bluuebunny/crossref_metadata_2025 huggingface dataset:
Silicon‐induced mitigatory effects in salt‐stressed hemp leaves
Authors: Berni Roberto , Mandlik Rushil , Hausman Jean‐Francois , Guerriero Gea
Published: March 2020

Silicon, a quasi‐essential element for plants, improves vigour and resilience under stress. Recently, studies on textile hemp (Cannabis sativa L.) showed its genetic predisposition to uptake silicic acid and accumulate it as silica in epidermal leaf cells and trichomes. Here, microscopy, silicon quantification and gene expression analysis of candidate genes involved in salt stress were performed in hemp to investigate whether the metalloid protects against salinity. The results obtained with microscopy reveal that silicon treatment ameliorated the symptoms of salinity in older fan leaves, where the xylem tissue showed vessels with a wider lumen. In younger ones, it was difficult to assess any mitigation of stress symptoms after silicon application. At the gene level, salinity with and without silicon induced the expression of a putative Si efflux transporter gene 2 (low silicon 2, Lsi2). The addition of the metalloid did not result in any statistically significant changes in the expression of genes involved in stress response, although a trend towards a decrease was observed. In conclusion, our results show that hemp stress symptoms can be alleviated in older leaves by silicon application, that the metalloid is accumulated in fan leaves and highlight one putative rice Lsi2 orthologue as responsive to salinity.
Clinical management of very small pigmented lesions: Improved clinical outcome through dermoscopy and reflectance confocal microscopy combination
Authors: Persechino Flavia , Franceschini Chiara , Iorio Alessandra , Carbone Anna , Ferrari Angela , Buccini Pierluigi , Piemonte Paolo , Eibenschutz Laura , Sperduti Isabella , Cota Carlo , Frascione Pasquale , Ardigo Marco
Published: March 2020

Introduction

Small‐sized pigmented lesions (SSPL) <3 mm in diameter are common pitfall in the daily dermatology practice. Dermoscopy alone is hampered by the lack of specific features inversely proportional to the diameter of the lesions and its performance is highly operator‐dependent. Reflectance confocal microscopy (RCM) has been demonstrated to be effective in the diagnosis of several difficult lesions where dermoscopy lacks to provide conclusive information.

Materials and Methods

A total of 179 lesions with uncertain or equivocal clinical and dermoscopy appearance were selected. Dermoscopist has been requested to express a diagnostic suspect when possible. Equivocal lesions underwent RCM performed by expert for second‐level evaluation before surgical excision for histological diagnosis. Results have been later statistically analysed.

Results

Dermoscopy was not diagnostic in large number of lesions with low concordance histology (39.1%) instead of a much high concordance when combined with RCM (93.9%).

Conclusions

Small‐sized pigmented lesions were more likely to be located on the face area. Diagnosis of pigmented BCC was relatively easy on dermoscopy and also in the case of small lesions showing typical signs of BCC. LM and MM have been seen to be particularly difficult to be diagnosed using only dermoscopy. The combination of digital dermoscopy and RCM represents the correct approach of SSPL.
Temperature Dependence of the Friction Coefficient of Grease-Lubricated PTFE Linear Bushings Against Titanium Grade 5 Alloy (Ti6Al4V) and Life Tests Operating at High-Speed
Authors: Valiente-Blanco I. , Perez-Diaz J. L. , Perez-del-Alamo J. L. , Diez-Jimenez E.
Published: March 2020

Linear bushings are a compact and reliable solution for mechanisms requiring relative linear displacement between moving parts. In this paper, we report the dependence of the coefficient of friction (COF) of polytetrafluoroethylene (PTFE) grease-lubricated bushings against a Ti6Al4 V (grade 5) alloy shaft at high temperatures up to 200 °C, for a motion speed of up to 0.47 m/s and a load pressure of 0.8 MPa. A proportional sensitivity of the COF with temperature is observed due to the change in the viscosity of the grease lubricant. Results of survival tests are also reported demonstrating a total sliding distance of 3200 m without maintenance and a total a total sliding distance of 10,200 m without critical failure.
Two-Stage Continuous Conversion of Carbon Monoxide to Ethylene by Whole Cells of Azotobacter vinelandii
Authors: Natzke Jace , Bruno-Bárcena José M.
Published: March 2020

Ethylene is an essential commodity feedstock used for the generation of a variety of consumer products, but its generation demands energy-intensive processes and is dependent on nonrenewable substrates. This work describes a continuous biological method for investigating the nitrogenase-mediated carbon monoxide reductive coupling involved in ethylene production using whole cells of
Azotobacter vinelandii
. If eventually adopted by industry, this technology has the potential to significantly reduce the total energy input required and the ethylene recovery costs, as well as decreasing greenhouse gas emissions associated with current production strategies.
Early Transcriptional Changes within Liver, Adrenal Gland, and Lymphoid Tissues Significantly Contribute to Ebola Virus Pathogenesis in Cynomolgus Macaques
Authors: Jankeel Allen , Menicucci Andrea R. , Woolsey Courtney , Fenton Karla A. , Mendoza Norma , Versteeg Krista , Cross Robert W. , Geisbert Thomas W. , Messaoudi Ilhem
Published: March 2020

