bluuebunny/crossref_metadata_2025 huggingface dataset:
Ambient seismic noise tomography in west-central and Southern Brazil, characterizing the crustal structure of the Chaco-Paraná, Pantanal and Paraná basins
Authors: Shirzad Taghi , Assumpcao Marcelo , Bianchi Marcelo
Published: December 2019

Surface wave analysis provides important information on crustal structure, but it is challenging to obtain accurate/robust models in aseismic regions because of the lack of local earthquake records. In this paper, interstation empirical Green's functions retrieved by ambient seismic noise in 75 broad-band stations from 2016 January to 2018 September were used to study crustal structure in west-central Brazil. Fast marching method was applied to calculate the 2-D surface wave tomographic maps, and local dispersion curves were estimated in the period range of 4–80 s for each geographic cell. 1-D damped least squares inversion method was then conducted to obtained shear wave velocity model. Finally, the average ($\tilde{\rm V}$S) of the calculated VSV and VSH quasi 3-D models were used to characterize the crustal structure. Besides the checkerboard test resolution, a stochastic test with the effect of errors in the dispersion curves and choice of inversion parameters were carried out to better evaluate model uncertainties. Our results show a clear relation between the sedimentary thickness and geological units with the shorter period tomographic maps. Agreement has also been observed in longer periods such as the clear N–S anomaly along the Asuncion and Rio Grande Arches representing the boundary between the Chaco-Paraná and the Paraná basins. A 3-D composite velocity model shows a crustal structure consisting of three main layers. Some differences in lower crustal properties were found between the Paraná and Chaco-Paraná basins, consistent with a recently postulated, gravity-derived Western Paraná suture zone. However, no high velocities along the SW–NE axis of the Paraná basin were found to confirm proposed underplating. At the eastern edge of the Pantanal basin, the thin crust seems to be associated with a very thin (or lack of) lower crustal layer, consistent with a recently proposed crustal delamination hypothesis for the formation of the Pantanal basin.
A Bayesian hierarchical approach to estimate growth parameters from length data of narrow spread
Authors: Zhou Shijie , Martin Sarah , Fu Dan , Sharma Rishi
Published: November 2019

Estimating fish growth from length frequency data is challenging. There is often a lack of clearly separated modes and modal progression in the length samples due to a combination of factors, including gear selectivity, slowing growth with increasing age, and spatial segregation of different year classes. In this study, we present an innovative Bayesian hierarchical model (BHM) that enables growth to be estimated where there are few distinguishable length modes in the samples. We analyse and identify the modes in multiple length frequency strata using a multinormal mixture model and then integrate the modes and associated variances into the BHM to estimate von Bertalanffy growth parameters. The hierarchical approach allows the parameters to be estimated at regional levels, where they are assumed to represent subpopulations, as well as at species level for the whole stock. We carry out simulations to validate the method and then demonstrate its application to Indian Ocean longtail tuna (Thunnus tonggol). The results show that the estimates are generally consistent with the range of estimates reported in the literature, but with less uncertainty. The BHM can be useful for deriving growth parameters for other species even if the length data contain few age classes and do not exhibit modal progression.
Safety of high-dose ivermectin: a systematic review and meta-analysis
Authors: Navarro Miriam , Camprubí Daniel , Requena-Méndez Ana , Buonfrate Dora , Giorli Giovanni , Kamgno Joseph , Gardon Jacques , Boussinesq Michel , Muñoz Jose , Krolewiecki Alejandro
Published: December 2019

Background

Ivermectin is a key anthelmintic for the control of neglected tropical diseases. The main indications for population-level control with ivermectin through mass drug administration are onchocerciasis and lymphatic filariasis; however, there is interest in using higher, fixed-dose regimens for the control of scabies, soil-transmitted helminths and malaria. Safety data for these higher-dose regimens are needed.

Methods

A systematic literature review and meta-analysis on the safety and doses of ivermectin was conducted. Eligible studies reported patient-level data and, for the meta-analysis, clinical trials reporting data on doses ≥200 and ≥400 μg/kg were included. Incidence ratios were used to compare adverse events by severity and organ system affected.

Results

The systematic search identified six studies for inclusion, revealing no differences in the number of individuals experiencing adverse events. A descriptive analysis of these clinical trials for a variety of indications showed no difference in the severity of the adverse events between standard (up to 400 μg/kg) and higher doses of ivermectin. Organ system involvement only showed an increase in ocular events in the higher-dose group in one trial for the treatment of onchocerciasis, all of them transient and mild to moderate in intensity.

