bluuebunny/crossref_metadata_2025 huggingface dataset:
Soil niche of rain forest plant lineages: Implications for dominance on a global scale
Authors: Procheş Şerban , Sukri Rahayu S. , Jaafar Salwana M. , Sieben Erwin J.J. , Zaini Nurul Hazlina , Abas Norain , Suhaini Siti Nurqayah , Juhairah Manjul Nurul Maz , Julaihi Muhammad Abdul Hakeem , Marshall David J. , Slik J.W. Ferry , Moodley Desika
Published: July 2019

Aim

Why some lineages are species‐rich and widespread, while others are species‐poor and localized, is a fundamental question in evolutionary biology and ecology. Diversification and range expansion relate to lineage‐specific niche characters, but this link has seldom been quantified across multiple lineages and environments. This study explored the link between local dominance and soil niche in rain forest plants, and tested the hypothesis that local soil niche patterns can be used to predict the global diversity and occupancy of equal‐aged plant lineages.

Location

The study was carried out in Brunei Darussalam (Borneo) and projected worldwide.

Methods

Our approach involved the subdivision of vascular plants into the lineages found 120 Mya, a time preceding the explosive radiation of the eudicots. We quantified the representation of the 120 Mya lineages in different forest types associated with dramatically different soils, but sharing the same climatic conditions. The forest types included primary and secondary lowland rain forest, flooded and nutrient‐impoverished inland forests, and mangroves. Niche breadth and position, estimated from the soil types that a lineage occupied, were used to predict global diversity and occupancy patterns, after accounting for relatedness to the dominant eudicots.

Results

Despite marked differences in soil characteristics among the forest types, three eudicot lineages (Malvidae, Fabidae, Asteridae) were consistently dominant over the other 28 lineages present. A broad, intermediate soil niche, relatedness to eudicots, and the interaction between these factors were found to be strong predictors of global diversity and occupancy.

Main conclusions

We show that vegetation plot data from one of the world's most diverse regions (in terms of plant species richness and ancient lineage representation) can be used to successfully predict lineage diversity and occupancy on a global scale. However, because lineage dominance likely depends on the interaction between soil niche and above‐ground factors, including above‐ground niche features should improve the accuracy of predicting global distribution and diversity—particularly when explaining eudicot dominance.
A cardiovascular risk prediction model for older people: Development and validation in a primary care population
Authors: van Bussel Emma F. , Richard Edo , Busschers Wim B. , Steyerberg Ewout W. , van Gool Willem A. , Moll van Charante Eric P. , Hoevenaar‐Blom Marieke P.
Published: July 2019

Cardiovascular risk prediction is mainly based on traditional risk factors that have been validated in middle‐aged populations. However, associations between these risk factors and cardiovascular disease (CVD) attenuate with increasing age. Therefore, for older people the authors developed and internally validated risk prediction models for fatal and non‐fatal CVD, (re)evaluated the predictive value of traditional and new factors, and assessed the impact of competing risks of non‐cardiovascular death. Post hoc analyses of 1811 persons aged 70‐78 year and free from CVD at baseline from the preDIVA study (Prevention of Dementia by Intensive Vascular care, 2006‐2015), a primary care‐based trial that included persons free from dementia and conditions likely to hinder successful long‐term follow‐up, were performed. In 2017‐2018, Cox‐regression analyses were performed for a model including seven traditional risk factors only, and a model to assess incremental predictive ability of the traditional and eleven new factors. Analyses were repeated accounting for competing risk of death, using Fine‐Gray models. During an average of 6.2 years of follow‐up, 277 CVD events occurred. Age, sex, smoking, and type 2 diabetes mellitus were traditional predictors for CVD, whereas total cholesterol, HDL‐cholesterol, and systolic blood pressure (SBP) were not. Of the eleven new factors, polypharmacy and apathy symptoms were predictors. Discrimination was moderate (concordance statistic 0.65). Accounting for competing risks resulted in slightly smaller predicted absolute risks. In conclusion, we found, SBP, HDL, and total cholesterol no longer predict CVD in older adults, whereas polypharmacy and apathy symptoms are two new relevant predictors. Building on the selected risk factors in this study may improve CVD prediction in older adults and facilitate targeting preventive interventions to those at high risk.
Adjunctive effect of modifying the implant‐supported prosthesis in the treatment of peri‐implant mucositis
Authors: de Tapia Beatriz , Mozas Carla , Valles Cristina , Nart José , Sanz Mariano , Herrera David
Published: July 2019

Aim

To evaluate the adjunctive effect of modifying the implant‐supported prosthesis to facilitate access to oral hygiene when treating peri‐implant mucositis.

Material and methods

A 6‐month randomized clinical trial was designed. Patients with peri‐implant mucositis were treated by implant surface debridement with plastic curettes and a plastic tipped ultrasonic device. Then, they were randomly assigned to either modifying their prosthesis to allow for better oral hygiene (test group) or not (control group). Subsequently in both groups, individualized oral hygiene instructions were provided. Clinical and radiographical outcomes were evaluated at baseline and 1, 3 and 6 months after treatment.

