bluuebunny/crossref_metadata_2025 huggingface dataset:
Running Repairs: Coordinating Meaning in Dialogue
Authors: Healey Patrick G. T. , Mills Gregory J. , Eshghi Arash , Howes Christine
Published: April 2018

People give feedback in conversation: both positive signals of understanding, such as nods, and negative signals of misunderstanding, such as frowns. How do signals of understanding and misunderstanding affect the coordination of language use in conversation? Using a chat tool and a maze‐based reference task, we test two experimental manipulations that selectively interfere with feedback in live conversation: (a) “Attenuation” that replaces positive signals of understanding such as “right” or “okay” with weaker, more provisional signals such as “errr” or “umm” and (2) “Amplification” that replaces relatively specific signals of misunderstanding from clarification requests such as “on the left?” with generic signals of trouble such as “huh?” or “eh?”. The results show that Amplification promotes rapid convergence on more systematic, abstract ways of describing maze locations while Attenuation has no significant effect. We interpret this as evidence that “running repairs”—the processes of dealing with misunderstandings on the fly—are key drivers of semantic coordination in dialogue. This suggests a new direction for experimental work on conversation and a productive way to connect the empirical accounts of Conversation Analysis with the representational and processing concerns of Formal Semantics and Psycholinguistics.
Can Strategic Ignorance Explain the Evolution of Love?
Authors: Bear Adam , Rand David G.
Published: April 2018

People's devotion to, and love for, their romantic partners poses an evolutionary puzzle: Why is it better to stop your search for other partners once you enter a serious relationship when you could continue to search for somebody better? A recent formal model based on “strategic ignorance” suggests that such behavior can be adaptive and favored by natural selection, so long as you can signal your unwillingness to “look” for other potential mates to your current partner. Here, we re‐examine this conclusion with a more detailed model designed to capture specific features of romantic relationships. We find, surprisingly, that devotion does not typically evolve in our model: Selection favors agents who choose to “look” while in relationships and who allow their partners to do the same. Non‐looking is only expected to evolve if there is an extremely large cost associated with being left by your partner. Our results therefore raise questions about the role of strategic ignorance in explaining the evolution of love.
Ethnic minorities and trade: The Soviet Union as a natural experiment
Authors: Gokmen Gunes , Nikishina Elena , Vézina Pierre‐Louis
Published: April 2018

This paper examines the role of ethnic minorities in bilateral trade between countries of the ex‐Soviet Union. We argue that both forced re‐settlement of entire ethnic groups during the Stalin era and artificially drawn borders in Central Asia led to an exogenous ethnic composition within countries. Using data collected by ethnologists on the share of ethnic groups across countries, we build an index of bilateral ethnic networks and estimate its effect on trade using a gravity model. While ethnic networks do not seem to have played a role in inter‐republic trade during the Soviet Union, we find a positive and significant effect of ethnic networks on trade in the years following the collapse of the Soviet Union. This effect, however, eroded steadily from the early 2000s.
Severe lactic acidosis and hypoglycemia due to acute metformin intoxication in a dog
Authors: Ueda Yu , Wong Christine , Borchers Angela
Published: April 2018

Objective

To report a case of severe lactic acidosis and hypoglycemia due to acute metformin intoxication in a dog.

Case Summary

A female neutered Rat Terrier was presented for an acute onset of seizure‐like episodes, weakness, and vomiting approximately 14 hours after ingestion of 198 mg/kg of metformin. The dog was found to be laterally recumbent, paddling, and unresponsive shortly before presentation. On physical exam, the dog was in hypovolemic shock and hypothermic. Blood work revealed severe lactic acidosis and hypoglycemia. The dog was volume resuscitated with intravenous crystalloids and dextrose, followed by a continuous infusion of intravenous fluids and dextrose, as well as administration of isotonic sodium bicarbonate. Repeat blood work showed minimal improvement of the hyperlactatemia for 3 hours despite resolution of hypovolemia and hypoglycemia followed by gradual improvement over the next 9 hours of hospitalization. High performance liquid chromatography/tandem mass spectrometry analysis showed markedly increased plasma metformin concentrations at 3.9 μg/mL. The dog was discharged from the hospital within 24 hours and showed no recurrence of clinical signs one year following discharge.

New or Unique Information Provided

Metformin‐associated lactic acidosis and hypoglycemia is a severe complication in human patients, but has not been reported in veterinary medicine. Aggressive treatment with supportive care including IV fluids and dextrose administration resulted in resolution of the clinical signs in this patient. Metformin toxicosis should be considered in dogs with severe hyperlactatemia and hypoglycemia of unknown etiology.
Thrombin generation potential and clot‐forming capacity of thawed fresh‐frozen plasma, plasma frozen within 24 h and solvent/detergent‐treated plasma (octaplasLG®), during 5‐day storage at 1–6°C
Authors: Heger A. , Neisser‐Svae A. , Trawnicek L. , Triulzi D.
Published: April 2018

To enable rapid availability of plasma in emergency situations, the shelf‐life of thawed fresh‐frozen plasma (FFP) has been extended from 24 h to 5 days. The aim of this study was to evaluate the thrombin generation (TG) potential and clot‐forming ability during 5 days of refrigerated storage of thawed FFP, plasma frozen within 24 h and solvent/detergent‐treated plasma octaplasLG®. During storage for 5 days, TG capacity decreased significantly over time, and rotational thromboelastometry showed significantly prolonged clotting times. However, the stability studies confirmed comparable in vitro haemostatic potentials of all three thawed plasma products at day 5.
Unknown beaked whale echolocation signals recorded off eastern New Zealand
Authors: Giorli Giacomo , Goetz Kimberly T. , Delarue Julien , Maxner Emily , Kowarski Katie A. , Bruce Martin Steven , McPherson Craig
Published: April 2018

