bluuebunny/crossref_metadata_2025 huggingface dataset:
Data-driven design strategy in fused filament fabrication: status and opportunities
Authors: Zhang Yongjie , Moon Seung Ki
Published: December 2020

The advent of additive manufacturing (AM) has brought about radically new ways of designing and manufacturing of end-use parts and components, by exploiting freedom of design. Due to the unique manufacturing process of AM, both design and process parameters can strongly influence the part properties, thereby enlarging the possible design space. Thus, finding the optimal combination of embodiment design and process parameters can be challenging. A structured and systematic approach is required to effectively search the enlarged design space, to truly exploit the advantages of AM. Due to lowered costs in computing and data collection in the recent years, data-driven strategies have become a viable tool in characterization of process, and researches have starting to exploit data-driven strategies in the design domain. In this paper, a state-of-the-art data-driven design strategy for fused filament fabrication (FFF) is presented. The need for data-driven strategies is explored and discussed from design and process domain, demonstrating the value of such a strategy in designing an FFF part. A comprehensive review of the literature is performed and the research gaps and opportunities are analysed and discussed. The paper concludes with a proposed data-driven framework that addresses the identified research gaps. The proposed framework encompasses knowledge management and concurrent optimization of embodiment design and process parameters to derive optimal FFF part design. Contribution of this paper is twofold: A review of the state-of-the-art is presented, and a framework to achieve optimal FFF part design is proposed.
Idiopathic adult intestinal intussusception: a rare cause of an acute surgical abdomen
Authors: Gange Eliot R , Grieco Marco A , Myers Scott D , Guenther Timothy M
Published: December 2020

Intussusception is uncommon among adults. The condition, which is defined as a telescoping of a proximal portion of the small or large bowel into the lumen of an adjacent segment of bowel, is most commonly seen in children. Among pediatric cases, the majority is benign and treated non-operatively. However, in adults, intussusception is the result of pathologic and often malignant lead points in the majority of cases. This makes surgical resection and tissue diagnosis the only definitive treatment option. While the majority of adult intussusception cases involves a pathologic lead point, a small percentage is idiopathic, without an identifiable lead point. We present a 32-year-old man with acute on chronic abdominal pain and cross-sectional imaging that identified jejunal intussusception, which was confirmed in operating room and resected. Interestingly, no pathologic lead point was identified on pathologic review. We discuss our diagnostic approach, surgical decision making and final tissue diagnosis.
A Novel Biocontrol Strain Bacillus amyloliquefaciens FS6 for Excellent Control of Gray Mold and Seedling Diseases of Ginseng
Authors: Wang Rui , Wang Chunwei , Zuo Bing , Liang Xinyuan , Zhang Danni , Liu Renxuan , Yang Lina , Lu Baohui , Wang Xue , Gao Jie
Published: December 2020

The biocontrol efficacy of Bacillus amyloliquefaciens FS6 against seedling diseases and gray mold of ginseng (Panax ginseng), as well as application techniques, were evaluated in a series of field trials. FS6 fermentation broth showed a strong antagonistic effect against the ginseng fungal pathogens, and the inhibition rates on mycelial growth and spore germination were 84 to 88% and 71 to 72%, respectively. Field evaluation showed that combination of seed and soil treatments exhibited better protection than that of individual treatment alone. FS6 wettable powder soil treatment in combination with thiamethoxam plus metalaxyl-M plus fludioxonil for seed coating performed the best, with >83% overall control efficacy for seedling diseases. FS6 had a long-acting effect of >78% control efficacy on ginseng gray mold at 30 days after the last application, almost 2.5- and 2-fold better than that of B. amyloliquefaciens B7900 wettable powder and cyprodinil, respectively. In addition, FS6 reduced the diversity and relative abundance of fungi and affected the fungi and bacterial composition in the rhizosphere soil of ginseng. Therefore, FS6 can be used to effectively control seedling diseases and gray mold in ginseng.
Role of Yeasts in the Cranberry Fruit Rot Disease Complex
Authors: Zalewski Zachary D. , Page Rae , Lankau Richard A. , McManus Patricia S.
Published: December 2020

Cranberry fruit rot (CFR) is an economically important disease caused by at least 10 species of filamentous fungi. Despite the application of fungicides, incidence of CFR is sometimes high, raising the possibility of a role for microbes other than fungi in the CFR complex. Isolation of microbes from rotten berries on culture media that favor either bacteria or yeasts resulted in mucoid colonies from <15% of dry-harvested rotten berries but up to 60% of wet-harvested berries. The mucoid colonies were identified as yeasts, primarily in the family Saccharomycetaceae. Inoculation of sound berries with three yeasts, Hanseniaspora uvarum, Pichia fermentans, and Pichia terricola, resulted in significantly higher incidence and severity of rot symptoms compared with mock-inoculated controls; these yeasts were recovered from inoculated berries, providing evidence of their pathogenicity. The minimum concentrations of azoxystrobin, chlorothalonil, and prothioconazole that resulted in 80% inhibition of growth compared with untreated controls (MIC80) were determined for a subset of yeasts. In general, MIC80s were higher for azoxystrobin and prothioconazole (usually >64 µg/ml) than for chlorothalonil (usually ≤1 µg/ml). To complement culture-dependent studies, DNA was isolated from wet- and dry-harvested rotten berries, and fungi were identified to the level of family by high-throughput sequencing of the fungal internal transcribed spacer region. There were no fungal families consistently detected among samples by one method (culturing or high-throughput sequencing) and missed by the other that have not previously been reported in cranberry; however, some fungal families were found to be more abundant by one method versus the other. Harvest method (wet or dry) had a significant effect on the composition of fungal communities of rotten berries (P < 0.001), and operational taxonomic units representing the Saccharomycetaceae were more abundant in wet- than dry-harvested berries. Taken together, the results suggest that some yeasts are pathogenic to cranberry and may be especially relevant in wet-harvested berries.
In Vitro Screening of Various Bacterially Produced Double-Stranded RNAs for Silencing Cercospora cf. flagellaris Target Genes and Suppressing Cercosporin Production
Authors: Zivanovic Marija , Chen Zhi-Yuan
Published: December 2020

