bluuebunny/crossref_metadata_2025 huggingface dataset:
Thermal conductivity measurements in nanosheets via bolometric effect
Authors: Çakıroğlu Onur , Mehmood Naveed , Çiçek Mert Miraç , Karluk Azimet Akber , Rasouli Hamid Reza , Durgun Engin , Kasırga T Serkan
Published: March 2020

Thermal conductivity measurement techniques for materials with nanoscale dimensions require fabrication of very complicated devices or their applicability is limited to a class of materials. Discovery of new methods with high thermal sensitivity are required for the widespread use of thermal conductivity measurements in characterizing materials’ properties. We propose and demonstrate a simple non-destructive method with superior thermal sensitivity to measure the in-plane thermal conductivity of nanosheets and nanowires using the bolometric effect. The method utilizes laser beam heating to create a temperature gradient, as small as a fraction of a Kelvin, over the suspended section of the nanomaterial with electrical contacts. Local temperature rise due to the laser irradiation alters the electrical resistance of the device, which can be measured precisely. This resistance change is then used to extract the temperature profile along the nanomaterial using thermal conductivity as a fitting parameter. We measured the thermal conductivity of V2O3 nanosheets to validate the applicability of the method and found an excellent agreement with the literature. Further, we measured the thermal conductivity of metallic 2H-TaS2 for the first time and performed ab initio calculations to support our measurements. Finally, we discussed the applicability of the method on semiconducting nanosheets and performed measurements on WS2 and MoS2 thin flakes.
The Pedicled Robertson Mammaplasty: Minimization of Complications in Obese Patients With Extreme Macromastia
Authors: Restifo Richard J
Published: March 2020

Background

Breast reduction for extreme macromastia in obese patients is a potentially high-risk endeavor. Free nipple grafting as well as a variety of pedicled techniques have been advocated for large reductions in obese patients, but the number of different approaches suggests that no single method is ideal. This paper suggests the Robertson Mammaplasty, an inferior pedicle technique characterized by a curvilinear skin extension onto the pedicle, as a potentially favorable approach to this clinical situation.

Objectives

The author sought to determine the safety of the Pedicled Robertson Mammaplasty for extreme macromastia in obese patients.

Methods

The records of a single surgeon’s practice over a 15-year period were retrospectively reviewed. Inclusion criteria were a Robertson Mammaplasty performed with a >3000-g total resection and a patient weight at least 20% above ideal body weight. Records were reviewed for patient characteristics, operative times, and complications.

Results

The review yielded 34 bilateral reduction patients that met inclusion criteria. The mean resection weight was 1859.2 g per breast, the mean body mass index was 36.4 kg/m2, and the mean sternal notch-to-nipple distance was 41.4 cm. Mean operative time was 122 minutes. There were no cases of nipple necrosis and no major complications that required reoperation under general anesthesia. A total 26.4% of patients had minor complications that required either local wound care or small office procedures, and 4.4% received small revisions under local anesthesia.

Conclusions

The Pedicled Robertson Mammaplasty is a fast and safe operation that yields good aesthetic results and a relative minimum of complications in the high-risk group of obese patients with extreme macromastia.

Level of Evidence: 4
Multivariate one-sided testing in matched observational studies as an adversarial game
Authors: Cohen P L , Olson M A , Fogarty C B
Published: March 2020

We present a multivariate one-sided sensitivity analysis for matched observational studies, appropriate when the researcher has specified that a given causal mechanism should manifest itself in effects on multiple outcome variables in a known direction. The test statistic can be thought of as the solution to an adversarial game, where the researcher determines the best linear combination of test statistics to combat nature’s presentation of the worst-case pattern of hidden bias. The corresponding optimization problem is convex, and can be solved efficiently even for reasonably sized observational studies. Asymptotically, the test statistic converges to a chi-bar-squared distribution under the null, a common distribution in order-restricted statistical inference. The test attains the largest possible design sensitivity over a class of coherent test statistics, and facilitates one-sided sensitivity analyses for individual outcome variables while maintaining familywise error control through its incorporation into closed testing procedures.
Paediatric aortic valve replacement using decellularized allografts
Authors: Horke Alexander , Bobylev Dmitry , Avsar Murat , Meyns Bart , Rega Filip , Hazekamp Mark , Huebler Michael , Schmiady Martin , Tzanavaros Ioannis , Cesnjevar Robert , Ciubotaru Anatol , Laufer Günther , Zimpfer Daniel , Jashari Ramadan , Boethig Dietmar , Cebotari Serghei , Beerbaum Philipp , Tudorache Igor , Haverich Axel , Sarikouch Samir
Published: March 2020

OBJECTIVES

Options for paediatric aortic valve replacement (AVR) are limited if valve repair is not feasible. Results of paediatric Ross procedures are inferior to adult Ross results, and mechanical AVR imposes constant anticoagulation with the inherent risks.

METHODS

The study design was a prospective, multicentre follow-up of all paediatric patients receiving decellularized aortic homografts (DAHs) for AVR in 8 European centres.

