bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnetic Reconnection of Solar Flux Tubes and Coronal Reconnection Signatures in the Solar Wind at 1 AU
Authors: Burkholder B. L. , Otto A.
Published: November 2019

The origin of interplanetary magnetic field that is frozen‐in to the solar wind plasma flow is clearly magnetic flux from the Sun's corona. However, the filamented structure of magnetic fields observed in the solar wind cannot be accounted for quite so simply. Given the 2 days or more for solar wind to travel from the Sun to 1 AU, some argue that many current sheets are present due to turbulence and other in‐transit effects in the dynamic plasma outflow. Alternatively, it is postulated that a “flux tube texture” of the solar wind exists as fossil structure of the corona. In this paper we examine the possible influence of magnetic reconnection occurring close to the Sun or in the solar wind on the character of current sheets observed by Magnetospheric Multiscale at 1 AU. Photospheric convection is used to perturb a magnetic carpet‐like configuration, which has well‐segmented open flux tubes defined by topological elements of the magnetic field. Flux tube boundaries in the model are defined by magnetic sepratrix surfaces which are a preferential location for strong currents and magnetic reconnection. Reconnection is associated with signatures in the magnetic field and plasma that may advect with the solar wind all the way to 1 AU. Aided by three‐dimensional coronal modeling and two‐dimensional simulation examples of reconnection layers, we examine properties of current sheets observed by Magnetospheric Multiscale and how these solar wind boundaries may relate to reconnection operating earlier in the solar wind or corona.
Lagrangian Evolution of Two Madagascar Cyclonic Eddies: Geometric Properties, Vertical Structure, and Fluxes
Authors: Morris T. , Aguiar‐González B. , Ansorge I. , Hermes J.
Published: November 2019

We investigate the 3‐D Lagrangian evolution of two Madagascar cyclonic eddies based on ad hoc Argo experiments undertaken in April and July 2013. Eight Argo floats were configured to measure temperature and salinity at high temporal resolutions (daily and five‐daily experiments) and varying park depths (300, 500, 650, and 1,000 m) to test their performance with regard to retention within the eddies described. Near‐surface eddy properties are derived from an eddy detection and tracking algorithm applied to satellite altimetry data and a quasi eddy‐resolving (1/4°) ocean general circulation model (GLORYS2v4). Both eddies propagated southwestward from southwest Madagascar (26°S, 40°E), where the South East Madagascar Current separates from the continental shelf. During a travel of about 130 days at an average speed of 11 km day−1, the eddies experienced well‐defined growth, mature, and decay phases, interacting with the Agulhas Current at the KwaZulu‐Natal Bight (28°S, 34°E). Model‐based estimates indicate the April (July) eddy showed mean trapping water depths of 595 ± 294 m (914 m ± 107 m), volume transport about 13.4 ± 5.2 Sv (21.2 ± 9.1 Sv), heat flux of −0.07 ± 0.06 PW (‐0.2 ± 0.09 PW), and freshwater flux of 0.04 ± 0.04 Sv (0.09 ± 0.05 Sv). Peak estimates were found for both eddies during the mature eddy phase. These results highlight the role of Madagascar cyclonic eddies as transporters of cooled and freshened source waters into the Agulhas Current and illustrate the benefits of ad hoc Argo configurations for the study of 3‐D Lagrangian eddy dynamics in combination with a “state‐of‐the‐art” ocean model and remotely sensed data.
Microphysics of Snowfall Over Coastal East Antarctica Simulated by Polar WRF and Observed by Radar
Authors: Vignon É. , Besic N. , Jullien N. , Gehring J. , Berne A.
Published: November 2019

The current assessment of the Antarctic surface mass balance mostly relies on reanalysis products or climate model simulations. However, little is known about the ability of models to reliably represent the microphysical processes governing the precipitation. This study makes use of recent ground‐based precipitation measurements at Dumont d'Urville station in Adélie Land to evaluate the representation of the precipitation microphysics in the Polar version of the Weather Research Forecast (Polar WRF) atmospheric model. During two summertime snowfall events, high‐resolution simulations are compared to measurements from an X‐band polarimetric radar and from a Multi‐Angle Snowflake Camera (MASC). A radar simulator and a “MASC” simulator in Polar WRF make it possible to compare similar observed and simulated variables. Radiosoundings and surface‐meteorological observations were used to assess the representation of the regional dynamics in the model. Five different microphysical parameterizations are tested. The simulated temperature, wind, and humidity fields are in good agreement with the observations. However, the amount of simulated surface precipitation shows large discrepancies with respect to observations, and it strongly differs between the simulations themselves, evidencing the critical role of the microphysics. The inspection of vertical profiles of reflectivity and mixing ratios revealed that the representation of the sublimation process by the low‐level dry katabatic winds strongly influences the actual amount of precipitation at the ground surface. By comparing the simulated radar signal as well as MASC and model particle size distributions, it is also possible to identify the microphysical processes involved and to pinpoint shortcomings within the tested parameterizations.
The Possible Responses of Polar Ozone to Solar Proton Events in March 2012 by FengYun‐3 Satellite Observations
Authors: Huang Cong , Huang Fu‐Xiang , Zhang Xiao‐Xin , Lv Jing‐Tian , Cao Dong‐Jie , Liu Dan‐Dan
Published: November 2019

