bluuebunny/crossref_metadata_2025 huggingface dataset:
One-pot Synthesis of Hierarchical Mesoporous ZSM-5 from the Assembly of Nanocrystals Using Urea as Additive
Authors: Ma Yuanyuan , Li Zhifang , Zhao Nan , Han Fuzhong , Kan Qiubin
Published: January 2020

A hierarchical mesoporous ZSM-5 catalyst with aggregated nanocrystals structure was one-pot hydrothermally synthesized by using urea as the additive. The crystalline phase, morphology and hierarchical architectures were characterized by the XRD, SEM, TEM and N2 adsorption/desorption analyses. The nano-aggregates showed MFI crystalline phase and were composed of connected nanoparticles. The samples had the high surface area and the pore volume from intercrystalline among the nanoparticles due to spontaneously stacking of nanocrystals. The pyridine-adsorbed FTIR and the catalytic performances in the alkylation of phenol and tert-butyl alcohol were applied to evaluate the accessibility of acid sites and the catalytic activities for the hierarchical mesoporous ZSM-5 samples. The samples possessed high accessibility of acid sites which resulted from their large amount of mesopores, and its catalytic activity was improved dramatically. The phenol conversion could reach up to 95.6%, and the corresponding selectivity of 4-TBP and 2,4-DTBP was 44% and 51.5%, respectively.
Enabling Precision Oncology Through Precision Diagnostics
Authors: Brown Noah A. , Elenitoba-Johnson Kojo S.J.
Published: January 2020

Genomic testing enables clinical management to be tailored to individual cancer patients based on the molecular alterations present within cancer cells. Genomic sequencing results can be applied to detect and classify cancer, predict prognosis, and target therapies. Next-generation sequencing has revolutionized the field of cancer genomics by enabling rapid and cost-effective sequencing of large portions of the genome. With this technology, precision oncology is quickly becoming a realized paradigm for managing the treatment of cancer patients. However, many challenges must be overcome to efficiently implement the transition of next-generation sequencing from research applications to routine clinical practice, including using specimens commonly available in the clinical setting; determining how to process, store, and manage large amounts of sequencing data; determining how to interpret and prioritize molecular findings; and coordinating health professionals from multiple disciplines.
Contributions of Eosinophils to Human Health and Disease
Authors: Klion Amy D. , Ackerman Steven J. , Bochner Bruce S.
Published: January 2020

The human eosinophil has long been thought to favorably influence innate mucosal immunity but at times has also been incriminated in disease pathophysiology. Research into eosinophil biology has uncovered a number of interesting contributions by eosinophils to health and disease. However, it appears that not all eosinophils from all species are created equal. It remains unclear, for example, exactly how having eosinophils benefits the human host when helminth infections in the developed world have become scarce. This review focuses on our current state of knowledge as it relates to human eosinophils. When information is lacking, we discuss lessons learned from mouse studies that may or may not directly apply to human biology and disease. It is an exciting time to be an “eosinophilosopher” because the use of biologic agents that selectively target eosinophils provides an unprecedented opportunity to define the contribution of this cell to eosinophil-associated human diseases.
Cardiac sympathetic nerve transdifferentiation reduces action potential heterogeneity after myocardial infarction
Authors: Wang Lianguo , Olivas Antoinette , Francis Stuart Samantha D. , Tapa Srinivas , Blake Matthew R. , Woodward William R. , Habecker Beth A. , Ripplinger Crystal M.
Published: January 2020

Cardiac sympathetic nerves undergo cholinergic transdifferentiation following reperfused myocardial infarction (MI), whereby the sympathetic nerves release both norepinephrine (NE) and acetylcholine (ACh). The functional electrophysiological consequences of post-MI transdifferentiation have never been explored. We performed MI or sham surgery in wild-type (WT) mice and mice in which choline acetyltransferase was deleted from adult noradrenergic neurons [knockout (KO)]. Electrophysiological activity was assessed with optical mapping of action potentials (AP) and intracellular Ca2+ transients (CaT) in innervated Langendorff-perfused hearts. KO MI hearts had similar NE content but reduced ACh content compared with WT MI hearts (0.360 ± 0.074 vs. 0.493 ± 0.087 pmol/mg; KO, n = 6; WT, n = 4; P < 0.05). KO MI hearts also had higher basal ex vivo heart rates versus WT MI hearts (328.5 ± 35.3 vs. 247.4 ± 62.4 beats/min; KO, n = 8; WT, n = 6; P < 0.05). AP duration at 80% repolarization was significantly shorter in the remote and border zones of KO MI versus WT MI hearts, whereas AP durations (APDs) were similar in infarct regions. This APD heterogeneity resulted in increased APD dispersion in the KO MI versus WT MI hearts (11.9 ± 2.7 vs. 8.2 ± 2.3 ms; KO, n = 8; WT, n = 6; P < 0.05), which was eliminated with atropine. CaT duration at 80% and CaT alternans magnitude were similar between groups both with and without sympathetic nerve stimulation. These results indicate that cholinergic transdifferentiation following MI prolongs APD in the remote and border zone and reduces APD heterogeneity.