RESULTS

A total of 106 children (77 boys) were operated (mean age 10.1 ± 4.8 years, DAH diameter 20.5 ± 3.8 mm). A total of 60 (57%) had undergone previous surgical interventions: 34 with 1, 15 with 2 and 11 with ≥3. There was one early death in a 12-year-old girl, who underwent her fourth aortic valve operation, due to intracerebral haemorrhage on extracorporeal membrane oxygenation after coronary reimplantation problems following 3-sinus reconstruction 1 year earlier. One 2-year-old patient died due to sepsis 2 months postoperatively with no evidence for endocarditis. In addition, a single pacemaker implantation was necessary and a 2.5-year-old girl underwent successful HTx due to chronic myocardial failure despite an intact DAH. After a mean follow-up of 3.30 ± 2.45 years, primary efficacy end points mean peak gradient (18.1 ± 20.9 mmHg) and regurgitation (mean 0.61 ± 0.63, grade 0–3) were very good. Freedom from death/explantation/endocarditis/bleeding/stroke at 5 years was 97.8 ± 1.6/85.0 ± 7.4/100/100/100% respectively. Calculated expected adverse events were lower for DAH compared to cryopreserved homograft patients (mean age 8.9 years), lower than in Ross patients (9.4 years) and in the same range as mechanical AVR (12.8 years).

CONCLUSIONS

Even though the overall number of paediatric DAH patients and the follow-up time span are still limited, our data suggest that DAHs may present a promising additional option for paediatric AVR.
International Organizations and the Creation of Customary International Law
Authors: Daugirdas Kristina
Published: March 2020

This article argues that international organizations ‘as such’ can contribute directly to the creation of customary international law for three independent reasons. First, the states establishing an international organization may subjectively intend for that organization to be able to contribute to the creation of at least some kinds of customary international law. Second, that capacity may be an implied power of the organization. Third, that capacity may be a byproduct of other features or authorities of the international organization – specifically, the combination of international legal personality and the capacity to operate on the international plane. Affirming international organizations’ direct role in making customary international law will not dramatically change the content of customary international law or the processes by which rules of customary international law are ascertained. But recognizing that role is significant because it will reinforce other conclusions about how international organizations fit into the international legal system, including that customary international law binds international organizations. Such recognition may also shift the way lawyers within international organizations carry out their work by affecting the sources they consult when answering legal questions, the materials they make publicly available and the kinds of expertise that are understood to be necessary to discharge their responsibilities. Finally, affirming international organizations’ role in creating customary international law may make international organizations more willing to comply with those rules.
Quantifying the Autonomic Response to Stressors—One Way to Expand the Definition of “Stress” in Animals
Authors: Gaidica Matt , Dantzer Ben
Published: March 2020

Quantifying how whole organisms respond to challenges in the external and internal environment (“stressors”) is difficult. To date, physiological ecologists have mostly used measures of glucocorticoids (GCs) to assess the impact of stressors on animals. This is of course too simplistic as Hans Seyle himself characterized the response of organisms to “noxious stimuli” using multiple physiological responses. Possible solutions include increasing the number of biomarkers to more accurately characterize the “stress state” of animal or just measuring different biomarkers to more accurately characterize the degree of acute or chronic stressors an animal is experiencing. We focus on the latter and discuss how heart rate (HR) and heart rate variability (HRV) may be better predictors of the degree of activation of the sympathetic–adrenal–medullary system and complement or even replace measures of GCs as indicators of animal health, welfare, fitness, or their level of exposure to stressors. The miniaturization of biological sensor technology (“bio-sensors” or “bio-loggers”) presents an opportunity to reassess measures of stress state and develop new approaches. We describe some modern approaches to gathering these HR and HRV data in free-living animals with the aim that heart dynamics will be more integrated with measures of GCs as bio-markers of stress state and predictors of fitness in free-living animals.
Satellite cells and their regulation in livestock
Authors: Gonzalez Madison L , Busse Nicolas I , Waits Christy M , Johnson Sally E
Published: March 2020

Satellite cells are the myogenic stem and progenitor population found in skeletal muscle. These cells typically reside in a quiescent state until called upon to support repair, regeneration, or muscle growth. The activities of satellite cells are orchestrated by systemic hormones, autocrine and paracrine growth factors, and the composition of the basal lamina of the muscle fiber. Several key intracellular signaling events are initiated in response to changes in the local environment causing exit from quiescence, proliferation, and differentiation. Signals emanating from Notch, wingless-type mouse mammary tumor virus integration site family members, and transforming growth factor-β proteins mediate the reversible exit from growth 0 phase while those initiated by members of the fibroblast growth factor and insulin-like growth factor families direct proliferation and differentiation. Many of these pathways impinge upon the myogenic regulatory factors (MRF), myogenic factor 5, myogenic differentiation factor D, myogenin and MRF4, and the lineage determinate, Paired box 7, to alter transcription and subsequent satellite cell decisions. In the recent past, insight into mouse transgenic models has led to a firm understanding of regulatory events that control satellite cell metabolism and myogenesis. Many of these niche-regulated functions offer subtle differences from their counterparts in livestock pointing to the existence of species-specific controls. The purpose of this review is to examine the mechanisms that mediate large animal satellite cell activity and their relationship to those present in rodents.
Assessment of Tobacco Exposure During Pregnancy by Meconium Analysis and Maternal Interview
Authors: López-Rabuñal Ángela , Lendoiro Elena , González-Colmenero Eva , Concheiro-Guisán Ana , Concheiro-Guisán Marta , Peñas-Silva Patricia , Macias-Cortiña Manuel , López-Rivadulla Manuel , Cruz Angelines , de-Castro-Ríos Ana
Published: March 2020