In this work, we use observations by the Solar Backscatter Ultraviolet Sounder and Space Environment Monitor on FengYun‐3 to analyze the polar ozone depletion during the solar proton events (SPEs), which occurred in early March 2012. The ozone distributions changed evidently with the increasing energetic proton flux (the particle energy is over 100 MeV) at the approximate altitude of 30 km. From the ozone profile relative changes, the short‐term impacts of SPEs can be distinguished from the long‐term effects of ozone season variations after the SPEs take place and cause about 4–17% of the short‐term polar ozone decreases at the different levels in the upper stratosphere of both hemispheres. In the upper stratosphere, the SPE‐related polar ozone depletion is more significant and continuous in the Northern Hemisphere but shows the short‐term effects in the Southern Hemisphere during the March SPEs. The ozone depletion responses to the first SPE on 7 March are more pronounced in this altitude region than the second one on 13 March in both hemispheres due to the “harder” particle energy spectrum.
Probabilistic Forecast of Single‐Phase Flow in Porous Media With Uncertain Properties
Authors: Jun Yang Hyung , Boso Francesca , Tchelepi Hamdi A. , Tartakovsky Daniel M.
Published: November 2019

Uncertainty about geologic makeup and properties of the subsurface renders inadequate a unique quantitative prediction of flow and transport. Instead, multiple alternative scenarios have to be explored within the probabilistic framework, typically by means of Monte Carlo simulations (MCS). These can be computationally expensive, and often prohibitively so, especially when the goal is to compute the tails of a distribution, that is, probabilities of rare events, which are necessary for risk assessment and decision making under uncertainty. We deploy the method of distributions to derive a deterministic equation for the cumulative distribution function (CDF) of hydraulic head in an aquifer with uncertain (random) hydraulic conductivity. The CDF equation relies on a self‐consistent closure approximation, which ensures that the resulting CDF of hydraulic head has the same mean and variance as those computed with statistical moment equations. We conduct a series of numerical experiments dealing with steady‐state two‐dimensional flow driven by either a natural hydraulic head gradient or a pumping well. These experiments reveal that the CDF method remains accurate and robust for highly heterogeneous formations with the variance of log conductivity as large as five. For the same accuracy, it is also up to four orders of magnitude faster than MCS in computing hydraulic head with a required degree of confidence (probability).
Trametes orientalis polysaccharide alleviates PM2.5-induced lung injury in mice through its antioxidant and anti-inflammatory activities
Authors: Zheng Yi , Fan Jing , Chen Hong-wei , Liu En-qi
Published: November 2019

Trametes orientalis polysaccharide (TOP-2) could alleviate PM2.5-induced lung injury in mice via its antioxidant and anti-inflammatory activities.
Synthesis, characterization and in vitro anti-cancer activity of vanadium-doped nanocrystalline hydroxyapatite
Authors: Kalniņa Daina , Levina Aviva , Pei Alexander , Gross Kārlis Agris , Lay Peter A.
Published: November 2019

Nanocrystalline V(v)-doped hydroxyapatite and its reduced analogue (V(v) and V(iv) mixture) show promising in vitro cytotoxicity against cultured human bone cancer cells.
Nanoparticle mediated silencing of tenascin C in hepatic stellate cells: effect on inflammatory gene expression and cell migration
Authors: Vivero-Escoto Juan L. , Vadarevu Hemapriyadarshini , Juneja Ridhima , Schrum Laura W. , Benbow Jennifer H.
Published: November 2019

Mesoporous silica nanoparticles efficiently knock-down tenascin-C in hepatic stellate cells resulting in decrease of inflammatory cytokine levels and hepatocyte migration.
Finite element analysis of single pair gear tooth root crack
Authors: Dong Shaojun , Luan Zhongquan , Ma Chao
Published: November 2019

In the current research, the analysis about the stress and meshing stiffness for the single gear meshing process with two cases came out, which are case without tooth root cracking and with tooth root cracking. First, the solid assemble model for the two cases are set up with Pro/E software. With the format of parosolid, the model is imported into Ansys. In analysis, the contact, loading, and bonging condition are added. Then, computation came out. The results show that the stress in the compression position is greater than that in the tension position during gear engagement, and the stress increases when cracks occur. The research can provide theoretical basis for fault diagnosis to provide spectrum analysis and provide reference for theoretical analysis and meshing stiffness.
Development of fault diagnosis system for wind power planetary transmission based on labview
Authors: Yang Zhihan , Wang Shaohong , Ma Chao , Huang Jingnan
Published: November 2019

The article uses LabView to develop a fault diagnosis system for wind power planetary transmissions. First, use LabView software to create a signal acquisition system. Then, the built wind turbine planetary transmission experiment platform was combined with the NI9171 data acquisition card and the upper computer. The hysteresis brake was used in the laboratory to simulate the external wind environment, and the planetary gear transmission planetary gear crack fault diagnosis and testing experiments were performed. The frequency domain signal is obtained from the initial time domain signal obtained by the experiment through the EMD and envelope demodulation method. The frequency of the corresponding planetary gear crack in the frequency domain signal is compared with the theoretical calculation of the planetary gear crack failure frequency. The results show that the frequency of the corresponding planetary gear cracks in the frequency domain spectra obtained by the experiment is basically consistent with the theoretical calculation of the frequency of cracks in planetary gears. The fault diagnosis system developed by LabView is reliable. The experiment provides a theoretical basis for fault diagnosis, optimisation design, and life prediction of wind turbine planetary transmissions.
MiR-210-3p attenuates lipid accumulation and inflammation in atherosclerosis by repressing IGF2
Authors: Qiao Xiang-Rui , Wang Liang , Liu Mengping , Tian Yuling , Chen Tao
Published: November 2019