NEW & NOTEWORTHY Cardiac sympathetic neurons undergo cholinergic transdifferentiation following myocardial infarction; however, the electrophysiological effects of corelease of norepinephrine and acetylcholine (ACh) have never been assessed. Using a mouse model in which choline acetyltransferase was deleted from adult noradrenergic neurons and optical mapping of innervated hearts, we found that corelease of ACh reduces dispersion of action potential duration, which may be antiarrhythmic.
Research on Cooperative Control of the Hydraulic System of Multiple Intelligent Vehicles Combined Transportation
Authors: Wang Jianjun , Zhao Jingyi
Published: January 2020

The multi-vehicle combined transportation of large-scale equipment or goods is studied, and various combined transportation modes are obtained. The research on four-vehicle combined transportation is studied, the four transport vehicles must ensure synchronization in the process of running, and the steering must be coordinated, otherwise major accidents may occur. Aiming at the stability control of multi-vehicle running synchronization, the system transfer function of pump-controlled motor in driving system is established, and the PID control is added. The simulation results show that adding the PID control algorithm can improve the speed stability of the transport vehicle. And the geometric model of the steering mechanism is established, the functional relationship between the steering angle and the stroke of the steering cylinder is obtained, and the relationship between the electric signal of proportional valve and the steering angle is deduced. On this basis, the coordinated control system of four-vehicle running synchronization and steering coordination based on CAN (controller area network) bus is designed. The master-slave synchronization control strategy and the PID control are applied to the four-vehicle combined transportation. According to the data collected from the test, it is proved that the control strategy fully meets the transportation requirements, and can provide theoretical basis and design method reference for the safe and reliable combined transportation of various types of transport vehicles.
Inventory Optimization of Fresh Agricultural Products Supply Chain Based on Agricultural Superdocking
Authors: Shen Lixin , Li Fucheng , Li Congcong , Wang Yumin , Qian Xueqi , Feng Tao , Wang Cong
Published: January 2020

The “agricultural superdocking” mode which has been strong supported by the government has become the main way for fresh agricultural products to enter the market in China. Based on the analysis of fresh agricultural products supply chain inventory management under the “agricultural superdocking” mode, this paper constructs an integrated inventory model for fresh agricultural products of “farmers’ professional cooperatives + distribution centers + supermarkets.” Considering multiple members at each echelon of a supply chain, a model that maximizes the overall profit of the supply chain is proposed. The model assumes that the market demand of fresh agricultural products is affected by freshness and sales prices, and the distribution center is responsible for not only storage, processing, and distribution but also coordinating the production and supply information of farmers’ professional cooperatives and the order sales information of supermarkets. An improved genetic algorithm is developed to solve the nonlinear optimization problem. Results of a case study show that the optimal supply and replenishment strategy under the given supply chain distribution process are obtained.
Research of Multimodal Medical Image Fusion Based on Parameter-Adaptive Pulse-Coupled Neural Network and Convolutional Sparse Representation
Authors: Xia Jingming , Lu Yi , Tan Ling
Published: January 2020

Visual effects of medical image have a great impact on clinical assistant diagnosis. At present, medical image fusion has become a powerful means of clinical application. The traditional medical image fusion methods have the problem of poor fusion results due to the loss of detailed feature information during fusion. To deal with it, this paper proposes a new multimodal medical image fusion method based on the imaging characteristics of medical images. In the proposed method, the non-subsampled shearlet transform (NSST) decomposition is first performed on the source images to obtain high-frequency and low-frequency coefficients. The high-frequency coefficients are fused by a parameter‐adaptive pulse-coupled neural network (PAPCNN) model. The method is based on parameter adaptive and optimized connection strength β adopted to promote the performance. The low-frequency coefficients are merged by the convolutional sparse representation (CSR) model. The experimental results show that the proposed method solves the problems of difficult parameter setting and poor detail preservation of sparse representation during image fusion in traditional PCNN algorithms, and it has significant advantages in visual effect and objective indices compared with the existing mainstream fusion algorithms.
A Stacking Ensemble for Network Intrusion Detection Using Heterogeneous Datasets
Authors: Rajagopal Smitha , Kundapur Poornima Panduranga , Hareesha Katiganere Siddaramappa
Published: January 2020

The problem of network intrusion detection poses innumerable challenges to the research community, industry, and commercial sectors. Moreover, the persistent attacks occurring on the cyber-threat landscape compel researchers to devise robust approaches in order to address the recurring problem. Given the presence of massive network traffic, conventional machine learning algorithms when applied in the field of network intrusion detection are quite ineffective. Instead, a hybrid multimodel solution when sought improves performance thereby producing reliable predictions. Therefore, this article presents an ensemble model using metaclassification approach enabled by stacked generalization. Two contemporary as well as heterogeneous datasets, namely, UNSW NB-15, a packet-based dataset, and UGR’16, a flow-based dataset, that were captured in emulated as well as real network traffic environment, respectively, were used for experimentation. Empirical results indicate that the proposed stacking ensemble is capable of generating superior predictions with respect to a real-time dataset (97% accuracy) than an emulated one (94% accuracy).
Sociodemographic and Behavioral Factors Associated with HIV Vulnerability according to Sexual Orientation
Authors: Serra Maria Aparecida A. O. , Milhomem Antoninho B. , Oliveira Samae B. , Santos Francisca Aline A. S. , Silva Roberta Araújo e , Costa Ana Cristina P. J. , Cunha Maria da Conceição S. O. , Silva Antônio Uelton A. , Freitas Roberto Wagner J. F. , Araújo Márcio Flávio M.
Published: January 2020