Smoking during pregnancy can have serious obstetric and fetal complications. Therefore, it is essential to identify in utero exposure to tobacco, being meconium the matrix of choice for this purpose. Meconium (n = 565) was analyzed for nicotine, cotinine and hydroxycotinine by LC–MS-MS. Then, tobacco meconium results were compared with smoking habits during pregnancy and neonatal outcomes measures (birth weight, length, head circumference, gestational age and Apgar scores). Although meconium analysis increased identification of in-utero exposure to tobacco (17.7% meconium positive specimens vs 13.5% mothers admitting tobacco use during pregnancy), there was a statistically significant relationship between meconium results and interview answers (P < 0.001). Birth weight was significantly lower for newborns with meconium positive results in males (P = 0.023) and females (P = 0.001), while for length significance was only observed in females (P = 0.001); however, when excluding meconium specimens positive for other drugs, a statistically significant difference was only found for female weight (P = 0.045). Meconium analysis proved to be more reliable for tobacco prenatal exposure detection than maternal interview. In addition, positive meconium results increased the probability for low birth weight, especially in females.
Development of Lucilia sericata (Diptera: Calliphoridae) Under Constant Temperatures and its Significance for the Estimation of Time of Death
Authors: Wang Man , Wang Yu , Hu Guoliang , Wang Yinghui , Xu Wang , Wu Maowang , Wang Jiangfeng
Published: March 2020

Forensic entomologists usually estimate the minimum postmortem interval (PMImin) using the time required for the oldest immature insects found on the corpse to grow to its development stage and age at the time of discovery. The sheep blow fly Lucilia sericata (Meigen, 1826) is a carrion fly found nearly worldwide, and important in forensics. We studied the development time of L. sericata from egg to adult at constant temperatures of 16, 19, 22, 25, 28, 31, and 34°C, and found that the times required are 913.2 ± 19.4, 588.8 ± 35.8, 459.8 ± 15.2, 373.2 ± 15.3, 308.0 ± 9.7, 272.5 ± 9.2, and 267.5 ± 10.5 h, respectively. We established three development models to infer the age of the immature insect: isomegalen diagram, isomorphen diagram, and thermal summation model. In addition, a regression analysis was performed on the relationship between body length and total development time from hatching to dispersing. The thermal summation constant during the development of L. sericata is 6023.2 degree hours and development threshold temperature is 9.19°C. The results of this experiment provide a basis for the use of L. sericata in the estimation of PMImin.
Curative resection of a duodenal gastrointestinal stromal tumor in the setting of von Willebrand’s disease
Authors: Litow Kyle , Jabbour Gaby , Bahn-Humphrey Alexandra , Stoller Christy , Rhee Peter , Latifi Rifat , Prabhakaran Kartik , Veillette Gregory
Published: March 2020

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the alimentary tract and usually presents with gastrointestinal hemorrhage. The diagnosis of GIST is typically made with upper endoscopy after excluding other causes of bleeding. The surgical management of GIST can be challenging depending upon the location of the tumor. We present a unique case of duodenal GIST in the setting von Willebrand’s disease diagnosed after emergent laparotomy for massive gastrointestinal hemorrhage. Key strategies in curing our patient were treating the underlying bleeding disorder, collaborating with radiology and gastroenterology teams, and early exploratory laparotomy for refractory hemorrhage. This case demonstrates the challenges of diagnosing and managing GIST in patients with underlying coagulopathies.
Chest Pain From Supplement Use in an Active Duty Soldier: A Case Report
Authors: Bridwell Rachel E , Yoo Michael J , Grove Jordan J , Ng Patrick C
Published: March 2020

In the active duty population, over-the-counter performance enhancing supplements are readily available and consumed, primarily in an unsupervised manner. While some of the active ingredients, such as caffeine and creatine, have been well studied, other sympathomimetic and vasoactive components in these products have minimal data regarding their safety profile. Further potentiating the associated risks of consumption, the quantities and purities of the reported ingredients are often unverified and can vary from serving to serving. We present a case of the deleterious side effect profiles of these lesser studied components in overconsumption in an active duty soldier. Although improvements are being made regarding product safety, the paucity of ingredient regulation and quality assurance can result in warfighter morbidity and mortality, especially when these supplements are abused or combined with other products.
Use of Pharmacy Quality Measures to Enhance Value-Based Performance Within the Military Health System
Authors: Costantino Ryan C , Nau David , Neigh Jeffrey J , Hoerner Paul J , Hull Jessica R , Perfetto Eleanor
Published: March 2020

Introduction

As the healthcare system shifts from fee-for service toward value-driven healthcare, interest has grown in medication-related quality metrics to evaluate quality and value within the healthcare system. While the Defense Health Agency (DHA) has taken steps to align healthcare quality measures across the enterprise, the extent to which DHA utilizes pharmacy quality measures (PQMs) or evaluates the quality of direct and purchased pharmacy care is unknown.

Materials and Methods

A comparison was made between existing PQMs utilized by DHA and all measures published and endorsed by the Pharmacy Quality Alliance (PQA), a recognized, PQM standard-setting organization. We also compared DHA PQMs to those used within the Medicare Part D Star Rating Program.

Results

DHA has implemented 10 (28%) of the 36 PQA measures available for evaluation as of August 2019. Of the five measures included in the 2020 CMS Part D Star Rating program, DHA has currently implemented four (80%) of the measures. DHA has implemented 3 of the 5 (60%) PQA CMS Display Measures, and 5 of 9 (56%) PQA CMS Patient Safety Report Measures that are not part of the Star Ratings, but that are used to benchmark and provide feedback to health plans.