Previous studies have shown that miR-210-3p is involved in the development and progression of atherosclerosis, but its specific mechanisms are still unclear. This study aims to reveal the mechanism of miR-210-3p and its target genes in macrophage lipid deposition and inflammatory response, and provide new ideas for the treatment of atherosclerosis. We found miR-210-3p increased sharply in the first 12 h induced by higher doses of ox-LDL in THP-1 macrophages and then gradually decreased. MiR-210-3p mimic transfection inhibited lipid uptake and inflammatory cytokine production in ox-LDL-induced macrophages. By inhibiting IGF2/IGF2R, miR-210-3p suppressed the expression of fatty acid transcriptase CD36 and transcription factor NF-κB in ox-LDL-induced macrophages. In conclusion, miR-210-3p inhibits the expression of CD36 and NF-κB by inhibiting IGF2 / IGF2R, thereby reducing lipid accumulation and inflammatory response in ox-LDL-induced macrophages. Enhancing miR-210-3p expression may be a new strategy for the treatment of atherosclerosis.
Exercise interventions to prevent hamstring injuries in athletes: A systematic review and meta‐analysis
Authors: Vatovec Rok , Kozinc Žiga , Šarabon Nejc
Published: November 2019

The aim of this meta‐analysis was to assess the effectiveness of exercise‐based interventions for prevention of hamstring injuries in sport. PubMed, Cochrane Central Register of Controlled Trials, Web of Science, ResearchGate, CINAHL, PEDro, ScienceDirect and Google Scholar databases were searched for randomized controlled trials and prospective cohort studies exploring the effects of exercise interventions on hamstring injury incidence. Subgroup analyses were performed to determine effects of several independent variables related to the interventions. Altogether, 17 studies were included. Exercise interventions decreased hamstring injury risk (RR = 0.49; 95%CI = 0.40–0.59; p < 0.001). There were similar effects found for interventions performed ≤2 times per week (RR = 0.35; 95%CI = 0.15–0.82) and the interventions performed >2 times per week (RR = 0.44; 95%CI = 0.31–0.61). Similarly, there were similar effects found for the interventions with progressive increase in load (RR = 0.53; 95%CI = 0.37–0.74) and the interventions with constant loads (RR = 0.46; 95%CI = 0.36–0.58). Other subgroup analyses (intervention supervision, sport type, inclusion of Nordic hamstring exercise and type of the trial) also showed no indications on specific characteristics of the interventions, that increase the preventive effects. Our findings showed that hamstring injury incidence can be decreased with exercise‐based interventions, and that weekly frequency and load progression are not among the most important variables to consider in prevention programmes design.
Pharmacist-driven penicillin skin testing service for adults prescribed nonpreferred antibiotics in a community hospital
Authors: Englert Ethan , Weeks Andrea
Published: November 2019

Purpose

Results of a study evaluating the implementation and impact of a pharmacist-driven penicillin skin testing (PST) service for patients prescribed alternative antibiotics in the community hospital setting are reported.

Methods

A prospective pilot service in which patients with a documented penicillin allergy (type I, immunoglobulin E [IgE]–mediated) and were prescribed alternative antibiotics received PST by a trained pharmacist was implemented; if test results were negative, the allergy was de-labeled from their electronic medical record. The primary objective was the percentage of patients switched to first-line antibiotics. Secondary objectives included length of stay (LOS) and inpatient antimicrobial costs to the health system.

Results

Twenty-two patients were proactively identified and received PST by a pharmacist. Of those tested, all were negative, with no type I (IgE-mediated) hypersensitivity reactions to the test itself or to the beta-lactam antibiotic administered thereafter; 68.2% (15/22) were successfully transitioned to a beta-lactam after PST. As a result, a decrease in the use of fluoroquinolones and vancomycin and an increase in use of narrow penicillin-based antibiotics and first- and second-generation cephalosporins were observed. The mean ± S.D. LOS per patient was 7.41 ± 6.1 days, and the total cost of inpatient antimicrobial therapy to the health system was $1,698.88.

Conclusion

A pharmacist-driven PST service was successfully implemented in a community hospital setting.
Combination of Lipofilling With Liposuction in the Correction of Pseudo Genu Varus Deformity
Authors: Okumus Ayhan
Published: November 2019

Background

The combined use of lipofilling and liposuction has not been reported for the correction of pseudo genu varus deformity.

Objectives

The aim of this study was to evaluate the utility of combined liposuction and lipofilling for a bilateral correction of pseudo genu varus deformity based on a single-center experience over a 13-year period.

Methods

A total of 72 patients with pseudo genu varus deformity treated with combined liposuction and lipofilling were included. Data on postoperative complications, the need for additional rounds of lipofilling, and aesthetic outcomes over an average of 5 years (range, 1-9 years) were recorded.

Results

Fat harvested from the upper medial portion of the knee was sufficient for lipofilling in 12 (16.7%) patients, and additional donor sites were used in 60 (83.3%) patients. A second round of lipofilling (average, 20 mL; range, 15-50 mL) was required in 17 (23.6%) patients within 6 months to 1 year after the operation. The need for additional lipofilling or liposuction was not noted for any other patients. None of the patients developed major complications such as fat necrosis, infections, contour deformities, or medial concavities during knee flexion.