Objective. To analyze sociodemographic and behavioral factors associated with vulnerability to HIV according to sexual orientation. Method. This is a cross-sectional study conducted using data on 3,818 people in the city of Imperatriz, Brazil, during 2015 and 2016. The survey’s questionnaires addressed sociodemographic and behavioral variables. For the data analysis, association (chi-square test) and strength of association (odds ratio) were observed. A significance level of p<0.05 and adjustment for age and gender were taken into consideration. Results. A substantial portion of the sample stated they were heterosexual (88.8%). These individuals demonstrated a lower chance of HIV infection (p<0.001), sexually transmitted infections (p<0.001), alcohol use (p<0.001) and condom use (p<0.001), compared to men who have sex with men and/or bisexuals. In this group, after adjusting for confounding variables, the factors associated with HIV infection were being male (p<0.001), unmarried (p<0.001), having completed higher education (p<0.001) and boasting multiple sexual partners (p<0.001). Conclusion. Behavioral and sociodemographic factors of vulnerability to HIV are predominant among men who have sex with men and/or are bisexual.
Use of Mustard Seed Footbaths for Respiratory Tract Infections: A Pilot Study
Authors: Goetz Katja , Hinz Aune , Steinhäuser Jost , von Rath Ulrich
Published: January 2020

Objective. Respiratory tract infections (RTIs) are the most commonly treated acute problems in general practice. Instead of treatment with antibiotics, therapies from the field of integrative medicine play an increasingly important role within the society. The aim of the study was to evaluate whether mustard footbaths improve the symptoms of patients with RTIs. Methods. The study was designed as a pilot study and was carried out as an interventional trial with two points of measurement. Between November and December 2017, six practices were invited to participate. Two of them participated in the study. Patients were included who presented with an RTI at one of the involved primary care practices during February and April 2018. Participants in the intervention group used self‐administered mustard seed powder footbaths at home once a day, to be repeated for six consecutive days. The improvement of symptoms was measured using the “Herdecke Warmth Perception Questionnaire” (HeWEF). A variance analysis for repeated measurements was performed to analyse differences between the intervention and control groups. Results. In this pilot study, 103 patients were included in the intervention group and 36 patients were included in the control group. A comparison of the intervention and control group before the intervention started showed nearly no difference in their subjective perception of warmth measured by the HeWEF questionnaire. Participants of the intervention group who used mustard seed footbaths for six consecutive days showed an improvement in four of the five subscales of the HeWEF questionnaire. Conclusions. This study could provide a first insight into a possible strategy to improve symptoms regarding RTI by using mustard seed footbaths.
Nasal Provocation Test with Cat and Dog Extracts: Results according to Molecular Components
Authors: Sánchez Andres , Cardona Ricardo , Munera Marlon , Calvo Victor , Tejada-Giraldo Manuela , Sánchez Jorge
Published: January 2020

Background. IgE sensitization (atopy) to pets is commonly evaluated using pet dander extracts. However, the diagnosis by components seems to be more adequate to evaluate the clinical relevance (allergy) of sIgE sensitization.Objective. To study the association between IgE sensitization to pet allergen components and clinical symptoms.Methodology. Dander extracts and sIgE levels to pet components (Can f 1, Can f 2, Can f 3, Can f 5, Fel d 1, Fel 2, and Fel 4) were measured in a rhinitis group (n=101) and a control group (n=68). Nasal provocation tests with pet extract were done in patients with atopy to pets.Results. Dog (34.6% vs. 23.5%) and cat dander (26.7% vs. 8.8%,p=0.05) IgE sensitization was frequent among rhinitis and no-rhinitis subjects, and it was similar to dog (29.7% vs. 20.5%) and cat (18.8% vs. 8.8%) components. Polysensitization for dog (3.1, 95% CI: 1.5 to 6.1,p<0.001) or cat (2.5, 95% CI: 0.8 to 8.0,p=0.01) components was the principal risk factor for a positive nasal provocation test. Additionally, positive nasal provocation test with one animal increased the risk of atopy and positive nasal provocation test to others animals. Pet ownership or asthma was not associated with increased risk of atopy or positive nasal provocation test.Conclusions. Sensitization to pet dander extract identifies atopic patients, but its utility to predict clinical relevance is poor. Allergenic components could help to define the clinical relevance of sensitization to furry animals and could reduce the need for provocation test.
Biomarkers for Diagnosis and Prediction of Outcomes in Contrast-Induced Nephropathy
Authors: Banda Justor , Duarte Raquel , Dix-Peek Therese , Dickens Caroline , Manga Pravin , Naicker Saraladevi
Published: January 2020