The echolocation signals of most beaked whale species are still unknown. In fact, out of the 22 species comprising the family Ziphiidae, only the echolocation pulses for 7 species have been clearly described. This study describes two distinct beaked whale echolocation signals recorded in the Cook Strait region using passive acoustic technology. These signals differ from previously described Ziphiid species clicks. A description of the time-frequency characteristics of the two signals is provided. Understanding the characteristics of these signals is necessary to correctly identify species from their echolocation signals and enables future monitoring of beaked whales using passive acoustics techniques.
Student-Athlete and Student Non-Athletes’ Stigma and Attitudes Toward Seeking Online and Face-to-Face Counseling
Authors: Bird Matthew D. , Chow Graig M. , Meir Gily , Freeman Jaison
Published: April 2018

This study investigated differences in stigmatization by others, self-stigma, and attitudes (value and discomfort) toward online counseling (OC) and face-to-face counseling (F2F), and the relationships between these variables, in college student-athletes (n = 101) and non-athletes (n = 101). Results revealed no differences in levels of stigmatization by others and self-stigma between student-athletes and non-athletes. Furthermore, both groups reported higher value, and less discomfort, in F2F compared to OC, while non-athletes reported higher levels of value in F2F compared to student-athletes. A multiple group path analysis revealed no difference in the relationship of the stigma and attitudes variables between the two groups. Stigmatization by others was a significant positive predictor of self-stigma and value in OC. In addition, self-stigma was a significant negative predictor of value in F2F, and a significant positive predictor of discomfort in F2F. The current findings have implications for university counseling centers and athletic departments.
Population Pharmacokinetic Model for Vancomycin Used in Open Heart Surgery: Model-Based Evaluation of Standard Dosing Regimens
Authors: Alqahtani Saeed A. , Alsultan Abdullah S. , Alqattan Hussain M. , Eldemerdash Ahmed , Albacker Turki B.
Published: April 2018

The purpose of this study was to investigate the population pharmacokinetics of vancomycin in patients undergoing open heart surgery. In this observational pharmacokinetic study, multiple blood samples were drawn over a 48-h period of intravenous vancomycin in patients who were undergoing open heart surgery. Blood samples were analyzed using an Architect i4000SR immunoassay analyzer. Population pharmacokinetic models were developed using Monolix 4.4 software. Pharmacokinetic-pharmacodynamic (PK-PD) simulations were performed to explore the ability of different dosage regimens to achieve the pharmacodynamic targets. A total of 168 blood samples were analyzed from 28 patients. The pharmacokinetics of vancomycin are best described by a two-compartment model with between-subject variability in clearance (CL), the volume of distribution of the central compartment (
V
1
), and volume of distribution of the peripheral compartment (
V
2
). The CL and the
V
1
of vancomycin were related to creatinine CL (CL
CR
), body weight, and albumin concentration. Dosing simulations showed that standard dosing regimens of 1 and 1.5 g failed to achieve the PK-PD target of AUC
0–24
/MIC > 400 for an MIC of 1 mg/liter, while high weight-based dosing regimens were able to achieve the PK-PD target. In summary, the administration of standard doses of 1 and 1.5 g of vancomycin two times daily provided inadequate antibiotic prophylaxis in patients undergoing open heart surgery. The same findings were obtained when 15- and 20-mg/kg doses of vancomycin were administered. Achieving the PK-PD target required higher doses (25 and 30 mg/kg) of vancomycin.
Metabolism of SKLB-TB1001, a Potent Antituberculosis Agent, in Animals
Authors: Xiong Lu , Gao Chao , Shi Yao-Jie , Tao Xin , Peng Cui-Ting , Rong Juan , Liu Kun-Lin , Lei Qian , Zhang Yi-Wen , Wang Ning-Yu , Yu Luo-Ting
Published: April 2018

Tuberculosis is a major global health problem, and the emergence of multidrug-resistant and extensively drug-resistant strains has increased the difficulty of treating this disease. Among the novel antituberculosis drugs in the pipeline, decaprenylphosphoryl-beta-
d
-ribose-2-epimerase (DprE1) inhibitors such as BTZ043 and pBTZ169 exhibited extraordinary antituberculosis potency. Here, the metabolites of the new DprE1 inhibitor SKLB-TB1001
in vivo
and its inhibition of cytochrome P450 isoforms and plasma protein binding (PPB)
in vitro
were studied. The results showed that rapid transformation and high PPB resulted in inadequate exposure
in vivo
and thus led to the moderate potency of SKLB-TB1001
in vivo
. This study provided explanations for the discrepant potency of this scaffold
in vivo
and
in vitro
. Meanwhile, it also provides a rationale for lead optimization of this very promising scaffold of antituberculosis agents to prevent them from being metabolized, thus improving their exposure
in vivo
.
An ATP-Dependent Ligase with Substrate Flexibility Involved in Assembly of the Peptidyl Nucleoside Antibiotic Polyoxin
Authors: Gong Rong , Qi Jianzhao , Wu Pan , Cai You-Sheng , Ma Hongmin , Liu Yang , Duan He , Wang Meng , Deng Zixin , Price Neil P. J. , Chen Wenqing
Published: April 2018