Conclusion

Opportunities exist within the DHA to leverage PQMs to evaluate the quality of pharmaceutical care, build trust with beneficiaries by increasing transparency, and maintain parity with the civilian healthcare system. Existing models and commercially available technology could be considered to rapidly operationalize the use of PQMs within the MHS.
An ionized superbubble powered by a protocluster at z = 6.5
Authors: Rodríguez Espinosa J M , Mas-Hesse J M , Salvador-Solé E , Calvi R , Manrique A , Chanchaiworawit K , Guzman R , Gallego J , Herrero A , Marín Franch A
Published: March 2020

We show herein that a proto-cluster of Ly α emitting galaxies, spectroscopically confirmed at redshift 6.5, produces a remarkable number of ionizing continuum photons. We start from the Ly α fluxes measured in the spectra of the sources detected spectroscopically. From these fluxes, we derive the ionizing emissivity of continuum photons of the protocluster, which we compare with the ionizing emissivity required to reionize the protocluster volume. We find that the sources in the protocluster are capable of ionizing a large bubble, indeed larger than the volume occupied by the protocluster. For various calculations, we have used the model AMIGA, in particular to derive the emissivity of the Lyman continuum photons required to maintain the observed volume ionized. Besides, we have assumed the ionizing photons escape fraction given by AMIGA at this redshift.
A new proxy to estimate the cosmic ray ionization rate in dense cores
Authors: Bovino S , Ferrada-Chamorro S , Lupi A , Schleicher D R G , Caselli P
Published: March 2020

Cosmic rays are a global source of ionization, and the ionization fraction represents a fundamental parameter in the interstellar medium. Ions couple to magnetic fields, and affect the chemistry and the dynamics of star-forming regions as well as planetary atmospheres. However, the cosmic ray ionization rate represents one of the bottlenecks for astrochemical models, and its determination is one of the most puzzling problems in astrophysics. While for diffuse clouds reasonable values have been provided from ${\mathrm{ H}_3}^+$ observations, for dense clouds, due to the lack of rotational transitions, this is not possible, and estimates are strongly biased by the employed model. We present here an analytical expression, obtained from first principles, to estimate the cosmic ray ionization rate from observational quantities. The theoretical predictions are validated with high-resolution 3D numerical simulations and applied to the well-known core L1544; we obtained an estimate of ζ2 ∼ 2–3 × 10−17 s−1. Our results and the analytical formulae provided represent the first model-independent robust tool to probe the cosmic ray ionization rate in the densest part of star-forming regions (on spatial scales of R ≤ 0.05 pc). An error analysis is presented to give statistical relevance to our study.
On the origins, meaning and influence of Jensen and Meckling’s definition of the firm
Authors: Gindis David
Published: March 2020

Jensen and Meckling’s 1976 definition of the firm as a legal fiction which serves as a nexus for contracts between individuals sits well with the Coasean narrative on the firm while at the same time being at odds with it. Available interviews with Jensen shed little light on the origins and meaning of this unusual definition. The article shows how the definition captured, and was a response to, the American socio-political context of the early and mid-1970s, and traces how Jensen and Meckling employed it once they themselves became immersed in the public debate about corporate responsibility and regulation in the late 1970s and early 1980s. It also considers Jensen and Meckling’s place in the literature on the economics of corporate law developed mostly in the 1980s.
A bottom-up approach to fermion mass hierarchy: a case with vector-like fermions
Authors: Kawamura Yoshiharu
Published: March 2020

We propose a bottom-up approach in which a structure of high-energy physics is explored by accumulating existence proofs and/or no-go theorems in the standard model or its extension. As an illustration, we study fermion mass hierarchies based on an extension of the standard model with vector-like fermions. It is shown that the magnitude of elements of Yukawa coupling matrices can become $O(1)$ and a Yukawa coupling unification can be realized in a theory beyond the extended model, if vector-like fermions mix with three families. In this case, small Yukawa couplings in the standard model can be highly sensitive to a small variation of matrix elements, and it seems that the mass hierarchy occurs as a result of fine tuning.
History of injury in a developing country: a scoping review of injury literature in Lebanon
Authors: Al-Hajj Samar , Pawliuk Colleen , Smith Jennifer , Zheng Alex , Pike Ian
Published: March 2020

Background

Lebanon, an Eastern Mediterranean country, suffers a large burden of injury as a consequence of conflict and war, political instability, and the lack of policies and safety regulations. This article aims to systematically map and comprehensively describe the injury research literature in Lebanon and, to identify gaps for future research.

Methods

MEDLINE, Embase, Eric and SafetyLit, and the grey literature, including conference proceedings, theses and dissertations, government and media reports, were searched without any date or language limits. Data were extracted from 467 documents using REDCap.

Results

War-related injuries were the most prevalent type of injury in Lebanon, followed by homicide and other forms of violence. While existing literature targeted vulnerable and at-risk populations, the vast majority focused solely on reporting the prevalence of injuries and associated risk factors. There are considerable gaps in the literature dealing with the integration of preventive programs and interventions across all populations.