Conclusions

Although within this review the safety of high-dose ivermectin appears to be comparable to standard doses, there are not enough data to support a recommendation for its use in higher-than-approved doses. Ocular adverse events, despite being transient, are of concern in onchocerciasis patients. These data can inform programme managers and guide operational research activities as new approaches for the use of ivermectin are evaluated.
A monoclonal antibody recognizing a new epitope on CD81 inhibits T-cell migration without inducing cytokine production
Authors: Hasezaki Takuya , Yoshima Tadahiko , Mattsson Mikael , Särnefält Anna , Takubo Keiko
Published: December 2019

CD81 is involved in leukocyte migration and cytokine induction. Previous work found that anti-CD81 monoclonal antibodies (mAbs) showed therapeutic potential for several immune diseases via inhibiting leukocyte migration. Although the suppression of cell migration is a promising approach for treating immune diseases, some anti-CD81 mAbs can induce cytokine production, which may exacerbate disease. To obtain new anti-human CD81 mAbs that inhibited migration in the absence of cytokine production enhancement activity, we screened a human single chain variable fragment by phage library. One of the new anti-CD81 mAbs isolated, DSP-8250, had equivalent inhibitory cell migration activity with the established anti-CD81 mAb 5A6, but it lacked cytokine induction activity. These mAbs recognized different epitopes on CD81. mAb 5A6, which had inhibitory activity on T-cell migration and increased cytokine production, bound to three residues, Ser179, Asn180 and Phe186 of CD81. In contrast, DSP-8250, which had inhibitory activity on T-cell migration but no cytokine enhancement activity, bound to four residues, His151, Ala164, Ser168 and Asn172 of CD81 as a unique epitope. These results indicate that the set of His151, Ala164, Ser168 and Asn172 forms a novel epitope that might make the application of anti-CD81 mAb therapeutically useful.
Teaching Climate Law: Trends, Methods and Outlook
Authors: Mehling Michael , van Asselt Harro , Kulovesi Kati , Morgera Elisa
Published: December 2019

Climate change presents unique challenges for legal education. As a subject matter, it is technically complex and normatively contested, evolves at a dynamic pace and crosses established boundaries between academic disciplines, branches of law, and levels of jurisdiction. Still, it has, by now, firmly entered the legal curriculum through general and specialised courses, and is also increasingly featured in courses on neighbouring areas of law. This article offers an initial, exploratory survey of the current state of climate law education, including courses, degree programmes, and teaching material, as well as teaching methods and the role of interdisciplinary approaches. Based on this survey, it identifies broader trends in the still nascent field, including a tendency towards consolidation and specialisation. Climate law will evolve over time, as will approaches to its instruction. For future climate lawyers, practical skills and sound judgment will therefore weigh more heavily than exhaustive command of doctrinal detail. Interactive teaching formats and experiential learning are therefore recommended as integral elements of climate law education, as is cautious exploration of an interdisciplinary approach to the topic.
Toward a blood-free diet for Anopheles darlingi (Diptera: Culicidae)
Authors: da Silva Costa Glaucilene , Rodrigues Moreno Magalhães Souza , Silva Alexandre de Almeida e
Published: December 2019

Due to ethical issues associated with the use of blood for mosquito laboratory experiments, an artificial diet that supports the production of eggs and larvae is highly desirable. We report the development of an artificial diet using direct feeding on protein-rich sugar solution (PRSS) as an alternative to whole blood and evaluated its effects on several biologic parameters of Anopheles darlingi (Root). Field-collected females were fed with different PRSSs containing bovine serum albumin (BSA) at 200 and 400 mg/ml with or without supplemental salts. Engorged mosquitoes were monitored for survival to oviposition, before being forced to oviposit. The proportion ovipositing, number of eggs, and number of larvae were recorded for each treatment. Mosquitoes promptly engorged on PRSSs. The mean proportion of mosquitoes fed with PRSS that survived to oviposition did not differ statistically from that of blood-fed ones. The oviposition proportion of females fed with PRSS at 200 mg/ml was similar to that of blood-fed mosquitoes, whereas mean egg production was lower for most PRSS-fed females, except for those fed with BSA at 400 mg/ml. However, the mean larval production of PRSS-fed mosquitoes was significantly lower than that of blood-fed females. Although feeding An. darlingi on simple PRSS triggered oogenesis and embryogenesis, our results highlight the need for additional nutrients to increase the number of larvae to improve overall reproduction potential.
Concordant PET/CT and ICG positive lymph nodes in endometrial cancer: a case of mistaken identity
Authors: Lee Hong L , Farrell Rhonda , Kamath Vasanth , Ho-Shon Ivan , Yap Francis
Published: December 2019

Endometrial carcinoma is the most common gynecological malignancy in developed countries. In early stage endometrial cancer, routine systemic pelvic lymphadenectomy showed no survival benefits and results in increased morbidity. The role of PET/CT imaging for the pre-operative detection of lymph node metastases in endometrial cancer is unclear. Sentinel lymph node (SLN) mapping may reduce the surgical staging morbidity while maintaining prognostic information of the lymph node status. Recently, indocyanine green (ICG) SLN mapping has been utilized to detect nodal metastasis in endometrial cancer. Endosalpingiosis is defined as the presence of tubal-like epithelium outside of the fallopian tube and can sometimes be misinterpreted as cancer metastasis. Here, we discuss a patient with newly diagnosed endometrial cancer who had pelvic and para-aortic lymph nodes with high glucose avidity on PET/CT, and ICG positivity on SLN mapping, suspected clinically to be metastatic adenocarcinoma, but with the pathological finding of endosalpingiosis only.
Antimicrobial Stewardship Challenges in the Deployed Setting
Authors: Barsoumian Alice E , Roth Amanda L , Solberg Steffanie L , Hanhurst Ashley S , Funari Tamara S , Crouch Helen , Florez Christopher , Murray Clinton K
Published: December 2019

Introduction

Up to 34% of combat trauma injuries are complicated by infection with multidrug-resistant organisms. Overutilization of antibiotics has been linked to increased multidrug-resistant organisms in combat-injured patients. Antimicrobial stewardship efforts at deployed medical treatment facilities have been intermittently reported; however; a comprehensive assessment of antimicrobial stewardship practices has not been performed.