Polyoxin (POL) is an unusual peptidyl nucleoside antibiotic, in which the peptidyl moiety and nucleoside skeleton are linked by an amide bond. However, their biosynthesis remains poorly understood. Here, we report the deciphering of PolG as an ATP-dependent ligase responsible for the assembly of POL. A
polG
mutant is capable of accumulating multiple intermediates, including the peptidyl moiety (carbamoylpolyoxamic acid [CPOAA]) and the nucleoside skeletons (POL-C and the previously overlooked thymine POL-C). We further demonstrate that PolG employs an ATP-dependent mechanism for amide bond formation and that the generation of the hybrid nucleoside antibiotic POL-N is also governed by PolG. Finally, we determined that the deduced ATP-binding sites are functionally essential for PolG and that they are highly conserved in a number of related ATP-dependent ligases. These insights have allowed us to propose a catalytic mechanism for the assembly of peptidyl nucleoside antibiotic via an acyl-phosphate intermediate and have opened the way for the combinatorial biosynthesis/pathway engineering of this group of nucleoside antibiotics.

IMPORTANCE
POL is well known for its remarkable antifungal bioactivities and unusual structural features. Actually, elucidation of the POL assembly logic not only provides the enzymatic basis for further biosynthetic understanding of related peptidyl nucleoside antibiotics but also contributes to the rational generation of more hybrid nucleoside antibiotics via synthetic biology strategy.
YtfB, an OapA Domain-Containing Protein, Is a New Cell Division Protein in Escherichia coli
Authors: Jorgenson Matthew A. , Young Kevin D.
Published: April 2018

While screening the Pfam database for novel peptidoglycan (PG) binding modules, we identified the OapA domain, which is annotated as a LysM-like domain. LysM domains bind PG and mediate localization to the septal ring. In the Gram-negative bacterium
Escherichia coli
, an OapA domain is present in YtfB, an inner membrane protein of unknown function but whose overproduction causes cells to filament. Together, these observations suggested that YtfB directly affects cell division, most likely through its OapA domain. Here, we show that YtfB accumulates at the septal ring and that its action requires the division-initiating protein FtsZ and, to a lesser extent, ZipA, an early recruit to the septalsome. While the loss of YtfB had no discernible impact, a mutant lacking both YtfB and DedD (a known cell division protein) grew as filamentous cells. The YtfB OapA domain by itself also localized to sites of division, and this localization was enhanced by the presence of denuded PGs. Finally, the OapA domain bound PG, though binding did not depend on the formation of denuded glycans. Collectively, our findings demonstrate that YtfB is a cell division protein whose function is related to cell wall hydrolases.

IMPORTANCE
All living cells must divide in order to thrive. In bacteria, this involves the coordinated activities of a large number of proteins that work in concert to constrict the cell. Knowing which proteins contribute to this process and how they function is fundamental. Here, we identify a new member of the cell division apparatus in the Gram-negative bacterium
Escherichia coli
whose function is related to the generation of a transient cell wall structure. These findings deepen our understanding of bacterial cell division.
A Bead-Based Flow Cytometric Assay for Monitoring Yersinia pestis Exposure in Wildlife
Authors: Chandler Jeffrey C. , Baeten Laurie A. , Griffin Doreen L. , Gidlewski Thomas , DeLiberto Thomas J. , Petersen Jeannine M. , Pappert Ryan , Young John W. , Bevins Sarah N.
Published: April 2018

Yersinia pestis
is the causative agent of plague and is considered a category A priority pathogen due to its potential for high transmissibility and the significant morbidity and mortality it causes in humans.
Y. pestis
is endemic to the western United States and much of the world, necessitating programs to monitor for this pathogen on the landscape. Elevated human risk of plague infection has been spatially correlated with spikes in seropositive wildlife numbers, particularly rodent-eating carnivores, which are frequently in contact with the enzootic hosts and the associated arthropod vectors of
Y. pestis
. In this study, we describe a semiautomated bead-based flow cytometric assay developed for plague monitoring in wildlife called the F1 Luminex plague assay (F1-LPA). Based upon Luminex/Bio-Plex technology, the F1-LPA targets serological responses to the F1 capsular antigen of
Y. pestis
and was optimized to analyze antibodies eluted from wildlife blood samples preserved on Nobuto filter paper strips. In comparative evaluations with passive hemagglutination, the gold standard tool for wildlife plague serodiagnosis, the F1-LPA demonstrated as much as 64× improvement in analytical sensitivity for F1-specific IgG detection and allowed for unambiguous classification of IgG status. The functionality of the F1-LPA was demonstrated for coyotes and other canids, which are the primary sentinels in wildlife plague monitoring, as well as felids and raccoons. Additionally, assay formats that do not require species-specific immunological reagents, which are not routinely available for several wildlife species used in plague monitoring, were determined to be functional in the F1-LPA.
Emerging Multidrug-Resistant Candida duobushaemulonii Infections in Panama Hospitals: Importance of Laboratory Surveillance and Accurate Identification
Authors: Ramos Ruben , Caceres Diego H. , Perez Marilyn , Garcia Nicole , Castillo Wendy , Santiago Erika , Borace Jovanna , Lockhart Shawn R. , Berkow Elizabeth L. , Hayer Lizbeth , Espinosa-Bode Andres , Moreno Jose , Jackson Brendan R. , Moran Jackeline , Chiller Tom , de Villarreal Gloriela , Sosa Nestor ,   the Red Nacional de Vigilancia Epidemiologica en Microbiologia Clinica Alexis Solis Osvaldo Cisterna Mellisa Herrera Nayarith Rojas Ana Samudio Lisbeth Wong, Vallabhaneni Snigdha
Published: April 2018