Cercospora leaf blight (CLB), primarily caused by Cercospora cf. flagellaris, is one of the most important diseases of soybean (Glycine max) in Louisiana. The pathogen produces cercosporin, a nonspecific toxin and an important virulence factor. There are no commercial cultivars with CLB resistance, and the pathogen has developed substantial resistance to the frequently used fungicides. Consequently, alternative methods are needed to manage CLB. One possibility is the RNA interference-based topical application of double-stranded (ds)RNA. The present study addressed the two most critical steps for this novel approach to be practical: inexpensively producing large quantities of dsRNA and identifying the right target genes for silencing. A screening method was developed to compare the effectiveness of Escherichia coli-produced dsRNAs targeting five fungal genes involved in cercosporin production for silencing in liquid culture. As much as 151.6 mg of dsRNA-containing total nucleic acids (TNAs) was produced from 1 liter of E. coli Luria broth culture using the L4440 vector. All tested dsRNAs reduced cercosporin production. However, significant target gene suppression was only detected in the cultures treated with dsRNAs from Avr4 and CTB8. The most potent dsRNA was from Avr4, which reduced 50% of cercosporin production at an estimated TNA concentration of 10.4 µg/ml (half maximal effective concentration [EC50]), and the least potent dsRNA was from HN-2, with an estimated EC50 of 46.7 µg/ml TNA. The present study paves the road for managing CLB under field conditions using dsRNA. Additionally, this approach could be adapted to identify the best dsRNAs to manage other fungal diseases.
Pediatric Seymour Fractures of the Toe
Authors: Baker Courtney E. , Leafblad Nels , Larson A. Noelle
Published: December 2020

Background:

Seymour fractures of the toe are physeal fractures with often occult concomitant nail bed injuries and thus are open fractures. They are uncommon injuries that without proper treatment can result in osteomyelitis. The literature has sparse information regarding the clinical outcomes for these injuries.

Methods:

A single-center retrospective review included juxta-epiphyseal fractures or Salter-Harris I/II fracture of the toe with documented concomitant nail bed injury or laceration. Clinical and radiographic data were recorded for consecutive fractures. The primary outcome was the incidence of osteomyelitis. Secondary outcomes included premature physeal arrest, development of nail dystrophy, and functionality of the toe.

Results:

Between 2006 and 2019, 19 patients were treated for this injury by the pediatric orthopaedic division. Complications included osteomyelitis (n=6), physeal arrest (n=4), and nail dystrophy (n=1). Days from injury to definitive treatment were significantly greater in patients who developed osteomyelitis compared with those who did not (P<0.01). Patients were significantly more likely to develop osteomyelitis if they did not receive acute definitive treatment (<48 h) (P<0.001; likelihood ratio, 17.9).

Conclusions:

Prompt definitive treatment of Seymour fractures of the toe was associated with a lower incidence of osteomyelitis. Greater awareness for these seemingly innocuous injuries is needed to provide an early treatment that may reduce the rate of osteomyelitis.

Level of Evidence:

Level IV—case series.
Percutaneous Transforaminal Endoscopic Discectomy Versus Open Microdiscectomy for Lumbar Disc Herniation
Authors: Gadjradj Pravesh S. , Harhangi Biswadjiet S. , Amelink Jantijn , van Susante Job , Kamper Steven , van Tulder Maurits , Peul Wilco C. , Vleggeert-Lankamp Carmen , Rubinstein Sidney M.
Published: December 2020

Study Design.

Systematic review and meta-analysis.

Objective.

To give a systematic overview of effectiveness of percutaneous transforaminal endoscopic discectomy (PTED) compared with open microdiscectomy (OM) in the treatment of lumbar disk herniation (LDH).

Summary of Background Data.

The current standard procedure for the treatment of sciatica caused by LDH, is OM. PTED is an alternative surgical technique which is thought to be less invasive. It is unclear if PTED has comparable outcomes compared with OM.

Methods.

Multiple online databases were systematically searched up to April 2020 for randomized controlled trials and prospective studies comparing PTED with OM for LDH. Primary outcomes were leg pain and functional status. Pooled effect estimates were calculated for the primary outcomes only and presented as standard mean differences (SMD) with their 95% confidence intervals (CI) at short (1-day postoperative), intermediate (3–6 months), and long-term (12 months).