Materials and Methods

A survey tool was modified to include detailed questions on antimicrobial stewardship practices at medical treatment facilities. A Joint Service, multidisciplinary team conducted on-site assessments and interviews to assess the status of antimicrobial stewardship best practices, with particular emphasis on antibiotic prophylaxis in combat injured, in the U.S. Central Command operational theaters. Limitations to implementing stewardship to the national standards were explored thematically.

Results

Nine Role 1, 2, and 3 medical facilities representing the range of care were assessed on-site. A total of 67% of the sites reported a formal antimicrobial stewardship program and 56% of the sites had an assigned head of antimicrobial stewardship. No military personnel in theater received training on antimicrobial stewardship and laboratory assets were limited. Personnel at these sites largely had access to Joint Trauma System guidelines describing antimicrobial prophylaxis for combat injured (89%), yet infrequently received feedback on their implementation and adherence to these guidelines (11%).

Conclusions

Antimicrobial stewardship programs in theater are in the early stages of development in theater. Areas identified for improvement are access to expertise, development of a focus on high-impact lines of effort, laboratory support, and the culture of antimicrobial prescribing. Risks can be mitigated through theater level formalization of efforts, expert mentoring through telehealth, and a focus on implementation and adherence and feedback to national guidelines.
Inward bound: the incredible journey of massive black holes as they pair and merge – I. The effect of mass ratio in flattened rotating galactic nuclei
Authors: Khan Fazeel Mahmood , Mirza Muhammad Awais , Holley-Bockelmann Kelly
Published: December 2019

Understanding how supermassive black holes (SMBHs) pair and merge helps to inform predictions of off-centre, dual, and binary active galactic nuclei (AGNs), and provides key insights into how SMBHs grow and co-evolve with their galaxy hosts. As the loudest known gravitational wave source, binary SMBH mergers also hold centrestage for the Laser Interferometer Space Antenna (LISA), a joint ESA/NASA gravitational wave observatory set to launch in 2034. Here, we continue our work to characterize SMBH binary formation and evolution through increasingly more realistic high-resolution direct N-body simulations, focusing on the effect of SMBH mass ratio, orientation, and eccentricity within a rotating and flattened stellar host. During the dynamical friction phase, we found a prolonged orbital decay for retrograde SMBHs and swift pairing time-scales for prograde SMBHs compared to their counterparts in non-rotating models, an effect that becomes more pronounced for smaller mass ratios Msec/Mprim = q. During this pairing phase, the eccentricity dramatically increases for retrograde configurations, but as the binary forms, the orbital plane flips so that it is almost perfectly prograde, which stifles the rapid eccentricity growth. In prograde configurations, SMBH binaries form and remain at comparatively low eccentricities. As in our prior work, we note that the centre of mass of a prograde SMBH binary itself settles into an orbit about the centre of the galaxy. Since even the initially retrograde binaries flip their orbital plane, we expect few binaries in rotating systems to reside at rest in the dynamic centre of the host galaxy, though this effect becomes smaller as q decreases.
The magnetic field and accretion regime of CI Tau
Authors: Donati J-F , Bouvier J , Alencar S H , Moutou C , Malo L , Takami M , Ménard F , Dougados C , Hussain G A ,   the MaTYSSE collaboration
Published: December 2019

This paper exploits spectropolarimetric data of the classical T Tauri star CI Tau collected with ESPaDOnS at the Canada–France–Hawaii Telescope, with the aims of detecting and characterizing the large-scale magnetic field that the star hosts, and of investigating how the star interacts with the inner regions of its accretion disc through this field. Our data unambiguously show that CI Tau has a rotation period of 9.0 d, and that it hosts a strong, mainly poloidal large-scale field. Accretion at the surface of the star concentrates within a bright high-latitude chromospheric region that spatially overlaps with a large dark photospheric spot, in which the radial magnetic field reaches −3.7 kG. With a polar strength of −1.7 kG, the dipole component of the large-scale field is able to evacuate the central regions of the disc up to about 50 per cent of the co-rotation radius (at which the Keplerian orbital period equals the stellar rotation period) throughout our observations, during which the average accretion rate was found to be unusually high. We speculate that the magnetic field of CI Tau is strong enough to sustain most of the time a magnetospheric gap extending to at least 70 per cent of the co-rotation radius, which would explain why the rotation period of CI Tau is as long as 9 d. Our results also imply that the 9 d radial velocity (RV) modulation that CI Tau exhibits is attributable to stellar activity, and thus that the existence of the candidate close-in massive planet CI Tau b to which these RV fluctuations were first attributed needs to be reassessed with new evidence.
Short- and long-term near-infrared spectroscopic variability of eruptive protostars from VVV
Authors: Guo (郭震) Zhen , Lucas P W , Contreras Peña C , Kurtev R G , Smith L C , Borissova J , Alonso-García J , Minniti D , Caratti o Garatti A , Froebrich D
Published: December 2019