Results

48 patients were included, and 45 completed the clinical trial (24 test and 21 control patients). After 6 months, changes in the modified bleeding index between the control and test groups were 0.50 (standard deviation −SD = 0.70) and 1.14 (SD = 0.96), respectively (p = 0.01). The changes in implant probing pocket depth at 6 months were −0.02 (SD = 0.61) and 0.31 (SD = 1.20) mm, respectively (p = 0.04).

Conclusions

Modifying the contour of the prostheses to improve access for oral hygiene significantly improved the clinical outcomes after standard mechanical treatment of peri‐implant mucositis.
Mobility of the upper cervical spine and muscle performance of the deep flexors in women with temporomandibular disorders
Authors: Ferreira Michele P. , Waisberg César B. , Conti Paulo César R. , Bevilaqua‐Grossi Débora
Published: July 2019

Background

Cervical spine disorders are frequently associated with temporomandibular disorders (TMDs). Although headache is common in TMD, few studies have considered headache regarding the functional performance of the cervical spine in TMD.

Objectives

To evaluate TMD subjects with and without self‐reported headache, assess the active and passive range of motion (ROM) of the upper cervical spine (C1‐C2) and performance of the deep cervical flexors, and evaluate the correlation of these outcomes with neck disability and temporomandibular pain.

Methods

In this cross‐sectional study, we assessed 57 women (40 with TMDs and 17 without TMDs [controls]). The TMD group was divided into 25 and 15 patients with and without self‐reported headache, respectively. We assessed the active and passive upper cervical ROMs using the flexion‐rotation test (FRT) and muscle performance using the craniocervical flexion test (CCFT). The neck disability index questionnaire and visual analog scale were used to assess self‐reported neck disability and temporomandibular pain, respectively.

Results

Compared to controls, all TMD subjects showed reduced cervical mobility on flexion/extension movements, reduced FRT findings and worse performance in CCFT (P < .05 all). Additionally, the CCFT and FRT findings were correlated with temporomandibular pain (r = .4 and .5, respectively) and neck disability (r = .3 and .4, respectively).

Conclusion

Women with TMDs, regardless of self‐reported headaches, showed limited flexion/extension ROM, limited upper cervical spine (C1‐C2) mobility and poor deep cervical flexor performance. Neck disability and temporomandibular pain showed a moderate correlation with the functional test findings, that is FRT and CCFT, in subjects with TMDs.
Is a small sea turtles rookery doomed to local extinction? Decreasing nesting trends at the Paria Gulf, Venezuela
Authors: Balladares Clemente , Quintero‐Torres Enrique
Published: July 2019

Small rookeries are rarely evaluated for marine turtles worldwide. Two species of sea turtles (Hawksbill, Eretmochelys imbricata; Leatherback, Dermochelys coriacea) nest on five main beaches of the northeast coast of the Paria Gulf in Venezuela. Population trends using generalized linear models at this rookery were assessed and compared with other small rookeries. Both species showed significant negative nesting trends: Nesting by critically endangered hawksbills decreased over nine seasons 2009–2017 (64–142 nests per year, General Linear Model Slope Value = −0.061; data pooled for five beaches); similarly, vulnerable leatherback nests decreased across the same period in the main beach Los Garzos (0–69 nests/year; GLMSV = −0.34). Besides human and natural predation of the nests, no significant environmental impacts affect the beaches except probably on Obispo Isthmus where a gas pipeline installation interrupted the nesting activity in 2014. Observed changes to the nesting trends in these small rookeries have a collective impact on broader conservation concerns for sea turtles in the region.
Double continuation regions for American and Swing options with negative discount rate in Lévy models
Authors: De Donno Marzia , Palmowski Zbigniew , Tumilewicz Joanna
Published: July 2019

In this paper, we study perpetual American call and put options in an exponential Lévy model. We consider a negative effective discount rate that arises in a number of financial applications including stock loans and real options, where the strike price can potentially grow at a higher rate than the original discount factor. We show that in this case a double continuation region arises and we identify the two critical prices. We also generalize this result to multiple stopping problems of Swing type, that is, when successive exercise opportunities are separated by i.i.d. random refraction times. We conduct an extensive numerical analysis for the Black–Scholes model and the jump‐diffusion model with exponentially distributed jumps.
Compositional diversity of ordinary chondrites inferred from petrology, bulk chemical, and oxygen isotopic compositions of the lowest FeO ordinary chondrite, Yamato 982717
Authors: Yamaguchi Akira , Kimura Makoto , Barrat Jean‐Alix , Greenwood Richard
Published: July 2019