Conclusions

Lebanon, historically and currently, experiences a high number of injuries from many different external causes. To date, efforts have focused on reporting the prevalence of injuries and making recommendations, rather than implementing and evaluating interventions and programs to inform policies. Future injury related work should prioritize interventions and prevention programs.
Social perspective-taking shapes brain hemodynamic activity and eye movements during movie viewing
Authors: Bacha-Trams Mareike , Ryyppö Elisa , Glerean Enrico , Sams Mikko , Jääskeläinen Iiro P
Published: March 2020

Putting oneself into the shoes of others is an important aspect of social cognition. We measured brain hemodynamic activity and eye-gaze patterns while participants were viewing a shortened version of the movie ‘My Sister’s Keeper’ from two perspectives: that of a potential organ donor, who violates moral norms by refusing to donate her kidney, and that of a potential organ recipient, who suffers in pain. Inter-subject correlation (ISC) of brain activity was significantly higher during the potential organ donor’s perspective in dorsolateral and inferior prefrontal, lateral and inferior occipital, and inferior–anterior temporal areas. In the reverse contrast, stronger ISC was observed in superior temporal, posterior frontal and anterior parietal areas. Eye-gaze analysis showed higher proportion of fixations on the potential organ recipient during both perspectives. Taken together, these results suggest that during social perspective-taking different brain areas can be flexibly recruited depending on the nature of the perspective that is taken.
Piloting a trachomatous trichiasis patient case-searching approach in two localities of Sudan
Authors: Sanders Angelia M , Adam Maha , Aziz Nabil , Callahan E Kelly , Elshafie Belgesa E
Published: March 2020

Background

Approximately 1.9 million people have become blind or visually impaired from trachoma, the leading cause of infectious blindness. Trachoma prevalence surveys conducted in Sudan have shown that thousands of Sudanese suffer from the advanced stages of the disease, trachomatous trichiasis (TT), and warrant sight-saving surgery. Sudan’s National Trachoma Control Program (NTCP) provides free TT surgery; however, given that many TT patients live in remote areas with limited access to health services, identifying patients and providing eye care services has proved challenging. For this reason, the Sudan NTCP piloted a systematic TT case-finding approach to identify patients.

Methods

In Gedarif state, 11 villages in Baladyat el Gedarif locality and 21 villages in West Galabat locality were included in a TT case-searching activity from September to November 2018. TT case finders were selected from the villages where the activity took place and were trained by ophthalmic medical assistants to identify possible patients.

Results

Of 66 626 villagers examined, 491 were identified as having TT by TT case finders. Of those, 369 were confirmed as true cases by the TT surgeons, a 75.2% (369/491) success rate.

Conclusions

The TT case-finding approach provides an example of an effective method for identifying TT patients and should be expanded to other parts of the country known to be endemic for trachoma.
Biogeography and Diversity of Multi-Trophic Root Zone Microbiomes in Michigan Apple Orchards: Analysis of Rootstock, Scion, and Local Growing Region
Authors: Bintarti A. F. , Wilson J. K. , Quintanilla-Tornel M. A. , Shade A.
Published: March 2020

Soil is a highly heterogeneous environment with many physical and chemical factors that are expected to vary within and across fruit orchards, and many of these factors also drive changes in the soil microbiome. To understand how biogeography influences apple root microbiomes, we characterized the bacterial and archaeal, fungal, nematode, oligochaete, and mycorrhizal communities of the root zone soil (soil adjacent to the tree trunk and expected to be influenced by the plant) across 20 sites that represent the main Michigan apple-producing region. Amplicon sequencing of the 16S rRNA and internal transcribed spacer genes were performed, as well as direct quantification of nematodes, oligochaetes, and mycorrhizal fungi with microscopy. The microbiome community structures were affected by site and rootstock, but not by scion. Microbiomes had taxa typical of soil, including an archaeal taxon affiliated with family Nitrososphaeraceae, bacterial phyla Proteobacteria and Acidobacteria, and fungal phyla Ascomycota and Basidiomycota. While many taxa were detected in all samples and collectively composed 41.55% of the relative abundances, they had average relative abundances each of less than 1%, with no notable dominance. We used network analysis to understand potential for intertrophic interactions, but detected few cross-kingdom associations. Together, these results show the complexity of the apple root zone microbiome and did not identify obvious biotargets that may universally associate with tree health. This suggests that the key attributes of the apple root zone community may be in the community-level functional traits that are shared and distributed across the membership, rather than by its composition.
Incidence, Severity, and Characterization of Phytophthora Foot Rot of Citrus in Texas and Implications for Disease Management
Authors: Chaudhary Shima , Laughlin David A. , Setamou Mamoudou , da Graça John V. , Kunta Madhurababu , Alabi Olufemi J. , Crosby Kevin M. , Ong Kevin L. , Ancona Veronica
Published: March 2020

Phytophthora-induced foot rot, also known as gummosis, is an important disease affecting citrus production worldwide. In Texas, the third-largest citrus-producing state in the United States, limited information is available on the etiology and epidemiology of foot rot in commercial orchards. This study comprises a survey of foot rot incidence and severity in Texas and the characterization of Phytophthora isolates associated with the disease. Surveys in 2015 and 2017 of 30 orchards in the Lower Rio Grande Valley (LRGV) region where commercial citrus production is concentrated in the state revealed that foot rot occurred in 97% of the orchards assessed. Overall, foot rot symptoms were observed on 33.7% of the trees evaluated and the disease severity index in the region was rated at 14.2 and 16.5% in 2015 and 2017, respectively. Lesions were mostly present on the scion, while the rootstock (sour orange) was not affected. Phytophthora nicotianae was the only Phytophthora sp. isolated from the surveyed orchards and from five additional residential sites on the Texas Coastal Bend (TCB). Sporangia and chlamydospores from 34 representative LRGV isolates of P. nicotianae were larger than those of TCB isolates. In both LRGV and TCB, A1 and A2 mating types were present in the same location, albeit the A2 mating type was more prevalent. All isolates were sensitive to mefenoxam (50% inhibition in the presence of mefenoxam [EC50] < 0.5 µg/ml), except for one TCB isolate (EC50 = 143.6 µg/ml). Our research indicates that treatment for Phytophthora foot rot in the region is necessary and, although mefenoxam is still useful, alternating chemistries for resistance management are required.
Decreased Sensitivity of Leptosphaeria maculans to Pyraclostrobin in Alberta, Canada
Authors: Wang Yixiao , Akhavan Alireza , Hwang Sheau-Fang , Strelkov Stephen E.
Published: March 2020