Results.

We identified 2276 citations, of which eventually 14 studies were included. There was substantial heterogeneity in effects on leg pain at short term. There is moderate quality evidence suggesting no difference in leg pain at intermediate (SMD 0.05, 95% CI –0.10–0.21) and long-term follow-up (SMD 0.11, 95% CI –0.30–0.53). Only one study measured functional status at short-term and reported no differences. There is moderate quality evidence suggesting no difference in functional status at intermediate (SMD –0.09, 95% CI –0.24–0.07) and long-term (SMD –0.11, 95% CI –0.45–0.24).

Conclusion.

There is moderate quality evidence suggesting no difference in leg pain or functional status at intermediate and long-term follow-up between PTED and OM in the treatment of LDH. High quality, robust studies reporting on clinical outcomes and cost-effectiveness on the long term are lacking.

Level of Evidence: 2
The Diagnostic Value of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for the Detection of Surgical Site Infection after Spine Surgery
Authors: Segawa Tomohide , Koga Hisashi , Oshina Masahito , Fukushima Masayoshi , Inanami Hirohiko
Published: December 2020

Study Design.

Retrospective case series.

Objective.

The purpose of this study was to assess the diagnostic yield of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) for surgical site infection (SSI) after spine surgery.

Summary of Background Data.

Diagnosis of SSI in the spine based on F-18 FDG PET/CT requires experienced nuclear medical physicians for a detailed analysis of F-18 FDG distribution pattern. It has also been reported that increases in the maximal standardized uptake values of F-18 FDG (SUVmax) closely correlated with SSI, suggesting potential of more objective and quantitative diagnosis.

Methods.

We assessed the diagnostic yield of F-18 FDG PET/CT (pattern-based diagnosis by nuclear medical physicians and SUVmax-based diagnosis) for SSI in 52 subjects who underwent spine surgery. The 52 subjects included 11 nonimplant and 41 implant cases. F-18 FDG PET/CT was performed in 33 and 19 cases in early (≤12 weeks after the surgery) and late (>12 weeks) phases, respectively. The final diagnosis of SSI was based on the results of pathogen identification, plain radiography, and CT and/or magnetic resonance imaging or response to antibiotics and/or reoperation.

Results.

SUVmax-based diagnosis was performed with a cut off value of 5.0 as determined by receiver operating characteristic analysis. Both pattern-based and SUVmax-based diagnoses demonstrated excellent diagnostic yields with high sensitivity (97% and 90%), specificity (100% and 100%), and accuracy (98% and 94%). High diagnostic yields (accuracy of ≥90%) were consistently observed irrespective of presence or absence of implantation or interval between surgery and F-18 FDG PET/CT.

Conclusion.

F-18 FDG PET/CT can be the procedure of choice for investigation of SSI in the spine when other imaging fails to provide a definitive diagnosis.

Level of Evidence: 4
RE-INVENTING CYANOACRYLATE RETINOPEXY IN THE 21ST CENTURY: LITERATURE REVIEW AND CASE SERIES
Authors: Khatri Anadi , Justin Grant A. , Singh Sweta , Rijal Roshija K. , Thapa Saraswati , Singh Kinsuk , Agrawal Rupesh
Published: December 2020

Purpose:

We report use of cyanoacrylate (N-butyl-Cyanoacrylate) in previously failed retinal reattachment surgeries for chorio-retinal colobomas. We report the surgical technique, its challenges, and long-term outcomes in three patients who underwent the surgery.

Methods:

A chart review of patients with chorio-retinal colobomas and retinal detachment repair with cyanoacrylate at a tertiary eye care center in Nepal. Cyanoacrylate was used to seal colobomatous retinal breaks in eyes which had undergone multiple retinal surgeries with failed outcome.

Results:

Three eyes that were operated using cyanoacrylate were included. All three patients had attached retina and none of the patients required a long-term tamponading agent. None of the patients underwent head positioning following the surgery. All of the patients had a visual acuity gain of 3/60 or more at the end of 8 months. No adverse or inflammatory reactions were noted.

Conclusion:

We demonstrate that cyanoacrylate is safe and less resource-demanding without a requirement of second surgery to remove a tamponading agent. It could be helpful in eyes with persistent retinal detachment in colobomatous eyes. Because we were able to achieve favorable outcomes without head positioning, we believe it may also be helpful in patients who are not suitable for positioning because of bodily or bony deformities and in retinal detachment with other coexisting trauma.
Ocular Discomfort and Quality of Life Among Patients in the Dry Eye Assessment and Management Study
Authors: Sayegh Rony R. , Yu Yinxi , Farrar John T. , Kuklinski Eric J. , Shtein Roni M. , Asbell Penny A. , Maguire Maureen G. ,   for the Dry Eye Assessment and Management (DREAM) Study Research Group
Published: December 2020

Purpose:

To assess the association of severity of ocular discomfort with measures of quality of life among patients with moderate to severe dry eye disease (DED).