Conclusions

The current findings strongly suggest that the combined use of liposuction and lipofilling for the correction of pseudo genu varus deformity is a feasible, effective, and safe alternative that seems to offer additional benefits compared with fat grafting alone, including a fast recovery, a low risk of complications, and an increased likelihood of a long-lasting correction of the calf contour.

Level of Evidence: 4
Improved dropClust R package with integrative analysis support for scRNA-seq data
Authors: Sinha Debajyoti , Sinha Pradyumn , Saha Ritwik , Bandyopadhyay Sanghamitra , Sengupta Debarka
Published: November 2019

DropClust leverages Locality Sensitive Hashing (LSH) to speed up clustering of large scale single cell expression data. Here we present the improved dropClust, a complete R package that is, fast, interoperable and minimally resource intensive. The new dropClust features a novel batch effect removal algorithm that allows integrative analysis of single cell RNA-seq (scRNA-seq) datasets.

Availability and implementation

dropClust is freely available at https://github.com/debsin/dropClust as an R package. A lightweight online version of the dropClust is available at https://debsinha.shinyapps.io/dropClust/.

Supplementary information

Supplementary data are available at Bioinformatics online.
Moving On from the Insect Apocalypse Narrative: Engaging with Evidence-Based Insect Conservation
Authors: Saunders Manu E , Janes Jasmine K , O’Hanlon James C
Published: November 2019

Recent studies showing temporal changes in local and regional insect populations received exaggerated global media coverage. Confusing and inaccurate science communication on this important issue could have counterproductive effects on public support for insect conservation. The insect apocalypse narrative is fuelled by a limited number of studies that are restricted geographically (predominantly the United Kingdom, Europe, the United States) and taxonomically (predominantly some bees, macrolepidoptera, and ground beetles). Biases in sampling and analytical methods (e.g., categorical versus continuous time series, different diversity metrics) limit the relevance of these studies as evidence of generalized global insect decline. Rather, the value of this research lies in highlighting important areas for priority investment. We summarize research, communication, and policy priorities for evidence-based insect conservation, including key areas of knowledge to increase understanding of insect population dynamics. Importantly, we advocate for a balanced perspective in science communication to better serve both public and scientific interests.
Individuals With Autism Spectrum Disorder Show Altered Event-Related Potentials in the Late Stages of Olfactory Processing
Authors: Okumura Toshiki , Kumazaki Hirokazu , Singh Archana K , Touhara Kazushige , Okamoto Masako
Published: November 2019

Atypical sensory reactivities are pervasive among people with autism spectrum disorder (ASD). With respect to olfaction, most previous studies have used psychophysical or questionnaire-based methodologies; thus, the neural basis of olfactory processing in ASD remains unclear. This study aimed to determine the stages of olfactory processing that are altered in ASD. Fourteen young adults with high-functioning ASD (mean age, 21 years; 3 females) were compared with 19 age-matched typically developing (TD) controls (mean age, 21 years; 4 females). Olfactory event-related potentials (OERPs) for 2-phenylethyl alcohol—a rose-like odor—were measured with 64 scalp electrodes while participants performed a simple odor detection task. Significant group differences in OERPs were found in 3 time windows 542 ms after the stimulus onset. The cortical source activities in these time windows, estimated using standardized low-resolution brain electromagnetic tomography, were significantly higher in ASD than in TD in and around the posterior cingulate cortex, which is known to play a crucial role in modality-general cognitive processing. Supplemental Bayesian analysis provided substantial evidence for an alteration in the later stages of olfactory processing, whereas conclusive evidence was not provided for the earlier stages. These results suggest that olfactory processing in ASD is altered at least at the later, modality-general processing stage.
Immunogenicity of Influenza Vaccination in Patients with Cancer Receiving Immune Checkpoint Inhibitors
Authors: Keam Bhumsuk , Kang Chang Kyung , Jun Kang Il , Moon Song Mi , Suh Koung Jin , Lee Dae-Won , Ock Chan-Young , Kim Miso , Choi Yunhee , Lim Yoojoo , Lee Kyung-Hun , Kim Se Hyun , Kim Tae Min , Kim Tae-Yong , Oh Do-Youn , Kim Dong-Wan , Im Seock-Ah , Lee Jong Seok , Kim Eu Suk , Kim Hong Bin , Kim Nam-Joong , Kim Yu Jung , Park Wan Beom , Oh Myoung-Don
Published: November 2019

Among prospectively enrolled adult patients with cancer receiving immune checkpoint inhibitors (ICIs; n = 46) or cytotoxic agents (n = 90), seroprotection and seroconversion rates after seasonal quadrivalent influenza vaccinations were higher with ICI than with cytotoxic chemotherapy. These results support annual influenza vaccinations for cancer patients receiving ICIs.

Clinical Trials Registration clinicaltrials.gov (NCT03590808).
Economic impacts of fall armyworm and its management strategies: evidence from southern Ethiopia
Authors: Kassie Menale , Wossen Tesfamicheal , De Groote Hugo , Tefera Tadele , Sevgan Subramanian , Balew Solomon
Published: November 2019

This paper explores the economic implications of fall armyworm (FAW) and its management strategies by exploiting exogenous variation in FAW exposure amongst households in southern Ethiopia. We find that FAW exposure affects maize yield and sales negatively, but not consumption. Furthermore, we find evidence of crowding-in and intensification of insecticide use in response to FAW exposure. We also find suggestive evidence that existing extension service arrangements lack the capacity to deal with emerging threats such as FAW. Results imply that targeted interventions aimed at improving the effectiveness of control measures and institutional capacity would be key to reduce the adverse effects of FAW.