Candida duobushaemulonii
, a yeast closely related to
Candida auris
, is thought to cause infections in rare cases and is often misidentified. In October 2016, the Panamanian Ministry of Health implemented laboratory surveillance for
C. auris
. Suspected
C. auris
isolates were forwarded to the national reference laboratory for identification by matrix-assisted laser desorption ionization–time of flight mass spectrometry and antifungal susceptibility testing. Between November 2016 and May 2017, 17 of 36 (47%) isolates suspected to be
C. auris
were identified as
C. duobushaemulonii.
These 17 isolates were obtained from 14 patients at six hospitals. Ten patients, including three children, had bloodstream infections, and MICs for fluconazole, voriconazole, and amphotericin B were elevated. No resistance to echinocandins was observed.
C. duobushaemulonii
causes more invasive infections than previously appreciated and poses a substantial problem, given its resistance to multiple antifungals. Expanded laboratory surveillance is an important step in the detection and control of such emerging pathogens.
Electrostatic Interactions between Hendra Virus Matrix Proteins Are Required for Efficient Virus-Like-Particle Assembly
Authors: Liu Yu Chih , Grusovin Julian , Adams Timothy E.
Published: April 2018

Hendra virus
(HeV) is a zoonotic paramyxovirus belonging to the genus
Henipavirus
. HeV is highly pathogenic, and it can cause severe neurological and respiratory illnesses in both humans and animals, with an extremely high mortality rate of up to 70%. Among the genes that HeV encodes, the matrix (M) protein forms an integral part of the virion structure and plays critical roles in coordinating viral assembly and budding. Nevertheless, the molecular mechanism of this process is not fully elucidated. Here, we determined the crystal structure of HeV M to 2.5-Å resolution. The dimeric structural configuration of HeV M is similar to that of Newcastle disease virus (NDV) M and is fundamental to protein stability and effective virus-like-particle (VLP) formation. Analysis of the crystal packing revealed a notable interface between the α1 and α2 helices of neighboring HeV M dimers, with key residues sharing degrees of sequence conservation among henipavirus M proteins. Structurally, a network of electrostatic interactions dominates the α1-α2 interactions, involving residues Arg57 from the α1 helix and Asp105 and Glu108 from the α2 helix. The disruption of the α1-α2 interactions using engineered charge reversal substitutions (R57E, R57D, and E108R) resulted in significant reduction or abrogation of VLP production. This phenotype was reversible with an R57E E108R mutant that was designed to partly restore salt bridge contacts. Collectively, our results define and validate previously underappreciated regions of henipavirus M proteins that are crucial for productive VLP assembly.

IMPORTANCE
Hendra virus is a henipavirus associated with lethal infections in humans. It is classified as a biosafety level 4 (BSL4) agent, and there are currently no preventive or therapeutic treatments available against HeV. Vital to henipavirus pathogenesis, the structural protein M has been implicated in viral assembly and budding, as well as host-virus interactions. However, there is no structural information available for henipavirus M, and the basis of M-driven viral assembly is not fully elucidated. We demonstrate the first three-dimensional structure of a henipavirus M protein. We show the dimeric organization of HeV M as a basic unit for higher-order oligomerization. Additionally, we define key regions/residues of HeV M that are required for productive virus-like-particle formation. These findings provide the first insight into the mechanism of M-driven assembly in henipavirus.
E1B-55K-Mediated Regulation of RNF4 SUMO-Targeted Ubiquitin Ligase Promotes Human Adenovirus Gene Expression
Authors: Müncheberg Sarah , Hay Ron T. , Ip Wing H. , Meyer Tina , Weiß Christina , Brenke Jara , Masser Sawinee , Hadian Kamyar , Dobner Thomas , Schreiner Sabrina
Published: April 2018

Human adenovirus (HAdV) E1B-55K is a multifunctional regulator of productive viral replication and oncogenic transformation in nonpermissive mammalian cells. These functions depend on E1B-55K's posttranslational modification with the SUMO protein and its binding to HAdV E4orf6. Both early viral proteins recruit specific host factors to form an E3 ubiquitin ligase complex that targets antiviral host substrates for proteasomal degradation. Recently, we reported that the PML-NB-associated factor Daxx represses efficient HAdV productive infection and is proteasomally degraded via a SUMO-E1B-55K-dependent, E4orf6-independent pathway, the details of which remained to be established. RNF4, a cellular SUMO-targeted ubiquitin ligase (STUbL), induces ubiquitinylation of specific SUMOylated proteins and plays an essential role during DNA repair. Here, we show that E1B-55K recruits RNF4 to the insoluble nuclear matrix fraction of the infected cell to support RNF4/Daxx association, promoting Daxx PTM and thus inhibiting this antiviral factor. Removing RNF4 from infected cells using RNA interference resulted in blocking the proper establishment of viral replication centers and significantly diminished viral gene expression. These results provide a model for how HAdV antagonize the antiviral host responses by exploiting the functional capacity of cellular STUbLs. Thus, RNF4 and its STUbL function represent a positive factor during lytic infection and a novel candidate for future therapeutic antiviral intervention strategies.

