos subtest from the Batería III Woodcock-Muñoz.

Participants and Method

Seventy-one Hispanic, primarily immigrant, Spanish-speaking PWE underwent neuropsychological assessment which included both confrontation naming measures. Seizure lateralization was agreed upon by consensus via an interdisciplinary epilepsy conference (left hemisphere [LH] = 35, right hemisphere [RH] = 36).

Results

Analyses used education adjusted standard scores. Independent t-tests revealed that, as expected, LH Vocabulario Sobre Dibujos scores were significantly lower than RH, t(69) = 2.0, p = 0.049. Notably, LH and RH MBNT scores did not significantly differ. ROC analyses of Vocabulario Sobre Dibujos yielded adequate classification accuracy (AUC = 0.639, p < .05; Sensitivity = 71%; Specificity = 89%); however, the MBNT was not significant (AUC = 0.594, p = .17).

Conclusions

Education adjusted standard scores for Vocabulario Sobre Dibujos outperformed the MBNT for detecting language impairment as well as discriminating between seizure laterality; thus, suggesting a need for further investigation and, possibly, evidence-based change in clinical neuropsychological practice with US Spanish speaking PWE.
Diagnosing Social Communication Disorder (SCD) in Multicultural Individuals: A Case Study
Authors: Jain D , Cohen M J , Fredrick-Keniston A
Published: August 2019

Objective

Explore the impact of culture, developmental stage, and cognitive functioning in a possible diagnosis of SCD.

Case Description

A 12-year-old South Asian, bilingual/bicultural adolescent male (X) presented with concerns regarding his executive and social functioning skills. His medical history was notable for craniosynostosis - successfully treated with craniofacial surgery at age 1 - and a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD), combined presentation.

Diagnostic Impressions and Outcomes

X demonstrated superior intellectual performance with some inefficiencies in cognitive processing. Challenges with social interaction were not observed over the course of testing but his mother reported difficulties understanding pragmatic aspects of communication (sexual innuendos in double entendres) and recognizing when conversation had moved to a different topic. He kept a small social circle and preferred the company of older children.

Discussion

In conceptualizing X’s difficulties with social pragmatics, we must keep in mind the socio-cultural context in which he is growing up. He is the son of immigrant parents with South Asian roots. He is at an adolescent developmental stage where he is beginning to explore his individual identity while navigating the differing mores between his South Asian home culture and his American host culture. Therefore, responding to sexual innuendos may be a decision that is fraught with cultural angst over what is appropriate in one context but not the other. His gifted abilities and ADHD may make it difficult for him to remain engaged in the classroom or with similar-aged peers who don’t challenge his intellectual proclivities. His ADHD may also explain his difficulty in recognizing when the topic of conversation has changed. In deciding whether to assign a diagnosis of SCD, it is important to remember these cultural and developmental factors which could explain his difficulties in a normalizing way. These factors should also inform potential therapeutic recommendations.
A Systematic Approach to Spanish Neuropsychological Evaluation: Case Report with a Mexican Woman in an Outpatient Setting
Authors: Rivera P , Savage K , Ball A
Published: August 2019

Objective

The following case will demonstrate a systematic approach to neuropsychological evaluation with Spanish-speaking individuals, which includes creating a suitable test battery, interpreting results with appropriate normative samples, and incorporating personal history.

Case Description

61-year-old, right-handed, Mexican female with 2 years of formal education, and with a recent history of subarachnoid hemorrhage with hydrocephalus. She was referred by her social worker and primary care provider to discern whether the reported cognitive complaints were due to a neurocognitive condition or depression.

Diagnostic Impressions and Outcomes

The evaluation was administered entirely in Spanish and some exams were modified to accommodate her limited literacy skills. She exhibited deficits in executive functioning, verbal fluency, and memory. Emotional testing revealed moderate depression with anxious distress, which she attributed to significant changes in everyday life. Her family informed us that she was the “matriarch of the family” and worked as a farm field truck driver, with significant difficulties/lack of engagement in both of these roles. Therefore, diagnoses of probable major vascular neurocognitive disorder and major depressive disorder with anxious distress were assigned. With this information, her providers were able to connect the family with community resources.

