bluuebunny/crossref_metadata_2025 huggingface dataset:
Topology Verification of Low Voltage Distribution Network Based on k-means Clustering Algorithm
Authors: Wang Junyi , Ji Xingquan , Li Kejun , Sun Qiaoyu
Published: August 2019

Aiming at the problem of topology connection error existing in GIS system of low voltage distribution network, a topology verification algorithm using AMI voltage measurement data combined with k-means clustering algorithm is proposed. Firstly, the voltage data of the consumers in the low-voltage substation area is obtained by the AMI measurement system. Then k-means clustering algorithm is used by the similarity to cluster the voltage curves to identify and verify the users connected on the incorrectly transformer stations. An improved method of noise processing using data density set is proposed to solve the problem of initial cluster centre selection in k-means. For the problem of k value selection, an automatic correction of optimal k value is proposed. The feasibility and effectiveness of the improved k-means clustering algorithm in topology verification are verified by a practical example.
An Optimization Algorithm of Robust Principal Component Analysis and Its Application
Authors: Xia Xinyuan , Gao Fei
Published: August 2019

With the rapid development of robust principal component analysis (RPCA), it has been widely used in signal processing, pattern recognition, computer vision and other fields. The RPCA model has characteristics of complete reconstruction of the original signal from the noise pollution, high-dimensional and high-order complex signals. In order to solve the problems of slow iteration speed and low recovery accuracy in typical algorithms, an improved robust principal component analysis (RPCA) algorithm is studied. Firstly, the idea of smooth approximate zero norm is introduced to build the objective optimization function, then the inertial momentum is used to optimize each iteration of the matrix recovery process, finally, the model parameters are optimized by the grid method. Through simulation and comparative analysis, the results show that the improved algorithm has high accuracy, fast processing speed and remarkable application effect in field of logging data processing.
A method of the people-serving police station location problem
Authors: Lu Peng , Wang Jijin , Ning Weixun , Xiao Xiaoqiang
Published: August 2019

The people-serving police station location problem targets to optimize the location of the police stations and minimize total costs. However, it is very difficult to directly give the solution to the problem. To solve the problem, a method of extending demand points is proposed, which can convert the original problem into a binary integer programming problem. By randomly generating maps, the GNU linear programming kit (GLPK) package is used to solve and verify the converted method.
Composite reduced-kernel weighted extreme learning machine for imbalanced data classification
Authors: Wang Dafei , Xie Wujie , Dong Wenhan
Published: August 2019

In order to solving the problem that the weighted extreme learning machine based on the ensemble learning method enhances the classification performance while increasing the running time of the algorithm, starting from the perspective of multi-core learning, a weighted extreme learning machine based on composite kernel functions and reduced-kernel technique is proposed. The composite kernel function based on Gaussian kernel and Polynomial kernel weighted combination is designed, which effectively improves the classification performance of weighted extreme learning machine. Meanwhile, based on the sample distribution characteristics of the imbalanced dataset, the balanced input sub-matrix is designed to reduce the computational cost of the composite kernel method. The eight binary classification imbalanced datasets of KEEL dataset repository were used for testing. The experimental results show that compared with the original weighted extreme learning machine algorithm, the G- mean and AUC classification performance indicators of the composite reduced-kernel weighted extreme learning machine algorithm are improved in each dataset, and the computation cost is effectively reduced.
Systematic Review of the Use of Telepathology During Intraoperative Consultation
Authors: Dietz Robin L , Hartman Douglas J , Pantanowitz Liron
Published: August 2019

Objective

To compare studies that used telepathology systems vs conventional microscopy for intraoperative consultation (frozen-section) diagnosis.

Methods

A total of 56 telepathology studies with 13,996 cases in aggregate were identified through database searches.

Results

The concordance of telepathology with the reference standard was generally excellent, with a weighted mean of 96.9%. In comparison, we identified seven studies using conventional intraoperative consultation that showed a weighted mean concordance of 98.3%. Evaluation of the risk of bias showed that most of these studies were low risk.

Conclusions

Despite limitations such as variation in reporting and publication bias, this systematic review provides strong support for the safety of using telepathology for intraoperative consultations.
Role of Inflammatory Biomarkers in the Prevalence and Incidence of Hypertension Among HIV-Positive Participants in the START Trial
Authors: Ghazi Lama , Baker Jason V , Sharma Shweta , Jain Mamta K , Palfreeman Adrian , Necsoi Coca , Murray Daniel D , Neaton James D , Drawz Paul E
Published: August 2019

BACKGROUND

The association between hypertension (HTN) and inflammatory biomarkers (interleukin-6 [IL-6] and high-sensitivity C-reactive protein [hsCRP]) in HIV-positive persons with CD4+ count >500 cells/mm3 is unknown.

METHODS

We studied HTN in participants of the Strategic Timing of AntiRetroviral Treatment (START) trial of immediate vs. deferred antiretroviral therapy (ART) in HIV-positive, ART naive adults with CD4+ count > 500 cells/mm3. HTN was defined as having a systolic blood pressure (BP) ≥140 mmHg, a diastolic BP ≥90 mmHg, or using BP-lowering therapy. Logistic and discrete Cox regression models were used to study the association between baseline biomarker levels with prevalent and incident HTN.