Methods:

This is a prospective, observational, cohort study within a randomized clinical trial. Patients (N = 535) in the Dry Eye Assessment and Management study with moderate to severe DED completed the Ocular Surface Disease Index on DED symptoms, the SF-36 on quality of life, and the Brief Ocular Discomfort Inventory questionnaire and had a comprehensive ophthalmic assessment by a study-certified clinician. The ocular discomfort on average over the past week was scored on an 11-point scale (0 for no discomfort and 10 for discomfort as bad as you can imagine).

Results:

The average ocular discomfort scores for patients ranged from 0 to 10, with a mean of 4.28. Discomfort scores did not vary with demographic characteristics, signs of DED, self-reported depression, or self-reported nonocular pain conditions. Ocular discomfort scores did correlate moderately to strongly with total Ocular Surface Disease Index scores (Spearman correlation coefficient, r
s, 0.47–0.67) and with measures of interference with activities of daily living [general activity level, mood, walking ability, ability for normal work, relations with other people, sleep, and enjoyment of life (r
s = 0.39–0.65)].

Conclusions:

Among patients in the Dry Eye Assessment and Management study, worse ocular discomfort was associated with worse overall DED symptoms and interfered to a greater degree with activities of daily living. Ocular discomfort is an important part of the assessment of patients with DED.
Nuclear heme oxygenase-1 improved the hypoxia-mediated dysfunction of blood-spinal cord barrier via the miR-181c-5p/SOX5 signaling pathway
Authors: Yu Deshui , Sun Rui , Shen Dequan , Ge Lihao , Xue Tao , Cao Yang
Published: December 2020

Our previous study demonstrated that adenovirus-delivered GFP nuclear heme oxygenase-1 (nuclear HO-1, NHO-1) fragments lacking 23 amino acids at the C-terminus (Ad-GFP-HO-1C[INCREMENT]23) showed the potential therapeutic effects mediated by its improvement of the blood-spinal cord barrier (BSCB) integrity. However, the NHO-1-mediated molecular mechanism in regulating the BSCB function remains unclear. The BSCB model in vitro was established via a coculture of primary rat brain microvascular endothelial cells (RBMECs) and spinal cord astrocytes on transwell system. NHO-1 markedly reduced the disruption of the BSCB integrity induced by hypoxia. And NHO-1 significantly attenuated the expression of miR-181c-5p, but increased the expression level of SOX5 protein. miR-181c-5p was shown as an essential miRNA for increasing the BSCB permeability under hypoxia condition. Furthermore, we identified that miR-181c-5p could regulate the expression of SOX5 through binding to the 3′-UTR of its mRNA. And the decreased BSCB permeability and upregulation of tight junction (TJ) protein expression induced by NHO-1 could be partly reversed by the inhibition of SOX5 or miR-181c-5p (+). The present study results provide a better understanding of the molecular mechanisms induced by NHO-1 in improving the BSCB integrity, which is associated with the regulation of miR-181c-5p/SOX5/TJ signaling pathway.
Metformin, valproic acid, and starvation induce seizures in a patient with partial SLC13A5 deficiency: a case of pharmaco-synergistic heterozygosity
Authors: Kopel Jonathan , Grooms Amy , Ganapathy Vadivel , Clothier Jeffrey
Published: December 2020

SLC13A5/NaCT is a sodium-coupled citrate transporter expressed in the plasma membrane of the liver, testis, and brain. In these tissues, SLC13A5 has important functions in the synthesis of fatty acids, cholesterol, and neurotransmitters. In recent years, patients homozygous for recessive mutations in SLC13A5, known as SLC13A5 deficiency [early infantile epileptic encephalopathy-25 (EIEE-25)], exhibit severe global developmental delay, early-onset intractable seizures, spasticity, and amelogenesis imperfecta affecting tooth development. Although the pathogenesis of SLC13A5 deficiency remains not clearly understood, cytoplasmic citrate deficits, decreased energy status in neurons, and citrate-zinc chelation are hypothesized to explain the neurological deficits. However, no study has examined the possibility of specific pharmacological drugs and/or lifestyle changes synergizing with heterozygosity of SLC13A5 deficiency to increase the risk of EIEE-25 clinical phenotype. Here, we report on a heterozygous SLC13A5-deficient patient who demonstrated evidence of pharmaco-synergistic heterozygosity upon administration of metformin, valproic acid, and starvation. The report illustrates the importance of careful consideration of the potential adverse effects of specific pharmacological treatments in patients with heterozygosity for disease-causing recessive mutations in SLC13A5.
‘Candidatus Phytoplasma stylosanthis’, a novel taxon with a diverse host range in Australia, characterised using multilocus sequence analysis of 16S rRNA, secA, tuf, and rp genes
Authors: Rodrigues Jardim Bianca , Kinoti Wycliff M. , Tran-Nguyen Lucy T. T. , Gambley Cherie , Rodoni Brendan , Constable Fiona E.
Published: December 2020