Discussion

The Hispanic population continues to be the fastest growing demographic in the United States. As more clinicians will work with members of this ethnicity in outpatient settings, it is important that they incorporate culturally-relevant factors in their approach to testing and interpretation of results. Nonetheless, this case demonstrates the current challenges and limitations, including modification of exams, differences in educational system that underlie test construction, and patient’s history. Recommendations for future areas of study and practice will also be discussed.
Shallow genetic divergence and distinct phenotypic differences between two Andean hummingbirds: Speciation with gene flow?
Authors: Palacios Catalina , García-R Silvana , Parra Juan Luis , Cuervo Andrés M , Stiles F Gary , McCormack John E , Cadena Carlos Daniel
Published: August 2019

Ecological speciation can proceed despite genetic interchange when selection counteracts the homogenizing effects of migration. We tested predictions of this divergence-with-gene-flow model in Coeligena helianthea and C. bonapartei, 2 parapatric Andean hummingbirds with marked plumage divergence. We sequenced putatively neutral markers (mitochondrial DNA [mtDNA] and nuclear ultraconserved elements [UCEs]) to examine genetic structure and gene flow, and a candidate gene (MC1R) to assess its role underlying divergence in coloration. We also tested the prediction of Gloger’s rule that darker forms occur in more humid environments, and examined morphological variation to assess adaptive mechanisms potentially promoting divergence. Genetic differentiation between species was low in both ND2 and UCEs. Coalescent estimates of migration were consistent with divergence with gene flow, but we cannot reject incomplete lineage sorting reflecting recent speciation as an explanation for patterns of genetic variation. MC1R variation was unrelated to phenotypic differences. Species did not differ in macroclimatic niches but were distinct in morphology. Although we reject adaptation to variation in macroclimatic conditions as a cause of divergence, speciation may have occurred in the face of gene flow driven by other ecological pressures or by sexual selection. Marked phenotypic divergence with no neutral genetic differentiation is remarkable for Neotropical birds, and makes C. helianthea and C. bonapartei an appropriate system in which to search for the genetic basis of species differences employing genomics.
Fast and accurate correction of optical mapping data via spaced seeds
Authors: Salmela Leena , Mukherjee Kingshuk , Puglisi Simon J , Muggli Martin D , Boucher Christina
Published: August 2019

Motivation

Optical mapping data is used in many core genomics applications, including structural variation detection, scaffolding assembled contigs and mis-assembly detection. However, the pervasiveness of spurious and deleted cut sites in the raw data, which are called Rmaps, make assembly and alignment of them challenging. Although there exists another method to error correct Rmap data, named cOMet, it is unable to scale to even moderately large sized genomes. The challenge faced in error correction is in determining pairs of Rmaps that originate from the same region of the same genome.

Results

We create an efficient method for determining pairs of Rmaps that contain significant overlaps between them. Our method relies on the novel and nontrivial adaption and application of spaced seeds in the context of optical mapping, which allows for spurious and deleted cut sites to be accounted for. We apply our method to detecting and correcting these errors. The resulting error correction method, referred to as Elmeri, improves upon the results of state-of-the-art correction methods but in a fraction of the time. More specifically, cOMet required 9.9 CPU days to error correct Rmap data generated from the human genome, whereas Elmeri required less than 15 CPU hours and improved the quality of the Rmaps by more than four times compared to cOMet.

Availability and implementation

Elmeri is publicly available under GNU Affero General Public License at https://github.com/LeenaSalmela/Elmeri.

Supplementary information

Supplementary data are available at Bioinformatics online.
DDAP: docking domain affinity and biosynthetic pathway prediction tool for type I polyketide synthases
Authors: Li Tingyang , Tripathi Ashootosh , Yu Fengan , Sherman David H , Rao Arvind
Published: August 2019

DDAP is a tool for predicting the biosynthetic pathways of the products of type I modular polyketide synthase (PKS) with the focus on providing a more accurate prediction of the ordering of proteins and substrates in the pathway. In this study, the module docking domain (DD) affinity prediction performance on a hold-out testing dataset reached 0.88 as measured by the area under the receiver operating characteristic (ROC) curve (AUC); the Mean Reciprocal Ranking (MRR) of pathway prediction reached 0.67. DDAP has advantages compared to previous informatics tools in several aspects: (i) it does not rely on large databases, making it a high efficiency tool, (ii) the predicted DD affinity is represented by a probability (0–1), which is more intuitive than raw scores, (iii) its performance is competitive compared to the current popular rule-based algorithm. DDAP is so far the first machine learning based algorithm for type I PKS DD affinity and pathway prediction. We also established the first database of type I modular PKSs, featuring a comprehensive annotation of available docking domains information in bacterial biosynthetic pathways.