RESULTS

Among 4,249 participants with no history of cardiovascular disease, the median age was 36 years, 55% were nonwhite, and the prevalence of HTN at baseline was 18.9%. After adjustment for race, age, gender, body mass index (BMI), diabetes, smoking, HIV RNA and CD4+ levels, associations of IL-6 and hsCRP with HTN prevalence were not significant (OR per twofold higher:1.10, 95% confidence interval [CI]: 0.99, 1.20 for IL-6 and 1.05, 95% CI: 0.99, 1.10 for hsCRP). Overall incidence of HTN was 6.8 cases/100 person years. In similarly adjusted models, neither IL-6 (Hazard ratios [HR] per twofold higher IL-6 levels: 0.97, 95% CI: 0.88, 1.08) nor hsCRP (HR per twofold higher hsCRP levels: 0.97, 95% CI: 0.92, 1.02) were associated with risk of incident HTN. Associations did not differ by treatment group. Age, race, gender, and BMI were significantly associated with both the prevalence and incidence of HTN.

CONCLUSIONS

Traditional risk factors and not baseline levels of IL-6 or hsCRP were associated with the prevalence and incidence of HTN in START.
Exaggerated Aortic Pulse Pressure and Wave Amplitude During Muscle Metaboreflex Activation in Type 2 Diabetes Patients
Authors: Figueroa Arturo , Maharaj Arun , Johnson Sarah A , Fischer Stephen M , Arjmandi Bahram H , Jaime Salvador J
Published: August 2019

Background

Peripheral mean arterial pressure (MAP) responses to muscle metaboreflex activation using postexercise muscle ischemia (PEMI) in type 2 diabetes patients (T2D) are contradictory. Given that aortic pulse pressure (PP) and wave reflections are better indicators of cardiac load than peripheral MAP, we evaluated aortic blood pressure (BP) and wave amplitude during PEMI.

METHODS

Aortic BP and pressure wave amplitudes were measured at rest and during PEMI following isometric handgrip at 30% maximum voluntary contraction (MVC) in 16 T2D and 15 controls. Resting aortic stiffness (carotid-femoral pulse wave velocity, cfPWV) and fasting blood glucose (FBG) were measured.

RESULTS

Increases in aortic MAP (Δ26 ± 2 mmHg vs. Δ17 ± 2 mmHg), PP (Δ15 ± 2 mmHg vs. Δ10 ± 1 mmHg), augmentation index (AIx) (Δ8.2 ± 1.0% vs. Δ4.5 ± 1.3%), augmented pressure (AP) (Δ11 ± 1 mmHg vs. Δ5 ± 1 mmHg), forward (Pf) (Δ9 ± 1 mmHg vs. Δ5 ± 1 mmHg), and backward pressure waves (Pb) (Δ10 ± 1 mmHg vs. Δ5 ± 1 mmHg) responses to PEMI were greater in T2D than controls (P < 0.05). Aortic PP, but not MAP, response to PEMI was correlated to Pf (r = 0.63, P < 0.001) and Pb (r = 0.82, P < 0.001) responses and cfPWV (r = 0.37, P < 0.05).

CONCLUSIONS

Aortic BP and pressure wave responses to muscle metaboreflex activation are exaggerated in T2D. Aortic PP during PEMI was related to increased wave reflection, forward wave amplitude, and aortic stiffness in T2D patients.
Using multiple measurements of tissue to estimate subject- and cell-type-specific gene expression
Authors: Wang Jiebiao , Devlin Bernie , Roeder Kathryn
Published: August 2019

Motivation

Patterns of gene expression, quantified at the level of tissue or cells, can inform on etiology of disease. There are now rich resources for tissue-level (bulk) gene expression data, which have been collected from thousands of subjects, and resources involving single-cell RNA-sequencing (scRNA-seq) data are expanding rapidly. The latter yields cell type information, although the data can be noisy and typically are derived from a small number of subjects.

Results

Complementing these approaches, we develop a method to estimate subject- and cell-type-specific (CTS) gene expression from tissue using an empirical Bayes method that borrows information across multiple measurements of the same tissue per subject (e.g. multiple regions of the brain). Analyzing expression data from multiple brain regions from the Genotype-Tissue Expression project (GTEx) reveals CTS expression, which then permits downstream analyses, such as identification of CTS expression Quantitative Trait Loci (eQTL).

Availability and implementation

We implement this method as an R package MIND, hosted on https://github.com/randel/MIND.

Supplementary information

Supplementary data are available at Bioinformatics online.
New concepts in C. difficile management
Authors: Mahida Y R
Published: August 2019

Background

Clostridium difficile infection is transmitted via spores, and the disease is mediated via secreted toxins. It represents a significant healthcare problem, and clinical presentation can range from asymptomatic carriage to life-threatening pseudomembranous colitis.

Sources of data

publications in the field, with a focus on recent developments and concepts.

Areas of agreement

infection control measures, antibiotic stewardship and current management of the initial episode of C. difficile infection.

Areas of controversy

selection and sequence of interventions for the management of recurrent C. difficile infection; management of persistent carriers of toxigenic C. difficile in patients at high risk of subsequent C. difficile infection.

Growing points

use of faecal microbiota transplantation for recurrent C. difficile infection.