Background. Serum creatinine is suboptimal as a biomarker in the early diagnosis of contrast-induced nephropathy (CIN). In this study, we investigated a panel of novel biomarkers in the early diagnosis of CIN and in assessing patient outcomes. Methods. This single-centre, nested, prospective case-controlled study included 30 patients with CIN and 60 matched controls. Serum and urine samples were collected before contrast administration and at 24 hours, 48 hours, and ≥5 days after contrast administration. Concentrations of NGAL, cystatin C, β2M, IL18, IL10, KIM1, and TNFα were determined using Luminex and ELISA assays. Outcomes were biomarker diagnostic discrimination performance for CIN and mortality after generation of area under receiver operating characteristic curves (AUROCs). Results. Median serum levels for 24 h cystatin C (p<0.01) and 48 h β2M levels (p<0.001) and baseline urine NGAL (p=0.02) were higher in CIN patients compared to controls with AUROCs of 0.75, 0.78, and 0.74, respectively, for the early diagnosis of CIN. Serum β2M levels were higher in CIN patients at all time points. Elevated baseline serum concentrations of IL18 (p<0.001), β2M (p=0.04), TNFα (p<0.001), and baseline urine KIM (p=0.01) and 24 h urine NGAL (p=0.02) were significantly associated with mortality. Baseline serum concentrations of IL18, β2M, and TNFα showed the best discrimination performance for mortality with AUROCs, all >0.80. Baseline NGAL was superior for excluding patients at risk for CIN, with positive and negative predictive ranges of 0.50–0.55 and 0.81–0.88, respectively. Cystatin C (p=0.003) and β2M (p=0.03) at 24 h independently predicted CIN risk. β2M predicted increased mortality of 40% at baseline and 50% at 24 hours. Conclusion. Serum cystatin C at 24 h was the best biomarker for CIN diagnosis, while baseline levels of serum IL18, β2M, and TNFα were best for predicting prognosis.
Spondylolysis in Young Athletes: An Overview Emphasizing Nonoperative Management
Authors: Goetzinger Sara , Courtney Selen , Yee Kathy , Welz Matthew , Kalani Maziyar , Neal Matthew
Published: January 2020

Lumbar spondylolysis is a unilateral or bilateral defect of the pars interarticularis, an isthmus of bone connecting the superior and inferior facet surfaces in the lumbar spine at a given level. Spondylolysis is common in young athletes participating in sports, particularly those requiring repetitive hyperextension movements. The majority of young athletes are able to return to full sport participation following accurate diagnosis and conservative management, including a structured treatment program. Surgical intervention for isolated pars injuries is seldom necessary. A progressive physical therapy (PT) program is an important component of recovery after sustaining an acute pars fracture. However, there is a paucity of literature detailing PT programs specific to spondylolysis. Here, we provide an overview of the epidemiology, natural history, radiographic evaluation, and management of pars fractures in young athletes. In addition, a detailed description of a physiotherapy program for this population that was developed at a spine center within an academic medical center is provided.
Automated Testing of Ultrawideband Positioning for Autonomous Driving
Authors: Vedder Benjamin , Svensson Bo Joel , Vinter Jonny , Jonsson Magnus
Published: January 2020

Autonomous vehicles need accurate and dependable positioning, and these systems need to be tested extensively. We have evaluated positioning based on ultrawideband (UWB) ranging with our self-driving model car using a highly automated approach. Random drivable trajectories were generated, while the UWB position was compared against the Real-Time Kinematic Satellite Navigation (RTK-SN) positioning system which our model car also is equipped with. Fault injection was used to study the fault tolerance of the UWB positioning system. Addressed challenges are automatically generating test cases for real-time hardware, restoring the state between tests, and maintaining safety by preventing collisions. We were able to automatically generate and carry out hundreds of experiments on the model car in real time and rerun them consistently with and without fault injection enabled. Thereby, we demonstrate one novel approach to perform automated testing on complex real-time hardware.
Cells Electrical Characterization: Dielectric Properties, Mixture, and Modeling Theories
Authors: Nasir Nida , Al Ahmad Mahmoud
Published: January 2020

Electrical detection of biotic materials and their properties is always crucial in Biomedical Engineering. It emphasizes elaborate analysis of a certain disease diagnosis using electrical means which includes the study of electrical properties followed by detection, identification, and quantification of biotic entities. Proper and early detection of cells, which can be normal or cancerous, holds never-ending demand. This review emphasizes the electrical characterization methods in modeling and classification of cell properties. Moreover, standard methods have been highlighted and discussed to yield performance analysis. This study suggests that techniques presented for single-cell analysis (SCA) are always precise and hold great scope compared to those for cell mixture. SCA plays a promising role in disease diagnosis and treatment planning, as it not only detects the cells but also helps in identification. Distinct electrical-based cell detection techniques are highlighted, along with the pros and cons of various SCA devices. The content, in terms of methodologies and available techniques, of this review paper is useful to attract researchers working in this area.
Efficacy and Safety of Pembrolizumab in Previously Treated Advanced Neuroendocrine Tumors: Results From the Phase II KEYNOTE-158 Study
Authors: Strosberg Jonathan , Mizuno Nobumasa , Doi Toshihiko , Grande Enrique , Delord Jean-Pierre , Shapira-Frommer Ronnie , Bergsland Emily , Shah Manisha , Fakih Marwan , Takahashi Shunji , Piha-Paul Sarina A. , O'Neil Bert , Thomas Sajeve , Lolkema Martijn P. , Chen Menghui , Ibrahim Nageatte , Norwood Kevin , Hadoux Julien
Published: January 2020

Purpose:

KEYNOTE-158 (ClinicalTrials.gov identifier: NCT02628067) investigated the efficacy and safety of pembrolizumab across multiple cancers. We present results from patients with previously treated advanced well-differentiated neuroendocrine tumors (NET).

Patients and Methods:

Pembrolizumab 200 mg was administered every 3 weeks for 2 years or until progression, intolerable toxicity, or physician/patient decision. Tumor imaging was performed every 9 weeks for the first year and then every 12 weeks. Endpoints included objective response rate (ORR) per RECIST v1.1 by independent central radiologic review (primary) and duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety (secondary).