Availability and implementation

The DDAP database is available at https://tylii.github.io/ddap. The prediction algorithm DDAP is freely available on GitHub (https://github.com/tylii/ddap) and released under the MIT license.

Supplementary information

Supplementary data are available at Bioinformatics online.
VisFeature: a stand-alone program for visualizing and analyzing statistical features of biological sequences
Authors: Wang Jun , Du Pu-Feng , Xue Xin-Yu , Li Guang-Ping , Zhou Yuan-Ke , Zhao Wei , Lin Hao , Chen Wei
Published: August 2019

Many efforts have been made in developing bioinformatics algorithms to predict functional attributes of genes and proteins from their primary sequences. One challenge in this process is to intuitively analyze and to understand the statistical features that have been selected by heuristic or iterative methods. In this paper, we developed VisFeature, which aims to be a helpful software tool that allows the users to intuitively visualize and analyze statistical features of all types of biological sequence, including DNA, RNA and proteins. VisFeature also integrates sequence data retrieval, multiple sequence alignments and statistical feature generation functions.

Availability and implementation

VisFeature is a desktop application that is implemented using JavaScript/Electron and R. The source codes of VisFeature are freely accessible from the GitHub repository (https://github.com/wangjun1996/VisFeature). The binary release, which includes an example dataset, can be freely downloaded from the same GitHub repository (https://github.com/wangjun1996/VisFeature/releases).

Supplementary information

Supplementary data are available at Bioinformatics online.
MKP1 phosphatase is recruited by CXCL12 in glioblastoma cells and plays a role in DNA strand breaks repair
Authors: Dedobbeleer Matthias , Willems Estelle , Lambert Jeremy , Lombard Arnaud , Digregorio Marina , Lumapat Paul Noel , Di Valentin Emmanuel , Freeman Stephen , Goffart Nicolas , Scholtes Felix , Rogister Bernard
Published: August 2019

Glioblastoma (GBM) is the most frequent and aggressive primary tumor in the central nervous system. Previously, the secretion of CXCL12 in the brain subventricular zones has been shown to attract GBM cells and protect against irradiation. However, the exact molecular mechanism behind this radioprotection is still unknown. Here, we demonstrate that CXCL12 modulates the phosphorylation of MAP kinases and their regulator, the nuclear MAP kinase phosphatase 1 (MKP1). We further show that MKP1 is able to decrease GBM cell death and promote DNA repair after irradiation by regulating major apoptotic players, such as Jun-N-terminal kinase, and by stabilizing the DNA repair protein RAD51. Increases in MKP1 levels caused by different corticoid treatments should be reexamined for GBM patients, particularly during their radiotherapy sessions, in order to prevent or to delay the relapses of this tumor.
Optimization of Insect Odorant Receptor Trafficking and Functional Expression Via Transient Transfection in HEK293 Cells
Authors: Miazzi Fabio , Hoyer Carolin , Sachse Silke , Knaden Markus , Wicher Dieter , Hansson Bill S , Lavista-Llanos Sofia
Published: August 2019

Insect odorant receptors (ORs) show a limited functional expression in various heterologous expression systems including insect and mammalian cells. This may be in part due to the absence of key components driving the release of these proteins from the endoplasmic reticulum and directing them to the plasma membrane. In order to mitigate this problem, we took advantage of small export signals within the human HCN1 and Rhodopsin that have been shown to promote protein release from the endoplasmic reticulum and the trafficking of post-Golgi vesicles, respectively. Moreover, we designed a new vector based on a bidirectional expression cassette to drive the functional expression of the insect odorant receptor coreceptor (Orco) and an odor-binding OR, simultaneously. We show that this new method can be used to reliably express insect ORs in HEK293 cells via transient transfection and that is highly suitable for downstream applications using automated and high-throughput imaging platforms.
Cytomegalovirus Viremia Associated With Increased Mortality in Cryptococcal Meningitis in Sub-Saharan Africa
Authors: Skipper Caleb , Schleiss Mark R , Bangdiwala Ananta S , Hernandez-Alvarado Nelmary , Taseera Kabanda , Nabeta Henry W , Musubire Abdu K , Lofgren Sarah M , Wiesner Darin L , Rhein Joshua , Rajasingham Radha , Schutz Charlotte , Meintjes Graeme , Muzoora Conrad , Meya David B , Boulware David R
Published: August 2019