Areas timely for developing research

role of specific microbiota-mediated interventions and vaccination in the treatment and prevention of C. difficile infection.
Sensitive Determination of C-Alkylated Flavonoids by HPLC-ESI-MS/MS Using Multiple Reaction Monitoring Approach: Pseudarthria hookeri as a Case Study
Authors: Faraz Ina , Ali Arslan , Ul Haq Faraz , Tchamgoue Joseph , Kouam Simeon F , Miana Ghulam Abbas , Musharraf Syed Ghulam
Published: August 2019

One of the major problems with the formulation of herbal medicines is the quality control of plant material to ensure its efficacy and safety. Quality control of medicinal plants requires analysis of many bioactive compounds present in the plant. C-alkylated flavonoids are an important bioactive subclass of flavonoids. A simple, rapid, sensitive and selective method is presented here for the quantification of bioactive C-alkylated flavonoids. This is the first quantitative method for analysis of C-alkylated flavonoids based on the multiple reaction monitoring (MRM) approach so far. This study focuses on method development for quantification of bioactive C-alkylated flavonoids. Quantification of a total of five C-alkylated flavonoids was done employing the MRM approach on an HPLC-QqQ-MS instrument. LODs and LOQs for quantified flavonoids were in the range of 0.41–1.32 and 1.23–3.96 ng/mL, respectively. Linear calibration curves between 25 and 1500 ng/mL were obtained with the regression coefficients of ≥0.996. Accuracy (% bias) and precision (% RSD) of the analyses were found to be less than 5%. Developed HPLC-ESI-MS/MS can be employed as a quality control method of plant raw materials.
Chemometrically Assisted Development of Ultra-High-Performance Liquid Chromatography Method for the Simultaneous Quantification of Sofosbuvir, Daclatasvir and Ledipasvir in Pharmaceutical Dosage Forms
Authors: Labidi Aymen , El Atrache Latifa Latrous
Published: August 2019

A new ultra-high-performance liquid chromatography method for the simultaneous quantification of sofosbuvir, daclatasvir and ledipasvir was developed. Two combinations of these direct-acting antivirals are used in hepatitis C virus infection therapy and show high efficacy and safety. Fractional factorial design was used for screening the most influential factors on separation and time analysis. These significant factors were optimized using a central composite design. The optimum resolution was carried out by using a Waters XBridge C18 column (150 mm, 4.6 mm ID, 5 μm) at a temperature of 35°C ± 2°C and acetonitrile/sodium perchlorate buffer (10 mM, pH = 3.2) (40: 60 v/v) as mobile phase at a flow rate of 1.5 mL min−1. UV detection was set at λ = 210 nm. A short chromatographic separation time was achieved. The developed method was validated according to the accuracy profile approach and was found specific, precise, faithful and accurate. The detection limits were between 0.07 and 0.13 μg mL−1. Hence, this novel method can be employed for the routine quality control analysis and in dissolution profile studies of generics containing these products.
Effective User Preference Clustering in Web Service Applications
Authors: Wang Yan , Zhou Jian-tao , Li Xinyuan , Song Xiaoyu
Published: August 2019

The research on personalized recommendation of Web services plays an important role in the field of Web services technology applications. Fortunately, not all users have completely different service preferences. Due to the same application scenarios and personal interests, some users have the same preferences for certain types of Web services. This paper explores the problem of user clustering in the service environment, grouping users according to their service preferences. It helps service providers to identify and characterize the preferences of similar users and provide them with customized services. We propose two combination-based clustering algorithms which make full use of the advantages of the K-means algorithm and the affinity propagation algorithm. In addition, a three-stage clustering process is elaborated to improve the accuracy of user clustering. To reduce the time complexity of the algorithms, we create a parallel execution model of the algorithms implemented by a higher-order MapReduce sequence linking technology. Extensive experiments on simulated datasets and real datasets are performed on the comparisons between the proposed algorithms and the other combination-based clustering algorithms. The experimental results substantiate that the proposed algorithms can effectively distinguish user group with different preferences.
Direction-based Spatial Skyline for Retrieving Arbitrary-Shaped Surrounding Objects
Authors: Shen Bojie , Islam Saiful , Taniar David
Published: August 2019

Retrieval of arbitrary-shaped surrounding data objects has many potential applications in spatial databases including nearby arbitrary-shaped object-of-interests retrieval surrounding a user. In this paper, we propose directional zone concept to determine directional similarity among spatial data objects. Then, we propose a novel query, called direction-based spatial skyline (DSS), which retrieves non-dominated arbitrary-shaped surrounding data objects in spatial databases for a user. The proposed DSS query is rotationally invariant as well as fair. We develop efficient algorithms for processing DSS queries in spatial databases by designing novel data pruning techniques using R-Tree data indexing scheme. Finally, we demonstrate the effectiveness and efficiency of our approach by conducting extensive experiments with real datasets.
Uncertainties and challenges in surgical and transcatheter tricuspid valve therapy: a state-of-the-art expert review
Authors: Chang Chun Chin , Veen Kevin M , Hahn Rebecca T , Bogers Ad J J C , Latib Azeem , Oei Frans B S , Abdelghani Mohammad , Modolo Rodrigo , Ho Siew Yen , Abdel-Wahab Mohamed , Fattouch Khalil , Bosmans Johan , Caliskan Kadir , Taramasso Maurizio , Serruys Patrick W , Bax Jeroen J , van Mieghem Nicolas M D A , Takkenberg Johanna J M , Lurz Philip , Modine Thomas , Soliman Osama
Published: August 2019