In Australia, Stylosanthes little leaf (StLL) phytoplasma has been detected in Stylosanthes scabra Vogel, Arachis pintoi Krapov, Saccharum officinarum L., Carica papaya L., Medicago sativa L., and Solanum tuberosum L. The 16S rRNA gene sequence of StLL phytoplasma strains from S. scabra, C. papaya, S. officinarum and S. tuberosum were compared and share 99.93–100 % nucleotide sequence identity. Phylogenetic comparisons between the 16S rRNA genes of StLL phytoplasma and other ‘Candidatus Phytoplasma’ species indicate that StLL represents a distinct phytoplasma lineage. It shares its most recent known ancestry with ‘Ca. Phytoplasma luffae’ (16SrVIII-A), with which it has 97.17–97.25 % nucleotide identity. In silico RFLP analysis of the 16S rRNA amplicon using iPhyClassifier indicate that StLL phytoplasmas have a unique pattern (similarity coefficient below 0.85) that is most similar to that of ‘Ca. Phytoplasma luffae’. The unique in silico RFLP patterns were confirmed in vitro. Nucleotide sequences of genes that are more variable than the 16S rRNA gene, namely tuf (tu-elongation factor), secA (partial translocation gene), and the partial ribosomal protein (rp) gene operon (rps19-rpl22-rps3), produced phylogenetic trees with similar branching patterns to the 16S rRNA gene tree. Sequence comparisons between the StLL 16S rRNA spacer region confirmed previous reports of rrn interoperon sequence heterogeneity for StLL, where the spacer region of rrnB encodes a complete tRNA-Isoleucine gene and the rrnA spacer region does not. Together these results suggest that the Australian phytoplasma, StLL, is unique according to the International Organization for Mycoplasmology (IRPCM) recommendations. The novel taxon ‘Ca. Phytoplasma stylosanthis’ is proposed, with the most recent strain from a potato crop in Victoria, Australia, serving as the reference strain (deposited in the Victorian Plant Pathology Herbarium as VPRI 43683).
Obesogenic Assesment of the Primary Schools Environment: A Qualitative Narrative Analysis
Authors: Ahmad Siti Rohaiza , Bush Robert
Published: December 2020

Background

While multiple influences on children’s food choices and eating habits have been proposed, including genetic, familial and environmental influences, it is increasingly the environments they live in, including schools, that are receiving attention as sites for understanding health-related behaviors.

Aim

To analyse the infrastructure of Brunei’s primary schools in terms of the level of obesogenicity and how the condition can be improved for the future.

Methods

Site of research was five purposely selected primary schools in Brunei Darussalam. In this research, the obesogenic audit tool used were developed from the Primary School Environmental Audit (PSEA) tool.

Results

Similarities and differences to the nutrition and physical activity environment across the five different schools was found. Consistency was observed across all school sites in the MOE and MOH formal rules and regulations that were applied to the school food-services operations.

Conclusion

The use of a modified PSEA audit tool, has successfully enabled the successful identification of the various elements of primary schools in Brunei that may have contributed to an obesogenic environment. The research approach in this study was to not only examine a school’s internal environment but its external environment as well. This ensured a more complete overview of what was in-place, allowing assessment of what could be better improved to make it more conducive to childhood obesity prevention.
On the Effects of Misclassification in Estimating Efficacy With Application to Recent COVID-19 Vaccine Trials
Authors: Buonaccorsi John P.
Published: December 2020

The recent trials for proposed COVID-19 vaccines have garnered a considerable amount of attention and as of this writing extensive vaccination efforts are underway. The first two vaccines approved in the United States are the Moderna and Pfizer vaccines both with estimated efficacy near 95%. One question which has received limited attention, and which we address here, is what affect false positives or false negatives have on the estimated efficacy. Expressions for potential bias due to misclassification of COVID status are developed as are general formulas to adjust for misclassification, allowing for either differential or non-differential misclassification. These results are illustrated with numerical investigations pertinent to the Moderna and Pfizer trials. The general conclusion, fortunately, is that the potential misclassification of COVID status almost always would lead to underestimation of the efficacy and that correcting for false positives or negatives will typically lead to even higher estimated efficacy.
Computational analysis of pathological image enables interpretable prediction for microsatellite instability
Authors: Zhu Jin , Wu Wangwei , Zhang Yuting , Lin Shiyun , Jiang Yukang , Liu Ruixian , Wang Xueqin , Zhang Heping
Published: December 2020

Objective

Microsatellite instability (MSI) is associated with several tumor types and its status has become increasingly vital in guiding patient treatment decisions. However, in clinical practice, distinguishing MSI from its counterpart is challenging since the diagnosis of MSI requires additional genetic or immunohistochemical tests. In this study, we aimed to establishe an interpretable pathological image analysis strategies to help medical experts to identify MSI automatically.

Design

Three cohorts of Haematoxylin and eosin-stained whole-slide images from 1033 patients with different tumor types were collected from The Cancer Genome Atlas. These images were preprocessed and tessallated into small tiles. A image-level interpretable deep learning model and a feature-level interpretable random forest model were built up on these files.

Results

Both models performed well in the three datasets and achieved image-level and feature-level interpretability repectively. Importantly, both from the image-level and feature-level interpretability, color features and texture characteristics are shown to contribute the most to the MSI prediction. Based on them, we established an interpretable classification framework. Therefore, the classification models under the proposed framework can serve as an efficient tool for predicting the MSI status of patients.