Highlights

The economic impact of fall armyworm (FAW) in southern Ethiopia assessed Fall armyworm significantly reduces maize yields and maize sales A positive correlation observed between FAW exposure and intensity of insecticide use Existing individual FAW control strategies do not significantly abate losses from FAW Improving institutional capacity is essential to control FAW
A neurobiological mechanism linking transportation noise to cardiovascular disease in humans
Authors: Osborne Michael T , Radfar Azar , Hassan Malek Z O , Abohashem Shady , Oberfeld Blake , Patrich Tomas , Tung Brian , Wang Ying , Ishai Amorina , Scott James A , Shin Lisa M , Fayad Zahi A , Koenen Karestan C , Rajagopalan Sanjay , Pitman Roger K , Tawakol Ahmed
Published: November 2019

Aims

Chronic noise exposure associates with increased cardiovascular disease (CVD) risk; however, the role of confounders and the underlying mechanism remain incompletely defined. The amygdala, a limbic centre involved in stress perception, participates in the response to noise. Higher amygdalar metabolic activity (AmygA) associates with increased CVD risk through a mechanism involving heightened arterial inflammation (ArtI). Accordingly, in this retrospective study, we tested whether greater noise exposure associates with higher: (i) AmygA, (ii) ArtI, and (iii) risk for major adverse cardiovascular disease events (MACE).

Methods and results

Adults (N = 498) without CVD or active cancer underwent clinical 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging. Amygdalar metabolic activity and ArtI were measured, and MACE within 5 years was adjudicated. Average 24-h transportation noise and potential confounders were estimated at each individual’s home address. Over a median 4.06 years, 40 individuals experienced MACE. Higher noise exposure (per 5 dBA increase) predicted MACE [hazard ratio (95% confidence interval, CI) 1.341 (1.147–1.567), P < 0.001] and remained robust to multivariable adjustments. Higher noise exposure associated with increased AmygA [standardized β (95% CI) 0.112 (0.051–0.174), P < 0.001] and ArtI [0.045 (0.001–0.090), P = 0.047]. Mediation analysis suggested that higher noise exposure associates with MACE via a serial mechanism involving heightened AmygA and ArtI that accounts for 12–26% of this relationship.

Conclusion

Our findings suggest that noise exposure associates with MACE via a mechanism that begins with increased stress-associated limbic (amygdalar) activity and includes heightened arterial inflammation. This potential neurobiological mechanism linking noise to CVD merits further evaluation in a prospective population.
Long-term ticagrelor for secondary prevention in patients with prior myocardial infarction and no history of coronary stenting: insights from PEGASUS-TIMI 54
Authors: Furtado Remo H M , Nicolau Jose C , Magnani Giulia , Im Kyungah , Bhatt Deepak L , Storey Robert F , Steg P Gabriel , Spinar Jindrich , Budaj Andrzej , Kontny Frederic , Corbalan Ramon , Kiss Robert G , Abola Maria Teresa , Johanson Per , Jensen Eva C , Braunwald Eugene , Sabatine Marc S , Bonaca Marc P
Published: November 2019

Aims

PEGASUS-TIMI 54 demonstrated that long-term dual antiplatelet therapy (DAPT) with aspirin and ticagrelor reduced the risk of major adverse cardiovascular events (MACE), with an acceptable increase in bleeding, in patients with prior myocardial infarction (MI). While much of the discussion around prolonged DAPT has been focused on stented patients, patients with prior MI without prior coronary stenting comprise a clinically important subgroup.

Methods and results

This was a pre-specified analysis from PEGASUS-TIMI 54, which randomized 21 162 patients with prior MI (1–3 years) and additional high-risk features to ticagrelor 60 mg, 90 mg, or placebo twice daily in addition to aspirin. A total of 4199 patients had no history of coronary stenting at baseline. The primary efficacy outcome (MACE) was the composite of cardiovascular death, MI, or stroke. Patients without history of coronary stenting had higher baseline risk of MACE [13.2% vs. 8.0%, adjusted hazard ratio (HR) 1.41, 95% confidence interval (CI) 1.15–1.73, in the placebo arm]. The relative risk reduction in MACE with ticagrelor (pooled doses) was similar in patients without (HR 0.82, 95% CI 0.68–0.99) and with prior stenting (HR 0.85, 95% CI 0.75–0.96; P for interaction = 0.76).

Conclusion

Long-term ticagrelor reduces thrombotic events in patients with prior MI regardless of whether they had prior coronary stenting. These data highlight the benefits of DAPT in prevention of spontaneous atherothrombotic events and indicate that long-term ticagrelor may be considered in high-risk patients with prior MI even if they have not been treated with stenting.