Numerous eruptive variable young stellar objects (YSOs), mostly Class I systems, were recently detected by the near-infrared Vista Variables in the Via Lactea (VVV) survey. We present an exploratory near-infrared spectroscopic variability study of 14 eruptive YSOs. The variations were sampled over one-day and one-to-two-year intervals and analysed in combination with VVV light curves. CO overtone absorption features are observed on three objects with FUor-like spectra: all show deeper absorption when they are brighter. This implies stronger emission from the circumstellar disc with a steeper vertical temperature gradient when the accretion rate is higher. This confirms the nature of fast VVV FUor-like events, in line with the accepted picture for classical FUors. The absence of Brγ emission in a FUor-like object declining to pre-outburst brightness suggests that reconstruction of the stellar magnetic field is a slow process. Within the one-day time-scale, 60 per cent of H2-emitting YSOs show significant but modest variation, and 2/6 sources have large variations in Brγ. Over year-long time-scales, H2 flux variations remain modest despite up to 1.8 mag variation in Ks. This indicates that emission from the molecular outflow usually arises further from the protostar and is unaffected by relatively large changes in accretion rate on year-long time-scales. Two objects show signs of on/off magnetospheric accretion traced by Brγ emission. In addition, a 60 per cent inter-night brightening of the H2 outflow is detected in one YSO.
Free energy landscape of salt-actuated reconfigurable DNA nanodevices
Authors: Shi Ze , Arya Gaurav
Published: December 2019

Achieving rapid, noninvasive actuation of DNA structures is critical to expanding the functionality of DNA nanotechnology. A promising actuation approach involves introducing multiple, short pairs of single-stranded DNA overhangs to components of the structure and triggering hybridization or dissociation of the overhangs via changes in solution ionic conditions to drive structural transitions. Here, we reveal the underlying basis of this new approach by computing via molecular simulations the free energy landscape of DNA origami hinges actuated between open and closed states. Our results reveal how the overhangs collectively introduce a sharp free-energy minimum at the closed state and a broad energy barrier between open and closed states and how changes in ionic conditions modulate these features of the landscape to drive actuation towards the open or closed state. We demonstrate the critical role played by hinge confinement in stabilizing the hybridized state of the overhangs and magnifying the energy barrier to dissociation. By analyzing how the distribution of overhangs and their length and sequence modulate the energy landscape, we obtain design rules for tuning the actuation behavior. The molecular insights obtained here should be applicable to a broad range of systems involving DNA hybridization within confined systems.
Sodium-glucose cotransporter 2 inhibition: which patient with chronic kidney disease should be treated in the future?
Authors: Neuen Brendon L , Jardine Meg J , Perkovic Vlado
Published: November 2019

The advent of sodium-glucose cotransporter 2 (SGLT2) inhibitors represents a major advance for people with type 2 diabetes (T2DM) and chronic kidney disease (CKD). The results of the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial have clearly demonstrated that canagliflozin prevents kidney failure and cardiovascular events. The results from three other large-scale randomized trials, collectively enrolling >30 000 participants, have provided further evidence that the effects of SGLT2 inhibition on major kidney outcomes in people with T2DM may be present across the class, although this will only be known for certain when Dapagliflozin and Renal Outcomes and Cardiovascular Mortality in Patients with CKD (DAPA-CKD) (NCT03036150) and The Study of Heart and Kidney Protection with Empagliflozin (EMPA-KIDNEY) (NCT03594110) are reported over coming years. Importantly, the benefits of SGLT2 inhibition have been achieved in addition to the current standard of care. This review summarizes evidence for SGLT2 inhibition in people with T2DM and CKD, evaluates key patient characteristics and concomitant drug use that may influence the use of these drugs in people with CKD, discusses current guideline recommendations and explores how these drugs may be used in people with CKD in the future, including in combination with other treatments.
The Association Between Smoking and Gut Microbiome in Bangladesh
Authors: Nolan-Kenney Rachel , Wu Fen , Hu Jiyuan , Yang Liying , Kelly Dervla , Li Huilin , Jasmine Farzana , Kibriya Muhammad G , Parvez Faruque , Shaheen Ishrat , Sarwar Golam , Ahmed Alauddin , Eunus Mahbub , Islam Tariqul , Pei Zhiheng , Ahsan Habibul , Chen Yu
Published: December 2019

Introduction

Epidemiological studies that investigate alterations in the gut microbial composition associated with smoking are lacking. This study examined the composition of the gut microbiome in smokers compared with nonsmokers.