Results:

A total of 107 patients with NETs of the lung, appendix, small intestine, colon, rectum, or pancreas were treated. Median age was 59.0 years (range, 29–80), 44.9% had ECOG performance status 1, 40.2% had received ≥3 prior therapies for advanced disease, and 15.9% had PD-L1–positive tumors (combined positive score ≥1). Median follow-up was 24.2 months (range, 0.6–33.4). ORR was 3.7% (95% CI, 1.0–9.3), with zero complete responses and four partial responses (three pancreatic and one rectal) all in patients with PD-L1–negative tumors. Median DOR was not reached, with one of four responses ongoing after ≥21 months follow-up. Median PFS was 4.1 months (95% CI, 3.5–5.4); the 6-month PFS rate was 39.3%. Median OS was 24.2 months (95% CI, 15.8–32.5). Treatment-related adverse events (AE) occurred in 75.7% of patients, 21.5% of whom had grade 3–5 AEs.

Conclusions:

Pembrolizumab monotherapy showed limited antitumor activity and manageable safety in patients with previously treated advanced well-differentiated NETs.
Characterizing Health Outcomes in Idiopathic Pulmonary Fibrosis using US Health Claims Data
Authors: Mortimer Kathleen M. , Bartels Dorothee B. , Hartmann Nadine , Capapey Jorge , Yang Jing , Gately Robert , Enger Cheryl
Published: January 2020

Background: Idiopathic pulmonary fibrosis (IPF) is a life-threatening interstitial lung disease (ILD). Characterizing health outcomes of IPF patients is challenging due to disease rarity. Objective: This study aimed to identify the burden of disease in patients newly diagnosed with IPF. Methods: Patients with ≥1 claim with an IPF diagnosis were identified from a United States healthcare insurer’s database (2000–2013). Patients with other known causes of ILD or aged <40 years were excluded. Subgroups were compared based on the 2011 change in International Classification of Diseases, 9th Revision (ICD-9) definition of IPF and occurrence of IPF testing. The prevalence and incidence of preselected health conditions of clinical interest were estimated. Results: Median age of newly diagnosed patients (n = 7,298) was 62 years (54.0% male). Restricting to patients with IPF diagnostic testing did not substantially affect cohort characteristics, nor did ICD-9 IPF coding change. Mean follow-up was 1.7 years; 16.8% of patients died; and a substantial proportion of patients were censored due to end of health plan enrollment (50.7%) and other causes of ILD (19.6%). The incidence of pulmonary hypertension, lung cancer, and claims-based algorithm proxy for acute respiratory worsening of unknown cause was 22.5, 17.6, and 12.6 per 1,000 person-years, respectively. Conclusions: Patients with IPF had a high disease burden with a variety of health outcomes observed, including a high rate of mortality. Database censoring due to changes in enrollment or other ILD diagnoses limited follow-up. Altering cohort entry definitions, including IPF testing or ICD-9 IPF coding change, had little impact on cohort baseline characteristics.
Autism Spectrum Disorder and the Gut Microbiota in Children: A Systematic Review
Authors: Bezawada Navya , Phang Tze Hui , Hold Georgina L. , Hansen Richard
Published: January 2020

Introduction: Differences in microbiota composition in children with autism spectrum disorder (ASD) compared to unaffected siblings and healthy controls have been reported in various studies. This study aims to systematically review the existing literature concerning the role of the gut microbiota in ASD. Methods: An extensive literature search was conducted using MEDLINE and EMBASE databases to identify studies (January 1966 through July 2019). Results: A total of 28 papers were included. The studies ranged from 12 to 104 participants who were aged between 2 and 18 years from various geographical areas. Majority of studies included faecal samples; however, 4 studies examined mucosal biopsies from different sites. The heterogeneity in ASD diagnostic methodology, gut site sampled and laboratory methods used made meta-analysis inappropriate. Species reported to be significantly higher in abundance in autistic children included Clostridium, Sutterella, Desulfovibrio and Lactobacillus. The findings are however inconsistent across studies. In addition, ­potential confounding effects of antimicrobial use, gastrointestinal symptoms and diet on the gut microbiota are unclear due to generally poor assessment of these factors. Conclusion: It is clear that the gut microbiota is altered in ASD, although further exploration is needed on whether this is a cause or an effect of the condition.
Gender Differences in Multiple Endocrine Neoplasia Type 1: Implications for Screening?
Authors: Manoharan Jerena , Bollmann Carmen , Kann Peter Herbert , Di Fazio Pietro , Bartsch Detlef K. , Albers Max B.
Published: January 2020

Background: Some gender-related differences have been reported in multiple endocrine neoplasia type 1 (MEN1), although not all reports are conclusive. This systematic review with analysis of the own MEN1 cohort evaluates gender differences and potential consequences for screening. Methods: A systematic review of the literature between 1990 and 2019 with the search terms “MEN1” or “multiple endocrine neoplasia type 1” and “gender” or “sex” was performed. In addition, the prospectively collected data of a genetically confirmed MEN1 cohort of the Philipps University Marburg were retrospectively analyzed. Results: Review of the literature identified five retrospective case series with original data of 1,057 MEN1 patients. One series suggested a higher frequency of pancreatic neuroendocrine neoplasms (NEN), especially gastrinomas, in men (61 vs. 54%) and a higher frequency of pituitary tumors in women (47 vs. 30%), but others did not. Only thymic NEN occurred predominantly in men throughout all studies. Women with MEN1 were found to have an increased risk of breast cancer. In the own series consisting of 116 MEN1 patients (male = 58, female = 58), thymic lesions were also more frequently detected in male patients (male = 5, female = 1). No gender difference was found with regard to the other manifestations. Conclusion: Regarding the typical MEN1 tumor manifestations, gender-adapted diagnostic and therapeutic approaches cannot be recommended. Female MEN1 patients should be encouraged to participate in breast cancer screening programs.
Feasibility of Online Haemodiafiltration in Sleep Apnoea: A Randomized Crossover Study
Authors: Chu Ginger , Suthers Belinda , Paech Gemma M. , Eyeington Lana , Gunawardhana Lakshitha , Palazzi Kerrin , McDonald Vanessa M. , Choi Peter
Published: January 2020