We performed a petrologic, geochemical, and oxygen isotopic study of the lowest FeO ordinary chondrite (OC), Yamato (Y) 982717. Y 982717 shows a chondritic texture composed of chondrules and chondrule fragments, and mineral fragments set in a finer grained, clastic matrix, similar to H4 chondrites. The composition of olivine (Fa11.17 ± 0.48 (1σ)) and low‐Ca pyroxene (Fs11.07 ± 0.98 (1σ)Wo0.90 ± 0.71(1σ)) is significantly more magnesian than those of typical H chondrites (Fa16.0‐20, Fs14.5‐18.0), as well as other known low‐FeO OCs (Fa12.8‐16.7; Fs13‐16). However, the bulk chemical composition of Y 982717, in particular lithophile and moderately volatile elements, is within the range of OCs. The bulk siderophile element composition (Ni, Co) is within the range of H chondrites and distinguishable from L chondrites. The O‐isotopic composition is also within the range of H chondrites. The lack of reduction textures indicates that the low olivine Fa content and low‐Ca pyroxene Fs content are characteristics of the precursor materials, rather than the result of reduction during thermal metamorphism. We suggest that the H chondrites are more compositionally diverse than has been previously recognized.
Appointing nurses trained in organ donation to improve family consent rates
Authors: Witjes Marloes , Jansen Nichon E. , van Dongen Jacqueline , Herold Ingeborg H. F. , Otterspoor Luuk , Haase‐Kromwijk Bernadette J. J. M. , van der Hoeven Johannes G. , Abdo Wilson F.
Published: July 2019

Background

One of the most important bottlenecks in the organ donation process worldwide is the high family refusal rate.

Aims and objectives

The main aim of this study was to examine whether family guidance by trained donation practitioners increased the family consent rate for organ donation.

Design

This was a prospective intervention study.

Methods

Intensive and coronary care unit nurses were trained in communication about donation (ie, trained donation practitioners) in two hospitals. The trained donation practitioners were appointed to guide the families of patients with a poor medical prognosis. When the patient became a potential donor, the trained donation practitioner was there to guide the family in making a well‐considered decision about donation. We compared the family consent rate for donation with and without the guidance of a trained donation practitioner.

Results

The consent rate for donation with guidance by a trained donation practitioner was 58.8% (20/34), while the consent rate without guidance by a trained donation practitioner was 41.4% (41/99, P = 0.110) in those patients where the family had to decide on organ donation.

Conclusions

Our data suggest that family guidance by a trained donation practitioner could benefit consent rates for organ donation.

Relevance to clinical practice

Trained nurses play an important role in supporting the families of patients who became potential donors to guide them through the decision‐making process after organ donation request.
Artificial neural network‐based modeling of snow properties using field data and hyperspectral imagery
Authors: Haq Mohd Anul , Ghosh Abhijit , Rahaman Gazi , Baral Prashant
Published: July 2019

This study attempts to model snow wetness and snow density of Himalayan snow cover using a combination of Hyperspectral image processing and Artificial Neural Network (ANN). Initially, a total of 300 spectral signature measurements, synchronized with snow wetness and snow density, were collected in the field. The spectral reflectance of snow was then modeled as a function of snow properties using ANN. Four snow wetness and three snow density models were developed. A strong correlation was observed in near‐infrared and shortwave‐infrared region. The correlation analysis of ANN modeled snow density and snow wetness showed a strong linear relationship with field‐based data values ranging from 0.87–0.90 and 0.88–0.91, respectively. Our results indicate that an Artificial Intelligence (AI) approach, using a combination of Hyperspectral image processing and ANN, can be efficiently used to predict snow properties (wetness and density) in the Himalayan region.

Recommendations for resource managers

Snow properties, such as snow wetness and snow density are mainly investigated through field‐based survey but rugged terrains, difficult weather conditions, and logistics management issues establish remote sensing as an efficient alternative to monitor snow properties, especially in the mountain environment.

Although Hyperspectral remote sensing is a powerful tool to conduct the quantitative analysis of the physical properties of snow, only a few studies have used hyperspectral data for the estimation of snow density and wetness in the Himalayan region. This could be because of the lack of synchronized snow properties data with field‐based spectral acquisitions.

In combination with Hyperspectral image processing, Artificial Neural Network (ANN) can be a useful tool for effective snow modeling because of its ability to capture and represent complex input‐output relationships.

Further research into understanding the applicability of neural networks to determine snow properties is required to obtain results from large snow cover areas of the Himalayan region.
Delayed recognition of childhood arterial ischemic stroke
Authors: Hori Ikumi , Tsuji Takeshi , Miyake Misa , Ueda Kazuto , Kataoka Erina , Suzuki Michio , Kobayashi Satoru , Kurahashi Hirokazu , Takahashi Yoshiyuki , Okumura Akihisa , Yoshikawa Tetsushi , Saitoh Shinji , Natsume Jun
Published: July 2019

Background

Few population‐based surveys of childhood arterial ischemic stroke (AIS) have been conducted in Asian countries. The aim of this study was to investigate the clinical features, time to diagnosis, and prognosis of childhood AIS in a population‐based cohort in Japan.

Methods

Children aged 29 days–15 years 11 months old, residing in the Aichi Prefecture of Japan with radiologically confirmed AIS during 2010–2014, were identified retrospectively through questionnaires. We analyzed 40 children (23 boys, 17 girls; median age, 7 years 3 months), and collected time interval information of 26 patients. The time from clinical onset to first physician assessment and the time to AIS diagnosis were calculated.

Results

The most common presentation was paralysis or paresis in 27 patients (71%). No underlying disorders or possible trigger factors were identified in 14 patients (35%). The median time from symptom onset to first physician assessment was 2.9 h. The median time from symptom onset to the confirmed AIS diagnosis was 27.0 h. The diagnosis of AIS was made in the first 6 h after onset of symptoms in 27% of patients for whom the time was available. Radiological diagnosis took longer than 24 h in 54% of these patients.