ClinicalTrials.gov Identifier

NCT01225562.
Treatment with JQ1, a BET bromodomain inhibitor, is selectively detrimental to R6/2 Huntington’s disease mice
Authors: Kedaigle Amanda J , Reidling Jack C , Lim Ryan G , Adam Miriam , Wu Jie , Wassie Brook , Stocksdale Jennifer T , Casale Malcolm S , Fraenkel Ernest , Thompson Leslie M
Published: November 2019

Transcriptional and epigenetic alterations occur early in Huntington’s disease (HD), and treatment with epigenetic modulators is beneficial in several HD animal models. The drug JQ1, which inhibits histone acetyl-lysine reader bromodomains, has shown promise for multiple cancers and neurodegenerative disease. We tested whether JQ1 could improve behavioral phenotypes in the R6/2 mouse model of HD and modulate HD-associated changes in transcription and epigenomics. R6/2 and non-transgenic (NT) mice were treated with JQ1 daily from 5 to 11 weeks of age and behavioral phenotypes evaluated over this period. Following the trial, cortex and striatum were isolated and subjected to mRNA-seq and ChIP-seq for the histone marks H3K4me3 and H3K27ac. Initially, JQ1 enhanced motor performance in NT mice. In R6/2 mice, however, JQ1 had no effect on rotarod or grip strength but exacerbated weight loss and worsened performance on the pole test. JQ1-induced gene expression changes in NT mice were distinct from those in R6/2 and primarily involved protein translation and bioenergetics pathways. Dysregulation of HD-related pathways in striatum was exacerbated by JQ1 in R6/2 mice, but not in NTs, and JQ1 caused a corresponding increase in the formation of a mutant huntingtin protein-dependent high molecular weight species associated with pathogenesis. This study suggests that drugs predicted to be beneficial based on their mode of action and effects in wild-type or in other neurodegenerative disease models may have an altered impact in the HD context. These observations have important implications in the development of epigenetic modulators as therapies for HD.
Risk Factors and Molecular Epidemiology of Complicated Intra-Abdominal Infections With Carbapenem-Resistant Enterobacteriaceae: A Multicenter Study in China
Authors: Liu Jiao , Zhang Lidi , Pan Jingye , Huang Man , Li Yingchuan , Zhang Hongjin , Wang Ruilan , Zhao Mingyan , Li Bin , Liu Long , Gong Ye , Bian Jinjun , Li Xiang , Tang Yan , Lei Ming , Chen Dechang
Published: November 2019

Background

Carbapenem-resistant Enterobacteriaceae (CRE) infections are associated with poor patient outcomes. Data on risk factors and molecular epidemiology of CRE in complicated intra-abdominal infections (cIAI) in China are limited. This study examined the risk factors of cIAI with CRE and the associated mortality based on carbapenem resistance mechanisms.

Methods

In this retrospective analysis, we identified 1024 cIAI patients hospitalized from January 1, 2013 to October 31, 2018 in 14 intensive care units in China. Thirty CRE isolates were genotyped to identify β-lactamase-encoding genes.

Results

Escherichia coli (34.5%) and Klebsiella pneumoniae (21.2%) were the leading pathogens. Patients with hospital-acquired cIAI had a lower rate of E coli (26.0% vs 49.1%; P < .001) and higher rate of carbapenem-resistant Gram-negative bacteria (31.7% vs 18.8%; P = .002) than those with community-acquired cIAI. Of the isolates, 16.0% and 23.4% of Enterobacteriaceae and K pneumoniae, respectively, were resistant to carbapenem. Most carbapenemase-producing (CP)-CRE isolates carried blaKPC (80.9%), followed by blaNMD (19.1%). The 28-day mortality was 31.1% and 9.0% in patients with CRE vs non-CRE (P < .001). In-hospital mortality was 4.7-fold higher for CP-CRE vs non-CP-CRE infection (P = .049). Carbapenem-containing combinations did not significantly influence in-hospital mortality of CP and non-CP-CRE. The risk factors for 28-day mortality in CRE-cIAI included septic shock, antibiotic exposure during the preceding 30 days, and comorbidities.

Conclusions

Klebsiella pneumoniae had the highest prevalence in CRE. Infection with CRE, especially CP-CRE, was associated with increased mortality in cIAI.
Presentation and Management of Staphylococcal Scalded Skin Syndrome in a Child After a Burn Injury: A Case Report
Authors: Pidgeon Thomas Edward , D’Asta Federica , Ogboli Malobi , Wilson Yvonne
Published: November 2019

This case report describes the clinical course of a child who developed staphylococcal scalded skin syndrome (SSSS) after a burn injury. The intent is to aid other units in recognizing the presentation of SSSS after a pediatric burn and to optimize subsequent management. The main clinical finding was of rapid, progressive, superficial epidermal loss at sites separate from the original burn, involving 55% of the total body surface area, 13 days after a 6% scald burn to the face, neck, and chest. Diagnosis was confirmed by multidisciplinary team clinical assessment and histopathology of an intraoperative skin biopsy. This confirmed epidermal cleavage at the granular cell layer. These findings were later supported by Staphylococcus aureus cultured from the burn wound, and a positive epidermolytic toxin A assay. Management was with general medical supportive care, clindamycin and flucloxacillin intravenous antibiotic therapy, and cleansing and dressing of the areas of epidermal loss. Key learning points from this case were that SSSS presented after a burn injury and that 13 days elapsed between the burn and SSSS. Factors differentiating it from toxic epidermal necrolysis are described, including the value of histopathology in confirming the diagnosis. The prompt use of antibiotics and attentive wound care are advocated as an effective management strategy.
Population Growth of Alphitobius diaperinus (Coleoptera: Tenebrionidae) on Various Commodities
Authors: Rumbos C I , Pantazis I , Athanassiou C G
Published: November 2019