Background: Sleep apnoea is prevalent in dialysis patients. Previous studies identified excessive inflammation in ­patients with sleep apnoea. Online haemodiafiltration ­(OL-HDF) may reduce systematic inflammation through better clearance of middle molecules. We aimed to determine the feasibility of OL-HDF in sleep apnoea management. Methods: Eligible dialysis patients were screened for risk of sleep apnoea by nocturnal oximetry followed by a diagnostic sleep study to assess apnoea-hypopnea index (AHI). Patients with AHI ≥15/h were invited to a randomized crossover trial. The intervention was 2-month high-flux haemodialysis (HF-HD) followed by 2-month OL-HDF or vice versa with 1-month washout via HF-HD. Feasibility was assessed by patient recruitment and the primary outcome, severity of sleep apnoea (AHI). Secondary outcomes were pro-inflammatory cytokines, patient-reported daytime sleepiness, quality of sleep and health-related quality of life. Results: Of 65 participants at risk of sleep apnoea, only 15 were consented and randomized (mean age 70 years, 80% male, mean AHI 42.2/h). AHI was not statistically different between OL-HDF versus HF-HD (55.6/h vs. 48.3/h, p = 0.134); however, when sleep apnoea was stratified into obstructive and central apnoea, patients had less obstructive episodes after treated by OL-HDF (23.2/h vs. 18.6/h, p = 0.178); a sensitivity analysis was performed excluding outliers, and the treatment effect for obstructive episodes was found to be statistically significant (11.1 vs. 18.2/h, p = 0.019). Pro-inflammatory biomarkers and patient-reported outcomes were similar between OL-HDF and HF-HD. Conclusion: Patient recruitment was a major challenge in this feasibility study. OL-HDF may reduce obstructive sleep apnoea; however, the result needs to be confirmed by larger studies.
Associação do perfil microbiológico com alterações citológicas em mulheres quilombolas atendidas nas unidades básicas de saúde
Authors: Aragão Francisca Bruna Arruda , Santos Gerusinete Rodrigues Bastos Dos , Lobão Walder Jansen Mello De , Oliveira Anderson Pereira De , Monteiro Silvio Gomes , Santos Lana Meireles , Reis Andréa Dias , Neto Marcelino Santos , Batista José Eduardo
Published: January 2020

Objetivo: Analisar o perfil microbiológico e relacionar com as alterações citológicas de mulheres quilombolas que possuem lesões cérvico-vaginais. Material e Métodos. Este foi um estudo de corte transversal de 5 meses, baseado em 154 mulheres quilombolas, na faixa etária de 13 a 74 anos, registradas no Sistema Único de Saúde (SUS) e que possuem lesões cérvico-vaginais. Resultados. Mulheres com idade >45 anos (43,5%) foram as que mais realizaram exames Papanicolaou, seguido das mulheres com 31 a 45 anos (31,2%) e posteriormente ≤30 anos (25,3%). A infecção mais comum em mulheres com idade ≤30 foi Gardnerella sp. (35,8%), já em mulheres na faixa de 31 a 45 anos foi Lactobacillus sp. (47,9%). A prevalência global das alterações citológicas foi de 7,8%, com maior frequência na faixa de 31 a 45 anos. Conclusão. As mulheres com vaginose bacteriana apresentaram maior prevalência de atipias celulares e não houve associação estatisticamente significante entre faixa etária e alterações cérvico-vaginais, bem como, a microbiota não apresentou associação com anormalidades citológicas.
Trends in Usage and Clinical Outcomes of Coronary Atherectomy
Authors: Beohar Nirat , Kaltenbach Lisa A. , Wojdyla Daniel , Pineda Andrés M. , Rao Sunil V. , Stone Gregg W. , Leon Martin B. , Sanghvi Kintur A. , Moses Jeffrey W. , Kirtane Ajay J.
Published: January 2020

Background:

Adjunctive coronary atherectomy (CA) can be utilized in treating severely calcified coronary lesions; however, the temporal trends, patient selection, and variation in use of CA have not been well described. We sought to assess the trends in usage, interhospital variability, and outcomes with CA among patients undergoing percutaneous coronary intervention (PCI).

Methods:

All patients undergoing PCI in the National Cardiovascular Data Registry CathPCI Registry from July 1, 2009 to December 31, 2016 (N=3 864 377) were analyzed based on utilization of either rotational or orbital CA. Intervals using date of index CA grouped into 2009 Q3 to 2010, 2011 to 2012, 2013 to 2014, and 2015 to 2016 and hospital-level quartiles based on annual CA volumes were evaluated. The primary outcome measure was in-hospital major adverse cardiac events defined as a composite of all-cause mortality, periprocedural myocardial infarction, or stroke. Independent variables associated with outcomes were determined.