Conclusions

Long in‐hospital delays exist in the diagnosis of AIS in children, likely due to lack of awareness of stroke by doctors. Further efforts to increase public and physician awareness of childhood stroke are needed to ensure early diagnosis and treatment.
A Real Options‐Based Decision‐Making Model for Infrastructure Investment to Prevent Rainstorm Disasters
Authors: Wang Tao , Liu Bingsheng , Zhang Jiaming , Li Guijun
Published: July 2019

Extreme precipitation caused by global climate change is expected to have a severe impact on urbanized areas. While decision‐makers struggle with climate uncertainty, an effective infrastructure adaptation strategy attaches great importance to preventing disasters resulting from rainfall. We propose a decision‐making model to incorporate the probability of rainfall disasters and recommend investing time when evaluating projects related to climate adaptation. We use a hydrological statistical model and economic and technical factors to estimate the expected economic losses in several rainfall disaster scenarios, and the value of the adaptation infrastructures is calculated using a real options pricing approach. Then the decision‐making model is applied to a case study involving a campus rainfall disaster prevention facility at the Central University of Finance and Economics in Beijing, China. We established three submerged scenarios with different rainfall intensities, then we evaluated the premium of holding an option to defer and pointed out the optimal investing time in each scenario. This model is expected to provide guidance for the development of adaptation infrastructure for relatively small areas such as communities and universities. And we proved that using real options‐based approach could provide more managerial flexibility for investors.
An Approximate Dynamic Programming Approach to Dynamic Pricing for Network Revenue Management
Authors: Ke Jiannan , Zhang Dan , Zheng Huan
Published: July 2019

Much of the network revenue management (NRM) literature considers capacity control problems where product prices are fixed and the product availability is controlled over time. However, for industries with imperfect competition, firms typically retain some pricing power and dynamic pricing models are more realistic than capacity control models. Dynamic pricing problems are more challenging to solve; even the deterministic version is typically nonlinear. In this study, we consider a dynamic programming model and use approximate linear programs (ALPs) to solve the problem. Unlike capacity control problems, the ALPs are semi‐infinite linear programs, for which we propose a column generation algorithm. Furthermore, for the affine approximation under a linear independent demand model, we show that the ALPs can be reformulated as compact second order cone programs (SOCPs). The size of the SOCP formulation is linear in model primitives, including the number of resources, the number of products, and the number of periods. In addition, we consider a version of the model with discrete price sets and show that the resulting ALPs admit compact reformulations. We report numerical results on computational and policy performance on a set of hub‐and‐spoke problem instances.
Assessing Impacts of Store and Salesperson Dimensions of Retail Service Quality on Consumer Returns
Authors: Ertekin Necati , Ketzenberg Michael E. , Heim Gregory R.
Published: July 2019

This study contributes to the understanding of consumer return behavior by examining associations between in‐store customer shopping experiences and subsequent customer returns. Return rates can vary a great deal across stores within a company and across salespersons within a store. We empirically examine returns across these two levels with respect to three retail service quality dimensions: salesperson friendliness, salesperson competence, and store environment. We conduct a detailed analysis using transaction data and customer survey responses from 25,131 customers at a national jewelry retailer. We find salesperson friendliness, salesperson competence, and store environment are significantly associated with subsequent return events, since, theoretically, customers use the three service quality dimensions as information cues to form their product quality perceptions. Our analysis reveals managerially relevant insights for retailers. The empirical associations suggest retailer management might obtain the most benefit in reducing returns from improving salesperson competence, which is followed by improving store environment and improving salesperson friendliness. We also conduct analyses using customer shopping attributes to identify how retailers might modify service for different customer segments to increase the efficacy of return prevention. Lastly, our counterfactual analysis predicts substantial improvements in return rates and net sales due to potential store execution efforts targeted at improving salesperson friendliness, salesperson competence, or store environment. The predictions support the idea that return prevention should start at the point of sale.
A systematic review: Current trends and take rates of cultured epithelial autografts in the treatment of patients with burn injuries
Authors: Lo Cheng H. , Chong Elaine , Akbarzadeh Shiva , Brown Wendy A. , Cleland Heather
Published: July 2019

Several issues persist in clinical translation and application of cultured epithelial autografts during treatment of patients with massive burn injuries. The aim of this systematic review is to determine (1) current practice and trends in clinical application and (2) clinical efficacy of cultured epithelial autografts. A structured literature search was performed in Ovid MEDLINE from 1946 and Ovid EMBASE from 1974 until present. All published peer‐reviewed randomized or non‐randomized clinical studies, cohort studies, prospective, or retrospective series involving human application of cultured epithelial autografts in the setting of burn injury were included. From 7,267 studies initially identified, 77 studies were included in the analysis. In 96% (74/77) of these series, the sample size was less than 100 patients. In 76.6% (59/77) publications, average burn treated exceeded 40% total body surface area. Overall, cultured epithelial autograft take rates reported in the literature were inconsistent and varied significantly from 0 to 100%. There was a recent trend for co‐application of cultured grafts with autologous skin grafts, achieving relatively high and consistent take rates of 73–96%. Results from cultured epithelial autograft application remained unpredictable. This technology remains an adjunct or biological dressing, and not an alternative to conventional split skin graft. However, it has contributed to wound closure and it has been life saving in selected circumstances. Skin tissue engineering should continue as the clinical need for skin replacement is foreseeable into the future.
Dimethyl sulfoxide by near-ambient pressure XPS
Authors: Avval Tahereh G. , Cushman Cody V. , Bahr Stephan , Dietrich Paul , Meyer Michael , Thißen Andreas , Linford Matthew R.
Published: July 2019