Ebola virus (EBOV) remains a high-priority pathogen since it continues to cause outbreaks with high case fatality rates. Although it is well established that EBOV results in severe organ damage, our understanding of tissue injury in the liver, adrenal glands, and lymphoid tissues remains limited. We begin to address this knowledge gap by conducting longitudinal gene expression studies in these tissues, which were collected from EBOV-infected cynomolgus macaques. We report robust and early gene expression changes within these tissues, indicating they are primary sites of EBOV infection. Furthermore, genes involved in metabolism, coagulation, and adaptive immunity were downregulated, while inflammation-related genes were upregulated. These results indicate significant tissue damage consistent with the development of hemorrhagic fever and lymphopenia. Our study provides novel insight into EBOV-host interactions and elucidates how host responses within the liver, adrenal glands, and lymphoid tissues contribute to EBOV pathogenesis.
Protein-Mediated and RNA-Based Origins of Replication of Extrachromosomal Mycobacterial Prophages
Authors: Wetzel Katherine S. , Aull Haley G. , Zack Kira M. , Garlena Rebecca A. , Hatfull Graham F.
Published: March 2020

Bacteriophages are the most abundant biological entities in the biosphere and are a source of uncharacterized biological mechanisms and genetic tools. Here, we identify segments of phage genomes that are used for stable extrachromosomal replication in the prophage state. Autonomous replication of some of these phages requires a RepA-like protein, although most lack
repA
and use RNA-based systems for replication initiation. We describe a suite of plasmids based on these prophage replication functions that vary in copy number, stability, host range, and compatibility. These plasmids expand the toolbox available for genetic manipulation of
Mycobacterium
and other
Actinobacteria
, including
Gordonia terrae
.
BordetellaDermonecrotic Toxin Is a Neurotropic Virulence Factor That Uses CaV3.1 as the Cell Surface Receptor
Authors: Teruya Shihono , Hiramatsu Yukihiro , Nakamura Keiji , Fukui-Miyazaki Aya , Tsukamoto Kentaro , Shinoda Noriko , Motooka Daisuke , Nakamura Shota , Ishigaki Keisuke , Shinzawa Naoaki , Nishida Takashi , Sugihara Fuminori , Maeda Yusuke , Horiguchi Yasuhiko
Published: March 2020

Bordetella pertussis, which causes pertussis, a contagious respiratory disease, produces three major protein toxins, pertussis toxin, adenylate cyclase toxin, and dermonecrotic toxin (DNT), for which molecular actions have been elucidated. The former two toxins are known to be involved in the emergence of some clinical symptoms and/or contribute to the establishment of bacterial infection. In contrast, the role of DNT in pertussis remains unclear. Our study shows that DNT affects neural cells through specific binding to the T-type voltage-gated Ca2+channel that is highly expressed in the central nervous system and leads to neurological disorders in mice after intracerebral injection. These data raise the possibility of DNT as an etiological agent for pertussis encephalopathy, a severe complication ofB. pertussisinfection.
mSphere of Influence: Interferon Ultra Is a Means To Fight Viral Disease
Authors: Bamford Connor G. G.
Published: March 2020

Connor G. G. Bamford works in the fields of virology and innate immunity. In this mSphere of Influence article, he reflects on how three papers by Manry et al. (J. Manry, G. Laval, E. Patin, S. Fornarino, et al., J Exp Med 208:2747–2759, 2011,
https://doi.org/10.1084/jem.20111680
), Terczyńska-Dyla et al. (E. Terczyńska-Dyla, S. Bibert, F. H. T. Duong, I. Krol, et al., Nat Commun 5:5699, 2014,
https://doi.org/10.1038/ncomms6699
), and Schoggins et al.
Structural and Functional Changes in Prokaryotic Communities in Artificial Pit Mud during Chinese Baijiu Production
Authors: Liu Mao-Ke , Tang Yu-Ming , Guo Xiao-Jiao , Zhao Ke , Penttinen Petri , Tian Xin-Hui , Zhang Xin-Yu , Ren Dao-Qun , Zhang Xiao-Ping
Published: March 2020

Strong-flavor baijiu (SFB) accounts for more than 70% of all Chinese liquor production. In the Chinese baijiu brewing industry, artificial pit mud (APM) has been widely used since the 1960s to construct fermentation cellars for production of high-quality SFB. To gain insights at the systems level into the mechanisms driving APM prokaryotic taxonomic and functional dynamics and into how this variation is connected with high-quality SFB production, we performed the first combined metagenomic, metaproteomic, and metabolomic analyses of this brewing microecosystem. Together, the multi-omics approach enabled us to develop a more complete picture of the changing metabolic processes occurring in APM microbial communities during high-quality SFB production, which will be helpful for further optimization of APM culture technique and improvement of SFB quality.
Inherited cause of in utero digital malformations
Authors: Gooch Catherine , Wright Caitlin , Nelson Katherine , Robin Nathaniel
Published: March 2020