Leptosphaeria maculans, the causal agent of blackleg of canola (Brassica napus), can be managed with pyraclostrobin and other strobilurin fungicides. Their frequent application, however, poses a risk for the development of insensitivity in fungal populations. A collection of L. maculans single-spore isolates recovered from infected canola stubble in Alberta, Canada, in 2016 was evaluated for its pyraclostrobin sensitivity. In conventional growth plate assays, the concentration of pyraclostrobin required to inhibit fungal growth by 50% (EC50) was determined to be 0.28 mg/liter in a subset of 38 isolates. This EC50 was four times greater than the mean EC50 (0.07 mg/liter) of baseline isolates collected in 2011. Two hundred sixty-three isolates were screened further with two discriminatory doses of 0.28 and 3.5 mg/liter of pyraclostrobin, resulting in growth inhibition values ranging from 16 to 82% and 41 to 100%, respectively. In microtiter plate assays with the same isolates, the mean EC50 was determined to be 0.0049 mg/liter, almost 3.3 times greater than the mean EC50 (0.0015 mg/liter) of the baseline isolates. The sensitivity of the isolates was also evaluated in microtiter plate assays with discriminatory doses of 0.006 and 0.075 mg/liter of pyraclostrobin, resulting in inhibition values ranging from 20 to 88% and 49 to 100%, respectively. This is the first report of isolates of L. maculans with increased insensitivity to pyraclostrobin in Canada, suggesting the need for improved fungicide stewardship.
Detection of the GenusPhytophthoraand the SpeciesPhytophthora nicotianaeby LAMP with a QProbe
Authors: Hieno Ayaka , Li Mingzhu , Afandi Auliana , Otsubo Kayoko , Suga Haruhisa , Kageyama Koji
Published: March 2020

Phytophthora is an oomycete genus with worldwide distribution, and many of its species cause destructive diseases. In Japan, Phytophthora species are listed as quarantine organisms with the exception of Phytophthora nicotianae. For effective quarantine control, we designed a Phytophthora genus-specific loop-mediated isothermal amplification (LAMP) primer set and a P. nicotianae species-specific quenching probe (QProbe) to establish a simultaneous LAMP-based detection method. We confirmed the specificity of the genus-specific primers, and all 161 taxa were detected. No other species in the closely related genera Pythium and Phytopythium gave positive results with the exception of two species, Phytopythium delawarense and Phytopythium fagopyri. These two species gave inconsistent results. We used annealing curve analysis with the QProbe to demonstrate that P. nicotianae could be distinguished from other species. DNA from inoculated and naturally infected plants was extracted using a time-saving extraction kit and subjected to the simultaneous detection method. We confirmed that all Phytophthora DNAs in the plant samples were detected, and P. nicotianae was specifically identified. This simultaneous detection method will make quarantine inspections faster and easier.
Pharmacological Characteristics and Efficacy of Fluazinam AgainstCorynespora cassiicola, Causing Cucumber Target Spot in Greenhouses
Authors: Li Tao , Xiu Qian , Zhang Jie , Wang Jian Xin , Duan Ya Bing , Zhou Ming Guo
Published: March 2020

Cucumber target spot, caused by Corynespora cassiicola, is a devastating fungal disease in greenhouses in China. Lack of resistant cultivars and unscientific use of fungicides aggravated the difficulty to manage this disease. In recent years, resistance of C. cassiicola to benzimidazoles, quinone outside inhibitors, and succinate dehydrogenase inhibitors has occurred in China. Here, we tested the fluazinam sensitivity distribution of 79 C. cassiicola isolates from different provinces in China based on mycelial growth inhibition. The EC50values of fluazinam ranged from 0.1002 to 0.3129 µg/ml with a mean of 0.2136 ± 0.0495 µg/ml, and the sensitivity frequency was normally distributed (P = 0.2083, Shapiro–Wilk test). Meanwhile, the EC50values for spore germination inhibition ranged from 0.0992 to 0.2278 µg/ml with a mean of 0.1499 ± 0.0504 µg/ml. This indicated that fluazinam exhibited an excellent in vitro fungicidal activity on both mycelial growth and spore germination. In addition, fluazinam also exhibited a good in planta control efficacy on detached cucumber leaves in the protective and curative assays. Moreover, the biological and physiological characteristics of C. cassiicola as affected by fluazinam were determined. Fluazinam not only significantly inhibited respiration and adenosine triphosphate production but also caused the increase of cell membrane permeability and the dysfunctions of cellular homeostasis. Interestingly, we found that fluazinam especially damaged vacuole structures, causing the redistribution of vacuole substances. Taken together, our findings provide not only essential references for resistance management of C. cassiicola but also interesting insights for further revealing the action mode of fluazinam against plant pathogens.
Dissecting Genetic Resistance to Fire Blight in Three Pear Populations
Authors: Zurn Jason D. , Norelli John L. , Montanari Sara , Bell Richard , Bassil Nahla V.
Published: March 2020