Aims and Methods

Stool samples were collected in a cross-sectional study of 249 participants selected from the Health Effects of Arsenic Longitudinal Study in Bangladesh. Microbial DNA was extracted from the fecal samples and sequenced by 16S rRNA gene sequencing. The associations of smoking status and intensity of smoking with the relative abundance or the absence and presence of individual bacterial taxon from phylum to genus levels were examined.

Results

The relative abundance of bacterial taxa along the Erysipelotrichi-to-Catenibacterium lineage was significantly higher in current smokers compared to never-smokers. The odds ratio comparing the mean relative abundance in current smokers with that in never-smokers was 1.91 (95% confidence interval = 1.36–2.69) for the genus Catenibacterium and 1.89 (95% confidence interval = 1.39–2.56) for the family Erysipelotrichaceae, the order Erysipelotrichale, and the class Erysipelotrichi (false discovery rate-adjusted p values = .0008–.01). A dose–response association was observed for each of these bacterial taxa. The presence of Alphaproteobacteria was significantly greater comparing current with never-smokers (odds ratio = 4.85, false discovery rate-adjusted p values = .04).

Conclusions

Our data in a Bangladeshi population are consistent with evidence of an association between smoking status and dosage with change in the gut bacterial composition.

Implications

This study for the first time examined the relationship between smoking and the gut microbiome composition. The data suggest that smoking status may play an important role in the composition of the gut microbiome, especially among individuals with higher levels of tobacco exposure.
Support for E-cigarette and Tobacco Control Policies Among Parents of Adolescents
Authors: Czaplicki Lauren , Perks Siobhan N , Liu Michael , Cuccia Alison , Patel Minal , Vallone Donna , Schillo Barbara
Published: December 2019

Introduction

Parents are essential stakeholders for policy implementation. However, data on parents’ support for e-cigarette- and tobacco-related policies is limited. This study examines parents’ support for five e-cigarette- and tobacco-related policies targeted to prevent youth initiation and exposure to industry marketing practices.

Methods

Data were from a 2018 nationally representative sample of US parents of 11- to 18-year-old middle and high school students. Weighted adjusted logistic regression models examined correlates of support for policy outcomes, controlling for demographics. Analyses were performed among the full sample (n = 2743) and among current tobacco users (n = 355).

Results

The majority of parents, including current tobacco users, supported tobacco control efforts to protect adolescents. More than 90% of all parents supported restrictions on e-cigarette marketing to youth and 75% supported a ban on flavored e-cigarette sales. Additionally, more than 80% of all parents supported increasing the age of tobacco product sale to 21, limiting tobacco retailer density near schools, and keeping tobacco products out of view where youth shop. Presence of strict home tobacco rules or reporting a high priority to prevent child’s e-cigarette use were significantly associated with higher odds of policy support. Results were similar among current tobacco users.

Conclusions

Parents are an important group of tobacco control stakeholders and should be utilized to garner support for tobacco control policies in the context of the recent growth in youth tobacco and e-cigarette use. Parents’ public support for tobacco control policies, particularly regulations on e-cigarette sales and marketing, can motivate advocates and policymakers to advance tobacco control policy agendas.

Implications

Youth tobacco and e-cigarette use in the United States has increased in recent years. Parents are important stakeholders to inform policy agendas and advance efforts to restrict youth access and exposure to tobacco products. This study provides evidence that parents of adolescents are highly supportive of youth-centered tobacco control policies, particularly those that restrict access to youth-targeted e-cigarette marketing and the sale of youth-appealing flavored e-cigarettes. Utilizing policy support to mobilize parents may be an important advocacy strategy to advance tobacco control policy agendas and curb rising rates of youth e-cigarette and tobacco use.
Association between physical activity and sickness absenteeism in university workers
Authors: López-Bueno R , Smith L , Andersen L L , López-Sánchez G F , Casajús J A
Published: December 2019

Background

Sedentary occupations have increased by more than 10% in Western countries over the last two decades, and the yearly global cost of physical inactivity has been estimated to be $53.8 billion. As workers tend to move less in the workplace, they are more likely to develop a sedentarism-related chronic condition and to be absent from work due to illness, although research evidence on the issue remains unclear.

Aims

To investigate associations between physical activity (PA) and sickness absenteeism in the workplace among Spanish university workers.

Methods

We conducted cross-sectional research with data from 1025 workers aged 18–65 years (43% women) from a Spanish university. Physical Activity Vital Sign (PAVS) and International Physical Activity Questionnaire (IPAQ) short versions were used to evaluate levels of PA. Workplace absenteeism was self-reported by participants. Written questionnaires distributed during medical checks included PAVS, IPAQ and the question about absenteeism among other information. The association between PA and sickness absenteeism was examined using adjusted multiple linear regression.

Results

After adjusting for age, sex, job function, chronic conditions, sedentarism and smoking, each weekly hour of PA reduced sickness absence by −1.20 (95% confidence interval: −2.40–0.00) days per year.