Amniotic band sequence (ABS) is common birth defect of incompletely understood origin. Here we describe a case of ABS in a child with paternally inherited Ehlers-Danlos syndrome, vascular type (vEDS). This is the third reported instance of ABS associated with paternally inherited vEDS in the medical literature. The two main theories of ABS formation are the extrinsic and intrinsic. The extrinsic theory states that placental tears form fibrous cords that wrap around the fetus; the intrinsic states that poor vascularisation in the fetus leads to necrosis of distal extremities. We believe this case supports extrinsic theory as it shows that as an amnion weakened by vEDS in fetal components is associated with ABS.
Synchronous metaplastic breast carcinoma and lung adenocarcinoma: a rare case and review of the literature
Authors: Lane Rebecca , Yan Felicia , Higgins Daniel , Agarwal Gauri
Published: March 2020

Synchronous primary cancers occur in 1.7% of breast cancer cases and metaplastic breast cancer (MBC) occurs in less than 1% of breast cancer cases. We present a previously healthy 66-year-old woman diagnosed with MBC after surgical resection of a presumed cyst. A second primary cancer, multifocal lung adenocarcinoma, was discovered during the staging process for her MBC. Remarkably she had not experienced pulmonary or constitutional symptoms at the time of diagnosis. She received chemotherapy with paclitaxel and carboplatin, followed by immunotherapy with nivolumab. At 24 months of follow-up after her initial diagnosis, she was breast cancer-free with stable pulmonary nodules. This case highlights that rather than assuming multifocal lesions represent metastasis, biopsies should be considered as clinical management could be significantly altered in the presence of a synchronous cancer. Furthermore, platinum-based chemotherapy agents have potential to be considered in the treatment of MBC.
PSMA-PET/CT-avid metastatic prostate cancer to the penis
Authors: Mansbridge Margaret Mary , Strahan Andrew , Parker Jonathon , Rhee Handoo
Published: March 2020

Penile metastases from prostate cancer (PC) are rarely reported in the literature. Most commonly diagnosed due to presentation with malignant priapism and other urinary symptoms or from findings on clinical examination, prognosis has been reported to be poor. The authors outline a case of penile metastasis from advanced PC. Initially treated with neoadjuvant androgen deprivation therapy for locally advanced PC, this patient displayed upfront castrate resistance, and subsequent prostate-specific membrane antigen positron emission tomography revealed penile metastatic deposits. The patient was treated with external beam radiotherapy, and worsening urethral stricture disease resulted in the placement of a suprapubic catheter.
Bleb-related tuberculous endophthalmitis following combined phacoemulsification and trabeculectomy with mitomycin C
Authors: Seth Praveen Kumar , Sharma Savitri , Senthil Sirisha
Published: March 2020

A one-eyed 67-year-old man with 20/400 vision, dense cataract, previously failed trabeculectomy and medically uncontrolled advanced glaucoma underwent a single-site phacoemulsification with repeat trabeculectomy and mitomycin C. One-week postoperatively, vision in the right eye improved to 20/120, good bleb and intraocular pressure (IOP) of 14 mm Hg. By third postoperative week, patient presented to the emergency with diminished vision, pain and redness in right eye of 2 days duration and was diagnosed to have bleb-related endophthalmitis (BRE). Vitreous biopsy, smear from the bleb were taken and underwent pars plana vitrectomy with intraocular antibiotic injection. Smears and cultures were negative however, aqueous DNA-PCR was positive forMycobacterium tuberculosis. Revisited history revealed treated pulmonary tuberculosis 3 years ago with a positive Mantoux test (17 mm) and hilar prominence on chest X-ray. One month after starting anti-tubercular therapy (ATT), the BRE resolved and vision improved to 20/60 with IOP of 14 mm Hg and the ATT was continued.
Protocol for a prospective, observational, longitudinal study in paediatric patients with moderate-to-severe atopic dermatitis (PEDISTAD): study objectives, design and methodology
Authors: Paller Amy S , Guttman-Yassky Emma , Irvine Alan D , Baselga Eulalia , de Bruin-Weller Marjolein , Jayawardena Shyamalie , Zhang Annie , Mina-Osorio Paola , Rizova Elena , Ozturk Zafer E
Published: March 2020

Introduction

Atopic dermatitis (AD) is a chronic inflammatory skin disease often associated with atopic comorbidities and has significant impact on children and their families. There is a lack of robust and longitudinal long-term data on disease characteristics and typical clinical practice with currently available treatments in children with moderate-to-severe AD. Hence, an observational study is needed to evaluate AD characteristics and progression in paediatric patients with moderate-to-severe AD.

Methods and analysis

Pediatric Study in Atopic Dermatitis (PEDISTAD) is a prospective, observational, longitudinal study in paediatric patients with moderate-to-severe AD who are currently receiving systemic or topical treatment and whose disease is not adequately controlled by topical prescription therapies or for whom those therapies are not medically advisable. 1300 children at 100–150 sites in approximately 20 countries worldwide will be enrolled and followed for 5 years. AD therapy is at the discretion of the investigator. Data collected will include: AD disease characteristics and comorbidities; current therapy for AD and initiation of new treatments/changes in current treatment; patient-reported/caregiver-reported outcomes; days missed from school/work for the patient/caregiver; healthcare professional visits; safety and biomarkers.

Ethics and dissemination

This study is conducted in accordance with the principles established by the 18th World Medical Assembly and all subsequent amendments and the guidelines for Good Epidemiology Practice. Each individual country assures that ethics approval has been received and local regulatory requirements are met. Ethics approval has been obtained in all countries currently participating in PEDISTAD. Study data will be disseminated in manuscripts submitted to peer-reviewed medical journals as well as in abstracts submitted to congresses and in the resulting posters and presentations.