Background

Cryptococcal meningitis and tuberculosis are both important causes of death in persons with advanced human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Cytomegalovirus (CMV) viremia may be associated with increased mortality in persons living with HIV who have tuberculosis. It is unknown whether concurrent CMV viremia is associated with mortality in other AIDS-related opportunistic infections.

Methods

We prospectively enrolled Ugandans living with HIV who had cryptococcal meningitis from 2010–2012. Subsequently, we analyzed stored baseline plasma samples from 111 subjects for CMV DNA. We compared 10-week survival rates among those with and without CMV viremia.

Results

Of 111 participants, 52% (58/111) had detectable CMV DNA (median plasma viral load 498 IU/mL, interquartile range [IQR] 259–2390). All samples tested were positive on immunoglobin G serology. The median CD4+ T cell count was 19 cells/µL (IQR 9–70) and did not differ by the presence of CMV viremia (P = .47). The 10-week mortality rates were 40% (23/58) in those with CMV viremia and 21% (11/53) in those without CMV viremia (hazard ratio 2.19, 95% confidence interval [CI] 1.07–4.49; P = .03), which remained significant after a multivariate adjustment for known risk factors of mortality (adjusted hazard ratio 3.25, 95% CI 1.49–7.10; P = .003). Serum and cerebrospinal fluid cytokine levels were generally similar and cryptococcal antigen-specific immune stimulation responses did not differ between groups.

Conclusions

Half of persons with advanced AIDS and cryptococcal meningitis had detectable CMV viremia. CMV viremia was associated with an over 2-fold higher mortality rate. It remains unclear whether CMV viremia in severely immunocompromised persons with cryptococcal meningitis contributes directly to this mortality or may reflect an underlying immune dysfunction (ie, cause vs effect).

Clinical Trials Registration

NCT01075152.
Chlorhexidine Bathing to Prevent Central Line–Associated Bloodstream Infections in Hematology Units: A Prospective, Controlled Cohort Study
Authors: Tien Kuei-Lien , Sheng Wang-Huei , Shieh Shiouh-Chu , Hung Yen-Ping , Tien Hwei-Fang , Chen Yi-Hsuan , Chien Li-Jung , Wang Jann-Tay , Fang Chi-Tai , Chen Yee-Chun
Published: August 2019

Background

Chlorhexidine (CHG) bathing decreases the incidence of bloodstream infections in intensive care units, but its effect has been understudied in patients with hematological malignancies in noncritical care units.

Methods

Adults with hematological malignancies hospitalized for cytotoxic chemotherapy in noncritical care units were offered daily 2% CHG bathing. We compared outcomes of patients who chose CHG bathing (CHG group) with outcomes of those who did not choose CHG bathing (usual-care group). The primary outcome was gram-positive cocci–related, skin flora–related, or central line–associated bloodstream infection. The negative control outcome was gut-origin bacteremia.

Results

The CHG group (n = 485) had a crude incidence rate of the primary outcome that was 60% lower than the rate for the usual-care group (n = 408; 3.4 vs 8.4 per 1000 patient-days, P = .02) but had a similar crude incidence rate of the negative control outcome (4.5 vs 3.2 per 1000 patient-days; P = .10). In multivariable analyses, CHG bathing was associated with a 60% decrease in the primary outcome (adjusted hazard ratio [HR], 0.4; P < .001). In contrast, CHG bathing had no effect on the negative control outcome (adjusted HR, 1.1; P = .781). CHG bathing was well tolerated by participants in the CHG group.