Near-ambient pressure x-ray photoelectron spectroscopy (NAP-XPS) is a less traditional form of XPS that allows samples to be analyzed at relatively high pressures, i.e., greater than 2500 Pa. With NAP-XPS, XPS can probe moderately volatile liquids, biological samples, porous materials, and/or polymeric materials that outgas significantly. In this submission, we show survey, O 1s, C 1s, S 2p, and S 2s NAP-XPS spectra from dimethyl sulfoxide (DMSO), a widely used organic solvent that is miscible with water. The sample was analyzed directly in its native, liquid state at room temperature. In general, both liquid and gas phase peaks are observed in the narrow scans. Due to the importance of DMSO in both chemistry and biology, it is likely that it will appear in future NAP-XPS analyses. Accordingly, these data may serve as a reference for future work.
Oxygen gas, O2(g), by near-ambient pressure XPS
Authors: Avval Tahereh G. , Chatterjee Shiladitya , Hodges Grant T. , Bahr Stephan , Dietrich Paul , Meyer Michael , Thißen Andreas , Linford Matthew R.
Published: July 2019

Near-ambient pressure x-ray photoelectron spectroscopy (NAP-XPS) is a less traditional form of XPS that allows samples to be analyzed at relatively high pressures, i.e., greater than 2500 Pa. With NAP-XPS, XPS can probe moderately volatile liquids, biological samples, porous materials, and/or polymeric materials that outgas significantly. In this submission, we show the survey, O 1s, valence band, and O KLL Auger NAP-XPS spectra of oxygen gas, O2, a material that would be difficult to analyze by conventional XPS. A small N 1s signal from N2(g) is also observed in the survey spectrum. The O 1s narrow scan is fit to Gaussian-Lorentzian sum functions. The Lorentzian character of this synthetic line shape was varied to obtain the best fit. Since it is likely that O2(g) will be present in other NAP-XPS analyses, these data should serve as a useful reference for other researchers.
Study of defects in β-Ga2O3 by isothermal capacitance transient spectroscopy
Authors: Lin Yu-Yao , Neal Adam T. , Mou Shin , Li Jian V.
Published: July 2019

The authors use isothermal capacitance transient spectroscopy to detect three deep defects located at approximately 0.6, 0.8, and 1.0 eV below the conduction band of β-Ga2O3 materials. The electrical properties of these defects such as their capture cross sections and concentrations are characterized, and their potentially adverse effects on power electronic devices are discussed. Because the isothermal capacitance transient spectroscopy method is implementable by instruments intended for steady-state capacitance-voltage measurement, it is promising for use as an effective characterization and monitoring tool for deep defects in β-Ga2O3 and other wide bandgap semiconductors.
Determining the dependence of marine pile driving sound levels on strike energy, pile penetration, and propagation effects using a linear mixed model based on damped cylindrical spreading
Authors: Martin S. Bruce , Barclay David R.
Published: July 2019

Acoustic recordings were made during the installation of four offshore wind turbines at the Block Island Wind Farm, Rhode Island, USA. The turbine foundations have four legs inclined inward in a pyramidal configuration. Four bottom mounted acoustic recorders measured received sound levels at distances of 541–9067 m during 24 pile driving events. Linear mixed models based on damped cylindrical spreading were used to analyze the data. The model's random effects coefficients represented useful information about variability in the acoustic propagation conditions. The received sound levels were dependent on the angle between pile and seabed, strike energy, and pile penetration (PP). Deeper PPs increased sound levels in a frequency dependent manner. The estimated area around the piles where auditory injury and disturbance to marine life could occur were not circular and changed by up to an order of magnitude between the lowest and highest sound level cases. The study extends earlier results showing a linear relationship between the peak sound pressure level and per-strike sound exposure level. Recommendations are made for how to collect and analyze pile driving data. The results will inform regulatory mitigations of the effects of pile driving sound on marine life, and contribute to developing improved pile driving source models.
Repurposing Quinacrine against Ebola Virus Infection
In Vivo
Authors: Lane Thomas R. , Comer Jason E. , Freiberg Alexander N. , Madrid Peter B. , Ekins Sean
Published: July 2019