Fire blight, caused by the bacterial pathogen Erwinia amylovora, is a persistent problem for pear (Pyrus spp.) growers in the United States. Growing resistant cultivars is one of the best options for managing fire blight. The cultivars Potomac and Old Home and the selection NJA2R59T69 display resistance to fire blight. As such, three mapping populations (El Dorado × Potomac, Old Home × Bartlett, and NJA2R59T69 × Bartlett) were developed to identify genomic regions associated with resistance to fire blight. Progeny were phenotyped during 2017 and 2018 by inoculating multiple actively growing shoots of field-grown seedling trees with E. amylovora isolate E153n via the cut-leaf method. Genotyping was conducted using the recently developed Axiom Pear 70 K Genotyping Array and chromosomal linkage groups were created for each population. An integrated two-way pseudo-testcross approach was used to map quantitative trait loci (QTLs). Resistance QTLs were identified on chromosome 2 for each population. The QTLs identified in the El Dorado × Potomac and Old Home × Bartlett populations are in the same region as QTLs that were previously identified in Harrow Sweet and Moonglow. The QTL in NJA2R59T69 mapped proximally to the previously identified QTLs and originated from an unknown Asian or occidental source. Future research will focus on further characterizing the resistance regions and developing tools for DNA-informed breeding.
Proteome Responses to Individual Pathogens and Abiotic Conditions in Rice Seedlings
Authors: Sruthilaxmi Chitathoor Balasubramane , Babu Subramanian
Published: March 2020

Rice plants under field conditions experience various biotic and abiotic stresses and are adapted to survive using a molecular cross-talk of genes and their protein products based on the severity of a given stress. Seedlings of cultivated variety ASD16 (resistant to fungal disease, blast; tolerant to abiotic stress, salinity) were subjected to salt, drought, high temperature and low temperature stress as well as infection by Rhizoctonia solani and Xanthomonas oryzae pv. oryzae (causing reemerging diseases such as sheath blight and leaf blight), respectively, the sheath blight and bacterial leaf blight pathogens. Leaf proteome was analyzed using two-dimensional electrophoresis and differentially expressed proteins were identified using mass spectrometry. In addition to many other differentially expressed proteins, acidic endochitinase was found to be upregulated during fungal infection and drought treatment, and a germin-like protein upregulated during fungal infection and high temperature stress. These two proteins were further validated at the gene expression level using reverse transcription-PCR in dual stress experiments. Pot culture plants were subjected to fungal infection followed by drought and drought followed by fungal infection to validate chitinase gene expression. Similarly, plants subjected to fungal infections followed by high temperature stress and vice versa were used to validate the expression of germin-like protein-coding gene. The results of the present study indicate that chitinase and germin-like protein are potential targets for further exploration to develop rice plants resistant or tolerant to biotic and abiotic stresses.
Internal carotid artery blood flow is enhanced by elevating blood pressure during combined propofol-remifentanil and thoracic epidural anaesthesia
Authors: Olesen Niels D. , Frederiksen Hans-Jørgen , Storkholm Jan H. , Hansen Carsten P. , Svendsen Lars B. , Olsen Niels V. , Secher Niels H.
Published: March 2020

BACKGROUND

Anaesthesia reduces mean arterial pressure (MAP), and to preserve organ perfusion, vasopressors are often used to maintain MAP above 60 mmHg. Cognitive dysfunction is common following major surgery and may relate to intra-operative cerebral hypoperfusion.

OBJECTIVE

The aim of this study was to evaluate whether internal carotid artery (ICA) blood flow increases when MAP is kept higher than 60 mmHg using noradrenaline.

DESIGN

A randomised, cross-over trial.

SETTING

Department of Anaesthesia, Rigshospitalet, Copenhagen, Denmark, from December 2017 to April 2018.

PATIENTS

Patients with median [IQR] age 71 [63 to 75] years underwent pancreaticoduodenectomy (n = 19), total pancreatic resection (n = 1) or gastro-entero anastomosis (n = 2) during combined propofol-remifentanil and thoracic epidural anaesthesia.

INTERVENTION

MAP was maintained between 60 to 65, 70 to 75 and 80 to 85 mmHg, in a random order, by noradrenaline infusion at a stable level of anaesthesia.

MAIN OUTCOME MEASURES

Primary outcome was change in ICA flow at MAP 60 to 65 vs. 80 to 85 mmHg. Secondary outcomes were change in ICA flow at MAP 60 to 65 vs. 70 to 75 and 70 to 75 vs. 80 to 85 mmHg. Duplex ultrasound evaluated ICA flow.

RESULTS

A (mean ± SD) increase in MAP from 62 ± 1 to 82 ± 1 mmHg elevated ICA flow from 196 ± 53 to 226 ± 61 ml min−1 (mean difference 31 ml min−1; 95% CI 19 to 42; P < 0.0001). An increase in MAP from 62 ± 1 to 72 ± 1 mmHg elevated ICA flow to 210 ± 52 ml min−1 (P = 0.0271) and ICA flow increased further (P = 0.0165) when MAP was elevated to 82 ± 1 mmHg.