Conclusions

The implementation of PA promotion strategies aimed at university employees may lead to a reduction of days off work due to illness.
An unusual cause of lacunar infarcts: Lambl’s excrescences on aortic valve shown in detail by 3D transesophageal echocardiography
Authors: Çöllüoğlu Tuğçe , Önalan Orhan
Published: November 2019

Lambl’s excrescences (LE) are rare cardiac structures. They are associated with catastrophic thromboembolic and coronary events. Despite resulting in such important events, 2D echocardiographic imaging modalities may overlook LE owing to very thin cardiac structures. So, 3D echocardiographic imaging modalities may fully offer this cardiac mass and provide us to more accurately guess the complication rate related to LE due to the fact that 3D echocardiographic imaging techniques have higher spatial resolution and are not based on the geometric assumption. Indeed, another benefit of 3D echocardiographic imaging modalities in this population is that these imaging modalities clearly provide the relationship to adjacent structures of LE and its movement over a cardiac cycle in 3D space. In our case report, we aim to present the usefulness of 3D echocardiography as a modality to clearly offer all features of LE, furthermore to give valuable information about management in patients with thromboembolic events leading to LE.
A case of tracheal pleomorphic adenoma misdiagnosed as asthma
Authors: Takahashi Mamoru , Yorozuya Takahumi , Miyasaka Yuki , Kodama Kentaro , Yoshikawa Takumi , Taya Tetsuya , Mori Yuki , Ikeda Kimiyuki , Miyajima Satsuki , Chiba Hirofumi , Takahashi Hiroki
Published: November 2019

A 51-year-old woman had an incidental finding of a tracheal tumor during oesophagogastroduodenoscopy following the diagnosis of asthma for 2 months. A computed tomography scan revealed a 15-mm tumor in the subglottis. Endoscopic resection was performed safely, and pleomorphic adenoma was diagnosed histologically. The patient’s condition was satisfactory 30 months after the procedure. Tracheal pleomorphic adenoma is rare and may be misdiagnosed as asthma. If the tumor is large, surgery may be required; however, endoscopic polypectomy may be effective if the tumor is small. Therefore, early diagnosis of tracheal pleomorphic adenoma is important. At the first visit, the flow–volume curve suggested upper airway obstruction, which should have raised the suspicion of an upper airway obstruction. In patients with suspected asthma, early pulmonary function testing is needed to substantiate asthma diagnosis and prevent an alternative diagnosis being missed.
Addition of Slowly Repeated Evoked Pain Responses to Clinical Symptoms Enhances Fibromyalgia Diagnostic Accuracy
Authors: de la Coba Pablo , Bruehl Stephen , del Paso Gustavo A. Reyes
Published: December 2019

Objective

Fibromyalgia is a chronic pain syndrome characterized by central sensitization. A novel protocol based on slowly repeated evoked pain (SREP) appears to be a useful marker of pain sensitization in fibromyalgia patients. Whether SREP enhances diagnostic accuracy beyond key clinical symptoms that characterize fibromyalgia has not been examined.

Methods

Fifty fibromyalgia patients, 30 rheumatoid arthritis patients, and 50 healthy individuals were evaluated to assess clinical pain, as well as fatigue, insomnia, pain catastrophizing, and negative mood. The SREP protocol consisted of a series of nine low-intensity painful pressure stimuli of five seconds’ duration with 30-second interstimulus intervals. SREP sensitization was indexed by increases in pain intensity ratings across stimuli.

Results

SREP sensitization was observed in fibromyalgia but not in rheumatoid arthritis or healthy individuals. As expected, fibromyalgia patients exhibited a more negative psychosocial profile than did rheumatoid arthritis patients and healthy individuals. SREP was positively associated with clinical pain, fatigue, insomnia, and catastrophizing, but not with negative mood. SREP discriminated fibromyalgia cases from rheumatoid arthritis and healthy individuals even when current clinical pain was included in the analysis. Combining fatigue, insomnia, and SREP led to near perfect diagnostic accuracy (99%) in differentiating fibromyalgia from healthy individuals and 86.3% accuracy in discriminating fibromyalgia from rheumatoid arthritis.

Conclusions

These results provide further evidence of SREP as a marker of pain sensitization in fibromyalgia and suggest that it captures aspects of fibromyalgia not fully captured by clinical features. Combining SREP with assessment of clinical features could potentially improve fibromyalgia diagnosis.
Behçet: the syndrome
Authors: Bettiol Alessandra , Prisco Domenico , Emmi Giacomo
Published: December 2019

Behçet’s syndrome (BS) is a systemic vasculitis characterized by a relapsing and remitting course. It can involve the skin, mucosa, joints, vessels (arteries and/or veins), eyes, and nervous and gastrointestinal systems, and so is referred to as a syndrome rather than as a unique and nosologically distinct condition. These involvements may present alone or co-exist in the same patient. Although all the possible combinations of the above-mentioned manifestations may occur, clusters of commonly co-existing involvements (also referred to as ‘disease phenotypes’) have been suggested, namely ‘mucocutaneous and articular’, ‘peripheral vascular and extra-parenchymal neurological’ and ‘parenchymal neurological and ocular’ phenotypes have been described. Patient-specific demographic and genetic features have been described as positively or negatively associated with specific disease phenotypes. This review will focus on the different clinical features of Behçet’s syndrome, summarizing current evidence on the distinct disease manifestations as well as the major phenotypes.
Selection for bull fertility: a review
Authors: Butler Madison L , Bormann Jennifer M , Weaber Robert L , Grieger David M , Rolf Megan M
Published: December 2019