Quinacrine hydrochloride is a small-molecule, orally bioavailable drug that has been used clinically as an antimalarial and for many other applications. A machine learning model trained on Ebola virus (EBOV) screening data identified quinacrine as a potent (nanomolar)
in vitro
inhibitor.
Streptococcus oralis subsp.
dentisani
Produces Monolateral Serine-Rich Repeat Protein Fibrils, One of Which Contributes to Saliva Binding via Sialic Acid
Authors: Ronis Allen , Brockman Kenneth , Singh Anirudh K. , Gaytán Meztlli O. , Wong Alexander , McGrath Sean , Owen C. David , Magrini Vincent , Wilson Richard K. , van der Linden Mark , King Samantha J.
Published: July 2019

Our studies reveal that the oral colonizer and cause of infective endocarditis
Streptococcus oralis
subsp.
dentisani
displays a striking monolateral distribution of surface fibrils. Furthermore, our data suggest that these fibrils impact the structure of adherent bacterial chains.
Behaviors and Energy Source of
Mycoplasma gallisepticum
Gliding
Authors: Mizutani Masaki , Miyata Makoto
Published: July 2019

Mycoplasmas, the smallest bacteria, are parasitic and occasionally commensal.
Mycoplasma gallisepticum
is related to human-pathogenic mycoplasmas—
Mycoplasma pneumoniae
and
Mycoplasma genitalium
—which cause so-called “walking pneumonia” and nongonococcal urethritis, respectively. These mycoplasmas trap sialylated oligosaccharides, which are common targets among inﬂuenza viruses, on host trachea or urinary tract surfaces and glide to enlarge the infected areas. Interestingly, this gliding motility is not related to other bacterial motilities or eukaryotic motilities. Here, we quantitatively analyze cell behaviors in gliding and clarify the direct energy source. The results provide clues for elucidating this unique motility mechanism.
Less invasive surfactant administration (LISA): chances and limitations
Authors: Herting Egbert , Härtel Christoph , Göpel Wolfgang
Published: July 2019

Non-invasive ventilation and especially the application of continuous positive airway pressure (CPAP) has become standard for the treatment of premature infants with respiratory problems. However, CPAP failure may occur due to respiratory distress syndrome, that is, surfactant deficiency. Less invasive surfactant administration (LISA) aims to provide an adequate dose of surfactant while the infant is breathing spontaneously, thus avoiding positive pressure ventilation support. Using a thin catheter for surfactant application allows infants to maintain function of the glottis and continue spontaneous breathing, whereas the INtubate-SURfactant-Extubate (INSURE) procedure is connected with sedation/analgesia, regular intubation and a (brief) period of positive pressure ventilation. Individual studies and meta-analyses summarised in this review point in the direction that LISA is more effective than standard treatment or INSURE both in terms of short-term (avoidance of mechanical ventilation) and long-term (intracerebral haemorrhage and bronchopulmonary dysplasia) outcomes. Open questions include exact treatment thresholds for different gestational ages, the usefulness of devices/catheters that have recently been purpose-built for the LISA technique and especially the question of analgesia/sedation during the procedure. The current technology still demands laryngoscopy with all its unpleasant effects for infants. Therefore, studies with pharyngeal surfactant deposition immediately after delivery, the use of laryngeal airways for surfactant administration and attempts to nebulise surfactant are under way. Finally, LISA is not simply an isolated technical procedure for surfactant delivery but rather part of a comprehensive non-invasive approach supporting the concept of a gentle transition to the extrauterine world enabling preterm infants to benefit from the advantages of spontaneous breathing.
Professionals’ accounts of genetic testing in adoption: a qualitative study
Authors: Arribas-Ayllon Michael , Clarke Angus , Shelton Katherine
Published: July 2019

Objective

To explore social workers’ and medical advisors’ accounts of genetic testing in adoption.

Methods

A qualitative study using semi-structured interviews to gather in-depth accounts of retrospective cases. Data were analysed thematically to identify professionals’ knowledge and expectations.

Results

Twenty professionals working in adoption services (including 8 medical advisors and 12 social workers) participated in this study. Social workers adopted an essentialist (single-gene) model to discuss genetic testing in relation to past cases. They assumed that testing was a generic procedure for detecting the presence or absence of a specific aetiology, the results of which were believed to be definitive and mutually exclusive. By contrast, medical advisors were circumspect and agnostic about the meaning of results, especially in relation to chromosomal microarray testing. Whereas social workers believed that genetic testing provided clarity in assessment and therefore assisted adoption, medical advisors emphasised the uncertainties of testing and the possibility that prospective adopters might be misled. Medical advisors also reported inappropriate requests to test children where there was a family history of a genetic condition, or to confirm or exclude a diagnosis of fetal alcohol spectrum disorder in children presenting with non-specific dysmorphic features.