IMPORTANCE
Daxx is a PML-NB-associated transcription factor that was recently shown to repress efficient HAdV productive infection. To counteract this antiviral measurement during infection, Daxx is degraded via a novel pathway including viral E1B-55K and host proteasomes. This virus-mediated degradation is independent of the classical HAdV E3 ubiquitin ligase complex, which is essential during viral infection to target other host antiviral substrates. To maintain a productive viral life cycle, HAdV E1B-55K early viral protein inhibits the chromatin-remodeling factor Daxx in a SUMO-dependent manner. In addition, viral E1B-55K protein recruits the STUbL RNF4 and sequesters it into the insoluble fraction of the infected cell. E1B-55K promotes complex formation between RNF4- and E1B-55K-targeted Daxx protein, supporting Daxx posttranslational modification prior to functional inhibition. Hence, RNF4 represents a novel host factor that is beneficial for HAdV gene expression by supporting Daxx counteraction. In this regard, RNF4 and other STUbL proteins might represent novel targets for therapeutic intervention.
The S Gene Is Necessary but Not Sufficient for the Virulence of Porcine Epidemic Diarrhea Virus Novel Variant Strain BJ2011C
Authors: Wang Di , Ge Xinna , Chen Dongjie , Li Jie , Cai Yueqi , Deng Jin , Zhou Lei , Guo Xin , Han Jun , Yang Hanchun
Published: April 2018

The recently emerged highly virulent variants of porcine epidemic diarrhea virus (PEDV) have caused colossal economic losses to the worldwide swine industry. In this study, we investigated the viral virulence determinants by constructing a series of chimeric mutants between the highly virulent strain BJ2011C and the avirulent strain CHM2013. When tested in the 2-day-old piglet model, wild-type (WT) BJ2011C caused severe diarrhea and death of the piglets within 72 h. In contrast, its chimeric derivative carrying the S gene from CHM2013 (BJ2011C-SCHM) was avirulent to the piglets. Moreover, reciprocal substitution of the BJ2011C S gene (CHM2013-SBJ) did not enable CHM2013 to gain any virulence. However, when the whole structural protein-coding region of BJ2011C (CHM2013-SPBJ) was swapped, CHM2013 started to gain the ability to efficiently colonize the intestinal tract and caused diarrhea in piglets. A further gain of virulence required additional acquisition of the 3′ untranslated region (UTR) of BJ2011C, and the resultant virus (CHM2013-SP + 3UTRBJ) caused more severe diarrhea and death of piglets. Together, our findings suggest that the virulence of PEDV epidemic strains is a multigenic event and that the S gene is only one of the necessary determinants.

IMPORTANCEThe recently emerged highly virulent PEDV variants are the major cause of the global porcine epidemic diarrhea (PED) pandemic. The S gene of the variants undergoes remarkable variations and has been thought to be the virulence determinant for the enhanced pathogenesis. Our studies here showed that the S gene is only part of the story and that full virulence requires cooperation from other genes. Our findings provide insight into the pathogenic mechanism of the highly virulent PEDV variants and have implications for future vaccine development.
Application of outpatient cardiac testing among emergency department patients with syncope
Authors: Cook Olivia G , Mukarram Muhammad A , Kim Soo-Min , Arcot Kirtana , Nemnom Marie-Joe , Taljaard Monica , Sivilotti Marco L A , Rowe Brian H , Thiruganasambandamoorthy Venkatesh
Published: April 2018

Objectives

2.6% of ED syncope patients will suffer cardiac serious adverse events (SAEs) within 30 days of disposition, and outpatient cardiac testing can improve patient safety. The objective is to determine whether outpatient cardiac testing for ED syncope patients is being appropriately ordered after discharge. To this end, we describe the proportion of high-risk and non-high (low and medium)-risk ED syncope patients as per the Canadian Syncope Risk Score (CSRS) who have a SAE after ED discharge, and the proportion referred for outpatient cardiac testing.

Methods

Our multicentre prospective cohort study enrolled adult syncope patients between 2010 and 2014 in five academic EDs. We collected patient characteristics, disposition, CSRS predictors, outpatient referrals and testing results (Holter, echocardiography), and 30-day adjudicated SAE (death due to unknown/cardiac cause, myocardial infarction, arrhythmia and structural heart disease). We used descriptive statistics (mean, SD) to report our results.

Results

Of 3584 enrolled patients (mean age 50.9 years, 57.7% women), 800 patients (22.3%) received an outpatient referral. Of these 800 patients, 40.3% of the non-high-risk patients (305/756) and 54.5% of the high-risk patients (24/44) received outpatient cardiac testing. Of all patients who received cardiac testing, five (1.5%; 95% CI 0.6% to 3.5%) suffered outpatient SAE (60.0% arrhythmias). Of all patients who did not receive cardiac testing, four patients (0.9%; 95% CI 0.3% to 2.2%) suffered SAE (all arrhythmias). Of the 20 (45.5%) high-risk patients who did not receive testing, two patients (10.0%; 95% CI 2.8% to 30.1%) suffered arrhythmias outside the hospital, while among the 451 (59.7%) non-high-risk patients, only two (0.4%; 95% CI 0.1% to 1.6%) suffered outpatient arrhythmias.

Conclusion

Outpatient cardiac testing is largely underused, especially among high-risk ED syncope patients. Better guidelines for outpatient cardiac testing are needed, as the practice is highly variable and mismatched with patient risk.
Maternal depression is associated with injuries in children aged 2–4 years: the Pelotas 2004 Birth Cohort
Authors: Siqueira Barcelos Raquel , da Silva dos Santos Iná , Matijasevich Alicia , Anselmi Luciana , Barros Fernando Celso
Published: April 2018

Introduction

Injuries during childhood, which mostly consist of falls, burns, drowning, poisonings and car crashes, are among the main causes of death among children and young adults in several countries.