CONCLUSION

During combined propofol-remifentanil and thoracic epidural anaesthesia, ICA flow increased by approximately 15% when the MAP was elevated from about 60 to 80 mmHg. Treatment of a reduction in MAP brought about by anaesthesia seems to enhance ICA flow.

TRIAL REGISTRATION

Clinicaltrials.gov ID: NCT03309917.
Improvement in pre-operative risk assessment in adults undergoing noncardiac surgery by a process-oriented score
Authors: Vogelsang Heike , Herzog-Niescery Jennifer , Botteck Nikolaj M. , Hasse Fabian , Peszko Adam , Weber Thomas P. , Gude Philipp
Published: March 2020

BACKGROUND

Pre-operative risk assessment is important to quantify the patient's risks of morbidity and mortality, but its quality differs. We created a process-oriented score (PRO-score) for risk evaluation of adults as a three-stage warning score checklist with concrete guidance. It contains the contents of current guidelines and the assessment of vital signs.

OBJECTIVES

We investigated whether the PRO-score is suitable to detect ‘red flag’ warning signs not only in American Society of Anesthesiologists (ASA) physical status (PS) 3 or 4 patients but also in ASA-PS 1 or 2 patients. Resulting medical, therapeutic or structural consequences were recorded.

DESIGN

Prospective single-centre study.

SETTING

The study was performed in a German university hospital between November 2015 and December 2018.

PATIENTS

We included 54 455 adult patients undergoing a pre-operative risk assessment for general or regional anaesthesia and elective noncardiac surgery.

RESULTS

In all, 388 patients presented ‘red flag’ warning signs in the PRO-score during risk assessment; 85 (21.9%) were labelled ASA-PS 1 or 2, 244 (62.9%) ASA-PS 3 and 59 (15.2%) ASA-PS 4. Additional examinations were performed in 179 patients and technical tests in 175 patients (ASA-PS 1 or 2: 53 and 63 patients, respectively). After re-evaluation of the peri-operative risk in an interdisciplinary conference, surgery was cancelled in 44 patients (ASA-PS 1 and 2, 17 patients) or performed under local anaesthesia in 15 patients (ASA-PS 1 and 2, 2 patients). A downgrading to PRO-score 2 was reached in 168 patients after therapeutic interventions (ASA-PS 1 and 2, 54 patients). Undergoing surgery despite ‘red flag’ events resulted in major complications in 34 patients, and 16 patients died (ASA-PS 1 or 2: 7 and 3 patients, respectively).

CONCLUSION

The PRO-score detected warning signs in ‘healthy’ ASA-PS 1 or 2 and in ASA-PS 3 or 4 patients. Furthermore, it influenced the management of these patients, and thus improved the process quality of risk assessment. The physical examination should include the assessment of vital signs.
Oocyte activation, oolemma piercing, and real-time viability confirmation in human oocytes using electrophysiological techniques
Authors: Mor Amir , Seli Emre
Published: March 2020

Purpose of review

To discuss the recent applications of electrophysiological principles to the optimization and automation of the IVF laboratory.

Recent findings

There is growing evidence showing improvement of live birth rates following oocyte electro-activation. Novel applications using electrophysiological techniques are now employed to determine oocyte penetration and viability in real-time.

In this short review, we summarize the recent advances in the integration of electrophysiological techniques into the assisted reproductive technology laboratories. We describe the potential clinical applications and their advantages such as creation of reliable automated cell injection systems and novel manual intracytoplasmic sperm injection (ICSI) training platforms. We also discuss theoretical adverse effects and ways to mitigate them.
Antibiotic Prescribing for Viral Respiratory Infections in the Pediatric Emergency Department and Urgent Care
Authors: Desai Neil M. , Sadlowski Jennifer L. , Mistry Rakesh D.
Published: March 2020

Background:

Viral acute respiratory tract infections (vARTI) are a frequent source of inappropriate antibiotic prescribing. We describe the prevalence of antibiotic prescribing for vARTI in the pediatric emergency department (ED) and urgent care (UC) within a health system, and identify factors associated with overall and broad-spectrum antibiotic prescribing.

Methods:

Retrospective chart review within a single pediatric referral health system. Visits of patients, 3 months– 17 years old, with a discharge diagnosis of a vARTI from 2010 to 2015. Data collected included specific vARTI diagnosis, site type (ED or UC), provider type [pediatric emergency medicine subspecialist or physicians, nurse practitioners, physician assistants (non-PEM)] and discharge antibiotics. Odds ratios and 95% confidence intervals (CI) were calculated where appropriate.

Results:

There were 132,458 eligible visits, mean age 4.1 ± 4.3 years. Fifty-three percent were treated in an ED. Advanced practice providers, a term encompassing nurse practitioners and physician assistants, were the most common provider type (47.7%); 16.5% of patients were treated by a pediatric emergency medicine subspecialist. Antibiotics were prescribed for 3.8% (95% CI: 3.72–3.92) of children with vARTI; 25.4% (95% CI: 24.2–26.6) of these were broad-spectrum, most commonly first-generation cephalosporins (11%; 95% CI 10.2–11.9). Patients treated in an ED or by a non-PEM and those receiving chest radiograph (CXR) received antibiotics most frequently. Prescribing rates varied by specific vARTI diagnosis.

Conclusions:

Patients discharged from the pediatric ED or UC with vARTI receive inappropriate antibiotics at a lower rate than reported in other community settings; however, they frequently receive broad-spectrum agents.