Tricuspid regurgitation (TR) is a frequent and complex problem, commonly combined with left-sided heart disease, such as mitral regurgitation. Significant TR is associated with increased mortality if left untreated or recurrent after therapy. Tricuspid regurgitation was historically often disregarded and remained undertreated. Surgery is currently the only Class I Guideline recommended therapy for TR, in the form of annuloplasty, leaflet repair, or valve replacement. As growing experience of transcatheter therapy in structural heart disease, many dedicated transcatheter tricuspid repair or replacement devices, which mimic well-established surgical techniques, are currently under development. Nevertheless, many aspects of TR are little understood, including the disease process, surgical or interventional risk stratification, and predictors of successful therapy. The optimal treatment timing and the choice of proper surgical or interventional technique for significant TR remain to be elucidated. In this context, we aim to highlight the current evidence, underline major controversial issues in this field and present a future roadmap for TR therapy.
Effects of allochthonous dissolved organic matter input on microbial composition and nitrogen-cycling genes at two contrasting estuarine sites
Authors: Happel Elisabeth M , Markussen Trine , Teikari Jonna E , Huchaiah Vimala , Alneberg Johannes , Andersson Anders F , Sivonen Kaarina , Middelboe Mathias , Kisand Veljo , Riemann Lasse
Published: August 2019

Heterotrophic bacteria are important drivers of nitrogen (N) cycling and the processing of dissolved organic matter (DOM). Projected increases in precipitation will potentially cause increased loads of riverine DOM to the Baltic Sea and likely affect the composition and function of bacterioplankton communities. To investigate this, the effects of riverine DOM from two different catchment areas (agricultural and forest) on natural bacterioplankton assemblages from two contrasting sites in the Baltic Sea were examined. Two microcosm experiments were carried out, where the community composition (16S rRNA gene sequencing), the composition of a suite of N-cycling genes (metagenomics) and the abundance and transcription of ammonia monooxygenase (amoA) genes involved in nitrification (quantitative PCR) were investigated. The river water treatments evoked a significant response in bacterial growth, but the effects on overall community composition and the representation of N-cycling genes were limited. Instead, treatment effects were reflected in the prevalence of specific taxonomic families, specific N-related functions and in the transcription of amoA genes. The study suggests that bacterioplankton responses to changes in the DOM pool are constrained to part of the bacterial community, whereas most taxa remain relatively unaffected.
The Methylotroph Gene Order Browser (MGOB) reveals conserved synteny and ancestral centromere locations in the yeast family Pichiaceae
Authors: Douglass Alexander P , Byrne Kevin P , Wolfe Kenneth H
Published: August 2019

The yeast family Pichiaceae, also known as the ‘methylotrophs clade’, is a relatively little studied group of yeasts despite its economic and clinical relevance. To explore the genome evolution and synteny relationships within this family, we developed the Methylotroph Gene Order Browser (MGOB, http://mgob.ucd.ie) similar to our previous gene order browsers for other yeast families. The dataset contains genome sequences from nine Pichiaceae species, including our recent reference sequence of Pichia kudriavzevii. As an example, we demonstrate the conservation of synteny around the MOX1 locus among species both containing and lacking the MOX1 gene for methanol assimilation. We found ancient clusters of genes that are conserved as adjacent between Pichiaceae and Saccharomycetaceae. Surprisingly, we found evidence that the locations of some centromeres have been conserved among Pichiaceae species, and between Pichiaceae and Saccharomycetaceae, even though the centromeres fall into different structural categories—point centromeres, inverted repeats and retrotransposon cluster centromeres.
Effectiveness of extended- versus normal-release nitrofurantoin for cystitis: an instrumental variable analysis
Authors: ten Doesschate Thijs , Groenwold Rolf H H , Bonten Marc J M , van Werkhoven Cornelis H
Published: August 2019

Background

It is unknown whether nitrofurantoin 50 mg normal-release every 6 h (NF50) and nitrofurantoin 100 mg extended-release every 12 h (NF100) are equally effective for treating cystitis in primary care. In the Netherlands, GP prescription of either option largely depends on pharmacy procurement, rather than on patient-related factors.

Methods

GP data between January 2013 and July 2018 were retrospectively collected. Inclusion criteria were the use of nitrofurantoin for uncomplicated cystitis, complicated cystitis or cystitis in pregnancy. Criteria for early and late failure were a second antibiotic prescription for cystitis or pyelonephritis within 14 and 28 days post-prescription, respectively. Crude and confounder-adjusted (CA) risk differences (RDs) were estimated using linear regression. Instrumental variable analysis and CA instrumental variable analysis used GP practice proportion of NF50 versus NF100 use as the instrumental variable.

Results

For uncomplicated cystitis (n=46855), treatment with NF50 and NF100 resulted in late failure in 9.7% and 9.6%, respectively. The CA RD, instrumental variable RD and CA instrumental variable RD were 0.2% (95% CI=−0.5 to 0.8), −0.7% (95% CI=−1.7 to 0.3) and 0.0% (95% CI=−0.9 to 1.0), respectively. In complicated cystitis (n=10767), late failure occurred in 10.9% and 11.1% after using NF50 and NF100, respectively [CA RD=0.5% (95% CI=−1.2 to 1.8), instrumental variable RD=−0.8% (95% CI=−3.4 to 1.8) and CA instrumental variable RD=−0.3% (95% CI=−3.0 to 2.4)]. For cystitis in pregnancy (n=1087), NF50 and NF100 resulted in late failure in 13.4% and 7.8%, respectively [CA RD=−5.4% (95% CI=−10.0 to −1.4), instrumental variable RD=−8.9% (95% CI=−16.0 to −1.8) and CA instrumental variable RD=−8.9% (95% CI=−16.0 to −1.7)]. No differences were observed in early failure.