Objectives

To investigate the association between maternal depression and the incidence of injuries during childhood.

Methods

In 2004, children who were born in the municipality of Pelotas, Brazil, were enrolled in a population-based birth cohort, with evaluations at birth and at 3, 12, 24 and 48 months of age. Maternal depression during pregnancy was evaluated at the time of delivery. At 12 and 24 months post partum, the Edinburgh Postnatal Depression Scale (EPDS) was used. The injuries incidence rates at ages of 24–48 months and the crude and adjusted IRRs were calculated with 95% CI through Poisson’s regression.

Results

A total of 3533 children were analysed. The incidence of injuries was higher among children whose mothers presented depressive symptoms during pregnancy and at 12 and 24 months compared with those whose mothers did not present any symptoms. In the adjusted analysis, the IRR among girls whose mothers presented depressive symptoms during pregnancy and EPDS ≥13 at 12 and 24 months was 1.31 (1.15–1.50); and, among boys, 1.18 (1.03–1.36).

Interpretation

Maternal depression is associated with higher incidence of injuries between 24 and 48 months of age, in both sexes.
Effects of anterior compartment fasciotomy on intramuscular compartment pressure in patients with chronic exertional compartment syndrome
Authors: Roscoe David , Roberts A J , Hulse D , Shaheen A F , Hughes M P , Bennet A N
Published: April 2018

Background

Patients with chronic exertional compartment syndrome (CECS) have pain during exercise that usually subsides at rest. Diagnosis is usually confirmed by measurement of intramuscular compartment pressure (IMCP) following exclusion of other possible causes. Management usually requires fasciotomy but reported outcomes vary widely. There is little evidence of the effectiveness of fasciotomy on IMCP. Testing is rarely repeated postoperatively and reported follow-up is poor. Improved diagnostic criteria based on preselection and IMCP levels during dynamic exercise testing have recently been reported.

Objectives

(1) To compare IMCP in three groups, one with classical symptoms and no treatment and the other with symptoms of CECS who have been treated with fasciotomy and an asymptomatic control group. (2) Establish if differences in IMCP in these groups as a result of fasciotomy relate to functional and symptomatic improvement.

Methods

Twenty subjects with symptoms of CECS of the anterior compartment, 20 asymptomatic controls and 20 patients who had undergone fasciotomy for CECS were compared. All other possible diagnoses were excluded using rigorous inclusion criteria and MRI. Dynamic IMCP was measured using an electronic catheter wire before, during and after participants exercised on a treadmill during a standardised 15 min exercise challenge. Statistical analysis included t-tests and analysis of variance.

Results

Fasciotomy results in reduced IMCP at all time points during a standardised exercise protocol compared with preoperative cases. In subjects responding to fasciotomy, there is a significant reduction in IMCP below that of preoperative groups (P<0.001). Postoperative responders to fasciotomy have no significant differences in IMCP from asymptomatic controls (P=0.182).

Conclusion

Fasciotomy reduces IMCP in all patients. Larger studies are required to confirm that the reduction in IMCP accounts for differences in functional outcomes and pain reductions seen in postoperative patients with CECS.
Bridging the gap: using ‘Paired Learning’ to improve clinician/management understanding
Authors: Monaghan Hannah , Swenson Connie , Kerins Joanne , Sloan Sue
Published: April 2018

Background

Leadership in the National Health Service (NHS) embraces two distinct groups: managers and clinicians, often arriving with differing backgrounds, skill sets and outlook. ‘Bridging the gap’ between the two, with a relational paired learning (PL) approach, has been run in NHS Lothian for 4 years (three cohorts) to positively impact the organisation and its leadership.

Methods

In the initial pilot six doctors and six general managers were paired together. Subsequently cohorts expanded with doctors paired with other senior managers, including the Director of eHealth, a non-executive member of the NHS Lothian Board and shadowing of the Chairman of NHS Lothian. All cohorts used PL ‘Contracts’ for their work together and then engaged in conversation, shadowing and reflection. Preprogramme and postprogramme questionnaires and postprogramme interviews explored the effect of PL on ‘preparedness’ for leadership and an understanding of the role and ethos of the corresponding group, and the running of the programme.

Results

The questionnaires and interviews have shown that the programme had a positive impact on preparedness to lead, and participants described a shift in attitudes with increased understanding of the ‘other’ group and increased ability to work collaboratively together in the future. The ‘Trainee Management Forum’ was developed as a result of PL collaborative working and provides regular engagement and learning for junior doctors and managers at all levels of the organisation.

Conclusion

NHS Lothian PL has been impactful for those involved and is perceived to add value to the organisation, with further cohorts of doctors and managers continuing to engage with this opportunity.
Volcaniclastic lithostratigraphy and paleoenvironment of the lower Eocene McAbee fossil beds, Kamloops Group, British Columbia, Canada
Authors: Lowe Alexander J. , West Christopher K. , Greenwood David R.
Published: April 2018