Conclusion

This study establishes a interpretable classification framework to for predicting the MSI status of patients and provide more insights to pathologists with clinical understanding.
Identification of Leptotrichia goodfellowii infective endocarditis by next-generation sequencing of 16S rDNA amplicons
Authors: Lieberman Joshua A. , Kurosawa Kyoko , SenGupta Dhruba , Cookson Brad T. , Salipante Stephen J. , Busch David
Published: December 2020

The oral aerotolerant anaerobe Leptotrichia goodfellowii is an unusual cause of endocarditis and is amenable to treatment with β-lactam antibiotics. Because this organism is difficult to identify by conventional methods, molecular detection is a key diagnostic modality. Broad-range 16S rDNA PCR followed by Sanger sequencing constitute the first-line molecular approach, yet poor DNA quality, contaminating DNA, or low template quantity make identification challenging. Here we report a case of culture-negative, aortic and mitral valve endocarditis in a 66-yr-old woman with a history of cardiomyopathy, atrial fibrillation with intracardiac pacer, poor dentition, and recent tooth infection. In this case, 16S rDNA amplicon Sanger sequencing was not sufficient for pathogen identification because of interfering DNA, but deconvolution of the clinical sample using reflexive next-generation amplicon sequencing enabled confident identification of a single pathogenic organism, L. goodfellowii. The patient developed a sigmoid colon perforation and died despite additional surgical treatment. Most Leptotrichia endocarditis cases have been subacute and have been successfully treated with antibiotics, with or without valve replacement. This case highlights both an unusual etiologic agent of endocarditis, as well as the rational utilization of advanced molecular diagnostics tools for characterizing serious infections.
Macromolecular phasing using diffraction from multiple crystal forms
Authors: Metz Markus , Arnal Romain D. , Brehm Wolfgang , Chapman Henry N. , Morgan Andrew J. , Millane Rick P.
Published: December 2020

A phasing algorithm for macromolecular crystallography is proposed that utilizes diffraction data from multiple crystal forms – crystals of the same molecule with different unit-cell packings (different unit-cell parameters or space-group symmetries). The approach is based on the method of iterated projections, starting with no initial phase information. The practicality of the method is demonstrated by simulation using known structures that exist in multiple crystal forms, assuming some information on the molecular envelope and positional relationships between the molecules in the different unit cells. With incorporation of new or existing methods for determination of these parameters, the approach has potential as a method for ab initio phasing.
Dual and single hedging strategy: a novel comparison from the direct and cross hedging perspective
Authors: Feng Yun , Cui Yan
Published: December 2020

Purpose

The purpose of this paper is to deeply study and compare the dual and single hedging strategy, from the direct and cross hedging perspective.

Design/methodology/approach

The authors not only first consider the dual hedge of integrated risks in this oil prices and foreign exchange rates setting but also make a novel comparison between the dual and single hedging strategy from a direct and cross hedging perspective. In total, six econometric models (to conduct one-step-ahead out-of-sample rolling estimation of the optimal hedge ratio) and two hedging performance criteria are employed in two different hedging backgrounds (direct and cross hedging).

Findings

Results show that in the direct hedging background, a dual hedge cannot outperform the single hedge. But in the cross dual hedging setting, a dual hedge performs much better, possibly because the dual hedge brings different levels of advantages and disadvantages in the two different settings and the superiority of the dual hedge is more obvious in the cross dual hedging setting.

Originality/value

The existing literature that deals with oil prices and foreign exchange rates mostly concentrates on their relationship and comovements, while the dual hedge of integrated risks in this setting remains underresearched. Besides, the existing literature that deals with dual hedge gets its conclusions only based on a single specific background (direct or cross hedging) and lacks deeper investigation. In this paper, the authors expand the width and depth of the existing literature. Results and implications are revealing.
The effects of Medicaid on access to care and adherence to recommended preventive services
Authors: Hill Steven C. , Abdus Salam
Published: December 2020

Objective

To quantify the impact of Medicaid enrollment on access to care and adherence to recommended preventive services.

Data Source

2005‐2015 Medical Expenditure Panel Survey Household Component.

Study Design

We examined several access measures and utilization of several preventive services within the past year and within the time frame recommended by the United States Preventive Services Task Force, if more than a year. We estimated local average treatment effects of Medicaid enrollment using a new, two‐stage regression model developed by Nguimkeu, Denteh, and Tchernis. This model accounts for both endogenous and underreported Medicaid enrollment by using a partial observability bivariate probit regression as the first stage. We identify the model with an exogenous measure of Medicaid eligibility, the simulated Medicaid eligibility rate by state, year, and parents vs childless adults. A wide range of changes in Medicaid eligibility occurred during the time period studied.

Data Collection/Extraction methods

Sample of low‐income, nonelderly adults not receiving disability benefits.

Principal Findings

Medicaid enrollment decreased the probability of having unmet needs for medical care by 7.5 percentage points and the probability of experiencing delays getting prescription drugs by 7.7 percentage points. Medicaid enrollment increased the probability of having a usual source of care by 16.5 percentage points, the probability of having a routine checkup by 17.1 percentage points, and the probability of having a flu shot in past year by 12.6 percentage points.