Conclusions

In patients with cystitis in pregnancy, NF100 was associated with a lower incidence of late clinical failure compared with NF50. We found no differences in clinical failure between NF50 and NF100 for uncomplicated and complicated cystitis.
Preoperative prognostic nutritional index as a method to predict postoperative complications after major head and neck surgery with free tissue transfer reconstruction
Authors: Imai Takayuki , Asada Yukinori , Morita Sinkichi , Saijo Satoshi , Fujii Keitaro , Kishimoto Kazuhiro , Yamazaki Tomoko , Goto Takahiro , Matsuura Kazuto
Published: August 2019

Background

Head and neck (H&N) cancer patients are often malnourished and have diminished immunity. H&N surgery with free tissue transfer reconstruction (HNS-FTTR) is associated with a relatively high incidence of postoperative complications.

Methods

Associations between possible risk factors and postoperative Clavien–Dindo (C–D) grades ≥ II and ≥ IIIa wound healing- or infection-related complications, postoperative overall complications and prolonged hospital stay were investigated in 188 patients who underwent HNS-FTTR during 2014–2018. The preoperative prognostic nutritional index (PNI) was calculated using the serum albumin level and total lymphocyte count.

Results

C–D ≥ II and ≥ IIIa complications were seen in 66 (35.1%) and 37 (19.7%) patients, respectively. Multivariate analysis showed that (i) previous irradiation was significantly associated with C–D ≥ II wound healing- or infection-related complications and prolonged hospital stays [odds ratio (OR) 3.096 and 3.328; P = 0.007 and 0.008, respectively]; and (ii) operation time of ≥9 h 20 min was a significant risk factor for C–D ≥ IIIa wound healing- or infection-related complications, and C–D ≥ IIIa overall complications (OR 2.987 and 2.257; P = 0.021 and 0.047, respectively). (3) Only preoperative PNI ≤ 40 was associated with all occurrences of C–D ≥ II and ≥ IIIa wound healing- or infection-related complications, C–D ≥ II and ≥ IIIa overall complications, and prolonged hospital stays (OR 3.078, 2.918, 2.627, 3.132 and 3.116; P = 0.020, 0.046, 0.036, 0.023 and 0.025, respectively).

Conclusions

PNI, easily calculated, was the lone risk factor significantly predicting all C–D ≥ II and ≥ IIIa postoperative wound healing- or infection-related complications, C–D ≥ II and ≥ IIIa postoperative overall complications and prolonged hospital stay after HNS-FTTR.
Climatic niche shift of an invasive shrub (Ulex europaeus): a global scale comparison in native and introduced regions
Authors: Christina Mathias , Limbada Fawziah , Atlan Anne
Published: August 2019

Aims

Invasive species, which recently expanded, may help understand how climatic niche can shift at the time scale of the current global change. Here, we address the climatic niche shift of an invasive shrub (common gorse, Ulex europaeus) at the world and regional scales to assess how it could contribute to increasing invasibility.

Methods

Based on a 28 187 occurrences database, we used a combination of 9 species distribution models (SDM) to assess regional climatic niche from both the native range (Western Europe) and the introduced range in different parts of the world (North-West America, South America, North Europe, Australia and New Zealand).

Important Findings

Despite being restricted to annual mean temperature between 4°C and 22°C, as well as annual precipitation higher than 300 mm/year, the range of bioclimatic conditions suitable for gorse was very large. Based on a native versus introduced SDM comparison, we highlighted a niche expansion in North-West America, South America and to a lesser degree in Australia, while a niche displacement was assessed in North Europe. These niche changes induced an increase in potential occupied areas by gorse by 49, 111, 202 and 283% in Australia, North Europe, North-West America and South America, respectively. On the contrary, we found no evidence of niche change in New Zealand, which presents similar climatic condition to the native environment (Western Europe). This study highlights how niche expansion and displacement of gorse might increase invasibility at regional scale. The change in gorse niche toward new climatic conditions may result from adaptive plasticity or genetic evolution and may explain why it has such a high level of invasibility. Taking into account the possibility of a niche shift is crucial to improve invasive plants management and control.
High-degree gravity modes in the single sdB star HD 4539
Authors: Silvotti R , Uzundag M , Baran A S , Østensen R H , Telting J H , Heber U , Reed M D , Vŭcković M
Published: August 2019

HD 4539 (alias PG 0044 + 097 or EPIC 220641886) is a bright (V  = 10.2) long-period V1093 Her-type subdwarf B (sdB) pulsating star that was observed by the Kepler spacecraft in its secondary (K2) mission. We use the K2 light curve (78.7 d) to extract 169 pulsation frequencies, 124 with a robust detection. Most of these frequencies are found in the low-frequency region typical of gravity (g-)modes, but some higher frequencies corresponding to pressure (p-)modes are also detected. Therefore HD 4539 is a hybrid pulsator and both the deep and surface layers of the star can potentially be probed through asteroseismology. The lack of any frequency splitting in its amplitude spectrum suggests that HD 4539 has a rotation period longer than the K2 run and/or that it is seen pole-on. From asymptotic period spacing we see many high-degree modes, up to l  = 12, in the spectrum of HD 4539, with amplitudes as low as a few ppm. A large fraction of these modes can be identified and for ∼29 per cent of them we obtain a unique and robust identification corresponding to l ≤ 8. Our study includes also a new determination of the atmospheric parameters of the star. From low-resolution spectroscopy we obtain Teff  = 22 800 ± 160 K, log g  = 5.20 ± 0.02, and log(N(He)/N(H))  = −2.34 ± 0.05. By fitting the SED we obtain Teff  = 23 470$^{+650}_{-210}$ K, R⋆  = 0.26 ± 0.01 R⊙, and M⋆  = 0.40 ± 0.08 M⊙. Moreover, from 11 high-resolution spectra we see the radial velocity variations caused by the stellar pulsations, with amplitudes of ≈150 m s−1 for the main modes, and we can exclude the presence of a companion with a minimum mass higher than a few Jupiter masses for orbital periods below ∼300 d.
What Would the Defendant have Done but for the Wrong?
Authors: Pratt Michael G
Published: August 2019