Trial registration number

NCT03687359; pre-results.
Does Gleason score of positive surgical margin after radical prostatectomy affect biochemical recurrence and oncological outcomes? Protocol for systematic review
Authors: John Athul , O'Callaghan Michael , Catterwell Rick , Selth Luke A
Published: March 2020

Introduction

Positive surgical margins (PSM) in cancer patients are commonly associated with worse prognosis and a higher risk of secondary treatment. However, the relevance of this parameter in prostate cancer patients undergoing radical prostatectomy (RP) remains controversial, given the inconsistencies in its ability to predict biochemical recurrence (BCR) and oncological outcomes. Hence, further assessment of the utility of surgical margins for prostate cancer prognosis is required to predict these outcomes more accurately. Over the last decade, studies have used the Gleason score (GS) of positive margins to predict outcomes. Herein, the authors aim to conduct a systematic review investigating the role of GS of PSM after radical prostatectomy in predicting BCR and oncological outcomes.

Methods and analysis

We will perform a search using MEDLINE, EMBASE, SCOPUS and COCHRANE databases. The review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will screen titles and abstracts to select articles appropriate for full-text review. Studies discussing GS of PSM after RP will be included. Given the change in reporting of GS, only articles from 2005 to 2019 will be included. The quality of the studies chosen will be assessed using the Newcastle Ottawa tool for non-randomised and Cochrane risk of bias for randomised control studies. We will adopt the grading of recommendations, assessment, development and evaluation framework to comment on quality of cumulative evidence. The primary outcome measure will be time to BCR. Secondary outcome measures include secondary treatment, disease-specific survival, disease progression-free and overall mortality at follow-up period. We aim to perform a meta-analysis if the level of heterogeneity is acceptable (I2<50%).

Ethics and dissemination

The review does not require ethics approval as it is a review of published literature. The findings of the review will be submitted for peer-reviewed publications and presented at scientific meetings.

PROSPERO registration number

CRD42019131800.
Experiences of accessing and using breast cancer services in Vietnam: a descriptive qualitative study
Authors: Jenkins Chris , Ngan Tran Thu , Ngoc Nguyen Bao , Hien Ho Thi , Anh Nguyen Hoang , Lohfeld Lynne , Donnelly Michael , Van Minh Hoang , Murray Liam
Published: March 2020

Objectives

To understand, describe and analyse the experiences of women with breast cancer in Vietnam when accessing and using breast cancer services.

Design

Descriptive qualitative study. Women were interviewed about their experiences from the first time they became aware of symptoms or changes to their body through treatment and post-treatment. This study is the first descriptive study on breast cancer in Vietnam from the perspective of women with a breast cancer diagnosis.

Participants

Women (n=13) who had completed or were still receiving treatment for breast cancer, purposively recruited from the north and south of Vietnam.

Results

An analysis of the experiences of women with breast cancer in Vietnam revealed a lack of awareness and knowledge about breast cancer and symptoms. Family and social support were described as key factors influencing whether a woman accesses and uses breast cancer services. Cost of treatment and out-of-pocket expenditures limited access to services and resulted in significant financial challenges for women and their families.

Conclusions

Vietnam has made huge strides in improving cancer care, and is tackling a complex and expanding public health challenge, however, there are a number of areas requiring strengthening and future research. While Vietnam has successfully expanded social health insurance coverage, changes that increase the percentage of costs covered for specific treatments, such as chemotherapy or radiotherapy, could benefit women and their families.
Accuracy of medical billing data against the electronic health record in the measurement of colorectal cancer screening rates
Authors: Rudrapatna Vivek A , Glicksberg Benjamin S , Avila Patrick , Harding-Theobald Emily , Wang Connie , Butte Atul J
Published: March 2020

Objective

Medical billing data are an attractive source of secondary analysis because of their ease of use and potential to answer population-health questions with statistical power. Although these datasets have known susceptibilities to biases, the degree to which they can distort the assessment of quality measures such as colorectal cancer screening rates are not widely appreciated, nor are their causes and possible solutions.

Methods

Using a billing code database derived from our institution’s electronic health records, we estimated the colorectal cancer screening rate of average-risk patients aged 50–74 years seen in primary care or gastroenterology clinic in 2016–2017. 200 records (150 unscreened, 50 screened) were sampled to quantify the accuracy against manual review.

Results

Out of 4611 patients, an analysis of billing data suggested a 61% screening rate, an estimate that matches the estimate by the Centers for Disease Control. Manual review revealed a positive predictive value of 96% (86%–100%), negative predictive value of 21% (15%–29%) and a corrected screening rate of 85% (81%–90%). Most false negatives occurred due to examinations performed outside the scope of the database—both within and outside of our institution—but 21% of false negatives fell within the database’s scope. False positives occurred due to incomplete examinations and inadequate bowel preparation. Reasons for screening failure include ordered but incomplete examinations (48%), lack of or incorrect documentation by primary care (29%) including incorrect screening intervals (13%) and patients declining screening (13%).