Conclusion

Medicaid enrollment increased access to care and use of some preventive services. Additional research is needed on impacts for subgroups, such as parents, childless adults, and the smaller and generally older populations for whom screening tests are recommended.
Restricted mean survival time as a function of restriction time
Authors: Zhong Yingchao , Schaubel Douglas E.
Published: December 2020

Restricted mean survival time (RMST) is a clinically interpretable and meaningful survival metric that has gained popularity in recent years. Several methods are available for regression modeling of RMST, most based on pseudo‐observations or what is essentially an inverse‐weighted complete‐case analysis. No existing RMST regression method allows for the covariate effects to be expressed as functions over time. This is a considerable limitation, in light of the many hazard regression methods that do accommodate such effects. To address this void in the literature, we propose RMST methods that permit estimating time‐varying effects. In particular, we propose an inference framework for directly modeling RMST as a continuous function of L. Large‐sample properties are derived. Simulation studies are performed to evaluate the performance of the methods in finite sample sizes. The proposed framework is applied to kidney transplant data obtained from the Scientific Registry of Transplant Recipients.
Science as collaborative knowledge generation
Authors: Ellemers Naomi
Published: December 2020

The COVID‐19 pandemic points to the need for scientists to pool their efforts in order to understand this disease and respond to the ensuing crisis. Other global challenges also require such scientific cooperation. Yet in academic institutions, reward structures and incentives are based on systems that primarily fuel the competition between (groups of) scientific researchers. Competition between individual researchers, research groups, research approaches, and scientific disciplines is seen as an important selection mechanism and driver of academic excellence. These expected benefits of competition have come to define the organizational culture in academia. There are clear indications that the overreliance on competitive models undermines cooperative exchanges that might lead to higher quality insights. This damages the well‐being and productivity of individual researchers and impedes efforts towards collaborative knowledge generation. Insights from social and organizational psychology on the side effects of relying on performance targets, prioritizing the achievement of success over the avoidance of failure, and emphasizing self‐interest and efficiency, clarify implicit mechanisms that may spoil valid attempts at transformation. The analysis presented here elucidates that a broader change in the academic culture is needed to truly benefit from current attempts to create more open and collaborative practices for cumulative knowledge generation.
Evaluation of lymphatic flow pattern using indocyanine green fluorescence imaging in a highly metastatic mouse model
Authors: Yamamoto Masashi , Taniguchi Kohei , Tominaga Tomo , Shibata Masa‐Aki , Inomata Yosuke , Komura Kazumasa , Osumi Wataru , Hamamoto Hiroki , Tanaka Keitaro , Okuda Junji , Uchiyama Kazuhisa
Published: December 2020

Recently, the feasibility of real‐time indocyanine green (ICG) fluorescence imaging–guided complete mesocolic excision in colon cancer surgery has been demonstrated; however, its application to the evaluation of lymphatic flow in widespread lymph node metastasis is uncertain. This study aimed to evaluate lymphatic flow using the real‐time ICG fluorescence imaging. A mouse model of subcutaneous inoculation of BJMC3879Luc2 cells, which have been demonstrated to highly metastasize to the lymph nodes, was used as an evaluation model. Tumor growth and lymphatic flow were monitored weekly by bioluminescent imaging and near‐infrared (NIR) fluorescence imaging, respectively. After sacrificing the mice, lymph node metastases were evaluated by bioluminescent imaging and histopathology. Lymphatic flows in a model of high lymph node metastasis were evaluated using NIR fluorescence imaging. Pathological metastases of bilateral axillary, femoral, and para‐aortic lymph nodes were detected in all inoculated mice (100%: 5/5). Real‐time NIR fluorescence imaging showed the primary lymphatic vessels staining through the metastatic lymph nodes as before the inoculation of the cancer cells. Hitherto, it has been considered that lymphatic flow was changed using the bypass pathway due to occlusion of the primary lymphatic vessels. In this presented study, real‐time ICG fluorescence imaging showed no changes in lymphatic flow after lymph node metastasis. Our results suggest that real‐time ICG fluorescence imaging may have potential for the guidance of colon cancer surgery in cases of widespread lymph node metastasis.
Association of beta‐hydroxybutyrate with development of heart failure: Sex differences in a Dutch population cohort
Authors: Flores‐Guerrero Jose L. , Westenbrink Berend Daan , Connelly Margery A. , Otvos James D. , Groothof Dion , Shalaurova Irina , Garcia Erwin , Navis Gerjan , de Boer Rudolf A. , Bakker Stephan J. L. , Dullaart Robin P. F.
Published: December 2020

Background

In the failing heart, energy metabolism is shifted towards increased ketone body oxidation. Nevertheless, the association of beta‐hydroxybutyrate (β‐OHB) with development of heart failure (HF) remains unclear. We investigated the association between plasma β‐OHB and the risk of HF in a prospective population‐based cohort.

Design

Plasma β‐OHB concentrations were measured in 6134 participants of the PREVEND study. Risk of incident HF with reduced (HFrEF) or preserved (HFpEF) ejection fraction was estimated using multivariable‐adjusted Cox regression models.