Suppose a defendant owed the claimant a duty that the defendant could have discharged by taking any one of several different measures. The defendant took none, violating the duty. When assessing damages, how should the court determine which measure the defendant would have taken had the defendant not committed the wrong? I explain how this peculiar counterfactual inquiry should proceed. I examine the role of counterfactual analysis in the assessment of damages generally, before exploring the special difficulty it raises in cases involving disjunctive duties (duties capable of being variously satisfied). By virtue of certain doctrinal assumptions, it is a difficulty that courts have mostly avoided. I argue that these assumptions are unjustifiable and should be jettisoned. The problem of how to determine the counterfactual, lawful conduct of a defendant who violated a disjunctive duty cannot be avoided. I propose a principled solution to the problem that can be straightforwardly applied by judges.
Rare but not beyond care: a young female with altered mental status and seizures
Authors: Pathireddy Samata , Bose Subashish , Baradhi Krishna , Aeddula Narothama Reddy
Published: August 2019

A 40-year-old Caucasian lady with focal crescentic glomerulonephritis (p-ANCA) demonstrated by kidney biopsy, was treated with intravenous pulse steroids followed by weekly outpatient rituximab infusions (375 mg/m2). Five days after the fourth and final rituximab infusion, she developed headaches, altered mental status and seizures. Upon transfer to our facility, magnetic resonance imaging of the brain revealed cortical white matter changes suggestive of possible progressive multifocal leukoencephalopathy (PML) or posterior reversible encephalopathy syndrome (PRES). She was aggressively treated with antihypertensives, anti-seizure medications, intravenous steroids, plasmapheresis and ventilatory support while awaiting cerebrospinal fluid analysis and polymerase chain reaction on John Cunningham virus DNA. She had a complete recovery and, at 1 year follow up, was found to be doing well. Awareness of potential complications of rituximab therapy, such as PRES or PML is critical in providing appropriate treatment.
Global and Specific Cortical Volume Asymmetries in Individuals With Psychosis Risk Syndrome and Schizophrenia: A Mixed Cross-sectional and Longitudinal Perspective
Authors: Damme Katherine S F , Vargas Teresa , Calhoun Vince , Turner Jessica , Mittal Vijay A
Published: August 2019

Cortical volumetric asymmetry (CVA) has been widely observed in individuals with psychosis, and is associated with etiological risk factors (e.g., genetics, neuromaturation) and treatment response. However, it is unclear whether CVA abnormalities emerge before psychotic illness onset. Understanding whether CVA manifests in clinical high-risk (CHR)—compared with healthy controls and schizophrenia patients (SCZ)—over time may inform our understanding of pathogenic factors. A total of 233 individuals: 73 CHR, 112 healthy controls, and 48 SCZ underwent an MRI and clinical interviews. Ninety-four individuals including healthy volunteers (HV) (n = 49) and CHR (n = 45), completed another scan at 12-months. CVA was compared by lobe in a repeated-measure design across groups, then nested by time in a longitudinal model. CHR and SCZ groups showed reduced global CVA compared with the healthy control groups but the CHR and SCZ group did not differ from each other. A group by lobe interaction indicated the presence of lobe specific reductions in frontal and cingulate CVA. Cingulate CVA was reduced in CHR and SCZ groups compared to HC groups but did not differ from each other. Frontal CVA was reduced in the older healthy controls compared with younger-HC and CHR, but did not differ from the similarly aged SZ group. CVA is similarly impacted in SCZ and CHR groups, potentially reflecting pathogenic processes. Longitudinal analyses provided further support for the neurodevelopmental hypothesis as CHR exhibited longitudinal changes in opposite directions from normative neuromaturation in HV, which was related to increasing risk for psychosis in the CHR.
The Use of Platelet-Rich Plasma and Rosuvastatin in Wound Healing in Rabbits: A Longitudinal Study
Authors: Tetila Amanda Feba , Breda Maria Rosa Santos , Nogueira Rosa Maria Barilli , Nai Gisele Alborghetti , Laposy Cecília Braga
Published: August 2019

OBJECTIVE

To test the hypothesis that platelet-rich plasma (PRP) improves wound healing in rabbits by analyzing morphologic alterations in lesions with the use of PRP alone or combined with rosuvastatin (RSV).

METHODS

Eight adult male New Zealand rabbits were used in this study. Researchers created four wounds on the back of each rabbit with an 8-mm punch. The control wound was treated with a 0.9% sodium chloride solution. Experimental wounds were treated with PRP, RSV, or both PRP and RSV. Dressings were changed with a new application of PRP and RSV every 4 days for 16 days. Wounds were biopsied on days 0, 7, 10, 14, and 17 for histopathologic evaluation of the scar tissue.