Conclusions

Billing databases are prone to substantial bias that may go undetected even in the presence of confirmatory external estimates. Caution is recommended when performing population-level inference from these data. We propose several solutions to improve the use of these data for the assessment of healthcare quality.
Relationship between regional left ventricular dysfunction and cancer-therapy-related cardiac dysfunction
Authors: Saijo Yoshihito , Kusunose Kenya , Okushi Yuichiro , Yamada Hirotsugu , Toba Hiroaki , Sata Masataka
Published: March 2020

Objective

The aim of our study was to assess the association between risk of cancer-therapy-related cardiac dysfunction (CTRCD) after first follow-up and the difference in echocardiographic measures from baseline to follow-up.

Methods

We retrospectively enrolled 87 consecutive patients (58±14 years, 55 women) who received anthracycline and underwent echocardiographic examinations both before (baseline) and after initial anthracycline administration (first follow-up). We measured absolute values of global longitudinal strain (GLS), apical longitudinal strain (LS), mid-LS and basal-LS at baseline and first follow-up, and per cent changes (Δ) of these parameters were calculated. Among 61 patients who underwent further echocardiographic examinations (second follow-up, third follow-up, etc), we assessed the association between regional left ventricular (LV) systolic dysfunction from baseline to follow-up and development of CTRCD, defined as LV ejection fraction (LVEF) under 53% and more absolute decrease of 10% from baseline, after first follow-up.

Results

LVEF (65%±4% vs 63±4%, p=0.004), GLS (23.2%±2.6% vs 22.2±2.4%, p=0.005) and basal-LS (21.9%±2.5% vs 19.9±2.4%, p<0.001) at first follow-up significantly decreased compared with baseline. Among the 61 patients who had further follow-up echocardiographic examinations, 13% developed CTRCD. In the Cox-hazard model, worse Δbasal-LS was significantly associated with CTRCD. By Kaplan–Meier analysis, patients with Δbasal-LS decrease of more than the median value (−9.7%) had significantly worse event-free survival than those with a smaller decrease (p=0.015).

Conclusions

Basal-LS significantly decreased prior to development of CTRCD, and worse basal-LS was associated with development of CTRCD in patients receiving anthracycline chemotherapy.
Sibling history is associated with heart failure after a first myocardial infarction
Authors: Glinge Charlotte , Oestergaard Louise , Jabbari Reza , Rossetti Sara , Skals Regitze , Køber Lars , Engstrøm Thomas , Bezzina Connie R , Torp-Pedersen Christian , Gislason Gunnar , Tfelt-Hansen Jacob
Published: March 2020

Objective

Morbidity and mortality due to heart failure (HF) as a complication of myocardial infarction (MI) is high, and remains among the leading causes of death and hospitalisation. This study investigated the association between family history of MI with or without HF, and the risk of developing HF after first MI.

Methods

Through nationwide registries, we identified all individuals aged 18–50 years hospitalised with first MI from 1997 to 2016 in Denmark. We identified 13 810 patients with MI, and the cohort was followed until HF diagnosis, second MI, 3 years after index MI, emigration, death or the end of 2016, whichever occurred first. HRs were estimated by Cox hazard regression models adjusted for sex, age, calendar year and comorbidities (reference: patients with no family history of MI).

Results

After adjustment, we observed an increased risk of MI-induced HF for those having a sibling with MI with HF (HR 2.05, 95% CI 1.02 to 4.12). Those having a sibling with MI without HF also had a significant, but lower increased risk of HF (HR 1.39, 95% CI 1.05 to 1.84). Parental history of MI with or without HF was not associated with HF.

Conclusion

In this nationwide cohort, sibling history of MI with or without HF was associated with increased risk of HF after first MI, while a parental family history was not, suggesting that shared environmental factors may predominate in the determination of risk for developing HF.
Evaluating trauma care, outcomes and costs in a system in crisis: the necessity of a Greek National Trauma Database
Authors: Prionas Apostolos , Tsoulfas George , Tooulias Andreas , Papakoulas Apostolos , Piachas Athanasios , Papadopoulos Vasileios
Published: March 2020

Background

At present there is no organized trauma system in Greece and no national trauma database. The objective of this study was to record and evaluate trauma management at our university hospital and to measure the associated healthcare costs, while laying the foundations for a national database and the organization of regional trauma networks.

Methods

Retrospective study of trauma patients (n=2320) between 2014 and 2015, through our single-center registry. Demographic information, injury patterns, hospital transfer, investigations, interventions, duration of hospitalization, Injury Severity Score (ISS), outcomes, complications and cost were recorded.

Results

Road traffic collisions (RTC) accounted for 23.2% of traumas. The proportion of patients who were transferred to the hospital by the National Emergency Medical Services decreased throughout the study (n2015=76/1192 (6.38%), n2014=109/1128 (9.7%)) (p<0.05). 1209 (52.1%) of our trauma patients did not meet the US trauma field triage algorithm criteria. Overtriage of trauma patients to our facility ranged from 90.7% to 96.7%, depending on the criteria used (clinical vs. ISS criteria). Ninety-one (3.9%) of our patients received operative management. Intensive care unit admissions were 21 (0.1%). Seventy-six (3.3%) of our patients had ISS>15 and their mortality was 31.6%. The overall non-salary cost for trauma management was €623 140. 53% of these costs were attributed to RTCs. The cost resulting from the observed overtriage ranged from €121 000 to €315 000. Patients who did not meet the US trauma triage algorithm criteria accounted for 10.5% of total expenses.