Results:

CA represented 1.7% (n=65 033) of the total PCI volume. Among hospitals performing PCI (n=1672), 577 (34.5%) did not perform any CA. Patients treated with CA were elderly, more often male, and had a history of diabetes, prior myocardial infarction, PCI, and coronary artery bypass grafting. The utilization of CA increased from 1.1% in Q3 2009 to 3.0% in Q4 of 2016 (5% quarterly increase in odds of CA; OR [95% CI], 1.05 [1.04–1.06],
P
<0.001). Among patients undergoing CA, there was a temporal decline in major adverse cardiac events (0.98 [0.97–0.99],
P
<0.001) and myocardial infarction (0.97 [0.96–0.98],
P
<0.001). In adjusted analyses, increasing hospital CA volume was associated with lower mortality (0.85 [0.76–0.96],
P
=0.01) and lower rates of PCI failure or complication requiring coronary artery bypass grafting (0.67 [0.56–0.79],
P
<0.001) but was associated with small increase in coronary perforation (1.18 [1.04–1.35],
P
<0.01).

Conclusions:

Although CA is performed infrequently, its use has increased over time. After accounting for potential confounders, higher CA volume was associated with lower risk of major adverse events counterbalanced by small risk of coronary perforation.
Mildly Abnormal Lipid Levels, but Not High Lipid Variability, Are Associated With Increased Risk of Myocardial Infarction and Stroke in “Statin-Naive” Young Population A Nationwide Cohort Study
Authors: Park Jun-Bean , Kim Da Hye , Lee Heesun , Hwang In-Chang , Yoon Yeonyee E. , Park Hyo Eun , Choi Su-Yeon , Kim Yong-Jin , Cho Goo-Yeong , Han Kyungdo , Kim Hyung-Kwan
Published: January 2020

Rationale:

In young adults, the role of mildly abnormal lipid levels and lipid variability in the risk of atherosclerotic cardiovascular diseases remains uncertain.

Objective:

To investigate the association of these abnormalities in lipid profiles with the risk of myocardial infarction (MI) and stroke in young population.

Methods and Results:

From the Korean National Health Insurance Service, a nationwide population-based cohort of 1 934 324 statin-naive adults aged 20 to 39 years, with ≥3 lipid profile measurements and without a history of MI and stroke, were followed-up until the date of MI or stroke, or December 31, 2017. The primary measure of lipid variability was variability independent of the mean. Higher baseline total cholesterol, LDL-C (low-density lipoprotein-cholesterol), and triglycerides and lower HDL-C (high-density lipoprotein-cholesterol) levels were significantly associated with increased MI risk; respective adjusted hazard ratios and 95% CIs comparing the highest versus lowest quartiles were 1.35 (1.20–1.53) for total cholesterol, 1.41 (1.25–1.60) for LDL-C, 1.28 (1.11–1.47) for triglycerides, and 0.82 (0.72–0.94) for HDL-C. Adjusted analyses for deciles of lipid profiles showed that MI risk was significantly elevated among participants with total cholesterol ≥223.4 mg/dL, LDL-C ≥139.5 mg/dL, HDL-C ≤41.8 mg/dL, and triglycerides ≥200.1 mg/dL. The associations between lipid levels and stroke risk were less prominent. Multivariable-adjusted restricted cubic spline analysis demonstrated that the increase in MI risk was not exclusively driven by extreme values of lipid profiles. Similar results were obtained on sensitivity analyses of baseline lipid levels. However, associations between lipid variability and the risk of MI and stroke varied depending on the measure of lipid variability used.

Conclusions:

Mildly abnormal baseline lipid levels were associated with an increased future risk of atherosclerotic cardiovascular disease events, particularly MI, whereas measures of lipid variability were not. Therefore, in young adults, achieving optimal lipid levels could be valuable in the prevention of atherosclerotic cardiovascular disease.
Monetary Neutrality with Sticky Prices and Free Entry
Authors: Bilbiie Florin O.
Published: January 2020

Monetary policy is neutral even with fixed prices if free entry determines product variety optimally, as in Dixit and Stiglitz (1977). Entry substitutes for price flexibility in the welfare-based price index when individual prices are sticky. In response to aggregate demand expansions, the intensive (quantity produced of each good) and ex tensive (number of goods being produced) margins move in offsetting ways, leaving aggregate production unchanged. Price stickiness thus generates deviations from monetary neutrality only in conjunction with entry frictions: when variety is not optimally determined (preferences are not Dixit-Stiglitz) or when entry is subject to sunk costs and lags. Wage stickiness instead implies nonneutrality even in the frictionless-entry benchmark.
Relationship Lending and the Great Depression
Authors: Cohen Jon , Hachem Kinda , Richardson Gary
Published: January 2020

The collapse of long-term lending relationships amplified the Great Depression. We demonstrate this by developing a new measure of lending relationships that can be calculated from widely available data at any level of aggregation. Our approach exploits differences in the responsiveness of loan rates to bank funding costs and is supported by historical evidence and theoretical arguments. The new measure reveals that the marginal impact of bank suspensions on economic activity was higher in more relationship-intensive areas, providing the first formal evidence that relationship lending propagated the real effects of banking sector distress in the early 1930s.
Of Mice and Merchants: Connectedness and the Location of Economic Activity in the Iron Age
Authors: Bakker Jan David , Maurer Stephan , Pischke Jörn-Steffen , Rauch Ferdinand
Published: January 2020