The lesser mealworm, Alphitobius diaperinus (Panzer), is a serious pest, but at the same time has been authorized in European Union (EU) for feed in aquaculture. In this study, we investigated, in laboratory bioassays, the population growth of this species, on a wide variety of commodities. In four series of bioassays, we studied the development of A. diaperinus population on various intact cereal grains, on soft wheat grains with different percentages of cracked kernels, on non-grain amylaceous commodities and on a variety of non-amylaceous commodities. Briefly, 20 g of each commodity were put separately inside plastic cylindrical vials. Then, 20 A. diaperinus adults were placed inside each vial and all vials were incubated at 30°C and 55% r.h. After 30 d, the vials were opened and the progeny production was evaluated. Alphitobius diaperinus showed a clear preference in amylaceous commodities, but in contrast, poor development was recorded on the non-amylaceous commodities tested. Hence, it developed well in most of the cereal intact grains tested, with the hard and soft wheat being the most suitable. Additionally, most non-grain amylaceous commodities were suitable, to a various degree, for the population growth of A. diaperinus. The increase of the percentage of cracked wheat positively affected the population growth of A. diaperinus. To our knowledge, this is the first study that examined the suitability of a wide range of commodities for the population growth of A. diaperinus.
Function Alternations of the Mandarin Particle Dou: Distributor, Free Choice Licensor, and ‘Even’
Authors: Xiang Yimei
Published: November 2019

Many languages have particles that possess multiple logical functions. Take the Mandarin particle dou for example. Varying by the item it is associated with and the prosodic pattern of the environment it appears in, dou can trigger a distributivity effect, license a pre-verbal free choice item, or evoke an even-like inference. Considering universal grammar a simple system, we need to figure out, for a multi-functional particle, which of its functions is primary, what parametric variations are responsible for the alternations in function, and how these variations are conditioned.

In this paper, I argue that the seemingly unrelated functions of dou share the same source: dou is a pre-exhaustification exhaustifier operating on sub-alternatives. Uniformly, dou affirms the truth of its propositional prejacent, negates the exhaustification of each sub-alternative, and presupposes a non-vacuity inference that there is at least one sub-alternative. Alternations in function result from minimal weakening operations on the semantics of sub-alternatives. In particular, sub-alternatives are primarily weaker alternatives, and the non-vacuity presupposition of dou yields a distributivity effect. When the semantics of sub-alternatives is weakened under particular syntactic or prosodic conditions, dou gains its other logical functions.
Love the Science, Hate the Scientists: Conservative Identity Protects Belief in Science and Undermines Trust in Scientists
Authors: Mann Marcus , Schleifer Cyrus
Published: November 2019

The decline in trust in the scientific community in the United States among political conservatives has been well established. But this observation is complicated by remarkably positive and stable attitudes toward scientific research itself. What explains the persistence of positive belief in science in the midst of such dramatic change? By leveraging research on the performativity of conservative identity, we argue that conservative scientific institutions have manufactured a scientific cultural repertoire that enables participation in this highly valued epistemological space while undermining scientific authority perceived as politically biased. We test our hypothesized link between conservative identity and scientific perceptions using panel data from the General Social Survey. We find that those with stable conservative identities hold more positive attitudes toward scientific research while simultaneously holding more negative attitudes towards the scientific community compared to those who switch to and from conservative political identities. These findings support a theory of a conservative scientific repertoire that is learned over time and that helps orient political conservatives in scientific debates that have political repercussions. Implications of these findings are discussed for researchers interested in the cultural differentiation of scientific authority and for stakeholders in scientific communication and its public policy.
Implicit and explicit motor learning interventions have similar effects on walking speed in people after stroke: a randomized controlled single blind trial
Authors: Jie Li-Juan , Kleynen Melanie , Meijer Kenneth , Beurskens Anna , Braun Susy
Published: November 2019

Background

Therapists may use (more) implicit or (more) explicit motor learning approaches to facilitate motor skill learning of stroke patients. The use of implicit motor learning approaches has shown promising results in healthy populations.

Objective

To assess whether an implicit motor learning walking intervention is more effective compared to an explicit motor learning walking intervention delivered at home with regard to walking speed in people after stroke in the chronic phase of recovery.

Design

Randomized controlled single blind trial.

Setting

Home environment.

Patients

79 people in the chronic phase after stroke (66.4 ± 11.0 years; 70.1 ± 64.3 months after stroke; walking speed 0.7 ± 0.3 m/s; Berg Balance Scale score 44.5 ± 9.5) were randomly assigned to an implicit (n=39) or explicit (n=41) group.

Intervention

Analogy learning was used as the implicit motor learning walking intervention, whereas the explicit motor learning walking intervention consisted of detailed verbal instructions. Both groups received nine training sessions, 30 minutes each, for a period of three weeks.

Measurements

The primary outcome was walking speed measured by the 10-Meter Walk Test. Outcome measures were assessed at baseline, immediate and 1-month post intervention.

Results

No statistically or clinically relevant differences between groups were obtained post intervention (between-group difference estimated 0.02 m/s [95% CI −0.04 to 0.08] and at follow-up (between-group difference estimated −0.02 m/s [95% CI −0.09 to 0.05], p=0,563).

Limitations

The treatment effects may have been diluted by “noise” accompanied with research within real life settings, complex tasks and a representative sample.