Discussion

Our results suggest that RTCs pose a significant financial burden. The prehospital triage of trauma patients is ineffective. A reduction of costs could have been achieved if prehospital triage was more effective.

Level of evidence

Level IV.
Variability in skeletal muscle fibre characteristics during repeated muscle biopsy sampling in human vastus lateralis
Authors: Nederveen Joshua P. , Ibrahim George , Fortino Stephen A. , Snijders Tim , Kumbhare Dinesh , Parise Gianni
Published: March 2020

The percutaneous muscle biopsy procedure is an invaluable tool for characterizing skeletal muscle and capillarization. Little is known about methodological or biological variation stemming from the technique in heterogeneous muscle. Five muscle biopsies were taken from the vastus lateralis of a group of young men (n = 29, 22 ± 1 years) over a 96-h period. We investigated the repeatability of fibre distribution, indices of muscle capillarization and perfusion, and myofibre characteristics. No differences between the biopsies were reported in myofibre type distribution, cross-sectional area (CSA), and perimeter. Capillary-to-fibre perimeter exchange index and individual capillary-fibre contacts were unchanged with respect to the location of the muscle biopsy and index of capillarization. The variability in the sampling distribution of fibre type specific muscle CSA increased when fewer than 150 muscle fibres were quantified. Variability in fibre type distribution increased when fewer than 150 muscle fibres were quantified. Myofibre characteristics and indices of capillarization are largely consistent throughout the vastus lateralis when assessed via the skeletal muscle biopsy technique.

Novelty Markers of muscle capillarization and perfusion were unchanged across multiple sites of the human vastus lateralis. Myofibre characteristics such as muscle cross-sectional area, perimeter, and fibre type distribution were also unchanged. Variation of muscle CSA was higher when fewer than 150 muscle fibres were quantified.
Minimum identifying codes in some graphs differing by matchings
Authors: Nikandish R. , Khani Nasab O. , Dodonge E.
Published: March 2020

For a vertex [Formula: see text] of a graph [Formula: see text], let [Formula: see text] be the set of [Formula: see text] with all of its neighbors in [Formula: see text]. A set [Formula: see text] of vertices is an identifying code of [Formula: see text] if the sets [Formula: see text] are nonempty and distinct for all vertices [Formula: see text] of [Formula: see text]. If [Formula: see text] admits an identifying code, then [Formula: see text] is called identifiable and the minimum cardinality of an identifying code of [Formula: see text] is denoted by [Formula: see text]. Let [Formula: see text] be two positive integers. In this paper, [Formula: see text] and [Formula: see text] are computed, where [Formula: see text] and [Formula: see text] represent the complement of a path and the complement of a cycle of order [Formula: see text], respectively. Among other results, [Formula: see text] is given, where [Formula: see text] is obtained from [Formula: see text] after deleting a maximum matching.
Measuring nonlinearity by means of static parameters in Bernoulli binary sequences distribution: A brief approach
Authors: Telles Charles Roberto
Published: March 2020

This paper analyzes Bernoulli’s binary sequences in the representation of empirical nonlinear events, analyzing the distribution of natural resources, population sizes and other variables that influence the possible outcomes of resource’s usage. Consider the event as a nonlinear system and the metrics of analysis consisting of two dependent random variables 0 and 1, with memory and probabilities in maximum finite or infinite lengths, constant and equal to 1/2 for both variables (stationary process). The expressions of the possible trajectories of metric space represented by each binary parameter remain constant in sequences that are repeated alternating the presence or absence of one of the binary variables at each iteration (symmetric or asymmetric). It was observed that the binary variables [Formula: see text] and [Formula: see text] assume on time [Formula: see text] specific behaviors (geometric variable) that can be used as management tools in discrete and continuous nonlinear systems aiming at the optimization of resource’s usage, nonlinearity analysis and probabilistic distribution of trajectories occurring about random events. In this way, the paper presents a model of detecting fixed-point attractions and its probabilistic distributions at a given population-resource dynamic. This means that coupling oscillations in the event occur when the binary variables [Formula: see text] and [Formula: see text] are limited as a function of time [Formula: see text].
Structure and dielectric properties of solid solutions Bi7Ti4+xWxNb1−2x−0.1V0.1O21 (x=0.1−0.4)
Authors: Zubkov S. V.
Published: March 2020

The structural and electrophysical characteristics of a number of solid solutions of layered oxides of the perovskite-type Bi7[Formula: see text]Wx[Formula: see text][Formula: see text][Formula: see text] ([Formula: see text]) are studied. According to X-ray powder diffraction data, all the compounds studied are single-phase and have the structure of Aurivillius phases ([Formula: see text]) with a rhombic crystal lattice (space group I2[Formula: see text]cm, [Formula: see text]). Changes in tetragonal and rhombic distortions of perovskite-like layers in compounds were considered depending on their chemical composition. The temperature dependences of the relative permittivity [Formula: see text] (T) were measured. It was shown that the Curie temperature [Formula: see text] of the perovskite-type oxides Bi7[Formula: see text]Wx[Formula: see text][Formula: see text][Formula: see text] ([Formula: see text]) linearly decreases with increasing parameter [Formula: see text]. The activation energies of charge carriers were obtained in different temperature ranges. It was found that there are three temperature regions with very different activation energies due to the different nature of the charge carrier s in the studied compounds. The effect of substitution of [Formula: see text] ions by [Formula: see text] ions is investigated. It was found that for a number of compounds, the substitution of niobium ions by vanadium ions led to an increase in the dielectric constant and a decrease in the dielectric loss tangent.
Quantification of Some Herbal Distillates’ Methanol to Evaluate a New Diagnostic Kit
Authors: Saadat Farshid , Hassanian Moghadam Hossein , Zamani Nasim , Rafizadeh Ali
Published: March 2020