Fertility is a critically important factor in cattle production because it directly relates to the ability to produce the offspring necessary to offset costs in production systems. Female fertility has received much attention and has been enhanced through assisted reproductive technologies, as well as genetic selection; however, improving bull fertility has been largely ignored. Improvements in bull reproductive performance are necessary to optimize the efficiency of cattle production. Selection and management to improve bull fertility not only have the potential to increase conception rates but also have the capacity to improve other economically relevant production traits. Bull fertility has reportedly been genetically correlated with traits such as average daily gain, heifer pregnancy, and calving interval. Published studies show that bull fertility traits are low to moderately heritable, indicating that improvements in bull fertility can be realized through selection. Although female fertility has continued to progress according to increasing conception rates, the reported correlation between male and female fertility is low, indicating that male fertility cannot be improved by selection for female fertility. Correlations between several bull fertility traits, such as concentration, number of spermatozoa, motility, and number of spermatozoa abnormalities, vary among studies. Using male fertility traits in selection indices would provide producers with more advanced selection tools. The objective of this review was to discuss current beef bull fertility measurements and to discuss the future of genetic evaluation of beef bull fertility and potential genetic improvement strategies.
Mathematics educators are speaking about PISA, aren’t they?
Authors: Giberti Chiara , Maffia Andrea
Published: December 2019

This paper sets out to explore the different uses made of Organisation for Economic Co-operation and Development Program for International Student Assessment (OECD-PISA) tests and data in mathematics education research. Through a comprehensive literature review of journals and conference papers, we show that although a large variety of topics is addressed, they do not cover all the topics considered in mathematics education research. Analysing the temporal and geographical distribution of papers, we find that there is increasing interest in the use of PISA in our field of research and that different countries are involved in different ways in mathematics education research about PISA. As a conclusion, we suggest that critical research into the effect of PISA can be developed further, especially in those countries that have joined the OECD survey in recent years. Other future research paths using data from PISA are detected.
Phylogeny, taxonomy and distribution of the Neotropical lizard genus Echinosaura (Squamata: Gymnophthalmidae), with the recognition of two new genera in Cercosaurinae
Authors: Vásquez-Restrepo Juan D , Ibáñez Roberto , Sánchez-Pacheco Santiago J , Daza Juan M
Published: December 2019

The family Gymnophthalmidae is a highly diverse Neotropical lizard clade. Although multiple phylogenetic and taxonomic studies have reshaped our understanding of gymnophthalmid systematics and diversity, many groups remain understudied. This is the case for the cercosaurine genus Echinosaura, which includes eight species of small riparian lizards distributed across lower Central America and northern South America. Here, we present a comprehensive phylogenetic analysis of Echinosaura, including DNA data for all species of the genus for the first time. To rigorously test the relationships of all Echinosaura, we have assembled the largest molecular dataset of cercosaurine lizards to date. Our analysis refutes the monophyly of Echinosaura, with E. apodema and E. sulcarostrum not closely related to the remaining species. To remedy the polyphyly of Echinosaura, we describe two new genera for E. apodema and E. sulcarostrum. Morphological distinctiveness and biogeography further support these taxonomic changes. In light of our phylogenetic results, we review the species-level taxonomy of the redefined Echinosaura based on morphological and genetic variation. We resurrect E. centralis and designate a neotype given the absence of type and topotypic material. In addition, we provide taxonomic accounts for each species and analyse their patterns of geographic distribution.
Palliative Care Engagement for Pediatric Ventricular Assist Device Patients: A Single-Center Experience
Authors: Knoll Christopher , Kaufman Beth , Chen Sharon , Murray Jenna , Cohen Harvey , Sourkes Barbara M. , Rosenthal David N. , Hollander Seth A.
Published: December 2019

Outcomes in pediatric patients with ventricular assist devices (VADs) for advanced heart failure (HF) are improving, but the risk of associated morbidity and mortality remains substantial. Few data exist on the involvement of pediatric palliative care (PPC) in this high-risk patient population. We aimed to characterize the extent of palliative care involvement in the care of patients requiring VAD placement at our institution. Single-center retrospective chart review analyzing all VAD patients at a large pediatric center over a 4 year period. Timing and extent of palliative care subspecialty involvement were analyzed. Between January 2014 and December 2017, 55 HF patients underwent VAD implantation at our institution. Pediatric palliative care utilization steadily increased over consecutive years (2014: <10% of patients, 2015: 20% of patients, 2016: 50% of patients, and 2017: 65% of patients) and occurred in 42% (n = 23) of all patients. Of these, 57% (n = 13) occurred before VAD placement while 43% (n = 10) occurred after implantation. Patients who died during their VAD implant hospitalization (24%, n = 13) were nearly twice as likely to have PPC involvement (62%) as those who reached transplant (38%). Of those who died, patients who had PPC involved in their care were more likely to limit resuscitation efforts before their death. Four patients had advanced directives in place before VAD implant, of which three had PPC consultation before device placement. Three families (5%) refused PPC involvement when offered. Pediatric palliative care utilization is increasing in VAD patients at our institution. Early PPC involvement occurred in the majority of patients and appears to lead to more frequent discussion of goals-of-care and advanced directives.
The relationship of chronic rhinosinusitis and depression
Authors: Smith Kristine A. , Alt Jeremiah A.
Published: December 2019