Conclusions

CHG bathing could be a highly effective approach for preventing gram-positive cocci–related, skin flora–related, or central line–associated bacteremia in patients with hematological malignancies who are hospitalized for cytotoxic chemotherapy in noncritical care units.
The Crafts–Harley view of German industrialization: an independent estimate of the income side of net national product, 1851–1913
Authors: Pfister Ulrich
Published: August 2019

Novel information on land rent is used to estimate the income side of German net national product (NNP) in 1851–1913 without recourse to output side aggregates. The new series shows higher values during the initial part of the period of observation, which narrows the wedge that opens up between existing estimates of NNP before the 1880s. The results support a modified Crafts–Harley view of the first phase of German industrialization: despite rapid catch-up growth of industrial leading sectors from the 1840s to the 1870s, the pace of aggregate growth accelerated only gradually. The initially small size of the modern sector and the simultaneity of the first phase of industrialization and the first wave of globalization account for this paradox. The labor share remained largely constant; the decline of the land share in NNP was compensated by a rise of the capital share.
Five-year outcomes following timely primary percutaneous intervention, late primary percutaneous intervention, or a pharmaco-invasive strategy in ST-segment elevation myocardial infarction: the FAST-MI programme
Authors: Danchin Nicolas , Popovic Batric , Puymirat Etienne , Goldstein Patrick , Belle Loïc , Cayla Guillaume , Roubille François , Lemesle Gilles , Ferrières Jean , Schiele François , Simon Tabassome ,   the FAST-MI Investigators
Published: August 2019

Aims

ST-segment elevation myocardial infarction (STEMI) guidelines recommend primary percutaneous coronary intervention (pPCI) as the default reperfusion strategy when feasible ≤120 min of diagnostic ECG, and a pharmaco-invasive strategy otherwise. There is, however, a lack of direct evidence to support the guidelines, and in real-world situations, pPCI is often performed beyond recommended timelines. To assess 5-year outcomes according to timing of pPCI (timely vs. late) compared with a pharmaco-invasive strategy (fibrinolysis with referral to PCI centre).

Methods and results

The French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) programme consists of nationwide observational surveys consecutively recruiting patients admitted for acute myocardial infarction every 5 years. Among the 4250 STEMI patients in the 2005 and 2010 cohorts, those with reperfusion therapy and onset-to-first call time <12 h (n = 2942) were included. Outcomes at 5 years were compared according to type of reperfusion strategy and timing of pPCI, using Cox multivariable analyses and propensity score matching. Among those, 1288 (54%) patients had timely pPCI (≤120 min from ECG), 830 (28%) late pPCI (>120 min), and 824 (28%) intravenous fibrinolysis. Five-year survival was higher with a pharmaco-invasive strategy (89.8%) compared with late pPCI [79.5%; adjusted hazard ratio (HR) 1.51; 1.13–2.02] and similar to timely pPCI (88.2%, adjusted HR 1.02; 0.75–1.38). Concordant results were observed in propensity score-matched cohorts and for event-free survival.

Conclusion

A substantial proportion of patients have pPCI beyond recommended timelines. As foreseen by the guidelines, these patients have poorer 5-year outcomes, compared with a pharmaco-invasive strategy.
Nurse-led vs. usual-care for atrial fibrillation
Authors: Wijtvliet E P J Petra , Tieleman Robert G , van Gelder Isabelle C , Pluymaekers Nikki A H A , Rienstra Michiel , Folkeringa Richard J , Bronzwaer Patrick , Elvan Arif , Elders Jan , Tukkie Raymond , Luermans Justin G L M , Van Asselt A D I Thea , Van Kuijk Sander M J , Tijssen Jan G , Crijns Harry J G M ,   RACE 4 Investigators
Published: August 2019

Background

Nurse-led integrated care is expected to improve outcome of patients with atrial fibrillation compared with usual-care provided by a medical specialist.