Methanol naturally exists in all plant products. In recent years, the consumption of certain kinds of herbal distillates has led to blurred vision, leading to neurotic blindness in Iran. The advanced methods needed for determination of methanol are not available in all parts of poor and developing countries. In this study, we evaluated some herbal distillates’ methanol with a new kit compared to gas chromatography for determining the efficacy of the kit. A gas chromatography apparatus was used to determine methanol concentration of 57 herbal distillates. At the same time, a spectrophotometer device was also used along with a newly designed kit based on the modified chromotropic acid method for the same purpose. All examined samples have different amounts of methanol from 21 to 770 mg/l. The methanol content of all samples was higher than the used kit’s limit of quantification (5 mg/l). The attained results by two used methods were very close together in both minimum (21 and 22 mg/l) and maximum (770 and 690 mg/l) amounts. The comparison of results was shown, and some of available herbal distillates in Iran have enough amounts of methanol to create chronic type of methanol poisoning. Our results suggested that the used kit had suitable efficacy for quantitative determination of herbal distillates’ methanol content. It was proved that the type of the herbal distillate did not affect the kit’s function. The new kit can be easily used with minimal equipment for quality control of herbal distillates in food industry area.
Factors Affecting the Foveal Avascular Zone Area in Healthy Eyes among Young Chinese Adults
Authors: Zhou Yifan , Zhou Minwen , Gao Min , Liu Haiyun , Sun Xiaodong
Published: March 2020

Purpose. To evaluate the influence of systemic and ocular factors on the foveal avascular zone (FAZ) area in young Chinese subjects’ healthy eyes. Methods. The current observational, cross‐sectional study included 344 eyes from 172 healthy individuals (103 women, 69 men). Optical coherence tomography angiography realized with the split‐spectrum amplitude‐decorrelation angiography (SSADA) algorithm was used to assess the area of superficial FAZ. To determine the related factors and to reveal their potential correlations with the FAZ area, comprehensive examinations including both systemic and ocular ones were executed. Systemic examination involved factors including age, gender, and body mass index, while ocular examination involved factors including BCVA, refractive error, intraocular pressure, axial length (AL), anterior chamber depth, and central corneal thickness. Especially for fundus examination, central macular thickness (CMT), retinal volume, mean retinal thickness, macular blood flow area/vessel density in the superficial retinal layer (SRL) and deep retinal layer (DRL), mean retinal nerve fiber layer (RNFL) thickness, ganglion cell layer (GCL) thickness, C/D rate, rim area, and subfoveal choroid thickness were assessed, using mixed‐effects regression models to appropriately account for intereye correlation. Subgroup analyses were performed based on gender and high myopia categories. Results. The mean FAZ area was 0.30 ± 0.11 mm2 and varied significantly across gender (P = 0.0024). AL, CMT, and RNFL thickness were found significantly correlated with the FAZ area in the univariate regression analysis (AL, P = 0.0005; CMT, P < 0.0001; and RNFL thickness, P = 0.0461). According to the multivariate results, CMT and macular blood flow in SRL were negatively correlated with FAZ (CMT: P < 0.0001; macular blood flow in SRL: P = 0.00223). Mean retinal thickness, mean GCL thickness, and macular blood flow in DRL were positively correlated with FAZ (mean retinal thickness: P = 0.0005; mean GCL thickness: P < 0.0001; and macular blood flow in DRL: P = 0.0099). Correlation results among these filtered factors and FAZ were more pronounced in non‐high‐myopic eyes than in high‐myopic eyes and had a significant difference when data of male and female subjects were processed separately from each other. Conclusion. The present cross‐sectional study performed comprehensive systemic and ocular examinations in young Chinese adults and filtered factors affecting FAZ. We indicated that among all the assessed candidate factors, gender, AL, retinal thickness, macular blood flow, RNFL, and GCL thickness affected the FAZ area most significantly. Such findings would facilitate future research concerning the role of FAZ variation in fundus diseases.
Optimal Operation Strategies under a Carbon Cap-and-Trade Mechanism: A Capital-Constrained Supply Chain Incorporating Risk Aversion
Authors: Qi Linming , Liu Lu , Jiang Liwen , Wang Zicheng , Zhao Weiliang
Published: March 2020