The lower Eocene McAbee fossil beds (∼53 Ma), in south-central British Columbia, Canada, represent a lacustrine sequence deposited during a time of pervasive regional volcanism. Previous studies on fossil assemblages at the McAbee fossil beds consist of amalgamated collections of plants from several disjunct and stratigraphically unconstrained exposures and horizons, with limited knowledge of the spatio-temporal variation in depositional and taphonomic setting. This study presents a high-resolution lithostratigraphic analysis of the McAbee main site to provide stratigraphic, paleoenvironmental, and taphonomic context to fossil collections. A lithostratigraphic framework was developed for the McAbee main site by correlating tuff marker beds. The sequence was divided into eight lithostratigraphic units on the basis of systematic lithologic trends, a result of varying degrees of volcanic influences. An absence of shallow water indicators, bioturbation, and evidence for fluvio–deltaic influence, and the nonrestricted presence of highly abundant and diverse well-preserved plant fossils indicates a deep water, yet relatively near shore facies, suggesting steep sided lake margins. This taphonomic regime imparts minimal transport- and degradation-induced biases in fossil plant assemblages and suggests plant fossils represent local vegetation growing near the point of deposition. The new lithostratigraphic framework coupled with a refined understanding of depositional setting and taphonomic regime demonstrates the opportunity to document conditions of forest ecology within a dynamic volcanic environment over millennial and multi-millennial time scales.
Guilty as charged: Nile perch was the cause of the haplochromine decline in Lake Victoria
Authors: Marshall Brian E.
Published: April 2018

Debate on the contribution of Nile perch (Lates niloticus) to the demise of Lake Victoria’s 500+ endemic haplochromine cichlids centers around the “top-down” and “bottom-up” hypotheses. The former suggests Nile perch destroyed the haplochromines, causing the disruption of food chains and nutrient cycling and so initiating the accelerated eutrophication of the lake. The latter proposes that haplochromines suppressed Nile perch by preying on its eggs and fry or competing with juveniles for food. A recent paper argued that accelerated eutrophication caused by a climatic event led to their collapse, allowing Nile perch to explode. However, the Nile perch population grew before haplochromines decreased, and they only collapsed once Nile perch biomass exceeded theirs. The chronology indicates that accelerated eutrophication of the lake followed rather than preceded the haplochromine collapse, suggesting that eutrophication was not its cause. A size-selective predation model developed to support the bottom-up hypothesis is discussed in light of existing data, but does not support the bottom-up hypothesis. It was concluded that the top-down model better fits the data and conforms to the law of parsimony.
DNA barcode identification of commercial fish sold in Mexican markets
Authors: Sarmiento-Camacho Stephanie , Valdez-Moreno Martha
Published: April 2018

The substitution of high-value fish species for those of lower value is common practice. Although numerous studies have addressed this issue, few have been conducted in Mexico. In this study, we sought to identify fresh fillets of fish, sharks, and rays using DNA barcodes. We analyzed material from “La Viga” in Mexico City, and other markets located on the Gulf and Caribbean coasts of Mexico. From 134 samples, we obtained sequences from 129, identified to 9 orders, 28 families, 38 genera, and 44 species. The most common species were Seriola dumerili, Pangasianodon hypophthalmus, Carcharhinus falciformis, Carcharhinus brevipinna, and Hypanus americanus. Pangasianodon hypophthalmus was most commonly used as a substitute for higher-value species. The substitution rate was 18% of the total. A review of the conservation status of the specimens identified against the IUNC list enabled us to establish that some species marketed in Mexico are threatened: Makaira nigricans, Lachnolaimus maximus, Hyporthodus flavolimbatus, and Isurus oxyrinchus are classified as vulnerable; Lopholatilus chamaeleonticeps and Sphyrna lewini are endangered; and the status of Hyporthodus nigritus is critical. These results will demonstrate to the Mexican authorities that DNA barcoding is a reliable tool for species identification, even when morphological identification is difficult or impossible.
Effects of ultra-thin Si-fin body widths upon SOI PMOS FinFETs
Authors: Liaw Yue-Gie , Chen Chii-Wen , Liao Wen-Shiang , Wang Mu-Chun , Zou Xuecheng
Published: April 2018

Nano-node tri-gate FinFET devices have been developed after integrating a 14 Å nitrided gate oxide upon the silicon-on-insulator (SOI) wafers established on an advanced CMOS logic platform. These vertical double gate (FinFET) devices with ultra-thin silicon fin (Si-fin) widths ranging from 27 nm to 17 nm and gate length down to 30 nm have been successfully developed with a 193 nm scanner lithography tool. Combining the cobalt fully silicidation and the CESL strain technology beneficial for PMOS FinFETs was incorporated into this work. Detailed analyses of [Formula: see text]–[Formula: see text] characteristics, threshold voltage [Formula: see text], and drain-induced barrier lowering (DIBL) illustrate that the thinnest 17 nm Si-fin width FinFET exhibits the best gate controllability due to its better suppression of short channel effect (SCE). However, higher source/drain resistance [Formula: see text], channel mobility degradation due to dry etch steps, or “current crowding effect” will slightly limit its transconductance [Formula: see text] and drive current.
Addendum to strangeness production and color deconfinement
Authors: Castorina P. , Plumari S , Satz H.
Published: April 2018

Recent extensive data from the beam energy scan of the STAR collaboration at BNL-RHIC provide the basis for a detailed update for the universal behavior of the strangeness suppression factor [Formula: see text] as function of the initial entropy density as proposed in our recent paper (P. Castorina, S Plumari and H. Satz, Int. J. Mod. Phys. E 26 (2017) 1750081, arXiv:1709.02706 [nucl-th]).
SIMULATION AND EXPERIMENTAL RESEARCH ON ADHESION ENHANCEMENT BETWEEN DIAMOND FILMS AND WC-Co SUBSTRATES BY EMPLOYING AMORPHOUS SiC INTERLAYER
Authors: CUI YU-XIAO , SUN FANG-HONG
Published: April 2018