Conclusion

Recent advances in genetic technologies are changing the ways in which professionals understand and tolerate uncertainty in adoption. Social workers and medical advisors have different understandings and expectations about the clinical utility of genetic testing. These findings have implications for social work training about genetic testing and enabling effective communication between professional groups.
A challenging diagnosis of MPO-C-ANCA EGPA
Authors: Lim Gareth , Lim Sheryl , Tee Shang-Ian , Ling Chai Yiing
Published: July 2019

Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystemic small-vessel vasculitic disease that can present with positive MPO-P-ANCA (myeloperoxidase–perinuclear–anti-neutrophil cytoplasmic antibody). It is a rare condition that is difficult to diagnose. We present the case of a 64-year-old man with late-onset adult asthma and treated nasopharyngeal carcinoma who initially presented to us with proximal myopathy. Thereafter, he developed a constellation of fleeting symptoms which included rhinosinusitis, mononeuritis multiplex, skin vasculitis and arthritis. Blood investigations showed that he had eosinophilia, and skin biopsy demonstrated dermal vasculitis with eosinophils. He was found to be MPO-C-ANCA positive, and although initially thought to have granulomatosis with polyangiitis, the diagnosis was later revised to EGPA. This case highlights the diagnostic challenges with atypical presentations of EGPA and also presents a rare case of positive MPO-C-ANCA that has never been described in EGPA before.
Gastropleural fistula masquerading as chylothorax in a child with lymphoma
Authors: Prasertsan Pharsai , Anuntaseree Wanaporn , Ruangnapa Kanokpan , Saelim Kantara
Published: July 2019

We report the case of an 8-year-old boy with diffuse large B cell lymphoma who developed a right-sided spontaneous pneumothorax with pleural effusion after recovery from septic shock. The pleural fluid was thought to be malignancy-associated chylothorax concomitant with complicated pleural effusion due to a milky-like appearance, a high level of triglycerides and Gram-negative bacteria staining in the fluid. He was put on total parental nutrition and octreotide for 2 weeks, but did not improve. The laboratory results also showed a persistent bacterial infection in the pleural fluid despite appropriate antibiotics. Eventually, a CT scan revealed a fistulous tract between the right pleural cavity and the stomach. Fistula repair was successful by right open thoracotomy with decortication. Even though the gastropleural fistula is a very rare condition in paediatric patients, the physician should consider this diagnosis in a patient who has an unusual presentation or refractory chylothorax-like pleural effusion.
Hyperbaric oxygen therapy in a case of cervical abscess extending to anterior mediastinum, with isolation ofPrevotella corporis
Authors: Ciodaro Francesco , Gazia Francesco , Galletti Bruno , Galletti Francesco
Published: July 2019

We present a case of an odontogenic abscess, first spreading at the lateral cervical level and then in mediastinum. We isolated an anaerobic bacterium,Prevotella corporis, rarely documented in literature. The mortality rates of cervical abscesses secondary to odontogenic infections and complicated by mediastinitis vary from 10% to 40%. Treatment of descending mediastinitis involves multidisciplinary teams such as otorhinolaryngology, thoracic surgeons, infectious disease physicians, anesthetists and intensivists. Due to the combined treatment with surgical drainage within 48 hours of hospitalisation, antibiotics and subsequent hyperbaric oxygen therapy, we have achieved complete recovery of the patient.
Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort
Authors: Chazelas Eloi , Srour Bernard , Desmetz Elisa , Kesse-Guyot Emmanuelle , Julia Chantal , Deschamps Valérie , Druesne-Pecollo Nathalie , Galan Pilar , Hercberg Serge , Latino-Martel Paule , Deschasaux Mélanie , Touvier Mathilde
Published: July 2019

Objective

To assess the associations between the consumption of sugary drinks (such as sugar sweetened beverages and 100% fruit juices), artificially sweetened beverages, and the risk of cancer.

Design

Population based prospective cohort study.

Setting and participants

Overall, 101 257 participants aged 18 and over (mean age 42.2, SD 14.4; median follow-up time 5.1 years) from the French NutriNet-Santé cohort (2009-2017) were included. Consumptions of sugary drinks and artificially sweetened beverages were assessed by using repeated 24 hour dietary records, which were designed to register participants’ usual consumption for 3300 different food and beverage items.

Main outcome measures

Prospective associations between beverage consumption and the risk of overall, breast, prostate, and colorectal cancer were assessed by multi-adjusted Fine and Gray hazard models, accounting for competing risks. Subdistribution hazard ratios were computed.

Results

The consumption of sugary drinks was significantly associated with the risk of overall cancer (n=2193 cases, subdistribution hazard ratio for a 100mL/d increase 1.18, 95% confidence interval 1.10 to 1.27, P<0.0001) and breast cancer (693, 1.22, 1.07 to 1.39, P=0.004). The consumption of artificially sweetened beverages was not associated with the risk of cancer. In specific subanalyses, the consumption of 100% fruit juice was significantly associated with the risk of overall cancer (2193, 1.12, 1.03 to 1.23, P=0.007).

Conclusions

In this large prospective study, the consumption of sugary drinks was positively associated with the risk of overall cancer and breast cancer. 100% fruit juices were also positively associated with the risk of overall cancer. These results need replication in other large scale prospective studies. They suggest that sugary drinks, which are widely consumed in Western countries, might represent a modifiable risk factor for cancer prevention.

Study registration

ClinicalTrials.govNCT03335644.
Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study
Authors: Walsh Laura K , Donelle Jessy , Dodds Linda , Hawken Steven , Wilson Kumanan , Benchimol Eric I , Chakraborty Pranesh , Guttmann Astrid , Kwong Jeffrey C , MacDonald Noni E , Ortiz Justin R , Sprague Ann E , Top Karina A , Walker Mark C , Wen Shi Wu , Fell Deshayne B
Published: July 2019

Objective

To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood.