Many small and medium enterprises (SMEs) with capital constraints often have no access or find it costly to obtain a loan from a bank; the retailer tends to borrow money from other enterprises in the supply chain by trade credit financing. We consider an emission-dependent supply chain with one emission-dependent manufacturer and one capital-constrained retailer in need of financing to explore the optimal operational and environmental strategies of a low-carbon supply chain under trade credit financing. We use a Stackelberg game model to depict the low-carbon supply chain. We analyse the optimal carbon-emission reduction effort, wholesale price, and order quantity in the equilibrium state. The impacts of key parameters, such as the retailer’s internal working capital, the manufacturer’s risk-aversion degree, and the carbon-trading price on the supply chain operation, are analysed. The results show that the retailer’s capital constraint causes the carbon-emission reduction effort, wholesale price, and order quantity to improve synchronously. The supply chain achieves a win-win outcome for both the manufacturer and the retailer when the capital-constrained retailer is funded via trade credit from the manufacturer. The in-depth development of financing is beneficial to the manufacturer but is a disadvantage for the retailer. When the initial carbon-emission quota is low, the manufacturer benefits from a relatively lower carbon-trading price. Otherwise, a higher carbon-trading price is better for the manufacturer. The “carbon-trading price trap” ensures that the retailer’s profit is minimal. We further investigate the scenario in which the manufacturer is risk averse and find that the retailer will purchase fewer products and that the manufacturer will gain less profit to decrease the carbon-emission reduction effort. The manufacturer’s risk aversion is unfavourable to both the economic and environmental outcomes of the whole supply chain. This research provides strategic support for a low-carbon supply chain to carry out operational decisions in the context of enterprise capital constraint. To examine the theoretical results, the data used in the existing literature are further used to simulate the corresponding conclusions. Our research enriches the existing supply chain finance literature and provides decision support for the supply chain core enterprise.
The Frequency of Ras Mutations in Cancer
Authors: Prior Ian A. , Hood Fiona E. , Hartley James L.
Published: March 2020

Ras is frequently mutated in cancer, however, there is a lack of consensus in the literature regarding the cancer mutation frequency of Ras, with quoted values varying from 10%–30%. This variability is at least in part due to the selective aggregation of data from different databases and the dominant influence of particular cancer types and particular Ras isoforms within these datasets. To provide a more definitive figure for Ras mutation frequency in cancer, we cross-referenced the data in all major publicly accessible cancer mutation databases to determine reliable mutation frequency values for each Ras isoform in all major cancer types. These percentages were then applied to current U.S. cancer incidence statistics to estimate the number of new patients each year that have Ras-mutant cancers. We find that approximately 19% of patients with cancer harbor Ras mutations, equivalent to approximately 3.4 million new cases per year worldwide. We discuss the Ras isoform and mutation-specific trends evident within the datasets that are relevant to current Ras-targeted therapies.
Optimization of T-cell Receptor–Modified T Cells for Cancer Therapy
Authors: Drakes Dylan J. , Rafiq Sarwish , Purdon Terence J. , Lopez Andrea V. , Chandran Smita S. , Klebanoff Christopher A. , Brentjens Renier J.
Published: March 2020

T-cell receptor (TCR)–modified T-cell gene therapy can target a variety of extracellular and intracellular tumor-associated antigens, yet has had little clinical success. A potential explanation for limited antitumor efficacy is a lack of T-cell activation in vivo. We postulated that expression of proinflammatory cytokines in TCR-modified T cells would activate T cells and enhance antitumor efficacy. We demonstrate that expression of interleukin 18 (IL18) in tumor-directed TCR-modified T cells provides a superior proinflammatory signal than expression of interleukin 12 (IL12). Tumor-targeted T cells secreting IL18 promote persistent and functional effector T cells and a proinflammatory tumor microenvironment. Together, these effects augmented overall survival of mice in the pmel-1 syngeneic tumor model. When combined with sublethal irradiation, IL18-secreting pmel-1 T cells were able to eradicate tumors, whereas IL12-secreting pmel-1 T cells caused toxicity in mice through excessive cytokine secretion. In another xenograft tumor model, IL18 secretion enhanced the persistence and antitumor efficacy of NY-ESO-1–reactive TCR-modified human T cells as well as overall survival of tumor-bearing mice. These results demonstrate a rationale for optimizing the efficacy of TCR-modified T-cell cancer therapy through expression of IL18.

See related commentary by Wijewarnasuriya et al., p. 732
How Does Affective Disorder Relate to Creativity? The Pathography of the Chinese Writer Yu Dafu
Authors: Chen Zhimin , Xiao Shifu
Published: March 2020

Background: Yu Dafu, arguably one of the greatest writers in modern Chinese history, is characterized by critics as having a sentimental and decadent style. His life is clearly marked by mood bipolarity, and it seems that his creativity was affected by extreme emotional states. However, this link remains unclear. Methods: Yu’s self-assessments in his works and letters are analyzed from the perspective of current psychiatric classifications. Examples are extracted from his writing career and habits to help illuminate the relationship between mental disorders and literary creativity. Results: Yu’s writing career seems to be divided into four blocks. He was in a deep depression when he studied abroad and taught in China and experienced a hypomanic episode afterward, when he created a magazine and fell in love. The pattern of his mood changes is consistent with the symptoms of bipolar II disorder. His maintenance of a high degree of literary productivity alongside his anguish during depressive episodes may suggests mixed states. Conclusions: Mood changes shaped Yu’s life and writing career. Depressive and hypomanic moods enhanced his creativity in several ways, and some situations in his life indicate that writing and literary pursuits also have reverse effects on one’s mental state. The perspective that mental disorders are seen as a certain profile of literary career can help us to better understand the writers.