Results

During median follow‐up for 8.2 years, 227 subjects were diagnosed with HF (137 with HFrEF; 90 with HFpEF). Cox regression analyses revealed a significant association of higher β‐OHB concentrations with incident HF (HR per 1 standard deviation increase, 1.40 (95% CI: 1.21‐1.63; P < .001), which was largely attributable to HFrEF. In women, the hazard ratio (HR) for HFrEF per 1 standard deviation increase in β‐OHB was 1.73 (95% confidence interval (CI): 1.17‐2.56, P = .005) in age, BMI, type 2 diabetes, hypertension, myocardial infarction, smoking, alcohol consumption, total cholesterol, HDL‐C, triglycerides, glucose, eGFR and UAE adjusted analysis. In men, in the same fully adjusted analysis, the HR was 1.14 (CI: 0.86‐1.53, P = .36) (P < .01 for sex interaction). In N‐terminal pro‐brain natriuretic peptide (NT‐proBNP)‐stratified analysis, the age‐adjusted association with HF was significant in women with higher NT‐proBNP levels (P = .008).

Conclusions

This prospective study suggests that high plasma concentrations of β‐OHB are associated with an increased risk of HFrEF, particularly in women. The mechanisms responsible for the sex differences of this association warrant further study.
The Functions and Legitimization of Suffering in Calais, France
Authors: Keen David Peter
Published: December 2020

The instrumentalisation of disaster – long considered a feature of wars and famines in Africa, for example – has now been brought right into the heart of Europe. Suffering in Calais has been manipulated for the purpose of deterrence and for domestic political purposes, and forms part of a wider system of outsourcing violence and suffering that has been legitimised through Arendt’s “action as propaganda” and through perverse distributions of shame.
Text network analysis of research topics and trends on global health nursing literature from 1974 ‐2017
Authors: Hong Hye Sun , Lee Soo‐Kyoung
Published: December 2020

Aims

The purpose of this study is to examine the relationship between keywords in existing global health nursing studies during 44 years (1974–2017) and to develop schematic diagrams of the relationship between these keywords from a macro perspective. It is to identify the trend of the literature in global health nursing field.

Design

A descriptive bibliometric analysis of publications in global health nursing.

Methods

The keywords from 7,115 articles and literatures were examined using the Text Rank Analyzer via the applied text network analysis with NetMiner 4.0.

Results

As for global health nursing, keywords with the most frequent appearance and the highest networking degree in centrality were ‘study’, ‘patient’, ‘nurse’, and ‘women’. Six central keywords were also found highly related to other keywords: ‘global health nursing’, ‘study’, ‘patient’, ‘care’, ‘nurse’, and ‘education’. By measuring the degree of keywords connected to other keywords in centrality, six clusters were established. Then, emerging topics assessed by time periods were identified as follows: the beginning phase (‘breastfeeding’, ‘women’, and ‘children’), the development phase (‘quality’, ‘life’, and ‘human immunodeficiency virus’), the maturation phase (‘mental health’, ‘depression’, and ‘global health’), and the expansion phase (‘pregnancy’, ‘palliative care’, and ‘infectious disease’).

Conclusion

The identified trends on this study will help nurse leaders to grasp the trends and insights for global health and to train future nurses to serve clients better in the practice fields.

Impact

Keywords with the highest appearance and centrality in the network were found in the global health articles. The bibliometric analysis showed various subjects according to the following phases: beginning development maturation and expansion. The awareness of the trend change in the global health helps nursing researchers and educators modify the curriculum of global health nursing and train future nurses to be equipped with the global health competencies.
Stroke disease‐specific quality of life trajectories after rehabilitation discharge and their sociodemographic and clinical associations: A longitudinal, multicentre study
Authors: Pucciarelli Gianluca , Brugnera Agostino , Greco Andrea , Petrizzo Antonello , Simeone Silvio , Vellone Ercole , Alvaro Rosaria
Published: December 2020

Aim

To investigate the longitudinal growth trajectories of disease‐specific quality of life (QoL) dimensions and their associations over 1 year.

Design

A longitudinal design. Data were collected between February 2015‐May 2017.

Methods

Four hundred and fifteen stroke survivors (mean age 70.6 years; 81% ischaemic stroke) were recruited after discharge from rehabilitation hospitals and were followed up every 3 months for 1 year. Changes in Stroke Impact Scale (SIS) dimension scores were evaluated using hierarchical linear models (HLMs) and linear, logarithmic, quadratic, and cubic time slope.

Results

We observed a significant linear and quadratic increase in most SIS dimensions from the baseline to 12‐month follow‐up, especially in physical dimensions. The communication dimension was stable over time, while the memory dimension increased only linearly. Higher physical dimension scores were significantly associated with lower age, hypercholesterolaemia, and better physical functioning at baseline, while higher communication was associated with lower age, better physical functioning, and a diagnosis of peripheral vascular disease. Better memory was associated with lower age, married status, better physical functioning, and left‐hemisphere stroke. Better participation was associated with lower age and better physical functioning. No significant associations were observed for emotion.

Conclusions

This study provides important information about the trajectories of stroke survivors' specific QoL and their associated variables.

Impact

Stroke has a great impact on stroke survivors' QoL. Disease‐specific QoL significantly increases from the baseline to 12‐month follow‐up, especially in physical dimensions. Lower age, hypercholesterolaemia, better physical functioning, and diagnosis of peripheral vascular disease seem to be associated with better QoL. Through the analyses of associated variables, we identified stroke survivors who are more at risk and who need more tailored interventions to improve their physical, psychological, emotional, and social dimensions.