MAIN RESULTS

Histopathology revealed reepithelialization in 100% of wounds treated with PRP alone after 17 days of treatment, compared with 50% of wounds treated with RSV alone and 75% of the wounds treated with PRP and RSV. Further, combining RSV and PRP reduced blood loss. The use of PRP alone induced 100% neovascularization, compared with 50% and 62.5% in wounds treated with PRP and RSV and RSV alone, respectively. All experimental wounds had a higher percentage of collagen fibers on day 17 postlesion when compared with control wounds (78.27% ± 4.69%). There were no significant differences among treatments; however, wounds treated with RSV alone had the lowest amount of collagen fibers (85.98% ± 3.51%). Wounds treated with PRP alone or PRP and RSV had 90.07% ± 6.20% and 90.76% ± 3.51% collagen fibers, respectively.

CONCLUSIONS

The results of this study indicate that PRP elicits higher healing activity in the first 7 days postlesion. Treatments with RSV alone or RSV and PRP did enhance other healing phases.
Co-occurring Substance Use Disorders in Youth With Chronic Medical Conditions: The Need for Integration of Addiction Treatment into Mainstream Medical Facilities
Authors: Chadi Nicholas , Schizer Miriam , Mountain-Ray Shannon , Thakur Aishwarya , Weitzman Elissa R. , Levy Sharon
Published: August 2019

Approximately 5% of adolescents in the US meet criteria for a substance use disorder (SUD), and many of them benefit from residential treatment programs at points in the course of the disorder to achieve early sobriety and stabilization. Youth with chronic medical conditions use alcohol, marijuana, and other substances at levels similar to peers, but are at greater risk of progression to heavy or problem use of alcohol, marijuana, and tobacco by young adulthood and often encounter unique treatment barriers that limit access to an appropriate level of care. We describe 2 such adolescents; a 15-year-old boy with type 1 diabetes who experienced interruptions in substance use treatment because of concerns regarding routine glycemic management and a 17-year-old boy with inflammatory bowel disease, who experienced treatment delays in the context of increasing alcohol and marijuana use because of digestive symptoms. For both of these adolescents, lack of access to professionals who could manage chronic medical conditions prevented delivery of substance use treatment and resulted in an increase in substance use behaviors. These cases illustrate the need for integrated substance use care within medical specialty settings. We propose opportunities for improvement, such as providing cross-training for medical and addiction treatment teams and integration of substance use treatment within traditional medical facilities.
Women's Preventive Services Initiative's Well-Woman Chart
Authors: Phipps Maureen G. , Son Sarah , Zahn Christopher , O'Reilly Nancy , Cantor Amy , Frost Jennifer , Gregory Kimberly D. , Jones Michelle , Kendig Susan M. , Nelson Heidi D. , Pappas Miranda , Qaseem Amir , Ramos Diana , Salganicoff Alina , Taylor Gabrelle , Conry Jeanne ,   for the Women's Preventive Services Initiative
Published: August 2019

The Well-Woman Chart summarizes current recommendations for preventive health services for women from adolescence and continuing across the lifespan. It was developed by the Women's Preventive Services Initiative, a national collaborative of women's health professional organizations and patient representatives. The Well-Woman Chart includes current clinical guidelines from the U.S. Preventive Services Task Force, Bright Futures from the American Academy of Pediatrics, and the Women's Preventive Services Initiative that are covered with no cost-sharing for public and most private insurance plans under the prevention service mandate of the Affordable Care Act. The structure of the Well-Woman Chart is based on age intervals and pregnancy status categories that align with existing recommendations. The target audience for the Well-Woman Chart is all clinicians providing preventive health care for women, particularly in primary care settings, and patients affected by the recommendations. The preventive services recommendations apply to females 13 years of age and older and pregnant females of any age. The Well-Woman Chart provides clinical guidance for screening, counseling, and other recommended preventive services for women during health care visits based on age, pregnancy status, and risk factors.
Gabapentin for Perioperative Pain Management for Uterine Aspiration
Authors: Gray Beverly A. , Hagey Jill M. , Crabtree Donna , Wynn Clara , Weber Jeremy M. , Pieper Carl F. , Haddad Lisa B.
Published: August 2019

OBJECTIVE:

To evaluate the effect of oral gabapentin in conjunction with usual oral pain management regimens of lorazepam, ibuprofen, oxycodone, and acetaminophen for surgical abortion on pain 5 minutes postprocedure.

METHODS:

This was a randomized, double-blind, placebo-controlled trial of patients from 6 0/7–14 6/7 weeks of gestation scheduled to undergo surgical abortion at the Duke Family Planning Clinic. Participants were administered 600 mg of oral gabapentin compared with placebo with usual oral pain management. Pain score was assessed using a 100-mm visual analog scale, with the primary outcome being pain score 5 minutes after the procedure. The effect of gabapentin was assessed using a linear regression model controlling for baseline pain. We also measured pain perception 24 hours after the procedure. Secondary outcome measures included anxiety, side effects, and usage of opiate pain medication in the 24-hour postoperative period.

RESULTS:

Out of 113 women screened for this study; 96 women were recruited, enrolled, and randomized to study treatment arm from August 2016 to June 2018. Pain at 5 minutes after the procedure was similar between the gabapentin and placebo groups (

JOURNAL/obsgy/04.03/00006250-201909000-00024/inline-formula1/v/2023-07-11T165522Z/r/image-tiff

=3.40; 95% CI −8.20 to 15.0; P=.56). Gabapentin and placebo were well tolerated, with no statistically significant difference in side effects or anxiety levels. Although prescription of opioids after the procedure was not standardized among patients, 73% of women received a short-term prescription for oxycodone. A lower percentage of women in the gabapentin group self-reported taking opioids in the 24 hours postprocedure (18% vs 47%; odds ratio 0.26; 95% CI 0.09–0.75).