Methods and results

We randomized 1375 patients with atrial fibrillation (64 ± 10 years, 44% women, 57% had CHA2DS2-VASc ≥ 2) to receive nurse-led care or usual-care. Nurse-led care was provided by specialized nurses using a decision-support tool, in consultation with the cardiologist. The primary endpoint was a composite of cardiovascular death and cardiovascular hospital admissions. Of 671 nurse-led care patients, 543 (81%) received anticoagulation in full accordance with the guidelines against 559 of 683 (82%) usual-care patients. The cumulative adherence to guidelines-based recommendations was 61% under nurse-led care and 26% under usual-care. Over 37 months of follow-up, the primary endpoint occurred in 164 of 671 patients (9.7% per year) under nurse-led care and in 192 of 683 patients (11.6% per year) under usual-care [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.69 to 1.04, P = 0.12]. There were 124 vs. 161 hospitalizations for arrhythmia events (7.0% and 9.4% per year), and 14 vs. 22 for heart failure (0.7% and 1.1% per year), respectively. Results were not consistent in a pre-specified subgroup analysis by centre experience, with a HR of 0.52 (95% CI 0.37–to 0.71) in four experienced centres and of 1.24 (95% CI 0.94–1.63) in four less experienced centres (P for interaction <0.001).

Conclusion

Our trial failed to show that nurse-led care was superior to usual-care. The data suggest that nurse-led care by an experienced team could be clinically beneficial (ClinicalTrials.gov NCT01740037).

Trial Registration number

ClinicalTrials.gov (NCT01740037).
Data envelopment analysis applications in primary health care: a systematic review
Authors: Zakowska Izabela , Godycki-Cwirko Maciek
Published: August 2019

Background

Strategic management of primary health care centres is necessary for creating an efficient global health care system that delivers good care.

Objectives

To perform a systematic literature review of the use of data envelopment analysis in estimating the relative technical efficiency of primary health care centres, and to identify the inputs, outputs and models used.

Methods

PubMed, MEDLINE Complete, Embase and Web of Science were searched for papers published before the 25 March 2019.

Results

Of a total of 4231 search results, 54 studies met the inclusion criteria. The identified inputs included personnel costs, gross expenditures, referrals and days of hospitalization, as well as prescriptions and investigations. Outputs included consultations or visits, registered patients, procedures, treatments and services, prescriptions and investigations. A variety of data envelopment analysis models used was identified, with no standard approach.

Conclusions

Data envelopment analysis extends the scope of tools used to analyse primary care functioning. It can support health economic analyses when assessing primary care efficiency. The main issues are setting outputs and inputs and selecting a model best suited for the range of products and services in the primary health care sector. This article serves as a step forward in the standardization of data envelopment analysis, but further research is needed.
Analysis of ballistic waves in seismic noise monitoring of water table variations in a water field site: added value from numerical modelling to data understanding
Authors: Garambois S , Voisin C , Romero Guzman M A , Brito D , Guillier B , Réfloch A
Published: August 2019

Passive seismic interferometry allows to track continuously the weak seismic velocity changes in any medium by correlating the ambient seismic noise between two points to reconstruct the Green’s function. The ballistic surface waves of the reconstructed Green’s functions are used to monitor the changes of water table induced by a controlled experiment in the Crépieux-Charmy (France) exploitation field. Viscoelastic numerical modelling of the monitoring experiment reproduces quite satisfactorily the sensitivity of the surface waves to the water table previously observed with seismic noise data. This numerical approach points out that this sensitivity is controlled by mode mixing of Rayleigh waves. It also made it possible to identify the refracted P wave and to extract its anticorrelated sensitivity to water table variations. Depending on the offset between receivers, it was observed numerically that the interferences between the different waves (with different velocities) composing the seismic wavefield slightly affect the quantitative sensitivity to water table changes. This suggests the use of an optimal spatial and temporal observation window for which wave interference is minor and does not blur the quantitative response to water table variations. We were thus able to determine the relationship between velocity and water table variations for all waves involved. From numerical computations, we identify a weak signal-to-noise ratio phase in the noise correlograms, with a anticorrelated sensitivity to the water table: the reconstructed refracted waves.
Predictors of Perianal Fistula Relapse in Crohn’s Disease
Authors: Malian Audrey , Rivière Pauline , Bouchard Dominique , Pigot François , Eléouet-Kaplan Marianne , Favreau-Weltzer Charlotte , Poullenot Florian , Laharie David
Published: August 2019

Background

Despite an optimal medico-surgical management of perineal Crohn’s disease (PCD), fistula relapse still occurs in 30% of patients. Our aim was to determine predictors of fistula relapse in patients in remission after treatment of a PCD lesion.