Conclusions

Implicit motor learning was not superior to the explicit motor learning to improve walking speed in people after stroke in the chronic phase of recovery.
Violin plot data: A concerto of crucial information on valve thrombogenicity categorized in vitro by valve motion and inferred flow velocity
Authors: Scotten Lawrence N. , Blundon David , Deutsch Marcus-André , Siegel Rolland
Published: November 2019

Objectives

This in vitro study compares mechanical (MHV) and bioprosthetic (BHV) heart valves for high amplitude short duration regional flow velocities (RFV) near valve closure.

Background

We previously tested several clinical and prototype valves and observed RFV at levels which may be related to a dimensionless thrombogenic potential (TP).

Methods

A total of four valves were tested in aortic and mitral sites under pulsatile circulation in a pulse duplicator. Valves included both clinical models and experimental prototypes. An optical approach measuring projected dynamic valve area (PDVA) to gauge valve motion was implemented. Pulsatile pressures and flow rates were measured by conventional techniques and a quasi-steady flow tester was used to measure valve leakage. RFV was derived using time-dependent volumetric flow rate/PDVA. Since flow velocity and fluid shear force are related through flow velocity gradient, TPs for valves that achieve near closure during the forward flow deceleration phase were determined as RFVs relative to the control mechanical valve RFV value of −126 m/s.

Results

TP is dimensionless and ranged between −0.45 and +1.0. Negative TPs arise when transient rebound of valve occluders is accompanied by water-hammer phenomena. Positive TPs occur during the decelerating forward flow. Bioprostheses had lowest TP transient of 0.15 with exception of a mock-transcatheter aortic valve (mTAVI) that incorporated by design a trivial perivalvular leak (∼1.35 ml/s). This device demonstrated a remarkably high transient TP of 0.95. The control mechanical valves had the highest TP of 1.0. The study implicates TP transients near mechanical valve closure, and not forward or non-flow phases, as primary to shear induced activation of the coagulation cascade.

Conclusions

Our data reveals distinct TP profile differences between valve models. If verifiable, the design of future valves may utilize currently available experimental tools to determine TPs resulting in advanced devices with significantly reduced TP.
Elevated heart rate after non-cardiac surgery: post-hoc analysis of a prospective observational cohort study
Authors: Patel Amour B. U. , May Shaun M. , Reyes Anna , Martir Gladys , Brealey David , Stephens Robert C. M. , Abbott Tom E. F. , Ackland Gareth L.
Published: November 2019

Background

Elevated heart rate (HR) is associated with accelerated mortality and independently predicts poorer outcomes in patients discharged from hospital after myocardial infarction and/or heart failure. We examined whether resting HR measured within 24 hours of hospital discharge following elective non-cardiac surgery was elevated compared to preoperative values. We also investigated the relationship between changes in HR with and/or autonomic function associated with morbidity after surgery.

Methods

We conducted a post-hoc analysis of HR data obtained in a prospective observational cohort study of patients ≥18years in whom serial Holter-based measurements of cardiac autonomic activity were made before, and for 48h after, surgery. The primary outcome was absolute discharge HR (beats minute-1), recorded at rest before hospital discharge. We examined the association between quartiles of discharge HR and autonomic measures (time/frequency domain heart rate variability) associated with morbidity (defined by Postoperative morbidity survey).

Results

In 157 patients (66 (42%) male; age 67(9) years), HR at hospital discharge (range: 53-122) increased by 5 beats minute-1(95%CI:3–7;p<0.001) compared to preoperative values. Patients in the upper quartile of discharge HR (≥85bpm) were more likely to sustain pulmonary (odds ratio (OR):2.18 (95%CI:1.07-4.44);p=0.03) and infectious (OR:2.31 (95%CI:1.13-4.75);p=0.02) morbidity within seven days of surgery, compared to lower quartiles. Pulmonary/infectious morbidity was associated with loss of cardiac vagal activity.

Conclusions

Heart rate on discharge from hospital following major elective non-cardiac surgery is frequently elevated and is promoted by morbidity associated with reductions in cardiac vagal activity.
Long-term retention on antiretroviral therapy among infants, children, adolescents and adults in Malawi: A cohort study
Authors: Mugglin Catrina , Haas Andreas , van Oosterhout Joep , Msukwa Malango , Tenthani Lyson , Estill Janne , Egger Matthias , Keiser Olivia
Published: November 2019

Objectives: We examine long-term retention of adults, adolescents and children on antiretroviral therapy under different HIV treatment guidelines in Malawi.
Design: Prospective cohort study.
Setting and participants: Adults and children starting ART between 2005 and 2015 in 21 health facilities in southern Malawi.
Methods: We used survival analysis to assess retention at clinic level, Cox regression to examine risk factors for loss to follow up, and competing risk analysis to assess long-term outcomes of people on antiretroviral therapy (ART).
Results: We included 132,274 individuals in our analysis, totalling 270,256 person years of follow up (PYFU; median per patient 1.3, interquartile range (IQR) 0.26-3.1), 62% were female and the median age was 32 years. Retention on ART was lower in the first year on ART compared to subsequent years for all guideline periods and age groups. Infants (0-3 years), adolescents and young adults (15-24 years) were at highest risk of LTFU. Comparing the different calendar periods of ART initiation we found that retention improved initially, but remained stable thereafter.
Conclusion: Even though the number of patients and the burden on health care system increased substantially during the study period of rapid ART expansion, retention on ART improved in the early years of ART provision, but gains in retention were not maintained over 5 years on ART. Reducing high attrition in the first year of ART should remain a priority for ART programs, and so should addressing poor retention among adolescents, young adults and men.