The finite element method (FEM) is employed to analyze the residual stress distribution of bi-layer (a-SiC [Formula: see text] diamond) film system, and the adhesion enhancement mechanism of a-SiC interlayer is further investigated. The influence of a-SiC interlayer on the surface topography of WC-Co substrate is taken into consideration by adopting a 3D surface topography model agreeing with the Atomic Force Microscope (AFM) characterization of a-SiC interlayer. For the sake of comparison, the stress distribution of a diamond film with no interlayer is also simulated. The simulation analysis reveals that the residual stress distribution is much more homogeneous after employing the a-SiC interlayer, which is supposed to be of great importance to the adhesion enhancement of diamond films. Afterwards, the diamond films with and without a-SiC interlayer are fabricated on WC-Co substrates. Raman mapping is carried out to measure the real residual stress distribution of as-fabricated a-SiC diamond films, which is in accordance with the simulation results. Moreover, the a-SiC interlayered diamond film exhibits better adhesion than the diamond film with no interlayer in adhesion evaluation, which can be ascribed to the more homogeneous residual stress distribution and better interfacial bonding after introducing the a-SiC interlayer.
EFFECT OF COUPLE STRESSES ON ELECTROKINETIC OSCILLATORY FLOW OF BLOOD IN THE MICROCIRCULATORY SYSTEM
Authors: MISRA J. C. , CHANDRA S.
Published: April 2018

Of concern in the paper is the development of a mathematical model of blood flow in the microcirculatory system. The study pertains to a situation, where the system is subject to the action of an external AC electric field and the flow is oscillatory. The general case when the frequency of the electric field is different from that of the flow has been studied. Blood is treated as a couple stress fluid. The flow is supposed to take place between two oscillatory plates and is considered to be of electro-osmotic type. Our study is aimed at examining the effect of couple stress at different frequencies of the capillary wall and the applied AC electric field on electroosmotic flow of blood. The computational results indicate very clearly that the electrokinetic velocity of blood reduces as the couple stress effect increases and that the velocity reduces, when the Reynolds number rises. The results of the present study will serve as a reasonably good estimate for electro-osmotic transport of blood in small blood vessels.
An Algorithm for Fluid–Solid Coupling Based on SPH Method and Its Preliminary Verification
Authors: Ma X. J. , Geni M. , Jin A. F.
Published: April 2018

Based on the fundamental theory of smoothed-particle hydrodynamics (SPH), a feasible algorithm for fluid–solid coupling on interface is applied to describe the dynamic behavior of fluid and solid by utilizing continuum mechanics governing equations. Numerical simulation is conducted based on the proposed SPH model and the fluid–solid interface coupling algorithm, and good agreement is observed with the experiment results. It is shown in the results that the present SPH model is able to effectively and accurately simulate the free-surface flow of fluid, deformation of the elastic solid and the fluid–solid impacting.
Effect of explicit deposit insurance premium on the moral hazard of banks’ risk-taking: Around the globe
Authors: Mumtaz Raheel , Jadoon Imran Abbas
Published: April 2018

The adoption of explicit deposit insurance increases the moral hazard of banks’ risk-taking, caused by the decrease in depositors’ discipline. Based on the contract theory, this study probes whether the inception of risk-based deposit insurance premium may limit the moral hazard of banks’ risk-taking triggered by the deposit insurance. This study conducted the analysis on 2,196 banks of 125 countries, covered by the Bankscope database from 2002 to 2014 period. The hierarchical linear models (HLM) were used for empirical estimation of research models. The findings revealed that risk-based deposit insurance premium deteriorated the moral hazard of banks’ risk-taking, incited by the enactment of explicit deposit insurance, while this effect was high for the small banks. Therefore, the small banks were more stable and positively affected by the selection of risk-based deposit insurance premium as compared to the larger counterparts. However, it cannot eliminate this negative effect completely. Hence, the implementation of the premium structure by policymakers on the finding of this study encouraged the depositors and investors’ confidence in the banking system around the globe.
The CX tower of Babel
Authors: Thompson Michael
Published: April 2018

This forum is dedicated to maximizing the success of HCI practitioners within the frenetic world of product and service design. It focuses on UX strategy approaches, leadership, management techniques, and above all the challenge of bringing HCI to peer-level status with longstanding business disciplines such as marketing and engineering.
--- Daniel Rosenberg, Editor
MatConvNet
Authors: Vedaldi Andrea , Lux Mathias , Bertini Marco
Published: April 2018

MatConvNet is an open source MATLAB toolbox implementing Convolutional Neural Networks (CNNs) for computer vision and multimedia applications, developed by the same authors of the famed VLFeat library. Both libraries have associated papers that have been presented within the Open Source Software Competition track of ACM Multimedia: "MatConvNet: Convolutional Neural Networks for MATLAB" [1] and "Vlfeat: an open and portable library of computer vision algorithms" [2]. At present, the MatConvNet paper is the second most cited ACM Multimedia paper, according to Google Scholar.

The pros of this toolbox is its simplicity, thanks to the integration with MATLAB environment, efficiency thanks to the use of GPUs and CuDNN libraries, and the fact that it can run and learn state-of-the-art CNNs. After all it has been developed by the same people that brought VGG-16 and VGG-19 CNNs...

Many pre-trained CNNs for image classification (e.g. ResNet), segmentation, face recognition (e.g. VGG Face), object (e.g. Fast-R CNN) and text detection (e.g. VGG Text) are available in the model zoo.