Methods

Consecutive patients treated for fistulizing PCD have been included in a retrospective study when they achieved fistula remission within 3 months after the surgery. Remission was defined as the absence of any draining fistula at clinical examination. Primary outcome was the occurrence of a fistula relapse, defined as a subsequent perianal draining fistula or an abscess confirmed clinically and/or by pelvic MRI.

Results

One hundred and thirty-seven patients (57% female, median age: 35 years) corresponding to 157 abscess events, including 120 (76.4%) treated by anti-TNF after drainage, achieved fistula remission after surgery. During the follow-up period (median duration: 43 months [interquartile range 26 to 64]), 34 (22%) patients experienced a fistula relapse within a median time of 1.8 years. Survival without fistula was 96.7% at 1 year, 78.4% at 3 years, and 74.4% at 5 years. Fistula relapse rates were not different in patients receiving infliximab or adalimumab (P = 0.66). In patients treated by anti-TNF at inclusion, discontinuation of anti-TNF therapy (odds ratio 3.49, P = 0.04), colonic location (OR 6.25, P = 0.01), and stricturing phenotype (odds ratio 4.39, P = 0.01) were independently associated with fistula relapse in multivariate analysis.

Conclusion

In patients achieving fistula remission of PCD, relapse rates are low and are not different between infliximab and adalimumab. Discontinuation of anti-TNF therapy is associated with increased relapse rate.
Congenital Cytomegalovirus Infection
Authors: Kabani Nazia , Ross Shannon A
Published: August 2019

Congenital cytomegalovirus (cCMV) infection is a leading cause of hearing loss and neurological disabilities in children, with the disease burden and disabilities due to cCMV greater than many other well recognized childhood conditions. A minority of infants with cCMV will have symptoms at birth. Infants with symptomatic cCMV are at higher risk for sequelae than those born without symptoms. The majority of infants with cCMV are asymptomatic at birth, but 10%–15% will develop hearing loss. Although clinical symptoms can help predict which infants will have sensorineural hearing loss, among asymptomatic cCMV there are currently no predictors of adverse outcome. The identification of a biomarker to identify those at highest risk of sequelae is highly desirable to target interventions to those who could potentially benefit. Because there is increasing rationale for establishing both targeted and universal screening programs for cCMV in the United States and worldwide, this is an urgent priority.
High Rates of Hepatitis B Virus (HBV) Functional Cure Among Human Immunodeficiency Virus-HBV Coinfected Patients on Antiretroviral Therapy in Zambia
Authors: Chihota Belinda V , Wandeler Gilles , Chilengi Roma , Mulenga Lloyd , Chung Raymond T , Bhattacharya Debika , Egger Mathias , Vinikoor Michael J
Published: August 2019

Among 284 human immunodeficiency virus (HIV)-hepatitis B virus (HBV) coinfected adults starting tenofovir-based antiretroviral therapy (ART) in Zambia, median baseline CD4+ count was 202 cells/mm3 and 41.6% were hepatitis B e-antigen positive. Within 2 years of therapy, 29 (10.2%) participants experienced HBV functional cure (confirmed loss of hepatitis B surface antigen). In multivariable analysis, baseline CD4 count <350 cells/mm3, female sex, and lower baseline HBV deoxyribonucleic acid were associated with increased odds of functional cure. Immune recovery during HIV-HBV treatment with ART may drive higher rates of functional cure than during HBV monoinfection treatment. Understanding the mechanisms underlying this phenomenon could inform immunomodulatory therapies for HBV cure.
Galactic chimney sweeping: the effect of ‘gradual’ stellar feedback mechanisms on the evolution of dwarf galaxies
Authors: Garratt-Smithson Lilian , Wynn Graham A , Power Chris , Nixon C J
Published: August 2019