Purpose of review

The aim of this article is to identify and describe the relationship between chronic rhinosinusitis (CRS) and comorbid depression, including the patient factors that may increase the risk of depression. The impact of comorbid depression on quality of life, response to treatment and healthcare utilization will also be assessed.

Recent findings

CRS is associated with a significantly increased prevalence of depression, where 9–26% of patients with CRS will have physician-diagnosed depression. An additional 40% will have undiagnosed depression that can be identified through screening tools. Patients without polyps are more likely to experience comorbid depression, as are patients with significant sleep dysfunction, olfactory dysfunction, and pain. CRS symptoms do improve with medical and surgical therapy in depressed patients, though baseline and posttreatment scores are worse. A similar degree of benefit from therapy is seen in both depressed and nondepressed patients. CRS treatment does seem to improve depression, whereas the effect of depression specific therapy is unknown. Depressed patients have a significantly larger economic burden because of their increased healthcare utilization and productivity losses.

Depression is a highly prevalent and impactful comorbidity in patients with CRS. Increased awareness of this relationship may improve patients’ overall quality of care.
Online interventions for sexual health in cancer
Authors: Matthew Andrew G. , Yang Zhiyong G.
Published: December 2019

Purpose of review

Recent advances in digital healthcare, combined with the increasing appreciation for the need for sexual health programming in cancer, has established a zeitgeist for further development of digital health interventions for sexual health in cancer. Developers of digital health interventions should consider two equally important factors: efficacy of the intervention, and participant engagement. This review describes the status of digital health interventions in sexual health within the oncology setting.

Recent findings

Sexual dysfunction and related psychological distress affecting patients and their partners is recognized as a significant survivorship care need in the oncology setting. Provision of care is challenged by traditional approaches to disease follow-up, and limited healthcare resources. Digital health interventions may offer efficient, accessible, and scalable care pathways. Digital health innovation in cancer survivorship and sexual health indicates trends toward efficacy, yet patient engagement remains a challenge. Implementation of established online patient engagement approaches are recommended.

Studies to date may underestimate the potential of digital health interventions in sexual health and cancer due to poor patient engagement. Developers of digital health intervention will benefit from effort in employing engagement strategies and engagement-efficacy analysis.
The conflict within: origin, proliferation and persistence of a spontaneously arising selfish mitochondrial genome
Authors: Dubie Joseph James , Caraway Avery Robert , Stout McKenna Margaret , Katju Vaishali , Bergthorsson Ulfar
Published: December 2019

Mitochondrial genomes can sustain mutations that are simultaneously detrimental to individual fitness and yet, can proliferate within individuals owing to a replicative advantage. We analysed the fitness effects and population dynamics of a mitochondrial genome containing a novel 499 bp deletion in the
cytochrome b(1)
(
ctb-1
) gene (Δ
ctb-1
) encoding the cytochrome
b
of complex III in
Caenorhabditis elegans.
Δ
ctb-1
reached a high heteroplasmic frequency of 96% in one experimental line during a mutation accumulation experiment and was linked to additional spontaneous mutations in
nd5
and
tRNA-Asn
. The Δ
ctb-1
mutant mitotype imposed a significant fitness cost including a 65% and 52% reduction in productivity and competitive fitness, respectively, relative to individuals bearing wild-type (WT) mitochondria. Deletion-bearing worms were rapidly purged within a few generations when competed against WT mitochondrial DNA (mtDNA) bearing worms in experimental populations. By contrast, the Δ
ctb-1
mitotype was able to persist in large populations comprising heteroplasmic individuals only, although the average intracellular frequency of Δ
ctb-1
exhibited a slow decline owing to competition among individuals bearing different frequencies of the heteroplasmy. Within experimental lines subjected to severe population bottlenecks (
n
= 1), the relative intracellular frequency of Δ
ctb-1
increased, which is a hallmark of selfish drive. A positive correlation between Δ
ctb-1
and WT mtDNA copy-number suggests a mechanism that increases total mtDNA
per se
, and does not discern the Δ
ctb-1
mitotype from the WT mtDNA. This study demonstrates the selfish nature of the Δ
ctb-1
mitotype, given its transmission advantage and substantial fitness load for the host, and highlights the importance of population size for the population dynamics of selfish mtDNA.

This article is part of the theme issue ‘Linking the mitochondrial genotype to phenotype: a complex endeavour’.