CONCLUSION:

The addition of gabapentin to usual oral pain management regimens with paracervical block did not reduce postoperative pain for patients undergoing outpatient surgical abortion. Although the addition of gabapentin was well tolerated and reduced oral opiate use 24 hours postprocedure, it did not affect the experience of pain during and immediately after the procedure.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02725710.
Enhanced Recovery After Surgery to Change Process Measures and Reduce Opioid Use After Cesarean Delivery
Authors: Hedderson Monique , Lee Derrick , Hunt Eric , Lee Kimberly , Xu Fei , Mustille Alex , Galin Jessica , Campbell Cynthia , Quesenberry Charles , Reyes Vivian , Huang Mengfei , Nicol Barbara , Paulson Shirley , Liu Vincent
Published: August 2019

OBJECTIVE:

To evaluate implementation of an enhanced recovery after surgery (ERAS) program for patients undergoing elective cesarean delivery by comparing opioid exposure, multimodal analgesia use, and other process and outcome measures before and after implementation.

METHODS:

An ERAS program was implemented among patients undergoing elective cesarean delivery in a large integrated health care delivery system. We conducted a pre–post study of ERAS implementation to compare changes in process and outcome measures during the 12 months before and 12 months after implementation.

RESULTS:

The study included 4,689 patients who underwent an elective cesarean delivery in the 12 months before (pilot sites: March 1, 2015–February 29, 2016, all other sites: October 1, 2015–September 30, 2016), and 4,624 patients in the 12 months after (pilot sites: April 1, 2016–March 31, 2017, all other sites: November 1, 2016–October 31, 2017) ERAS program implementation. After ERAS implementation mean inpatient opioid exposure (average daily morphine equivalents) decreased from 10.7 equivalents (95% CI 10.2–11.3) to 5.4 equivalents (95% CI 4.8–5.9) controlling for age, race–ethnicity, prepregnancy body mass index, patient reported pain score, and medical center. The use of multimodal analgesia (ie, acetaminophen and neuraxial anesthesia) increased from 9.7% to 88.8%, the adjusted risk ratio (RR) for meeting multimodal analgesic goals was 9.13 (RR comparing post-ERAS with pre-ERAS; 95% CI 8.35–10.0) and the proportion of time patients reported acceptable pain scores increased from 82.1% to 86.4% (P<.001). Outpatient opioids dispensed at hospital discharge decreased from 85.9% to 82.2% post-ERAS (P<.001) and the average number of dispensed pills decreased from 38 to 26 (P<.001). The hours to first postsurgical ambulation decreased by 2.7 hours (95% CI −3.1 to −2.4) and the hours to first postsurgical solid intake decreased by 11.1 hours (95% CI −11.5 to −10.7). There were no significant changes in hospital length of stay, surgical site infections, hospital readmissions, or breastfeeding rates.

CONCLUSIONS:

Implementation of an ERAS program in patients undergoing elective cesarean delivery was associated with a reduction in opioid inpatient and outpatient exposure and with changes in surgical process measures of care without worsened surgical outcomes.
Malignancies in systemic lupus erythematosus: an update
Authors: Ladouceur Alexandra , Clarke Ann E. , Ramsey-Goldman Rosalind , Bernatsky Sasha
Published: August 2019

Purpose of review

Patients with systemic lupus erythematosus (SLE) have altered incidences of certain malignancies as compared with the general population. This review summarizes the recent literature on risk of malignancy in SLE and proposed mechanisms for these altered susceptibilities.

Recent findings

Recent studies have confirmed previous data showing an increased risk of hematological, lung, thyroid, liver, cervical and vulvovaginal cancers, while demonstrating a decreased risk of breast and prostate cancer. Lymphomagenesis in SLE has been linked to increased activity of multiple inflammatory cytokines as well as possible viral causes. The decreased rates of hormone-sensitive cancers, such as breast and prostate is speculated to be related to the presence of lupus autoantibodies and downregulation of certain proteins in SLE. This knowledge has been utilized to investigate new therapeutic modalities for these malignancies.

Recent data confirm previously reported altered malignancy rates in SLE. There has been some elucidation of mechanisms underlying cancer development in SLE, although additional work is yet to be done.
Current strategies for vaccination in glioblastoma
Authors: Dutoit Valérie , Migliorini Denis , Dietrich Pierre-Yves
Published: August 2019

Purpose of review

Immunotherapy is viewed as a promising approach for glioblastoma and, in particular, therapeutic vaccines are being intensively studied. Here, we review results provided by recent clinical trials of glioblastoma vaccination and discuss the required strategies to optimize such approaches.

Recent findings

Two studies showed the feasibility of generating mutation-derived personalized vaccines in the short time frame given by the fast course of disease in glioblastoma. However, one of these demonstrated lack of mutation-derived cell surface presented MHC class I or II peptides in tumors with low mutational burden.

Whereas glioblastoma vaccines are well tolerated, impact on patient survival has yet to be proven. Combinations with immune checkpoint inhibitors are being tested, but strategies aiming at targeting the tumor microenvironment should be implemented as well. Finally, accurate immunomonitoring should be promoted in order to identify the best vaccine strategies, alone or in combination.