We investigate the impact of time-resolved ‘gradual’ stellar feedback processes in high redshift dwarf spheroidal galaxies. Here ‘gradual’ feedback refers to individual stellar feedback events which deposit energy over a period of time. We conduct high-resolution hydrodynamical simulations of dwarf spheroidal galaxies with halo masses of 107–108 M⊙, based on z = 6 progenitors of the Milky Way’s dwarf spheroidal galaxies. We also include a novel feedback prescription for individual massive stars, which includes stellar winds and an HMXB (high mass X-ray binary) phase, on top of supernovae. We find the mass of gas unbound across a 1 Gyr starburst is uniformly lowered if gradual feedback mechanisms are included across the range of metallicities, halo concentration parameters, and galaxy masses studied here. Furthermore, we find including gradual feedback in the smallest galaxies delays the unbinding of the majority of the gas and facilitates the production of ‘chimneys’ in the dense shell surrounding the feedback generated hot, pressurized ‘superbubble’. These ‘chimneys’ vent hot gas from the galaxy interior, lowering the temperature of the central 10 kpc of the gaseous halo. Additionally, we find radiative cooling has little effect on the energetics of simulations that include a short, violent starburst compared with those that have a longer, less concentrated starburst. Finally, we investigate the relative impact of HMXB feedback and stellar winds on our results, finding the ubiquity of stellar winds throughout each starburst makes them a defining factor in the final state of the interstellar medium.
Reconstructing probability distributions with Gaussian processes
Authors: McClintock Thomas , Rozo Eduardo
Published: August 2019

Modern cosmological analyses constrain physical parameters using Markov Chain Monte Carlo (MCMC) or similar sampling techniques. Oftentimes, these techniques are computationally expensive to run and require up to thousands of CPU hours to complete. Here we present a method for reconstructing the log-probability distributions of completed experiments from an existing chain (or any set of posterior samples). The reconstruction is performed using Gaussian process regression for interpolating the log-probability. This allows for easy resampling, importance sampling, marginalization, testing different samplers, investigating chain convergence, and other operations. As an example use case, we reconstruct the posterior distribution of the most recent Planck 2018 analysis. We then resample the posterior, and generate a new chain with 40 times as many points in only 30 min. Our likelihood reconstruction tool is made publicly available online.
UGC 1378 – a Milky Way sized galaxy embedded in a giant low surface brightness disc
Authors: Saburova Anna S , Chilingarian Igor V , Kasparova Anastasia V , Katkov Ivan Yu , Fabricant Daniel G , Uklein Roman I
Published: August 2019

The dominant physical processes responsible for the formation and longevity of giant gaseous and stellar discs in galaxies remain controversial. Although they are rare (less than 10 confirmed as of now), giant low-surface brightness (gLSB) discy galaxies provide interesting insights given their extreme nature. We describe observations of UGC 1378 including deep spectroscopy with the Russian 6-m telescope and multiband imaging with Binospec at the MMT. Galaxy UGC 1378 has both high surface brightness and an extended low surface brightness discs. Our stellar velocity dispersion data for the high surface brightness, Milky Way sized, disc appears inconsistent with a recent major merger, a widely discussed formation scenario for the very extended low surface brightness disc. We estimate the star formation rates (SFRs) from archival Wide-Field Infrared Survey Explorer data. The SFR surface density in the LSB disc is low relative to its gas density, consistent with recent gas accretion. We argue that the unusually large size of UGC 1378’s disc may be the product of a rich gas reservoir (e.g. a cosmic filament) and an isolated environment that has preserved the giant disc.
Barycentric interpolation on Riemannian and semi-Riemannian spaces
Authors: Pihajoki Pauli , Mannerkoski Matias , Johansson Peter H
Published: August 2019

Interpolation of data represented in curvilinear coordinates and possibly having some non-trivial, typically Riemannian or semi-Riemannian geometry is a ubiquitous task in all of physics. In this work, we present a covariant generalization of the barycentric coordinates and the barycentric interpolation method for Riemannian and semi-Riemannian spaces of arbitrary dimension. We show that our new method preserves the linear accuracy property of barycentric interpolation in a coordinate-invariant sense. In addition, we show how the method can be used to interpolate constrained quantities so that the given constraint is automatically respected. We showcase the method with two astrophysics related examples situated in the curved Kerr space–time. The first problem is interpolating a locally constant vector field, in which case curvature effects are expected to be maximally important. The second example is a general relativistic magnetohydrodynamics simulation of a turbulent accretion flow around a black hole, wherein high intrinsic variability is expected to be at least as important as curvature effects.