We study the causal relationship between geographic connectedness and development using one of the earliest massive trade expansions: the first systematic crossing of open seas in the Mediterranean during the time of the Phoenicians. We construct a geography-based measure of connectedness along the shores of the sea. We relate connectedness to economic activity, which we measure using the presence of archaeological sites. We find an association between better-connected locations and archaeological sites during the Iron Age, at a time when sailors began to cross open water routinely on a large scale. We corroborate these findings at the world level.
Environmental Regulations and the Cleanup of Manufacturing: Plant-Level Evidence
Authors: Najjar Nouri , Cherniwchan Jevan
Published: January 2020

For much of the industrialized world, pollution from manufacturing has been falling despite increased output. We examine how air quality standards---a common environmental regulation---have contributed to this cleanup of manufacturing. We develop a general equilibrium model to show how air quality standards can lead to a cleanup by causing reductions in plant emission intensity, relative changes in plant output, and plant entry and exit. We provide quasi-experimental evidence from Canada to highlight the magnitude of these responses. Our results suggest that air quality standards explain just under 40% of the cleanup of manufacturing.
How a Sheep Turned into a Giraffe: The Case of Deuteronomy 14:5
Authors: Miziur-Moździoch Maja
Published: January 2020

The scope of this article is to present an explanation for the enigmatic translation of zemer into kamelopardalis in Deuteronomy 14:5. A possible reason for this translation is the Hieroglyphic and Demotic zoonym sr, which in the Ptolemaic period was applied to both sheep and giraffes.
Melting Pots and Rejoinders? The Interplay among Literature Formation Processes during the Late Persian and Early Hellenistic Periods
Authors: Jonker Louis C.
Published: January 2020

Traditionally, the book of Chronicles had been studied in relationship to the deuteronomic-deuteronomistic traditions on which it is mainly based. However, in recent years Chronicles and Pentateuch studies have also started moving closer to one another. It is realised now that the finalisation of the Pentateuch in the post-exilic period and the formation of new literature (such as Chronicles and Ezra-Nehemiah) happened in temporal proximity to one another. It is therefore worthwhile to investigate the relationship between these late stages of literature formation of the Hebrew Bible to come to a deeper understanding of the dynamics of ideological discourses during the late Persian and early Hellenistic periods. The present contribution widens the scope further to include the prophetic literature of Ezekiel 40-48 (particularly 44) in the investigation.
Intraspecific variation in tree lizard escape behaviour in relation to habitat and temperature
Authors: Morris Cynthia L. , Lattanzio Matthew S.
Published: January 2020

Optimal escape theory has proven useful for understanding the dynamics of antipredator behaviour in animals; however, approaches are often limited to single-population studies. We studied how the escape behaviour of tree lizards (Urosaurus ornatus) varied across a disturbance gradient. We also considered how sex, body temperature, and perch temperature affected their escape decisions. Both sexes exhibited similar response patterns; however, lizards in the most-disturbed habitat, as well as cooler (body or perch temperature) lizards, initiated escape earlier (but did not flee further) than other animals. Increased wariness as indicated by earlier escape suggests that frequently-disturbed, more-open localities may be stressful habitats for species like U. ornatus. In addition, because cooler temperatures limit locomotor performance capacity, escape decisions should also depend on a species’ thermal ecology. Overall, we stress the importance of multi-population approaches for capturing the variety of ways species adaptively respond to the threat of predation across habitat gradients.
Tradition, Esotericism, Secrecy and Hiddenness in the Gospel Studies of P.D. Ouspensky and Maurice Nicoll
Authors: Willmett John
Published: January 2020

This article examines the views of Gurdjieff’s disciples P.D. Ouspensky and Maurice Nicoll on the esoteric nature of the Gospels. Utilising one of Wouter Hanegraaff’s definitions of esotericism as religious activity concerned predominantly with salvific knowledge of the ‘inner mysteries of religion’ reserved for a selected elite, Ouspensky’s and Nicoll’s view of the Gospels as the rendering in metaphorical form of esoteric knowledge as the formulation of the esoteric psychology of the path of inner evolution is discussed. Sources for this discussion are Ouspensky’s A New Model of the Universe (1931), and Nicoll’s The New Man (1950) and The Mark (1954). It is suggested that the Gospels render esoteric knowledge and its linguistic expression secret and hidden. Nicoll’s idea of the necessity for this secrecy and hiddenness in dealing with the esoteric, that esoteric knowledge given to those unprepared for it is dangerous, both because it will be spoiled, its truth and beauty destroyed, and because it will turn into what Nicoll calls “world poison”, is illustrated in a discussion of the thesis presented in Jacob Needleman’s A Sense of the Cosmos (1975), that the rise of modern science represents an abuse of esoteric knowledge. The article concludes by presenting ideas from Needleman, Ouspensky and Nicoll of what needs to be done in the face of this current widespread abuse of esoteric knowledge.
“Where There Is Power, Women Are Not”: Rethinking Women and Politics in Tanzania
Authors: Makulilo Alexander
Published: January 2020

The exclusion of women from politics is a historical and worldwide phenomenon. Evidently, the existing records within decision-making organs reveal significant under-representation of women. However, this state of affairs is neither natural nor unchanging. It must be noted that women suffer this political exclusion irrespective of the fact that they are demographically the majority in terms of population worldwide and in most individual countries. Tanzania is not distinct from this worldwide trend. Despite the fact that it is a signatory to several normative frameworks that seek for the inclusion of women in major decision-making organs, the actual situation is still critical. Using the public-private dichotomy, I note that the legal framework, nature of political parties, electoral system and economic position of women are central in explaining the exclusion of women from major decision organs.