Design

Retrospective cohort study.

Setting

Population based birth registry linked with health administrative databases in the province of Ontario, Canada.

Participants

All live births from November 2009 through October 2010 (n=104 249) were included, and children were followed until 5 years of age to ascertain study outcomes.

Main outcome measures

Rates of immune related (infectious diseases, asthma), non-immune related (neoplasms, sensory disorders), and non-specific morbidity outcomes (urgent or inpatient health services use, pediatric complex chronic conditions) were evaluated from birth to 5 years of age; under-5 childhood mortality was also assessed. Propensity score weighting was used to adjust hazard ratios, incidence rate ratios, and risk ratios for potential confounding.

Results

Of 104 249 live births, 31 295 (30%) were exposed to pH1N1 influenza vaccination in utero. No significant associations were found with upper or lower respiratory infections, otitis media, any infectious diseases, neoplasms, sensory disorders, urgent and inpatient health services use, pediatric complex chronic conditions, or mortality. A weak association was observed between prenatal pH1N1 vaccination and increased risk of asthma (adjusted hazard ratio 1.05, 95% confidence interval 1.02 to 1.09) and decreased rates of gastrointestinal infections (adjusted incidence rate ratio 0.94, 0.91 to 0.98). These results were unchanged in sensitivity analyses accounting for any potential differential healthcare seeking behavior or access between exposure groups.

Conclusions

No associations were observed between exposure to pH1N1 influenza vaccine during pregnancy and most five year pediatric health outcomes. Residual confounding may explain the small associations observed with increased asthma and reduced gastrointestinal infections. These outcomes should be assessed in future studies.
Understanding safety differently: developing a model of resilience in the use of intravenous insulin infusions in hospital in-patients—a feasibility study protocol
Authors: Iflaifel Mais Hasan , Lim Rosemary , Ryan Kath , Crowley Clare , Iedema Rick
Published: July 2019

Background

Intravenous insulin infusions are considered the treatment of choice for critically ill patients and non-critically ill patients with persistent raised blood glucose who are unable to eat, to achieve optimal blood glucose levels. The benefits of using intravenous insulin infusions as well as the problems experienced are well described in the scientific literature. Traditional approaches for improving patient safety have focused on identifying errors, understanding their causes and designing solutions to prevent them. Such approaches do not take into account the complex nature of healthcare systems, which cannot be controlled solely by following standards. An emerging approach called Resilient Healthcare proposes that, to improve safety, it is necessary to focus on how work can be performed successfully as well as how work has failed.

Methods and analysis

The study will be conducted at Oxford University Hospitals NHS Foundation Trust and will involve three phases. Phase I: explore how work is imagined by analysing intravenous insulin infusion guidelines and conducting focus group discussions with guidelines developers, managers and healthcare practitioners. Phase II: explore the interplay between how work is imagined and how work is performed using mixed methods. Quantitative data will include blood glucose levels, insulin infusion rates, number of hypoglycaemic and hyperglycaemic events from patients’ electronic records. Qualitative data will include video reflexive ethnography: video recording healthcare practitioners using intravenous insulin infusions and then conducting reflexive meetings with them to discuss selected video footage. Phase III: compare findings from phase I and phase II to develop a model for using intravenous insulin infusions.

Ethics and dissemination

Ethical approvals have been granted by the South Central—Oxford C Research Ethics Committee, Oxford University Hospitals NHS Foundation Trust and University of Reading. The results will be disseminated through presentations at appropriate conferences and meetings, and publications in peer-reviewed journals.
How does clinical space utilisation impact patient flow?
Authors: von Guionneau Alexandra , Burford Charlotte M
Published: July 2019

Background

Long waiting times in accident and emergency (A&E) departments remain one of the largest barriers to the timely assessment of critically unwell patients. In order to reduce the burden on A&Es, some trusts have introduced ambulatory care areas (ACAs) which provide acute assessment for general practitioner referrals. However, ACAs are often based on already busy acute medical wards and the availability of clinical space for clerking patients means that these patients often face long waiting times too. A cheap and sustainable method to reducing waiting times is to evaluate current space utilisation with the view to making use of underutilised workspace. The aim of this quality improvement project was to improve accessibility to pre-existing clinical spaces, and in doing so, reduce waiting times in acute admissions.

Methods

Data were collected retrospectively from electronic systems and used to establish a baseline wait time from arrival to having blood taken (primary outcome). Quality improvement methods were used to identify potential implementations to reduce waiting time, by increasing access to clinical space, with serial measurements of the primary outcome being used to monitor change.

Results

Data were collected over 54 consecutive days. The median wait time increased by 55 min during the project period. However, this difference in waiting time was not deemed significant between the three PDSA cycles (p=0.419, p=0.270 and p=0.350, Mann-Whitney U). Run chart analysis confirmed no significant changes occurred.

Conclusion

In acute services, one limiting factor to seeing patients quickly is room availability. Quality improvement projects, such as this, should consider facilitating better use of available space and creating new clinical workspaces. This offers the possibility of reducing waiting times for both staff and patients alike. We recommend future projects focus efforts on integration of their interventions to generate significant improvements.